UN Meeting on NCDs: More on Industry Role

Posted on by Corporations and Health Watch

In last week’s CHW commentary I asked, “Will the UN High Level Meeting on Non-Communicable Diseases Stand up to Multinational Corporations?” This week, I refer readers to several other recent analyses of the UN meeting scheduled for September 19th and 20th at the United Nations in New York City.

In a feature in last week’s British Medical Journal, Deborah Cohen investigates whether industry influence could derail the UN meeting. According to Cohen, who had access to the meeting’s draft document, “years of planning may be set to unravel. With only weeks to go before the summit, years of negotiations seem to be stalling.

“Discussions have stopped on the document that forms the spine of the summit, and charities are concerned that governments are trying to wriggle out of commitments.”

Cohen also notes that “ protection of financial interests” often blocks action to address the deeper determinants of NCDs. She describes a successful campaign by the European food industry to thwart a proposal before the European Parliament to create a traffic light labeling system for food products. Using the playbook written by the tobacco industry, food companies told members of the European Parliament that the any new regulations would lead to job losses.

Meanwhile, a statement released by the global advocacy group the Non-Communicable Disease Alliance, warned that “international progress on non-communicable diseases (NCDs) such as cancer, diabetes, cardiovascular disease and chronic respiratory disease, is at grave risk, because of recent efforts by some member states to postpone and weaken United Nations negotiations.” Apparently developed nations such as the US, UK and European Union states are unwilling to make financial commitments to reducing NCDs or to set measurable targets for reduction.

In another British Medical Journal analysis on the upcoming NCD meeting, Dr. Derek Yach, a former executive director of WHO and now Senior Vice President of Global Health and Agricultural Policy at PepsiCo, asserts that the UN meeting is “a perfect forum to develop a set of actions aimed at redesigning the food system to make meeting the optimal nutrition needs of all its first priority.” He warns, however, that “prescriptions will succeed only when farmers, food and agricultural companies, non-governmental agencies, and parts of the UN that have yet to be engaged in the high level meeting are brought into the process.”

Just what role food and agricultural companies ought to play at the UN meeting and other public deliberations on NCD policy is the question of the day. A recent report released by the UK House of Lords Science and Technology Select Committee concluded that industry’s call for voluntary codes of conduct were unlikely to be effective in changing dietary behavior and that stronger regulations may increase rather than decrease consumer choices.

Another perspective on the role of industry appeared in a reviewon obesity policy published in last week’s theme issue of Lanceton the topic of obesity. The authors recognize the opportunities for leadership at the UN meeting but note that to date “the most powerful activities by the private sector relevant to public policy are undoubtedly lobbying activities, which often undermine policies aimed at reducing obesity—e.g., in relation to regulations on marketing to children, traffic light labelling, and taxes on unhealthy foods.”

While most of the recent focus of industry role in NCDs has been on food and beverage companies, other observers have noted the importance of the tobacco and pharmaceutical industries. In a recent commentary in the British Medical Journal, Simon Chapman, a tobacco researcher and director of Australia’s Action on Smoking and Health has urged the UN High Level meeting to reject the Big Pharma’s effort to medicalize tobacco cessation, urging that promoting unassisted tobacco cessation is a more realistic and effective strategy for most nations.

In later posts, I’ll examine the role industry representatives actually play at the upcoming UN meeting.

 

Image Credits:

1. Mononoke via Flickr.

2. Brent Nashville via Flickr.

3. Stephencannon via Flickr.

International Pharmaceutical Manufacturers Define Role in Responding to Non-Communicable Diseases

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In preparation for the UN High Level Meeting on Non-Communicable Diseases, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) released its Framework for Action to outline the pharmaceutical industry’s focus in NCDs “The NCD framework is just the beginning; our vision is to work with others to identify what can be done in practice to help poor people access the care and treatment they need,” said IFPMA Director General Eduardo Pisani. “Together, we want to find ideas for concrete actions to put on the table in the aftermath of the UN NCD Summit in September. The Framework is our roadmap for this work.”  IFPMA’s Framework for Action centers on four main areas: innovation and research, access and affordability, prevention and health education, and partnerships.

Corporate Accountability International Call for Review of Conflicts of Interest at UN Meeting on Non-Communicable Diseases

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Corporate Accountability International, a global non-governmental organization, has called for closer monitoring of corporate conflicts of interest at the UN High Level Meeting on Non-Communicable Diseases. “If we are to reverse the staggering rates of preventable illness and death, the WHO and UN must safeguard public health policy from conflicts of interest,” said Gigi Kellett, a campaign director with Corporate Accountability International. “A fox guarding a hen house is a fox guarding a hen house. The global community has removed the tobacco industry’s seat from the tobacco control table due to its history of interference in policy. It’s time we hold other industries contributing to or profiting from today’s public health epidemics similarly accountable.” The group’s call was based in part on a recent report by the United Nations Joint Inspection Panel that recommended closer scrutiny of corporate involvement in the Global Compact, an agreement that brings corporations into UN work.   

Wine Retailers Protest Domination by Alcohol Wholesalers

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How does the alcohol industry influence politics? The Specialty Wine Retailers Association, a sector of the industry fearful of domination by alcohol wholesalers, recently released a report called Toward Liquor Domination How Alcohol Wholesalers, Time and Money Have Corrupted the American Alcohol Industry —A Study of Political Money and the Alcohol industry from 2005 to 2010.  It states that in the three election cycles between 2005 and 2010, American alcohol wholesalers have spent $82 million on contributions to federal and state political campaigns and federal lobbying efforts. The report also charges that “the success of the American alcohol wholesaler in buying protection from competition has put the other sectors of the alcohol industry under their control, reduced state tax revenues, and severely lim­ited consumer access to new products.”

US Pharmaceutical Companies Test Drugs on India’s Poor

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A recent report on Al Jazeera English found that US drug companies like Merck and AstraZeneca are increasingly conducting their clinical trials of new drugs in countries like India, Russia, China, Brazil, Poland, Uganda and Romania. Zeina Awad, a reporter for Al Jazeera’s “Fault Lines” program, traveled to India to investigate clinical research being conducted there. In an interview, Awad said she found many hospitals and doctors in India failed to follow international guidelines for clinical research.

Efforts to Immunize Food Manufacturers from Obesity-Related Lawsuits: A Challenge for Public Health

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Earlier this summer, Minnesota nearly enacted a law immunizing food and beverage (collectively “food”) manufacturers, marketers, and sellers from civil liability related to individuals’ claims of obesity or related health problems stemming from the purchase or consumption of a food product. The Personal Responsibility in Food Consumption Act (PRFCA) was introduced in Minnesota’s House of Representatives on January 31, 2011, by Representative Dean Urdahl. Shortly after the bill was introduced, Rep. Urdahl issued a press release saying, “My bill is about common sense and personal responsibility because, as citizens, we ultimately must be accountable for what we consume. If you eat too many cheeseburgers and get fat, don’t sue food retailers.”[1]

By late May 2011, the bill had been passed by the state’s Senate and House of Representatives. The bill’s text stated that

A producer, grower, manufacturer, packer, distributor, carrier, holder, marketer, or seller of a food or nonalcoholic beverage intended for human consumption, or an association of one or more such entities, must not be subject to civil liability based on any individual’s or group of individuals’ purchase or consumption of food or nonalcoholic beverages in cases where liability arises from weight gain, obesity, or a health condition associated with weight gain or obesity and resulting from the individual’s or group of individuals’ long-term purchase or consumption of a food or nonalcoholic beverage.[2]

The bill did not exempt food manufacturers from liability for obesity or weight gain claims that were based on “knowing and willful” violations of the law.[3]

On May 24, 2011, Minnesota’s Legislature presented the PRFCA to Governor Mark Dayton. Instead of signing the bill into law, Governor Dayton vetoed it on May 27th. In a letter to Kurt Zellers, the Speaker of the Minnesota House of Representatives, Governor Dayton explained that he supported “the bill’s expressed intent to hold individuals responsible for their own dietary choices.”[4] Despite this, he felt that the PRFCA would have created “too broad an exemption from liability” for food manufacturers and sellers.

Minnesota Governor Mark Dayton, who vetoed that state’s “Cheeseburger Bill”

Unlike Minnesota, 24 states have successfully enacted laws that limit liability or otherwise immunize the food industry from lawsuits related to claims of obesity or associated health problems.[5] These laws are largely a response to lawsuits brought in the early 2000s in which teenage-plaintiffs argued that fast food restaurants should have some responsibility for the country’s obesity epidemic, including their personal weight gain and health problems.[6]

A federal version of the Personal Responsibility in Food Consumption Act was introduced in the U.S. Congress in 2005. It received significant media attention and was the subject of heated Congressional debates. For example, in the House of Representatives, Rep. John Schwarz spoke in favor of the bill, arguing that

The most important step we can take to curb obesity is to impart to everyone in this country that obesity can be controlled when we take personal responsibility. A healthy and consistent diet, with an adequate amount of exercise, will work wonders. That’s the simple truth. . . .  Allowing consumers to sue their local restaurant, to sue half the food industry, means that we are telling our citizens, “It’s not your fault that you are obese.” . . . I support this legislation because it sends the message to everyone in the United States, young and old, that taking control of your weight is your responsibility, and taking personal responsibility is the only way that weight control can be achieved.[7]

Many public health advocates consider this type of position to be a form of victim-blaming which targets individuals who lack adequate access to healthy food and space that facilitates physical activity.

Opponents of the bill questioned why the federal government would want to allow an industry to act without the benefit of judicial oversight. Rep. Pete Stark explained that

Many of the pending cases are for false advertising, claiming food is low fat when it’s really not, and this bill is so broadly worded that it would preclude such cases from going forward. The threat of legitimate lawsuits against fast-food corporations is as much a part of creating social change as is the threat of a Congressional investigation. . . . Even more important than the issue of obesity or Congressional meddling in the judicial branch is the fundamental right of every American to have their day in court. . . . Congress has no business preemptively closing the courthouse doors to a particular group of Americans.[8]

This sentiment was echoed by consumer advocates, including Michael Jacobson, the executive director of the Center for Science in the Public Interest. He contended that “[i]f someone is saying that a 64-ounce soda at 7-Eleven contributed to obesity, that person should have his day in court. If it’s frivolous, the courts are accustomed to throwing those out.”[9] He described the food industry’s efforts “to get special exemptions from lawsuits” as “shameful.”

The federal Personal Responsibility in Food Consumption Act was reintroduced three times but ultimately has failed to become law. During the last decade, however, the National Restaurant Association has been instrumental in encouraging state legislators to pass so-called “commonsense consumption” laws,9 with Alabama’s bill being the most recently active in a state legislature.[10]

These “commonsense consumption” laws, which some have dubbed “cheeseburger bills,” raise a challenge for public health. They effectively remove or preempt individuals’ ability to turn to the court system to pursue obesity-related litigation.[11] While some of these lawsuits may be frivolous, others have the potential to influence how the food industry operates.

Some scholars have drawn parallels to the role of litigation against the tobacco industry in the 1990s. Although the thought of an individual suing a tobacco company for an illness allegedly related to smoking may not have been initially popular, those lawsuits and subsequent settlements led to the public availability of millions of pages of internal tobacco company documents. According to Professor Richard Daynard, “People changed their minds when documents started to come out about how tobacco companies misled customers about the alleged health benefits of light and low-tar cigarettes.”[9]

Daynard and others believe that a similar change could occur “when people learn the elaborate ways in which companies market products they may know to be unhealthy.”[9] The public loses the chance to learn about the food industry’s potentially harmful practices each time a state enacts a “commonsense consumption” law. In addition, the time and resources spent debating these bills could be better spent directly addressing the underlying public health issues related to obesity that persist throughout the nation.[12]

Jennifer Pomeranz is the Director of Legal Initiatives at the Rudd Center for Food Policy & Obesity at Yale University. She publishes and speaks on issues related to marketing to children, regulating unhealthy products, labeling, weight bias, and the government’s role in obesity and food policy.

 

Reference

[1] State Representative Dean Urdahl, “Cheeseburger Bill” Topped with Personal Responsibility and More, Feb. 23, 2011.

[2] Minn. HB 264, “Personal Responsibility in Food Consumption Act,” Jan 31, 2011.

[3] Minn. HB 264, “Personal Responsibility in Food Consumption Act,” Jan 31, 2011.

[4] Letter from Gov. Mark Dayton to Speaker Kurt Zellers, May 27, 2011.

[5] Trust for America’s Health, Supplement to “F as in Fat: How Obesity Policies are Failing in America, 2007,” Obesity-Related Legislation Action in States, Update, Aug. 2007.

[6] Melanie Warner, The Food Industry Empire Strikes Back, The New York Times, July 7, 2005

[7] Statement of Rep. John Schwarz, Congressional Record, p. 23085, Oct. 19, 2005.

[8] Statement of Rep. Pete Stark, Congressional Record, p. 23086, Oct. 19, 2005.

[9] Melanie Warner, The Food Industry Empire Strikes Back, New York Times, July 7, 2005.

[10] Alab. HB 193, “Commonsense Consumption Act,” Mar. 8, 2011,

[11] Pomeranz JL, Teret SP, Sugarman SD, Rutkow L, Brownell, KD. Innovative Legal Approaches to Address Obesity. Milbank Quarterly 2009;87:185-213.

[12] RWJF Trust for America’s Health, F as in Fat 2011, July 7, 2011.

 

Image Credits:

 

1. Razor 512 via Flickr.

2. GovernorDayton via Flickr.

3. Pisto Casero via Flickr.

Washington Budget Deal Threatens Consumer Protection and Public Health

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The recent budget deal negotiated by President Obama and Congress will lead to more polluted water, less consumer protection, smoggy skies, crumbling bridges, less education funding—and more unhealthy Americans, writes Andy Kroll in Mother Jones. The White House’s plan would slash this type of spending nearly in half as a percentage of gross domestic product, from about 3.3 percent of America’s GDP to as low as 1.7 percent, the lowest in nearly half a century, says Ethan Pollack, a senior policy analyst at the left-leaning Economic Policy Institute.

Study Finds Alcohol Advertising Influences Brand Preferences of Underage Drinkers

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More underage drinkers prefer a specific brand of distilled spirits, and some of the blame lies with TV advertising, according to a recent study by a group at Dartmouth College published in the July issue of Archives of Pediatric and Adolescent Medicine. The alcohol industry spent $1.7 billion in 2009 on TV advertising, according to the study. The Distilled Spirits Council of the United States (DISCUS) disputes the findings, citing other statistics that have shown a consistent decline in underage drinking.

Comments on the Interagency Working Group (IWG) Voluntary Standards for Foods Marketed to Children

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In July, Corporate Accountability International submitted the following comments to the US Federal Trade Commission:

Corporate Accountability International (formerly Infact) is a membership organization that protects people from irresponsible and dangerous corporate actions around the world. Our Value [the] Meal campaign is dedicated to reversing the global epidemic of diet-related disease by challenging the fast food industry to curb the range of its abusive practices. One of our primary demands calls on McDonald’s to stop marketing unhealthy food to our kids.

Corporate Accountability International’s 30 years of experience offers lessons that can be applied to the development of the FTC’s recommendations on the marketing of foods to children and we appreciate the opportunity to comment on the Interagency Working Group (IWG) voluntary standards for foods marketed to children.

We appreciate that the Interagency Working Group (IWG), by proposing these voluntary principles, recognizes that the current system of industry-defined guidelines on food marketing to children has been a dismal failure. Far from being science-based, industry’s guidelines are self-serving and have succeeded in ensuring that almost all of their worst products continue to be marketed to children. We appreciate the effort of the IWG in replacing that failed approach with one that is science-based, uniform, and applied industry-wide.

Another failure of the industry self-regulatory system is that it only applies to children under the age of 12. Corporate Accountability International strongly agrees with the IWG that marketing standards must apply to teenagers up to age 17. Industry has not offered any good reason for why it only cares about the potential adverse impacts of its marketing on children under the age of 12. What is clear is that industry fears the loss of the crucial teen market.

Voluntary Standards Will Not Work

The federal government should not continue to support and promote the concept of voluntary guidelines (or principles). Even if the new standards are an improvement over those defined by industry, we cannot trust industry to follow them.

In our thirty-year history, we have found that voluntary agreements have inherent and serious limitations and are not effective in addressing public health concerns. Voluntary initiatives have a limited scope in terms of the rights they include and the sectors they cover and many “laggard” companies choose not to join any voluntary initiative. In the US, the Better Business Bureau’s voluntary Children’s Food and Beverage Advertising Initiative has been highly criticized by public health advocates for being both limited in scope and limited in terms of the number of food companies that have joined the initiative.

Furthermore, voluntary initiatives typically fail to ensure that the principles that they advocate are upheld in practice. This is an inherent flaw of voluntary initiatives and food companies have already demonstrated their ability to exploit loopholes of voluntary marketing initiatives. Examples include the continued marketing of unhealthy brands under the banner of promoting “healthy messages” as well as nutrient profiling that allows companies to bolster claims of a product’s healthy nature. Overall, we have found that principles under voluntary initiatives are often narrowly conceived, inconsistent across different initiatives, and applied unevenly.

We believe that government regulation is the only feasible approach to reversing the negative public health impact of irresponsible practice of food industry marketing of unhealthy food to children.

Food Should Not Be Marketed to Children

While the food and media industries use the argument that limiting a corporation’s ability to market their products is a violation of the First Amendment, this argument conveniently ignores one simple fact: Deceptive advertising is not protected by the First Amendment. If a child cannot understand he or she is being marketed to, what else can this be called other than deceptive?

The scientific literature is clear that at younger ages, children do not have the cognitive capacity to understand that they are being marketed to. Therefore, it’s inherently deceptive to market anything to children. Corporate Accountability International is concerned that by setting standards for what can and cannot be marketed to children, the federal government is putting its stamp of approval on the very concept of marketing to children, which is contrary to both science and policy.

While older children may understand they are being marketed to, they are still adversely impacted by such advertising and are also in need of protection. The IWG must also consider that marketing aimed at teenagers is viewed by younger children – appealing indirectly to the under 12 group as they want to emulate older age groups. For instance, tobacco industry marketing icons such as Joe Camel and the Marlboro Man were claimed to appeal to young adults, but in reality it was determined that these branded characters attracted much younger audiences.

Corporate Accountability International is also concerned that by offering up nutrition standards, the food industry will just cleverly figure out how to reformulate its products, thereby creating more processed (with approved nutrients) junk food for kids. This has certainly been the industry approach thus far: finding more clever ways to market to kids as workarounds, as opposed to cutting back on marketing altogether.

Brand Marketing is a Major Concern

Corporate Accountability International applauds the IWG for recognizing that corporations often engage in brand advertising and marketing, without reference to a specific food product. We are very concerned about brand marketing. By its very nature, setting nutrition standards presupposes that brand marketing is insignificant, which is far from true. There are many ways that food companies can and do market brands in the absence of specific food products.

One of the best examples of this is advergaming: websites set up by food brands for the purpose of getting children to play games on their site. For example, the website Ronald.com is obviously targeting very young children. And of course, McDonald’s aim is to inculcate young vulnerable children with the idea that Ronald is fun, building brand loyalty that lasts a lifetime.

The entire approach by the IWG of setting nutrition standards on what sorts of foods “may” be marketed to children misses this bigger picture: Large food corporations like McDonald’s and Pepsi target children with big ad budgets and powerful emotional messages about how to eat, not with grams of fat and milligrams of salt. We recommend eliminating brand marketing targeted to children for those transnational corporations (i.e. McDonald’s, Coca Cola and Pepsi) whose portfolio contains a high percentage of junk foods.

Implementation Period is Too Long

Why are companies being given until 2016 (and 2021 for sodium) to comply with voluntary standards? Especially given there are no consequences for non-compliance, any timeline longer than one or two years is too generous. The food industry has had years to get its act together, it’s not like this issue is brand new. In fact, in its 2006 report, the Institute of Medicine recommended that Congress step in if industry didn’t improve things on their own in two years. Here we are five years later and now the IWG wants to give industry five more years?

Industry Lobbying is a Serious Sign of Bad Faith

For years, both the food and media industries have engaged in a concerted campaign to undermine public policy efforts related to food marketing to children. At the same time, industry has attempted to distract policymakers and the general public with schemes of industry self-regulation. In the meantime, marketing to children has gone along unabated, with the childhood obesity epidemic and other chronic health problems only getting worse.

In recent weeks, the pushback from industry regarding the IWG principles has heated up considerably, with all sorts of misleading claims being made. While talking points like “these are backdoor regulations” makes for a great media sound bite, the industry clearly needs a reality check. As David Vladeck made painfully clear in his public counter to arguments against the IWG standards, [1] it has no intension intention to regulate industry, so what exactly is all the complaining about?

This concerted PR and lobbying effort shows us that the food and media industries are not operating in good faith. To the contrary, their aim is to thumb their noses at government and advocates alike, acting like marketing to children is an inalienable right. Food companies and media conglomerates have now banded together to form the “Sensible Food Policy Coalition” for the sole purpose of derailing the IWG effort. Apparently, even the heavyhitting U.S. Chamber of Commerce has gotten in on the act. According to one account:

Core members of the coalition — including General Mills, Kellogg, PepsiCo and Time Warner — spent $6.6 million on lobbying in the first quarter of this year, disclosure records show. Overall, records show, the coalition’s main members have spent nearly $60 million on lobbying since the start of the Obama administration.[2]

How are children’s advocacy groups supposed to compete with that sort of lobbying muscle? In another 11th hour move, industry released an unpublished, non-peer-reviewed estimate on the IWG’s proposed voluntary principles alleged economic impact. How the industry’s bought and paid for two-page “report” concluded that 74,000 jobs would be “lost” defies both economics and common sense. Even if industry were to follow the voluntary principles, they can still find ways to spend their marketing dollars; they are very clever that way. History has shown industry just shifts marketing to other forms or media or other targets, they rarely if ever cut their marketing budgets.

But never mind the facts. These are tactics taken right out of Big tobacco’s playbook: Mount a massive public relations campaign, buy some science to confuse the issues, and when all else fails, call your friends in Congress.

Children Need Government Protection Right Now

It’s troubling that the IWG is considering weakening the standards. If the government is proposing voluntary principles that industry can choose to adopt or not, then why not set a good example and base them on the best public health policy available? Industry already provides us with watered down standards. It undermines the very purpose of having science-based standards if IWG weakens its final recommendations.

The food industry has demonstrated time and time again that it cannot be trusted. Left to their own devices, the food and media industries will just keep on doing what they do best: targeting children with the most highly processed and nutrient-deficient food products. We have already seen the adverse consequences of an unchecked system: a public health crisis of diet-related diseases among adults as well as disturbing health problems among children.

Make no mistake: inaction now means sentencing yet another generation of children to a lifetime of higher risks for life-threatening illnesses such as heart disease, diabetes, hypertension, just to name a few. Now is not the time to argue over salt and sugar grams. Now is the time for serious action to stop the predatory targeting of children by the food industry, before millions more children become chronically ill from the food they eat.

To the extent that the Federal Trade Commission does not have current authority to regulate food marketing to children, it should ask Congress to take action. To the extent the agency believes there may be First Amendment barriers to such regulation, let’s determine which of the most egregious forms of marketing do not deserve free speech protection, even under the current Supreme Court make-up, and start making some sound legal and policy arguments that just might convince the Court that children’s health should trump the economic interests of PepsiCo and McDonalds.

It’s time for the federal government to take leadership in protecting America’s kids and stop protecting an industry that is driving an epidemic of diet-related disease. Because if it doesn’t, who will?

 

References:

1. David Vladeck, comment on “What’s on the table,” Business Center Blog, comment posted July 1, 2011,

http://business.ftc.gov/blog/2011/07/whats-table (accessed July 14, 2011).

2. Senate Office of Public Records Lobbying Disclosure Act Database (Washington, D.C.),

http://soprweb.senate.gov/index.cfm?event=selectfields (accessed July 14, 2011).

 

Image Credits:

1. Kcolwell via Flickr.

2. Corporate Accountability International

Public Supports New Fuel Efficiency Standards as Auto Industry Launches Ad Campaign Opposing Them

Posted on by Corporations and Health Watch

A recent poll by the Pew Clean Energy Program found strong public support for the Obama Administration’s new fuel efficiency standards. The survey found that 82 percent of respondents support an increased fuel efficiency standard of 56 miles per gallon (mpg) by 2025, with 68 percent reporting that they “favor strongly” the new standard. Overwhelming majorities in every demographic subgroup support increased fuel efficiency to 56 mpg, including 70 percent of Republicans, 87 percent of Democrats and 88 percent of independents. Although the auto industry agree to these new rules, they also launched a radio ad campaign, accusing the Obama administration of threatening the industry’s recovery by seeking a 56-mpg fuel economy target by 2025.