Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Developing the political climate for action
Washington DC. It even managed to mobilize senators
to suggest that the US government might refuse
to honor its funding obligations to WHO if it did not
relent over the 916 report.
Simultaneously, the sugar industry was employing
scare tactics in sugar - producing developing countries,
spreading rumors that their local industries would
suffer if the WHO recommendation to limit added
sugars to less than 10% of dietary energy was adhered
to. Focusing on the agriculture ministries meant the
financial “ fear factor ” was taken seriously, and the
pressure on WHO was intensified by an elaborate and
secret critique delivered to the Director - General
personally by the US Department of Health and
Human Services. Timely media coverage exposed the
clumsy maneuvering of the DHHS Secretary, Tommy
Thompson, to a barrage of protests within the USA
as health professionals and NGOs recognized the
unseemly response of the Bush administration to
industry pressure.
The WHO ’ s global strategy was eventually approved
in Geneva in May 2004 11 —but only after an extended
debate in which the USA — represented by George
Bush Snr ’s godson, William Steiger —insisted that
even a footnote referring to the WHO 916 report must
be excised from the final text.
Achieving synergy among
non - governmental organizations
To strengthen WHO in the implementation of its
Global Strategy, the IOTF, with its own parent
body, the International Association for the Study of
Obesity, brought together a number of NGOs to form
the Global Prevention Alliance. This consolidated
the early collaboration that had developed with the
International Diabetes Federation, the World Heart
Federation, the International Union of Nutritional
Sciences and the International Pediatric Association.
This Global Alliance paved the way for a series of
initiatives to begin to galvanize national NGOs in a
number of countries to engage with their governments
and ministries in response to the global strategy.
This catalytic action prompted groups to be
formed initially in a range of countries, for example,
Malaysia, Singapore, Thailand, Hong Kong and Brazil.
A broader analysis also revealed that most medical
leaders have little understanding of public health pol-
icy - making and often spend their time vying for preferential
ministerial attention to their own speciality.
Nevertheless, WHO Europe, with major NGO
support, managed to convince European ministers of
health to sign a charter on obesity, which included
calls for many changes using legislative and regulatory
measures. This is, of course, simply a charter and has
no binding political significance, and similar solidly
founded documents produced in countries such as
the UK or Australia, which outline the dimensions
and forces involved in promoting obesity, do not in
themselves lead to coherent remedial action. The
simple explanation is that ministers consider it unwise
to take on the greatest industrial powers in the land.
The “ big food ” corporate sector includes multinational
companies that have a greater turnover than
many countries.
The recent analysis of obesity, undertaken as part
of the British Government ’ s Foresight Programme, 12
has illustrated in great detail the intricate “ hard -
wiring ” of the vast array of governmental and civil
society components that must be considered when
attempting to deal with the multi - factorial pressures
leading to obesity. This recognition of the need
for an overarching “societal” approach, combined
with the analysis of the projected economic burden 12
to society from obesity, was instrumental in the development
of the UK Government ’ s cross - sectoral strategy
on obesity. 13 Even so, this still does not really
tackle the key industrial factors which guarantee an
escalating rate of obesity. The climate of opinion is
beginning to move towards much higher expectations
for action, and this has led initially to vague pledges
by industry to improve the nutritional quality of
product ranges.
They have also made limited gestures towards
placing some constraints on marketing to children in
an effort to evade the prospect of more stringent
measures being enforced. This has been enough to
draw some medical and nutritional experts into collaboration
with industry, where they have the impression
that they are playing an important role in the
political process, so should not challenge the politicians
to greater action. This requires clearly independent,
media - sensitive groups to lobby for ever greater
change, so that reputable advisers can legitimately
press for progressive and innovative strategies to be
implemented.
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