Food Marketing Regulation and Childhood Obesity Prevention

Lead Research Organisation: Durham University
Department Name: Law

Abstract

Obesity, or excessive fatness, is not a new phenomenon. What is startling is the recent increase in overweight and obesity prevalence in almost every country in the world, including low and middle income countries. As obesity carries with it a wide range of health problems, it has also an adverse economic impact, imposing a cost not only on affected individuals and their families, but also on society as a whole. The challenge facing governments and health authorities is to deliver a sustainable response to overweight and the obesity 'pandemic' by putting in place effective multisectoral strategies dealing with the many determinants of obesity.

As the regulation of food marketing is seen as a cornerstone of effective obesity prevention strategies, the 193 Member States gathered at the Sixty-third World Health Assembly in 2010 unanimously endorsed a set of Recommendations intended to guide efforts by Member States in designing new and/or strengthening existing policies on food marketing to children (the Recommendations) through adoption of Resolution WHA 63.14. Since then, the World Health Organization has commissioned a Framework Implementation Report which I co-drafted with a view to putting some flesh on the bones of the Recommendations and provide guidance to Member States on how best to implement them.

The project is a follow up to the adoption of the Recommendations as interpreted by the Framework Implementation Report. It seeks to provide further guidance to Member States on how these Recommendations could help to improve the regulatory framework at a national level. It is therefore intended to assist policy makers and other stakeholders in developing the legal skills required to design food marketing policies. This will, in turn, contribute to the adoption of more effective childhood obesity prevention strategies.

The project is divided into three distinct, closely related phases. The first phase consists of a six-month placement at the headquarters of the World Health Organization in Geneva, in the Unit dealing with population-based prevention for diet and physical activity as two major risk factors for non communicable diseases. Using the Framework Implementation Report I co-drafted, I will provide direct support to a selected number of Member States from across the WHO Regions, including the UK as well as a range of low and middle income countries, to identify potential barriers to implementation and develop potential solutions. I will work on developing a specific evaluation tool which the selected Member States will use to identify the barriers for implementation and develop strategies to overcome them.

The second part of the project consists of the organisation of a one-day workshop in London which will focus on what the UK should do to fully comply with the Recommendations. This workshop will be designed specifically for all stakeholders directly or indirectly involved in the decision-making process and will ensure their participation at all stages of the workshop, from its preparation to its delivery and dissemination.

The third and final part of the project consists of the publication of a book in English on the regulation of food marketing to children which will capture existing knowledge on this issue and allow for its broad dissemination. It is therefore intended to support the development of effective childhood obesity prevention strategies at both national and international level.

Planned Impact

Firstly, the project will assist WHO and policy makers in developing the legal skills required to design food marketing policies. It will therefore contribute to the adoption of more effective childhood obesity prevention strategies at national, regional and international level. The project will be of particular benefit to the selected Member States working with the Investigator for the duration of the project, particularly during her six-month placement at WHO. It has been agreed that these States would include the UK in light of the her expertise and her knowledge of English law, as well as a selection of low and middle income countries which may not have the capacity to invest in policies restricting food marketing to children as much as growing obesity trends would require and are therefore in particular need for the development of creative solutions. The project nonetheless has the potential to reach all 193 Member States parties to the Recommendations through the sharing of the investigator's expertise with, and the training of, WHO staff members.

Secondly, the project will benefit consumer and public health organisations as key stakeholders involved in the design, implementation, monitoring and evaluation of obesity prevention strategies. The project will inform their advocacy campaigns for stronger restrictions on the marketing of food to children and therefore assist them in developing the tools required to promote public health objectives at national, regional and international level. In particular, it will help them counteract more effectively the misconceived argument regularly advanced by food and advertising industry operators - and often relayed by policy makers - that the constitutionally protected right to free commercial speech prevents the imposition of any restrictions on food marketing to children.

Similarly, the project should benefit child-focused NGOs and children's rights advocacy groups, with a stronger basis to propose alternative strategies in the future. Adopting a children's rights approach to the issue of unhealthy food marketing offers much potential for law and policy reform, even though the development of obesity prevention strategies has tended to be rather low (if at all) on the agenda of children's rights NGOs/campaigners. This project aims to promote the best interest of the child in all policy areas, as mandated by the UN Convention on the Rights of the Child. Indirectly, therefore, it should benefit children and their families, and therefore improve their welfare, particularly but not exclusively in the UK.

By developing a more thorough understanding of the arguments underpinning the debate about the regulation of food marketing to children, the project also has the potential to help food and advertising industry operators re-assess their position and more willingly embrace the need for significant changes in the discourse and the approaches they have adopted to date.

Finally, the Investigator's ability to frame the debate in more conceptual terms may also indirectly influence the thinking of policy makers and other stakeholders involved in the development of restrictions on the marketing of other products, including alcoholic beverages, tobacco products and pharmaceuticals, as part of effective public health strategies.

The project therefore has a very broad range of potential research user beneficiaries, both direct and indirect. This is due to at least three factors. Firstly, growing childhood obesity rates are a cause for concern in all countries in the world, thus making obesity a public health priority at national, regional and global levels. Secondly, obesity is a multifactorial condition which requires the concerted action of a broad range of stakeholders in a range of policy areas, including food marketing regulation. Finally, food marketing is a global issue affecting all countries in the world, thus making it an inherently international issue (see below).

Publications

10 25 50
 
Description Influencing diets through the provision of food information and the restriction of unhealthy food marketing
Geographic Reach Europe 
Policy Influence Type Participation in a guidance/advisory committee
Impact The report that the INSERM expert group produced was intended to change the attitude of the French population towards the regulation of the food industry to prevent obesity and related non-communicable diseases. In particular, this group reflected on the extent to which the regulation of food labelling and food marketing could contribute to better health outcomes at population level.
URL https://presse.inserm.fr/agir-sur-les-comportements-nutritionnels/27940/
 
Description Member of the Ad Hoc Expert Group on Science and Evidence advising the WHO Commission on Ending Childhood Obesity
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guideline committee
Impact The Ad Hoc Expert Group on Science and Evidence provided the evidence required to the WHO Commission on Ending Childhood Obesity to produce its recommendations to the World Health Assembly of May 2016. The WHA welcomed the report and has urged the WHO Director General to propose an implementation plan which is due to be discussed at the WHA in May 2018.
URL http://www.who.int/end-childhood-obesity/commissioners/en/
 
Description Building legal capacity for the implementation of the WHO Recommendations on the marketing of food and non-alcoholic beverages to children 
Organisation World Health Organization (WHO)
Country Global 
Sector Public 
PI Contribution I was asked to develop, organise and run two bi-regional workshops for the WHO with a view to helping Member States develop the legal capacity required to implement the WHO Recommendations on the marketing of foods and non-alcoholic beverages. Over 30 Member States from the European, the East-Mediterranean, the Western Pacific and the East-Asian Regions attended.
Collaborator Contribution The WHO identified the relevant members of the audience requiring training, reviewed the programme we had developed and played a key role in the running of the seminars both in Amman (June 2015) and in Kuala Lumpur (December 2015).
Impact - We have produced a package of course documents for WHO. - We have produced a report on the marketing of food and non-alcoholic beverages to children in the East-Mediterranean Region, looking specifically at how the WHO Recommendations on the marketing of foods and non-alcoholic beverages to children have been implemented in the Region. This report is in its third phase. We started to work on it in 2013 (as part of my secondment at WHO during my funded research leave); a draft was produced in 2015; it is now being updated for publication later in 2017. The updates are based on questionnaires that have been circulated to all 22 countries in the Region as well as our developing knowledge of the field. - We have been a member of a WHO EMRO working group on Law and NCD Prevention. - We have reinforced our existing links with WHO (which started in 2010) and have contributed to a range of events they have organised and have advised them and Member States on an ad hoc basis. For example, I am expected to travel to Oman in May 2017 with two of my colleagues from the Law & Non-Communicable Diseases Unit (based in the Law School of the University of Liverpool). Our visit will be intended to help the Omani Government develop its regulatory framework to better protect children from unhealthy food marketing. - As a result of this successful collaboration, we have joined a network advising the UN Interagency Task Force on the role that legal instruments can play in preventing non-communicable diseases. A meeting took place in New York in February 2016 to advise the Task Force on how it should reflect on the use of law in the prevention and control of NCDs.
Start Year 2015
 
Description Building legal capacity for the protection of children from harmful alcohol marketing 
Organisation IOGT International
Country United States 
Sector Learned Society 
PI Contribution We teamed up with IOGT and the European Regional Office of the WHO to design a training on children's rights and alcohol marketing to a range of NGOs based in Europe and whose main purpose is to fight alcohol-related harm. I travelled with three of PhD students and members of the Law & Non-Communicable Diseases Unit. We designed the training and delivered it over the course of a full day.
Collaborator Contribution Our partners contacted their network and were responsible for the logistics and the publicity around the event.
Impact We are reflecting on the way forward and have agreed with IOGT that we would produce a short briefing note for policy makers and civil society on the use of human rights (and children's rights more specifically) to protect children from the adverse impact of alcohol marketing.
Start Year 2016
 
Description Chidren's Rights and Food Marketing 
Organisation UNICEF
Country United States 
Sector Public 
PI Contribution Following recommendations from various experts on childhood obesity with whom we have worked over the years, we were contacted by UNICEF in the summer of 2015 to write a report on the impact of food marketing on children's rights.
Collaborator Contribution UNICEF has identified the issues which it would like us to focus on and has placed childhood obesity high on its agenda.
Impact The work is ongoing. We are about to submit the first policy report written which promotes a children's rights approach to childhood obesity prevention, and the regulation of unhealthy food marketing more specifically.
Start Year 2015
 
Description Children's Rights and Food Marketing 
Organisation UNICEF
Country United States 
Sector Public 
PI Contribution We have collaborated with UNICEF to help them reflect on how food marketing can be seen as a children's rights issue requiring that UNICEF and children's rights organisations become more fully involved in the debates on childhood overweight and obesity at national, regional and global levels. As a result of this collaboration, we have written a major policy report (A. Garde as lead author, with three PhD students at the University of Liverpool: S. Byrne, N. Gokani and B. Murphy). This report is due to be published in April 2018.
Collaborator Contribution We have designed and fully authored the report.
Impact Food Marketing and Children's Rights (policy report to be published very shortly by UNICEF)
Start Year 2015