Will the Ending Childhood Obesity (ECHO) report make a difference for consumers?

Justin Macmullan, Consumers International’s Head of Advocacy discusses the recent report by the Commission for Ending Childhood Obesity, endorsed by the World Health Assembly last week, and outlines what it means for consumers.

Helping consumers to choose healthy diets is a major challenge when, in many countries, the marketing of food, the food choices available and the prices of different foods all appear designed to promote an unhealthy diet high in calories, fat, sugar and salt.

With 70 million young children predicted to be overweight or obese by 2025 this is a major public health issue and one that Consumers International (CI) and our Members have campaigned on for many years, most recently for World Consumer Rights Day 2015. 

At this year’s World Health Assembly, governments and civil society had the opportunity to consider the World Health Organisation’s (WHO) latest initiative in this area, the Ending Childhood Obesity (ECHO) report  which was a personal initiative of Dr Margaret Chan the Director General of the WHO.

The report, which was developed by an appointed commission, delivered more than 30 recommendations across six areas including promoting intake of healthy foods; promoting physical activity; preconception and pregnancy care; early childhood diet and physical activity; health, nutrition and physical activity for school children; and weight management..

What’s in the report?

First of all, as the list of topics shows, this is a report about tackling obesity rather than diet-related disease. Therefore, for example, it includes recommendations on increasing physical activity as this helps to reduce obesity, but not on salt reduction as this is not directly related to obesity.

Looking specifically at the recommendations related to healthy diets, the report includes many of the issues CI and our Members have campaigned on including restricting marketing of unhealthy food to children, improved nutritional information including front of pack labelling, improving the availability of healthy food in public institutions, improving nutrition information in schools, introducing taxes of sugar sweetened beverages, promoting breast feeding. There are gaps – notably in relation to the impact of trade and investment agreements on the ability of governments to take action – but there is also much to welcome.

Another possible criticism is that it offers little that is new but, although this might be true, it does have the benefit of bringing these proposals and recommendations together in one place to create a comprehensive package, stating the proposals clearly and adding the logo of the WHO on the cover, which gives the whole exercise political status and weight.

Will it make a difference?

The challenge is what will happen next. Following a resolution agreed at this year’s World Health Assembly, the WHO is now charged with developing an implementation plan to support the report’s recommendations. If this is going to be effective it must deal with some of the issues that have frustrated previous initiatives in this area. 

CI’s Recommendations for a Global Convention to Protect and Promote Healthy Diets seeks to address these challenges by moving the discussion on from ad hoc initiatives to an international legal framework that would support action on a comprehensive set of policies at the national level. The ECHO report doesn’t include that recommendation, but their implementation plan does have the potential to go some way towards it.

To do that, the key area of accountability must be addressed. The Director General of the WHO, Dr Margaret Chan, on whose initiative this report was developed, has often used the phrase, ‘what gets counted gets done’ in relation to increasing accountability and delivering results. We hope the same maxim will apply to this important area of work.

A proposal to create a monitoring system as part of the implementation plan could signal genuine progress, but only if it is sufficiently strong, transparent and well publicised and monitors the quality and implementation of policies as well as results. Only this way can governments be held to account for their actions and a clear picture emerge of successes and challenges in implementation.

Read the statement on the ECHO that CI and 9 other NGOs gave at the WHA last week.

Coca Cola’s label move is only ‘inch-by-inch’ progress

Even when fizzy drinks giant Coke improves its labelling, it only serves to underline the need for a much tougher regulatory environment,  argues CI's Head of Campaigns Justin Macmullan. 

Last week, Coca Cola announced that it would introduce traffic light nutrition labels on the products that it sells in the UK.

It’s good news for UK consumers trying to choose a healthier diet, but this inch-by-inch approach underlines the need for a global agreement to protect and promote healthy diets.

These labels use red, amber and green to clearly signal to consumers whether the product contains high, medium or low levels of salt, sugar and fat.

This development is certainly good news for the nutrition labelling scheme in the UK. Many UK retailers have signed up to the scheme and with manufacturers also joining, the UK is now moving towards one widely used and understood labelling system.

But it is obvious that more needs to be done.

Dragging their feet

Of course it isn’t the responsibility of Coke to introduce national nutrition labelling schemes, but Coke and other multinational food companies can certainly help by not dragging their feet or lobbying against their use.

The traffic light labelling scheme has been around in the UK for several years and Coke only announced their intention to join last week having shunned it in the past.

Will other countries have to go through years of campaigning for their consumers to get the same deal as UK consumers?

Read the label 

In the same week as Coke’s labelling announcement, I noticed large posters outside my local supermarket advertising one litre bottles of Coke on special offer. It's not an uncommon sight in the UK.

Similarly Coke is one of the world’s biggest spenders when it comes to marketing. Take for example their investment in the football World Cup, when they linked their high fat sugar products to one of the biggest sporting events in the world.

And just yesterday it was announced Coke will sponsor the London Eye – a major UK tourist attraction.

It is hard not to conclude that Coke and other major food companies are only making small changes when they feel there is no other option, but failing to take the action that is really needed to tackle rates of obesity around the world.

Just one can of regular Coke has 35g of sugar and exceeds recent WHO recommendations for the amount of calories that an adult of normal weight should get from sugar in a day.

According to Coca-Cola’s annual report, Great Britain consumed 200 of the company’s beverages per person in 2012.

The same figure for Mexico was 745, equal to more than two drinks per day, whilst US citizens on average consumed just over 400 beverages per year. Not all of these beverages will be regular Coke.

A global convention 

Obesity and diet related diseases such as diabetes, and heart disease are a public health disaster in many countries and tackling the causes requires a comprehensive global approach. CI is calling on governments to support our proposal for a global convention to protect and promote healthy diets.

The time has come for a global convention to promote healthy diets

CI food expert Anna Glayzer sets out the case for targeting junk food with the kind of public health strategy used to fight smoking.

This week marks the ten year anniversary of the World Health Organization Global Strategy on Diet Physical Activity and Health.

The stated overall goal of that strategy was: "To promote and protect health by guiding the development of an enabling environment for sustainable actions at individual, community, national and global levels that, when taken together, will lead to reduced disease and death rates related to unhealthy diet and physical inactivity."

The Global Strategy on Diet Physical Activity and Health (or DPAS, as it is often abbreviated to) was a significant step forward for that time but it is now clear that much more is needed. 

Since 2004 obesity rates, along with diet related diseases like diabetes, have continued to climb steadily. In 2005 approximately 1.6 billion adults (age15+) were overweight and at least 400 million adults were obese.

By 2015, approximately 2.3 billion adults will be overweight and more than 700 million will be obese.

These rates are climbing far faster in developing countries. Diet related ill health now globally outranks tobacco as a cause of death.

In 2011, we reached the point where one person dies from diabetes every seven seconds.

Figures also show that 44% of the diabetes burden is attributable to overweight and obesity.

On 19 May,  CI published Recommendations Towards a Global Convention to Protect and Promote Healthy Diets.

The Recommendations are a joint initiative with World Obesity Federation, developed in consultation with our members and with public health experts around the world.  

We are calling on governments to make a binding commitment to introduce a raft of policy measures designed to help consumers make healthier choices and improve nutrition security for everyone.

The measures that we have included are not new. In developing the Recommendations, we drew on a growing body of existing policy packages such World Cancer Research Fund’s Nourishing Framework.
 
We call for:

• tighter controls on marketing of unhealthy food;
• for better provision of nutrition information to consumers;
• for healthy food to be served in public institutions;
• and for the use of economic tools to influence consumption patterns.  

Some countries have already implemented or partially implemented some of the measures we recommend.

What would be new about a global convention to protect and promote healthy diets would be the scale, ambition and level of co-ordination it would entail.

It would amount to the world taking the inpact of unhealthy diets as seriously as the impact of tobacco.

Of course we know that food is not the same as tobacco. There are however, some strong and often drawn parralels, in terms of impact and in terms of the actions of the protagonists.

Back in 1998, then director of the WHO, Dr Gro Harlem Brundtland said: ”The tobacco habit is extensively communicated!  It is communicated through the media, the entertainment industry, and most directly through the marketing and promotion of specific products.

“Global trade in tobacco has increased markedly over the last few years.  Direct foreign investment by multinationals in developing countries has also increased…Tobacco control cannot succeed solely through the efforts of individual governments, national nongovernmental organizations and media advocates.  We need an international response to an international problem.”

We recognise that the solution to the problem of unhealthy diets is complex. Our publication is not intended to offer a ready-to-wear global convention.

Hence we have called it Recommendations towards a global convention. We intend it as a conversation starter. It is however, a conversation that urgently needs to be had.  Inaction is costing millions of lives.

If the average adult reads 250 words per minute; in the time it took you to read this blog, at least 20 people will have died from diabetes. It’s time to take unhealthy diets seriously.