by Marion Nestle

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Jun 27 2023

The UNICEF-WHO Congress on infant formula marketing: a brief report

Last week, I attended and spoke at the UNICEF-WHO Global Congress on Implementation of the International Code of Marketing of Breast-Milk Substitutes at WHO headquarters in Geneva.

The meeting was attended by more than 400 government, health, and advocacy representatives from more than 100 countries.  Representatives of infant formula companies were not invited to participate.

Its purpose was to encourage governments to promote and enforce the International Code, which nearly all U.N. member states ratified and committed to in 1981 (the U.S. was a long-standing holdout).

This meant they would control inappropriate marketing of infant formulas by banning advertising to people who are pregnant or nursing, gifts of formula samples, and doing anything to make formula appear superior to breastfeeding.

The logic of the Congress:

  • Breastfeeding is the superior method for feeding human babies.
  • Successful breastfeeding requires support from families, society, and government.
  • It is quite easy to undermine confidence in the ability to breastfeed.
  • Formula companies do all they can to undermine confidence in breastfeeding.
  • Formula companies’ main goal is to sell more formula.
  • Formula companies promote their products as normal and superior.
  • Breastfeeding is easier when formula marketing is controlled.y

I talked about the food industry “playbook”—strategies and tactics used by industries (tobacco, chemical, drug, alcohol, and food as well as infant formula) to cast doubt on unfavorable research, fund their own research, and lobby against public health recommendations (photo: Arum Gupta).

Many country representatives discussed the effects of the playbook in their areas, and what they are trying to do to stop formula companies from using  the playbook to get around the Code.

The general consensus:  Formula companies should NOT be allowed to:

  • Advertise or market products in violation of the Code.
  • Participate in public health policymaking.
  • Partner with relevant government agencies or non-governmental groups.

Obviously, formula companies are not happy with such recommendations.  If you would like to see an example of the playbook in action, take a look at the response  from the International Special Dietary Foods Industries.

It was exciting to be with so many people who cared so deeply about this issue.

Resources

 

Jun 23 2023

Weekend reading: IPES Food on corporate governance of food systems

The prolific International Panel of Experts on Sustainable Food Systems has produced another must-see report:

Here’s what it’s about:

Corporate influence over food system governance has become the new normal: the 2021 UN Food Systems Summit exposed the ability of multinational agri-food corporations to influence food system decision-making and dominate seemingly inclusive ‘multi-stakeholder’ processes…corporations have
succeeded in convincing governments that they must be central in any discussion on the future of food systems. Public-private partnerships and ‘multi-stakeholder’ roundtables…have normalized a prominent role for corporations and given them an inside track to decision-making.

Here’s where it’s headed:

To meet the needs of those impacted by  worsening hunger and malnutrition, it will be necessary to address the influence of corporations at all levels, including through a UN-wide Corporate Accountability Framework and robust conflict of interest policies, taking inspiration from World Health Organization frameworks for tobacco control and engagement with non-state actors.

IPES Food is doing great work.  Read their reports!

Mar 28 2023

The Lancet series on commercial determinants of health (and, therefore, nutrition)

Executive Summary

Commercial actors can contribute positively to health and society, and many do, providing essential products and services. However, a substantial group of commercial actors are escalating avoidable levels of ill health, planetary damage, and inequity—the commercial determinants of health. While policy solutions are available, they are not currently being implemented, and the costs of harm caused by some products and practices are coming at a great cost to individuals and society.

A new Lancet Series on the commercial determinants of health provides recommendations and frameworks to foster a better understanding of the diversity of the commercial world, potential pathways to health harms or benefits, and the need for regulatory action and investment in enterprises that advance health, wellbeing, equity, and society.

  • Defining and conceptualising the commercial determinants of health: Anna B Gilmore, Alice Fabbri, Fran Baum, Adam Bertscher, Krista Bondy, Ha-Joon Chang, Sandro Demaio, Agnes Erzse, Nicholas Freudenberg, Sharon Friel, Karen J Hofman, Paula Johns, Safura Abdool Karim, Jennifer Lacy-Nichols, Camila Maranha Paes de Carvalho, Robert Marten, Martin McKee, Mark Petticrew, Lindsay Robertson, Viroj Tangcharoensathien, Anne Marie Thow

Although commercial entities can contribute positively to health and society there is growing evidence that the products and practices of some commercial actors—notably the largest transnational corporations—are responsible for escalating rates of avoidable ill health, planetary damage, and social and health inequity; these problems are increasingly referred to as the commercial determinants of health. The climate emergency, the non-communicable disease epidemic, and that just four industry sectors (ie, tobacco, ultra-processed food, fossil fuel, and alcohol) already account for at least a third of global deaths illustrate the scale and huge economic cost of the problem. This paper, the first in a Series on the commercial determinants of health, explains how the shift towards market fundamentalism and increasingly powerful transnational corporations has created a pathological system in which commercial actors are increasingly enabled to cause harm and externalise the costs of doing so….

Most public health research on the commercial determinants of health (CDOH) to date has focused on a narrow segment of commercial actors. These actors are generally the transnational corporations producing so-called unhealthy commodities such as tobacco, alcohol, and ultra-processed foods….Moving forward, it is necessary to develop a nuanced understanding of commercial entities that goes beyond this narrow focus, enabling the consideration of a fuller range of commercial entities and the features that characterise and distinguish them…Improved differentiation among commercial actors strengthens the capacity of practitioners, advocates, academics, regulators, and policy makers to make decisions about, to better understand, and to respond to the CDOH through research, engagement, disengagement, regulation, and strategic opposition.

This paper is about the future role of the commercial sector in global health and health equity. The discussion is not about the overthrow of capitalism nor a full-throated embrace of corporate partnerships. No single solution can eradicate the harms from the commercial determinants of health—the business models, practices, and products of market actors that damage health equity and human and planetary health and wellbeing. But evidence shows that progressive economic models, international frameworks, government regulation, compliance mechanisms for commercial entities, regenerative business types and models that incorporate health, social, and environmental goals, and strategic civil society mobilisation together offer possibilities of systemic, transformative change, reduce those harms arising from commercial forces, and foster human and planetary wellbeing. In our view, the most basic public health question is not whether the world has the resources or will to take such actions, but whether humanity can survive if society fails to make this effort.

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Jan 11 2023

WHO calls for soda taxes

For your calendar today at 6:30 pm EST:

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The World Health Organization has taken a major step: it calls on member countries to tax sugar-sweetened beverages.

“Taxes on sugar-sweetened beverages can be a powerful tool to promote health because they save lives and prevent disease, while advancing health equity and mobilizing revenue for countries that could be used to realize universal health coverage,” said Dr Ruediger Krech, Director of Health Promotion at WHO.

SSB, tobacco, and alcohol taxes have proven to be cost-effective ways of preventing diseases, injuries, and premature mortality. SSB tax can also encourage companies to reformulate their products to reduce sugar content.

More than that, WHO has produced a manual on how to develop and implement SSB taxation policies.

This tax manual is a practical guide for policy-makers and others involved in SSB tax policy development to promote healthy diets and populations. It features summaries and case studies of SSB global taxation evidence, and provides support on the policy-cycle development process to implement SSB taxation — from problem identification and situation analysis through policy design, development and implementation to the monitoring and evaluation phase. Additionally, the manual identifies and debunks industry tactics designed to dissuade policy-makers from implementing these taxes.

SSB taxes can be a win-win-win strategy: a win for public health (and averted health-care costs), a win for government revenue, and a win for health equity.

The manual summarizes everything anyone needs to know to justify taxes and to craft policy.  Get to work!

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Jan 3 2023

What’s up with appropriations?

President Biden signed H.R. 2617, the Consolidated Appropriations Act, 2023.  

I’m interested in what the $1.7 trillion , 1600-page bill does for food issues.  It mentions the word “food” 786 times.  It mentions “agriculture” 213 times.  Fortunately, most of this is in Division A.  Even so, one longs for summaries. For whatever they are worth, here are a few I’ve collected.

Let me see if I can make some sense of this.

USDA highlights

  • $25.48 billion in discretionary spending (more than last year, less than what Biden asked for).
  • $3.7 billion for research ($1.74 billion for the Agricultural Reseach Service and $1.7 billion for the National Institute of Food and Agriculture
  • $1.17 billion for Animal and Plant Health Inspection Service (APHIS), more than $60 million above last year’s.
  • $1.15 billion for the Food Safety and Inspection Service, including funding to reduce user fees and to retain veterinarians.
  • Nutrition programs: $154 billion for SNAP; $6 billion for WIC; an increase of $6.6 million for commodities; an increase of $11 million for emergency food assistance.
  • International food assistance: $1.75 billion for Food for Peace grants (an increase), and $243 million for the McGovern-Dole education program (an increase).

FDA 

  • $6.56 billion for everything (but this includes a large percentage to be derived from food, drug, and tobacco user fee revenues).  These include increases for food safety and  some core functions.

The bill does some other things worth mentioning.  It includes: funds to:

  • Expand the Summer EBT program and makes it permanent as of 2024.
  • Addresses SNAP EBT skimming (stealing benefits across state lines).
  • Test for testing for per- and polyfluoroalkyl substances (PFAS—forever chemicals)
  • Make sure lobster and crab fisheries are in compliance with rules about whales.

It takes a lot of expertise to analyze all of this.  Here are two reactions.

Heritage Action: This omnibus package represents the very worst of Washington: back-room deals, $1.85 trillion dollar spending bills full of pet projects and partisan priorities, and an Establishment more interested in their own power than the wellbeing of the American people. The GOP must stand united in their opposition to this bill.

The Center on Budget and Policy Priorities: The biggest disappointment of the year-end bill by far is the failure to expand the Child Tax Credit. The American Rescue Plan’s expanded credit and other relief measures drove the child poverty rate to a record low of 5.2 percent in 2021. But with the expansion’s expiration, that record progress in reducing child poverty in 2021 has sharply reversed.

There are lots of other criticisms of this bill floating around, mainly having to do with what the Biden Administration asked for but did not get, and concerns about inadequate funding of FDA for food safety.

On this last point, let me again say that the perennially underfunded FDA gets its appropriations from agriculture committees, even though it is an agency of the public health service.  Agriculture subcommittees could not care less about FDA.  FDA needs a mandated home in Congress and much better support than it now gets.

Happy new year.

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Dec 16 2022

Weekend reading: Monsanto

Stacy Malkan hasa new report out.

This report documents how Monsanto manipulated public opinion to minimize concerns about the potential dangers of glyphosate (Roundup).

In this report, we show how pesticide companies not only followed in the footsteps of Big Oil and Big Tobacco, they helped to write the public relations playbook that obscures the dangers of widely used products that science shows are threatening human and environmental health around the globe.

This report about Monsanto’s campaign to defend glyphosate tells one piece of a broader story: that for decades, pesticide companies have waged expensive PR campaigns to shape the narrative about science and our food system, pushing the twin ideas that pesticides — a term that encompasses insecticides, herbicides, fungicides, and more — are safe and that we need them to feed the world.

In recent years, groundbreaking global studies have shown the grave threat agricultural chemicals pose to biodiversity and public health and how they fail to deliver on their promises for greater agricultural productivity, leading to crop loss and weed and pest resistance.

Worth reading?  Definitely!

For the data and for the details of Monsanto’s highly effective PR campaign.

 

Nov 18 2022

Weekend reading: Commercial Determinants of Health

From Oxford University Press:

I was happy to be asked to contribute to this book: 

My thanks to Eric Crosbie, who did the heavy lifting on the chapter and also co-authored two other chapters (on trade and investment and on teaching commercial determinants of health.

This book brings together multiple authors and perspectives on how corporations selling unhealthful commodities—tobacco, alcohol, and junk food, for example—act to protect sales and marketing, regardless of effects on individual and collective health.

Chapters cover the policies and politics, the ways commercial interessts have taken over culture, how companies influence science, research, and marketing, examples of such influence, analyses of the legal issues, and recommendations for countering corporate actions.

The chapters are so informative and so well referenced that it’s hard to select specific examples.  But here’s one from George Annas’ chapter on “Corporations as Irresponsible Artificial People.”

The public health goal is to make the social responsibility of corporations a reality rather than just a feel-good marketing slogan.  This will require transforming the corporation from an instrument designed and run to make money while indifferent to polluting the planet and destroying the health of humans to an entity whose money-making must be consistent with preserving the health of the planet and its inhabitants.  Central to this objecti8ve is to replace the currfent post-2008 system in which profits are kept by the owners of capital, and losses are socialized by being paid for by governments, most notably for corporations that are “too big to fail.”  Any sustainable system requires that both gains and losses are shared by corporations and governments.  Sharing gains and lossers will require a restructuring of corporate tax, including a minimum tax for all corporations, but domestic and multinational.

Amen.  Everyone needs to understand that food corporations are not social service or public health agencies.  They are businesses stuck with responding to the shareholder value movement, which forces them to make profits their first and only priority.

This system needs to change.  This book provides the evidence.

Note: I discussed many of these same issues in Unsavorty Truth: How Food Companies Skew the Science of What We Eat.  

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Oct 12 2022

The FDA under siege

My book talk today:  Online with NYU’s Fales Library in conversation with Clark Wolf.  5:00-6:00 p.m.  Registration is HERE.

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The FDA has come under heavy criticism this year for its failure to handle the infant formula crisis adequately and for its internal disorganization and lack of leadership.

To deal with this, the FDA commissioned the Reagan Udall Foundation for the FDA to do an operational evaluation of its human foods and tobacco programs.  This Foundation is “an independent 501(c)(3) organization created by Congress ‘to advance the mission of the FDA to modernize medical, veterinary, food, food ingredient, and cosmetic product development, accelerate innovation, and enhance product safety.’”

As announced on July 19, 2022, the Reagan-Udall Foundation will facilitate, via two Independent Expert Panels, operational evaluations of FDA’s human foods and tobacco programs. Each evaluation will yield a report with operational recommendations to the FDA: one for human foods and the other for tobacco. Each evaluation, and therefore report delivery, is on its own 60-business-day timeline. Both reports will be delivered to the FDA Commissioner and made available to the public.

The Foundation began its work by

The two-day hearings were held right after the White House Conference on Hunger.  Videos are posted on YouTube

As far as I can tell, no reporter covered these hearings except for Helena Bottemiller Evich at Food Fix, which is what makes her newsletter an invaluable resource and essential to subscribe to (at least for me).

Her overview:

Wow, were people honest in their assessment of shortfalls at the agency.

There was a strong consensus among the nearly three-dozen experts who spoke that things are not working very well and serious changes are needed. The panel got an earful about problems with leadership structure, culture, inadequate funding and staffing, poor oversight of inspections and a lack of responsiveness to the public and Capitol Hill – as well as plenty of complaints about how painfully long it takes to get anything done.

If all of this sounds familiar, that’s because it is. I’m sure you are all tired of me referencing this, but I did an investigative piece on FDA earlier this year, based on more than 50 interviews, that found many of the same things.

Her piece goes into the details.  Subscribe and you can read them.

More complaints

  • One criticism of this entire procedure is that the Center for Veterinary Medicine (CVM) was excluded from the review.  This is a serious oversight, as noted by a letter from several groups to the FDA.
  • Senator Richard Burr says in a letter to the FDA that he won’t support funding until the agency cleans up its ac

We only have one food supply: it serves people and animals inextricably (an issue discussed in my books Feed Your Pet Right and Pet Food Politics).

In the meantime I want to know:  Why aren’t more journalists covering this issue?

The FDA is responsible for regulating the safety and health of 80% of the foods we eat.  If we want foods to be safe and healthy, we need a strong, vigilant FDA willing to stand up to lobbying and industry pressure.

This needs press attention.

The Reagan Udall Foundation has to issue reports within the next couple of months.  Let’s see how well those reports reflect what was said at the hearings.

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