WHO Attempts to Enlist the “Extremely Powerful Forces” of Industry to Combat NCDs

Nellie Bristol, Research Fellow
Global Health Policy Center, Center for Strategic and International Studies

The World Health Organization is in active dialogue with the food, beverage, alcohol, and even sporting goods industries to encourage marketing changes and product formulations to help curb the growing worldwide prevalence of non-communicable diseases (NCDs).

“Many of the risk factors for non-communicable diseases are amplified by the products and practices of large and economically powerful forces,” WHO Director-General Margaret Chan said May 20 in a speech before the World Health Assembly.

The situation represents a shift from the challenges associated with the Millennium Development Goals, she added. “No lawsuits were filed to stop countries from reducing the risks for child mortality. No research was funded by industry to cast doubt on the causes of maternal mortality. Mosquitoes do no have front groups, and mosquitoes don’t have lobbies,” she noted. “But the industries that contribute to the rise of NCDs do.”

While the organization has long had a “zero tolerance” policy in communicating with the tobacco industry, it is using newly strengthened conflict of interest guidelines to work with the food, beverage, and alcohol industries “to find acceptable public health solutions,” Chan said.

NCDs such as cardiovascular and chronic lung diseases, diabetes, and cancer are now the leading cause of premature death globally. The World Health Assembly this week is expected to finalize a monitoring framework to help countries curb the diseases, with an overall goal of reducing early deaths from NCDs by 25 percent by 2025. The framework includes voluntary targets for reductions in salt intake and inactivity as well as decreasing tobacco and harmful alcohol use.

Industry could take several actions to address NCD risk factors including reformulating products to reduce levels of salt, sugar, and fat, reducing portion sizes, and ensuring healthier food options are accessible and affordable. Sporting good manufacturers could make safe but affordable versions of products that encourage activity, like bicycles.

 But most changes need to be driven by the countries themselves through agreements or regulation. The UK, for example, developed voluntary guidelines with food and beverage industries regarding food labeling and salt and trans fat reduction. In 2012, South Africa enacted mandatory food labeling requirements http://www.ift.org/Public-Policy-and-Regulations/Recent-News/2012/April/New-food-labeling-rules-take-effect-in-South-Africa.aspx for both domestic and international manufacturers.    

Food labeling in the U.S. is addressed with federal regulations, but other aspects of improving product content is handled at the local level.  Some American jurisdictions have taken on the challenge, including the state of California, by banning artificial trans fats in restaurants. But it’s a hard slog that requires taking on both manufacturers and consumer preferences. New York City’s effort to place limits on large sugary drinks is an example. The law was not popular with the public and was then invalidated by the state Supreme Court a day before it was supposed to take effect.

At the international level, food manufacturers sometimes will reformulate products for markets that insist on it, but continue to produce unhealthier versions for those that don’t. WHO is helping member states negotiate with manufacturers to make food and beverage imports healthier. Some countries lack the regulatory clout or represent markets that are too small for manufacturers to make the effort. In those places, WHO is helping develop a regional approach.

With obesity and high blood pressure rising worldwide along with increasingly globalized food markets, industry has to be part of the solution. Companies are concerned that if they reformulate their products and others don’t, they will lose market share. A collective effort to slowly readjust tastes for unhealthful ingredients is required. The move will depend on manufacturers considering public health along with consumer tastes when making product and marketing decisions. WHO can use the momentum from adoption of the monitoring framework to work more closely with countries and industry to address what ultimately is a largely preventable global health crisis.

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