Statement: UN-Approved Public Health Pact: Strong on Awareness, Timid on Action

The U.N. Political Declaration shows that governments world-wide have achieved a much better understanding of the extent to which poor nutrition and excess alcohol consumption worsen public health, weaken workforce productivity, and drive-up expensive treatment-intensive costs related to cardiovascular disease, cancer, and diabetes. Leaders also acknowledged that prevention must be a cornerstone of global and national responses to NCDs. Such newly acquired top-level awareness is, alone, a great achievement, but a clear commitment to implement prevention policies is still missing.

Effective public policy reform is the first casualty of timid "partnering" with companies that make products that contribute to an increase in disease risks or products that treat disease symptoms. To their credit, governments agreed that tobacco companies should have no place at the table, but risk trusting multi-trillion dollar global purveyors of alcohol, junk food, and pharmaceutical drugs to voluntarily change their for-profit stripes. Governments cannot continue to allow conflicts of interest with the private sector to go unchallenged and unmanaged in the policy-making process. An ethical code of conduct is needed to guide interactions with the private sector, which we must not forget is answerable primarily to shareholders and not to public health.

The Political Declaration is silent on specifics and short on solid commitment to regulations that could, for example:

• Mandate salt and sugar reduction in high-salt and high-sugar processed foods;
• Realign food VAT/GST policies for food and agricultural subsidies with sound nutrition science;
• Mandate easy-to-understand front-of-pack nutrition labeling;
• Mandate nutrition information (e.g., sodium and calories) on restaurant menus;
• Prohibit the use of trans-fat laden partially hydrogenated oils in food;
• Protect children and young people from marketing of products that raise the risk of disease (e.g. banning the promotion of breast-milk substitutes and high-fat, -sugar and -salt foods to children and young people); and
• Prohibit advertising and brand sponsorship for alcohol beverages;
• Increase taxes on alcohol beverages;
• Require and enforce effective restrictions on impaired driving (such as random breath testing),and minimum purchase age; and
• Expand nutritious school meal programs.

The Political Declaration reinforced its support for the World Health Organization's landmark Framework Convention on Tobacco Control, but defers much of the job of addressing nutrition and alcohol to future work of WHO technical experts, Member States, and future U.N. meetings. Work left undone includes:

• developing tools to navigate the trade law barriers to health policy innovation;
• establishing workable, but energetic disease reduction targets and detailed policy implementation schedules; and
• vitally, instituting a mechanism to keep commercially self-interested parties at arms-length and public-interest groups constructively involved.

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*Members of the Conflict of Interest Coalition include:

Centre for Science in the Public Interest, Canada (CSPI-Canada)
Consumers International (CI)
Corporate Accountability International
Global Alcohol Policy Alliance (GAPA)
International Association for Consumer Food Organizations (IACFO)
International Association for the Study of Obesity (IASO)
International Baby Food Action Network (IBFAN)
National Heart Forum (NHF-UK)
World Cancer Research Fund International (WCRF International)