Gaining health : analysis of policy development in European ...

of the HCSP. A thorough situation analysis was made and
concrete, quantifiable targets were set in the report of the
expert group. In the mean time, INSERM issued a scientific
report on child obesity with key findings about the challenges
related to nutrition in French society (18,19).
Thanks to the reports of the HCSP and INSERM and the
Green Paper on food safety, all published nearly at the same
time, nutrition-related themes were took centre stage. In
addition, in 2000, France took over the EU presidency and
the Ministry of Health singled out nutrition as a key priority
in the French working programme. During the presidency,
national and international working groups were established
and on 13 December 2000, at the European Summit of
Health Ministers, nutrition was the key item on the agenda.
The next day, the French Prime Minister announced a
broad debate on nutrition and asked the Minister of Health
to launch a nutrition strategy and set up an Interministerial
Committee on Nutrition. A scientific Pilot Committee was
also established, whose members were middle-level administrators,
practitioners and researchers. The coexistence of
both committees is considered to have been fruitful. The
Interministerial Committee is a rather administrative, highlevel
body while the Pilot Committee carries out scientific
studies, coordinates activities, facilitates the exchange of
information and experience, and initiates further actions.
The report of the Interministerial Committee was issued
in early 2001 as the first PNNS. In 2005, after overwhelming
success and a positive evaluation, it was extended until
2008; its continuity is also ensured by the Public Health Act
of 2004.
The name of PNNS reflects its general aim of incorporating
and linking nutrition into the various fields of health promotion.
The guiding principles include a multisectoral approach
with quantifiable objectives, focusing on promotion and
primary prevention while embracing a food culture of
gastronomy and eating together, and based on independent
scientific analysis. PNNS includes nine specific objectives on
physical activity and nutrition. Strategies tackle the improvement
of both supply and demand for healthy food and
physical activity and partnership with the stakeholders from
the private sector such as producers, manufacturers, retailers
and caterers (in schools and places of work). To achieve
this, a multisectoral committee chaired by the Ministry of
Health was established in 2001, including representatives
of eight ministries, the food industry, consumer associations
and local authorities.
In 2004, a document was issued dealing specifically with
cycling (20). A general sports programme entitled “Move
for health” was adopted in 2004 to fight sedentary lifestyles
and promote physical activity and sport. The programme
aims at distributing information and evaluating the physical
condition of the population (21).
In 2002, national food guidelines were produced and
later a complementary brochure was published on physical
activity by the Pilot Committee and INPES. Separate
guidelines for adolescents were produced in 2004, addressing
both nutrition and physical activity. In 2005, three large
media campaigns were launched by INPES on fruit and
vegetables, physical activity and reducing the consumption
of sugary foods. Within the economic sector, bakers were
encouraged to reduce the salt content of bread. Leaflets
on healthy lifestyles for different population groups were
developed, as well as educational materials for teachers.
In September 2005, vending machines in school campuses
were banned and the quality of school meals was improved,
based on specific guidelines. Furthermore, a new policy on
food and drink advertising was introduced, requiring that all
carry health-related information provided by the Ministry of
Health. If a company does not want to include such information
in its advertisements, it has to donate 1.5% of the
advertising costs to be used for health promotion. An attempt
to amend the national public health law so that food
advertising on television would include this health-related
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Case studies: policy development in countries for tackling noncommunicable diseases