Abstract
BackgroundRegulation of food environments is needed to address the global challenge of poor nutrition, yet policy inertia has been a problem. A common argument against regulation is potential conflict with binding commitments under international trade and investment agreements (TIAs). This study aimed to identify which actors and institutions, in different contexts, influence how TIAs are used to constrain policy space for improving food environments, and to describe their core beliefs, interests, resources and strategies, with the objective of informing strategic global action to preserve nutrition policy space.MethodsWe conducted a global stakeholder analysis applying the Advocacy Coalition Framework, based on existing academic literature and key informant interviews with international experts in trade and investment law and public health nutrition policy.ResultsWe identified 12 types of actors who influence policy space in the food environment policy subsystem, relevant to TIAs. These actors hold various beliefs regarding the economic policy paradigm, the nature of obesity and dietary diseases as health problems, the role of government, and the role of industry in solving the health problem. We identified two primary competing coalitions: 1) a ‘public health nutrition’ coalition, which is overall supportive of and actively working to enact comprehensive food environment regulation; and 2) an ‘industry and economic growth’ focussed coalition, which places a higher priority on deregulation and is overall not supportive of comprehensive food environment regulation. The industry and economic growth coalition appears to be dominant, based on its relative power, resources and coordination. However, the public health nutrition coalition maintains influence through individual activism, collective lobbying and government pressure (e.g. by civil society), and expert knowledge generation.ConclusionsOur analysis suggests that industry and economic growth-focussed coalitions are highly capable of leveraging networks, institutional structures and ideologies to their advantage, and are a formidable source of opposition acting to constrain nutrition policy space globally, including through TIAs. Opportunities for global public health nutrition coalitions to strengthen their influence in the support of nutrition policy space include strategic evidence generation and coalition-building through broader engagement and capacity-building.
Highlights
Regulation of food environments is needed to address the global challenge of poor nutrition, yet policy inertia has been a problem
Our findings are organised into the following subsections: which stakeholders can influence nutrition policy space through international trade and investment agreements (TIA); what are the important networks and relationships between stakeholder groups; what are the primary coalitions operating in the policy subsystem of food environment regulations; how do these coalitions influence policy space through TIA mechanisms; and what are the strategies used to preserve policy space for food environment regulations
The formal and informal relationships identified in this analysis that relate to the mechanisms of influence on nutrition policy space have been summarised in Table 2 below
Summary
As agents who use and interpret TIAs in different ways, a variety of actors and institutions play a role in potentially constricting policy space— by influencing whether and how TIA mechanisms of nutrition policy space constraint are activated, or not [30] This may be, for example, through technical challenges on the basis of specific trade agreements, such as claims that regulations are discriminatory against other ‘like’ products, are more trade-restrictive than necessary as technical barriers to trade, or violate the rights given to investors to protect their investments (e.g. amounting to ‘indirect expropriation’ or lack of ‘fair and equitable treatment’) [31,32,33]. There may be appeals to associated neoliberal values in trade and investment forums, [34] in what Smith (2020) calls the ‘political determinants of health.’ [35] A more detailed understanding of the roles, interests, relationships and resources of the various stakeholders is necessary to inform strategic action to preserve nutrition policy space
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