Abstract
BackgroundDiet-related noncommunicable diseases represent a major global public health challenge, and require a multisectoral policy response. However, the use of trade policy in this context has met with varied success in the face of strong global trade liberalization agendas. The Government of Ghana has implemented an innovative food standards policy to limit the amount of fat in meat and meat cuts, in response to rising imports of low quality fatty meat cuts. This paper presents an analysis of the policy process and outcomes, as well as contextual factors in policy development, to enable policy learning in other jurisdictions.MethodsWe conducted 28 semi-structured policy analysis interviews with 37 stakeholders at the national and regional level in Ghana, and collated relevant documents. We analysed the data using the health policy analysis triangle and policy theories related to lesson drawing.ResultsThe standards were developed in response to health concerns related to fatty meat (particularly turkey tails), in a context of rising meat imports and a generalised concern about the low quality and high fat content of imported meats. The standards were the result of collaboration between the trade and health sectors. The standards apply to both imported and domestic meat, and were designed to be compliant with Ghana’s multilateral trade commitments. The overall effect of the ban has been to reduce availability of specific ‘low quality’ high-fat meats in the Ghanaian food supply, namely turkey tails and chicken feet.ConclusionsThis study indicates that the use of standards can reduce availability of high-fat meat in a national food supply. The main strength of a standards approach to reducing fatty meat (mainly imported) in the food supply is compliance with global trade law, while the main challenge is effective enforcement. However, the Government of Ghana appears to have developed a functional and flexible application of the policy. Features of this policy approach useful for policy learning include: collaboration at every stage between ministries of trade and health; considerations relating to compliance with international trade law; strategic enforcement of the policy; and the importance of public awareness efforts.
Highlights
Diet-related noncommunicable diseases represent a major global public health challenge, and require a multisectoral policy response
– Why was it proposed? – How did it get onto the political agenda? – Who is responsible for implementing the policy, and how has it been implemented? – What was the outcome of the policy initiative?. We drew on both qualitative and quantitative sources to answer these questions, including interviews, trade data, food availability and production data (FAOSTAT and local data), information on trade policy change and information on food supply policies (Euromonitor; United States Department of Agriculture Foreign Agricultural Service reports on policy and markets)
While these standards are quite recent, it is evident from interviews and documentation (e.g. World Trade Organization Trade Policy Reviews) that these standards regarding fat content appeared in the first edition of the standards, which are no longer available
Summary
Diet-related noncommunicable diseases represent a major global public health challenge, and require a multisectoral policy response. Even in Sub-saharan Africa, a region still beset by high rates of undernutrition and communicable diseases, the prevalence of diabetes, cancer and heart disease represent a significant burden of disease [2] These diseases have a complex causality: changing food supplies, urbanization, increasing life expectancy and sedentary work and leisure activities are giving rise to new patterns of eating and activity. The multisectoral approach recommended by the World Health Organization’s 2013–2020 global action plan includes the use of policies from finance, trade and agriculture [4] As part of this multisectoral approach, international institutions, non-government agencies and academics have recommended trade policies designed to improve the healthfulness of the food supply and prevent NCDs [5,6,7]. The importation of cheap high-fat cuts of meat has been identified in Africa and the Pacific as a contributor to both NCDs and agricultural underdevelopment [10,11]
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