Abstract
Addressing the determinants of non-communicable diseases (NCDs) is challenged by aggressive market promotion by tobacco, alcohol and unhealthy food industries in emerging countries with fast economic development; and interference by these industries in government policies aimed at containing consumption of unhealthy products. This editorial reviews market promotion and industry interference and classifies them into four groups of tactics: (a) interfering with the legislative process; (b) using front groups to act on their behalf; (c) questioning the evidence of tobacco harm and the effectiveness of harm-reduction interventions; and (d) appearing responsible in the eyes of the public, journalists and policy-makers. Despite active implementation of the Framework Convention on Tobacco Control (FCTC), the tobacco, alcohol and unhealthy food industries use similar tactics to aggressively interfere in policies, with the tobacco industry being the most aggressive. Policy interference by industries are effective in the context of poor governance, rampant corruption, conflict of interest among political and government actors, and regulatory capture in all levels of countries from low- to high-income. In addressing these interferences, government requires the practice of good governance, effective mechanisms to counteract conflict of interests among political and policy actors, and prevention of regulatory capture. The World Health Organization (WHO) Framework of Engagement with non-State Actors can be applied to the country context when engaging private entities in the prevention and control of NCDs.
Highlights
In the context of trade liberalization, which promotes the availability and consumption of goods and services through reduction of taxes and tariffs, the increased consumption of alcohol, unhealthy foods, and breast milk substitutes (BMS) is boosted by aggressive market promotion
Governments’ efforts to prevent and control non-communicable diseases (NCDs) through increased tax and price, and controlled advertising of these products are hampered by policy interference by alcohol, tobacco, and unhealthy food industries.[1]
Progress has been slow as it was limited by the lack of capacity in the health sector to convene partnerships with trade and commerce, to generate evidence for policy, and to track the implications of trade agreements relating to the health of the population.[3]
Summary
In the context of trade liberalization, which promotes the availability and consumption of goods and services through reduction of taxes and tariffs, the increased consumption of alcohol, unhealthy foods, and breast milk substitutes (BMS) is boosted by aggressive market promotion. To tackle the determinants of NCDs, the World Health Organization (WHO) suggests some ‘best buy’ interventions These are defined through an average cost-effectiveness ratio of international dollars ≤100 per disability-adjusted life years averted in low- and lower middle-income countries.[5] A systematic review shows that tobacco warnings increase people’s attention to and recall of health messages, which reduces smoking and motivates quitting.[6] Graphic pictures enhance the effectiveness of warning labels.[7] A. One-cent-per-ounce excise tax on SSB implemented across the United States would have prevented nearly 580 000 cases of childhood obesity and more than US$30 in health care cost savings for every US$1 investment.[12] This editorial reviews evidence on market promotion and policy interference by tobacco, alcohol and food industries when governments introduce measures to contain consumption of these products in order to prevent and control NCDs; and suggests how governments might find ways to overcome these challenges. Exclusive breastfeeding of newborns for 6 months in China went down steadily from 67% in 1998 to 50.8% in 2003, 27.6% in 2008 and 18.6% in 2013
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