Preventing Childhood Obesity - Evidence Policy and Practice.pdf

CHAPTER 25
Developing the political climate for action
Philip James 1,2 and Neville Rigby 1
1 International Association for the Study of Obesity, London, UK
2 Neville Rigby & Associates, London, UK
Summary and recommendations
for practice
Key elements in converting academic
analyses into policy implementation
• Prepare groundwork by producing coherent evidence,
reports and briefing papers, to promote
public and political awareness.
• Develop a broad consensus among eminent scientific/medical
leaders; anticipate poor support from
many clinicians with political ambitions and little
understanding of public policies.
• Engage openly with the media; focus on opinion
leaders. Repeatedly explain the issues willingly and
patiently.
• Be ready for confrontation from opposing viewpoints
and prepare reasoned responses developing
new work to answer the challenges.
• Create a movement by engaging different societal
and academic groups with established political connections
to agree the main consensus not the detail.
• Remember that political change takes time and
depends on a crisis or incessant vocal public and
expert lobbying.
• Focus on finance — health ministries are weak: other
ministers or the prime minister make decisions
affecting other sectors, based on economic arguments
and political pressure.
Introduction
Public health initiatives require a sophisticated
understanding, not only of medical concerns, but
Preventing Childhood Obesity. Edited by
E. Waters, B.A. Swinburn, J.C. Seidell and R. Uauy.
© 2010 Blackwell Publishing.
also of political issues in order to appreciate why
some initiatives succeed and others do not. The
national response to health needs is often delayed.
Examples of this delay include the slow reaction to
the HIV contamination of recombinant factor 8
plasma transfusions for hemophiliacs, and the
extremely slow response to the emergence of the
HIV/Aids epidemic. Similarly, the need to take
action in response to the huge death and disability
rates from coronary heart disease ( CHD ) was
ignored for years by many governments, allegedly on
the grounds that the scientific and medical communities
could not agree that a clear link existed
between CHD and high blood cholesterol levels,
induced by saturated fat intakes, high blood pressure
and smoking. Even if this could be proved, inaction
was justified by the view that it was the individual ’ s
own responsibility to change his or her diet and
lifestyle. The government ’ s role was seen as simply
providing health promotion messages to enable
consumers to make “ informed ” food choices. The
huge agricultural and food industries recognized
that they had to show concern for their customers
and a vague health educational message suited
their interests because their profits often depended
on continuing to sell high saturated fat - filled
products.
Given that it has taken several decades to see major
international initiatives even on tobacco, how do we
create the political will for action to be taken? We
conclude that the triggers owe less to a clear understanding
of the science, or even evidence for the benefits
of change, than to a political need to respond
publicly to an issue of pressing public concern. We
illustrate this from our own experience of political
responses to UK and global health concerns since the
mid - 1970s.
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