Together with 19 other organisations, the Association responded to the consultation on the third and fourth drafts of the Global Action Plan on the Prevention and Control of NCDs. Our formal response can be accessed here. Many of these partners have been working together over the last year under the umbrella of the Conflict of Interest Coalition.
Commenting on the third draft, the response welcomed the improvements made since the first draft, particularly the more detailed and comprehensive list of actions for member states to promote a healthy diet. Many of these recognise the more upstream determinants of healthy eating, and broaden the emphasis beyond the reformulation of unhealthy foods and public awareness campaigns. We urged wording that recognised and encouraged member states to protect food policy development and implementation from the undue influences of commercial and other vested interests. In the fourth draft many changes were made to the document. Importantly, the final draft highlighted among the overarching principles and approaches that public health policies, strategies and multisectoral action for the prevention and control of noncommunicable diseases must be protected from influence by any form of vested interest.
In the appendix, Member States were given recommendations for prioritising interventions when resources are limited. These focused on: salt reduction through mass media campaigns/reduced salt content in processed foods; replacement of trans-fats with polyunsaturated fats; and public awareness programme about diet and physical activity. In the main body of the Action Plan the policy options were stronger, clearer and directed (see Box 1 below).
Box 1. Extract from the Action Plan
32. The proposed action
is to advance the implementation of global strategies and recommendations to achieve the voluntary global targets set out below:
- A 30% relative reduction in mean population intake of salt/sodium intake
- Halt the rise in diabetes and
- A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure according to national circumstances.
Member States should consider developing or strengthening national nutrition policies and action plans and implementation of related global strategies including the global strategy on diet, physical activity and health, the global strategy for infant and young child feeding, the comprehensive implementation plan on maternal, infant and young child nutrition and WHOs set of recommendations on the marketing of foods and non-alcoholic beverages to children. Member States consider to implement other relevant strategies to promote healthy diets in the entire population, while protecting dietary guidance and food policy from undue influence of commercial and other vested interests.
Such policies and programme would aim to:
a) Promote and support exclusive breastfeeding for the first six months of life, continued breastfeeding until two years old and beyond and adequate and timely complementary feeding.
b) Develop guidelines, recommendations or policy measures that engage different relevant sectors, such as food producers and processors and other relevant commercial operators to:
Reduce level of salt/sodium in food
Virtually eliminate trans-fatty acids in food and to replace them with unsaturated fatty acids
Reduce the content of free sugars in food and non-alcoholic beverages
Reduce portion size and energy density of foods in order to limit excess calorie intake
c) Develop policy measures directed at food retailers and caterers to improve availability, affordability and acceptability of healthier products (plant foods, including fruit and vegetables, products with reduced content of salt/sodium, saturated fats, trans-fatty acids, free sugars)
d) Promote the provision and availability of healthy food in all public institutions including schools, other education institutions and well as in workplaces
e) As appropriate to national context, consider economic tools, including taxes and subsidies, to improve the affordability and encourage consumption of healthier food products and discourage consumption of less healthy options
f) Develop policy measures directed at the agricultural sector to reinforce the measures directed at food processes, retailers, caterers & public institutions, and provide greater opportunities for utilization of healthy local agricultural products and foods
g) Conduct public campaigns and social marketing initiatives to inform and encourage consumers about healthy dietary practices
h) Create health and nutrition promoting environment in schools and other education institutions, work sites, clinics and hospitals, and other public and private institutions including nutrition education
i) Provide nutrition labeling for all pre-packaged foods for which nutrition or health claims are made
j) Implement WHOs set of recommendations on the marketing of foods and non-alcoholic beverages to children, including mechanisms for monitoring.
The Association welcomed the recognition of the critical importance of building capacity at many levels to the effective implementation of the plans of actions for member states. We argued that it will be important to articulate actions that can be taken in the short-term to address specific immediate challenges and bottlenecks, while developing plans to address the longer term more structural challenges. We offered support to help the secretariat undertake proposed capacity assessments in member states.