In response, Public Health Division of the Pacific Community (SPC) has been driving an initiative to develop policies and legislative provisions for tackling the key risk factors, particularly tobacco use, harmful alcohol use, and dietary risks.
The result is the “Pacific Legislative Framework”.
This remarkable document, now available in English and French, consists of three parts.
The framework begins by setting out policy for addressing a surprisingly wide range of risk factors, including core areas of tobacco control, core areas of liquor control, health promotion, protection for breastfeeding, regulation of marketing of unhealthy foods and drinks to children, reducing consumption of salt, sugar and trans-fat in the diet, and tax measures for tobacco, alcohol and unhealthy food/sugar-sweetened drinks.
The “policy” element includes overall policy objectives and recommendations for each area, as well as priority areas for reform and a brief legislative plan.
The appendices to the Framework consist of draft legislative provisions covering each of the thematic areas/risk factors.
These provisions can be implemented as off-the-shelf legislation, or adapted by National Parliaments to national circumstances.
The Pacific Legislative Framework is an impressive effort – entirely driven by Pacific Island Countries and Territories themselves, in collaboration with the Pacific Community (SPC) and the WHO Western Pacific Regional Office.
The Framework is a logical extension in a chain of initiatives, driven by Pacific Island Countries and Territories, to address the burden of NCDs.
In 2017, the Pacific Monitoring Alliance for NCD Action (Pacific MANA) was established. Pacific MANA has developed a dashboard-style accountability tool to report on progress with policies and laws to address NCDs in Pacific Island Countries and Territories.
The MANA dashboard now functions as an accountability tool for action on NCDs in the Pacific.
There is a long way to go, and gaps to be filled, including political commitment and actions to prevent conflicts of interest that undermine tobacco control policies in the Pacific. There is also an urgent need for Pacific Island Countries and Territories to grow their capacity for enforcing public health laws.
Stay-at-home orders, curfews, and mandatory quarantine have brought public health law to the public’s attention during the Covid-19 pandemic.
While public health law might be new to some, there is an entire academic discipline devoted to it, with a host of researchers and practitioners based in law schools (including dedicated health law and public health law centres), research institutes, non-profits, and health departments around the world. Public health law experts also work for global organisations such as the World Health Organisation. This is a short explainer on the discipline of public health law for anyone coming to it for the first time.
Public health law is distinct from health law, which is concerned with the law’s role in areas such as the provision of healthcare, the regulation of healthcare professionals and new medical technologies, medical negligence, and health information privacy.
…the study of the legal powers and duties of the state to ensure the conditions for people to be healthy… and the limitations on the power of the state to constrain the autonomy, privacy, liberty, proprietary, or other legally protected interests of individuals for protection or promotion of community health.
A key focus is dedicated public health laws and their provisions on infectious disease control. These laws create the infrastructure for public health services and disease surveillance and reporting, but they also grant officials extensive powers to order the testing, treatment, vaccination, isolation, and quarantine of individuals with an infectious disease. These powers were rarely used in many countries (and may even have seemed archaic), until the Covid-19 global pandemic broke out. This is perhaps the first time that many people understood the coercive nature of public health law and saw these laws operating in practice.
There is now an extensive body of public health law research on national legal responses to Covid-19, as well on the international dimensions of the pandemic response, such as the WHO’s use of the International Health Regulations to declare Covid-19 a public health emergency of international concern (PHEIC).
Official powers on infectious disease control illustrate some of the fundamental tensions at the heart of public health law. These include the tension between protecting individual rights and freedoms and promoting collective goods. Another is between achieving public health goals and achieving other social and economic objectives. Management of Covid-19 demonstrates this, with measures such as quarantine (which limits freedom of movement and other individual rights) being used extensively in the name of public health. Stay-at-home orders also limited the spread of Covid-19 but came at the expense of people’s ability to work, and at the expense of national economic functioning.
Some might think that public health lawyers would be unquestionably in favour of such measures. But a key part of the discipline is testing when the use of government powers is justified, legitimate, and proportionate to the objectives governments are trying to achieve, and holding governments accountable for the misuse (or failure to use), their public health powers. It is crucial to critique the use of extraordinary government powers, particularly if accompanied by the suspension of usual human rights protection measures, and media freedoms.
These kinds of tensions between individual rights and collective goods also play out in relation to legal measures to prevent non-communicable diseases (NCDs) such as cardiovascular disease, diabetes, and cancer, which are now the leading cause of preventable death and illness globally. Governments have introduced a range of legal measures that address the risk factors for these diseases: some examples include restrictions on tobacco marketing, taxes on sugary drinks, and minimum floor prices for alcoholic drinks. Laws on NCD risk factors – particularly diet – are sometimes presented as the new, ‘fringe’ dimension of public health law, but measures such as sugary drinks taxes have been used (effectively) by governments around in the world.
There is a perception that the law shouldn’t be used to address these kinds of issues because they lack the fundamental justification found in infectious disease control measures: NCDs are by their nature non-infectious, and the development of a chronic illness is one person doesn’t pose a risk of transmission to others. Yet we accept a degree of government paternalism in many areas of public risk and safety (think of laws requiring seatbelt use, for example). This argument also ignores the huge costs these diseases impose on societies, economies, and healthcare systems, and would remove one of the most effective tools for preventing NCDs from governments’ toolboxes.
The discipline of public health law also acknowledges the critical health impact of laws outside the field of public health. Modern public health understands the determinants of health and illness as a set of interacting causes that operate at the individual level (genes, biology, and health behaviours), and encompass the conditions in which people live and work, their access to resources such as housing, education, and income, and the broader structural, economic, and cultural dimensions of our societies. Law itself can be seen as one of these broad, ‘social determinants‘ of health.
Addressing the social determinants of health requires changes to a wide range of laws and policies, including those on employment, housing, and social welfare. So, for example, organisations such as ChangeLab Solutions (a US public health law non-profit) have developed guidance on how urban planning laws can be designed to promote healthy and equitable communities. Social welfare laws in Australia have been analysed for their impact on the diets of people in lower income groups. As almost anything can be framed as a public health issue, so this brings to into question the legitimate scope of public health law, which can become the study of life, the universe, and everything.
As well as being interested in how law can address different illnesses and their causes, public health lawyers are concerned with the nature of ‘law’ and categorising the different powers available to governments to improve public health. In a foundational model, Lawrence Gostin describes these as the power to: tax and spend; alter the information environment; design and alter the physical environment; intervene in the economic system by addressing socio-economic disparities; directly regulate businesses, people, and professionals; and to deregulate when law and regulation is an impediment to public health. Clearly law is not just a prohibition on a particular form of activity or behaviour but is a mechanism to shape social norms, economic markets, and physical and informational environments.
The discipline of public health law understands that often there is not just one law operating in isolation, but that attention needs to be paid to supporting regulations and codes of practice (or in the case of international treaties, documents such as interpretive comments), as well as any case law interpreting statutory provisions. In some areas, the main source of law may be case law (or statute law), depending on jurisdiction. Understanding the interactions different legislative and regulatory instruments, and between legislation and case law, is a key skill that lawyers bring to the field of public health.
Lawyers also bring to the study of public health an understanding of the fundamental principles of the legal system (which obviously differ according to jurisdiction), including the division of powers between federal, state, and local governments, and how the powers and functions of each level of government are determined by legislative and constitutional frameworks. For example, the issue of pre-emption is critical in the US, where there is growing concern about state governments enacting new laws to limit the ability of public health officials and local government to introduce Covid-19 control measures.
Forms of regulation or governance developed by non-government actors are also increasingly important to public health, particularly in addressing obesity and diet-related health, which has seen the rise of industry self-regulation and collaborative partnerships with ‘Big Food’ in areas such as regulating junk food marketing to children. Public health law draws attention to the wide range of ‘soft’, collaborative, or voluntary forms of regulation developed by, or involving, businesses, trade industry bodies and NGOs. Some of these forms of ‘private regulation’ are just as complex and detailed as laws developed by governments. Public health law researchers pay close attention to the terms and conditions, implementation, and enforcement of these initiatives, as these are key factors which ultimately determine their impact on public health outcomes.
Lawyers have other specialised skills that we apply in public health law research. These include an understanding of the conventions and rules that should be followed in interpreting a legal document, and the ability to systematically identify, synthesize and analyse case law and legislation. This forms one important component of public health law research: ‘policy surveillance’, which can be used to create large databases of legal instruments that are a powerful tool for analysing law’s effect on health. Lawyers can also draft legislation and other legal documents relevant to public health.
But public health law research goes far beyond doctrinal analysis. As with other areas of legal research, it draws on a wide range of qualitative and quantitative methodologies, including health impact assessments, surveys, interviews and focus groups. It also uses theories from a variety of disciplines including epidemiology, law, sociology, political science, and psychology.
Public health law research is not simply the study of ‘law in books,’ though. Researchers analyse the implementation of laws, their enforcement, their impact on features of the physical environment relevant to health (think smoke-free laws), on people’s health-related behaviours, and on broader population health and equity outcomes. Researchers are interested in, for example, how laws on wearing seat belts or bicycle helmets are disproportionately enforced against homeless people or People of Colour. Consider too the argument that Covid-19 stay-at-home orders were used disproportionately against lower-income, diverse suburbs in Western Sydney, as compared to higher-income, majority white populations in Sydney’s Eastern suburbs. Finally, public health law research is concerned with the unintended health impacts of laws that are not targeting health, as with the effect of laws criminalizing drug use on illicit drug users’ risk of contracting HIV.
Since the outbreak of Covid-19, there has been commentary, discussion, and analysis of public health law from people with a range of different professional backgrounds. That’s great: these laws should be poked and prodded from different angles. But don’t forget: there’s an entire discipline of legal researchers who have spent their careers investigating the role of law in creating the conditions for people to live healthy, fulfilling lives.
The BMJ has published an Opinion calling on the Director-General of the World Health Organisation, Dr Tedros Adhanom Ghebreyesus, and the United Nations High Commissioner for Human Rights, Dr Michelle Bachelet, to jointly initiate a process to develop International Guidelines on Human Rights, Healthy Diets, and Sustainable Food Systems.
180 signatories from 38 countries have supported this Open Call – experts in global health and development, human rights, food systems, and HIV.
You can join the Call and add your name in support here, at the Healthy Societies 2030 website.
Healthy Societies is also hosting supporting documents, including a suggested process for strengthening links between human rights and healthy diets at the global level, and moving towards international guidelines. (You can contribute to the discussion form, follow on twitter, and join the mailing list).
But pausing for a moment.
How would International Guidelines on human rights and healthy diets make a difference?
These Guidelines helped to consolidate the framing of global strategy for HIV prevention and treatment in terms of the human rights of those affected by HIV.
And they provided language and conceptual tools for civil society organisations to hold governments to account.
In the BMJ Opinion, we argue that joint WHO/OHCHR guidelines could have a similar effect, by putting people at the centre of food systems, and strengthening the protection of health in global and national policies.
Framing global strategy effectively: the example of HIV
Getting global strategies right matters because they affect national strategies, actions and budgets.
A focus on human dignity, preventing discrimination, empowering those with, or at risk of HIV, and ensuring that no one is left behind – these human rights values lie at the core of global strategies to prevent transmission and treat infection.
It wasn’t always that way.
In Australia, in the 1980s and early 1990s, public debate about rising rates of HIV infection was often framed by prejudice and fear.
In Australia at that time, otherwise sane people were arguing that everyone in the country should be tested for HIV, and those with HIV should be removed from society or quarantined in the desert somewhere.
Fortunately, a kinder, more rational and humane approach – a human rights approach – prevailed.
By working with and through those affected by HIV – rather than against them – HIV rates have remained low in Australia.
It didn’t happen by accident. It took a great deal of effort to ensure that national strategy was framed in such a way as to make it effective.
(The Honourable Michael Kirby, a former Justice of the High Court, and tireless advocate for a human rights approach to HIV – especially during the critical decades of the 1980s and 1990s – is one of the signatories to this Open Call).
Why a human rights frame for healthy diets and sustainable food systems?
So human rights have played an honourable role in the global response to HIV.
But how could they have a similar positive impact on nutrition, diet, and health around the world?
Some of the most urgent public health problems today revolve around the interlinked crises of obesity, poor nutrition, hunger, and climate change.
The starting point is that in many countries, market forces are failing to deliver healthy diets, adequate nutrition and sustainable food systems.
If framing food purely as a commodity, and if framing food systems purely as business networks supplying commodities in response to market demand – was effective, then countries wouldn’t be buckling under the strain of a massive, preventable burden of diabetes, obesity and chronic, diet-related diseases.
The Lancet Commission on Obesity called for “a radical rethink of business models, food systems, civil society involvement, and national and international governance” to address these problems.
While many actions will need to be taken, the BMJ Opinion argues that human rights concepts and language are powerful, under-used tools.
Interested in the quality of food and drinks served in schools? Or the stealth marketing of unhealthy foods and drinks to children using online platforms? You could, of course, revert to the well-worn concepts of parental responsibility and consumer choice. How’s that working out?
International human rights law provides a powerful way to frame these, and other challenges.
States owe an obligation to respect, protect and fulfil the right to health, as recognised in Article 12 of the International Covenant on Economic, Social and Cultural Rights.
Joint WHO/OHCHR guidelines could help to push human rights concepts and language beyond the “UN human rights silo”.
The subtle form of forum sharing and coalition building that we advocate, through joint WHO/OHCHR guidelines, is increasingly recognised in other areas of the global health response, such as the Global Strategy to Accelerate Tobacco Control (2019), adopted by the Conference of the Parties to the WHO Framework Convention on Tobacco Control.
Many new ideas appear surprising at first glance. And action at the global level may appear indirect, and abstracted from reality.
However, International Guidelines on human rights and healthy diets could help to mobilize multisectoral action, strengthen the accountability of States and the private sector, and deepen community engagement in the urgent task of developing healthier, fairer and sustainable food systems.
Let’s leave no one behind.
You can join the Open Call on Dr Tedros and Dr Bachelet here.
Health security begins with adequate sanitation, drainage, and safe water supplies. But increasingly, mitigation will be needed against tidal surges and seawater level rises, and the impacts global warming will have on agriculture and food security, water supplies, housing and livelihoods.
Non-communicable diseases (NCDs) including diabetes and cardiovascular disease are out of control in the Pacific, thanks to high rates of smoking, obesity, and the displacement of traditional diets with cheap, imported junk foods. A culture of feasting may also play a role. (For further comment, see here, and here).
Significant progress has been made. Around Nukualofa, for example, you’ll find fresh fruit and vegetable markets, and curbside stalls selling locally-grown produce.
But geography and the absence of economies of scale work against these dispersed island groups. Tonga has beaches and coral waters to die for, yet it is not well known as a tourist destination.
On the island of Foa, in the Ha’apai island group, there are two low-key resorts owned by expats, where you’ll be charged NZ$60 for the 5km drive, across the causeway, to the airport.
A few Tongan nationals work at the resort, but how much money filters down to the impoverished communities that live on the island?
In any event, Pacific island economies need far more than tourism. They need more economic activity across the board, and the infrastructure to enable it.
Throughout the Pacific, public health legislation needs updating. Enduring sources of funding are needed to build regulatory capacity, including for enforcement. Episodic funding, with heavy emphasis on epidemic preparedness, is of course welcome but leaves other core challenges under-funded. The Pacific Commission’s Public Health Division has done magnificent work; this work, and the funding that supports it, needs to continue.
Australia’s “pivot” is an opportunity to re-set relations and to invest meaningfully in Pacific health priorities.
At least in this area, perhaps a bit of strategic competition isn’t a bad thing.
Are you interested in health law? Sydney Law School offers a Master of Health Law, and Graduate Diploma in Health Law that is open to lawyers, health professionals and other approved applicants. Click here, here and here for more information.
Judged by revenues, outdoor advertising of food, on billboards and other advertising spaces, is on the rise.
Sydney Trains generated over $12 million in advertising revenue in the 2013-14 financial year, and this was expected to increase to at least $100 million over the subsequent 5 years.
A research team, led by Emma Sainsbury, collected data in February (summer) and July (winter) of 2016, photographing a total of 6931 advertisements across the 178 stations in the network.
Each advertisement was coded as core (a healthy food or beverage recommended for daily consumption), or discretionary (high fat, sugar and/or salty food not recommended for daily consumption), based on the Australian Guide to Healthy Eating.
The results tell you what you probably already know: Sydney train stations are a great place to advertise junk food and beverages.
Just over a quarter of total advertisements (1915/6931, or 27.6%) promoted food and beverages.
Of the food and beverage advertisements, 84.3% were for discretionary foods/beverages, 8% were for core foods/beverages, and the remainder (7.6%) were miscellaneous advertisements, mostly brand-only advertisements that did not mention specific products.
Significantly, the core foods/beverages category consisted mostly of bottled water vending machines (74.4%), and billboard advertisements for bottled water (11%). When advertisements for bottled water were excluded, only 1.3% of food and beverage advertising on the Sydney train network was for core foods.
The most commonly advertised discretionary products were potato chips (25%), sugar-sweetened beverages (23%, mostly flavoured milks and soft drinks), and intense or artificially-sweetened beverages (18.7%).
Despite food advertisements comprising just over a quarter of all advertisements, Coca-Cola and PepsiCo (which includes PepsiCo beverages and The Smith’s Snackfood Company) were the largest advertisers overall, contributing 10.9% and 6.5% of total advertising across the network.
Advertisements for alcohol made up over 6% of food and beverage advertising, and about 2% of total advertising.
There is obviously a total disconnect between foods and beverages advertised on Sydney trains and the kinds of foods and drinks that make up a healthy diet.
What do advertisers have against healthy food and beverages, I wonder?
A large number of self-regulatory initiatives ostensibly regulate food and beverage advertising in Australia.
However, these have failed to achieve a healthy food advertising environment, probably by design.
The results of this study support the case for government to pressure industry to shift the mix of food and beverage advertising towards products that are more consistent with a healthy diet.
The paper reviews some of the regulatory approaches that might be used, from outright bans, to interim and longer-term targets for reductions in the overall volume of unhealthy food advertising, based on a credible nutrient profiling system that evaluates the quality of nutrition of the product.
Restrictions on the volume of particular kinds of advertising, as a percentage of total advertising, do exist in other jurisdictions.
In Ireland, for example, the General Commercial Communications Code limits the volume of television advertising of foods high in fat, salt or sugar, to a maximum of 25% of sold advertising time across the broadcast day (para 16.10).
However, much of the impetus for constraints on unhealthy food advertising arises from the belief that children are particularly vulnerable and deserve to be protected. Unlike, say, television programs that are made specifically for children, the train network is used by substantial numbers of both adults and children.
Another approach could be to significantly increase the proportion of train station advertising allocated to the promotion of healthy, core foods and beverages, perhaps through higher pricing strategies for advertising of junk foods and sugary drinks.
The food, beverage and advertising industries ought to be taking the lead here, but how likely is that?!
The prevailing ideology, shared by the food and beverage industries, their allies and lobbies, is that you get the health you deserve.
If you can beat temptation and eat a healthy diet, you deserve to be healthy.
But if you eat a poor diet, if you routinely consume the diet that is overwhelmingly advertised, then you get what’s coming to you.
That’s personal responsibility.
It’s great for business (there’s great margins on nutritionally poor foods), but not great for the health budget, nor for individuals and families.
Maybe that’s why the food and beverage industry needs round-the-clock lobbyists in Canberra to explain to politicians and the rest of us how the world works.
Because otherwise someone might start asking crazy questions…like…Why shouldn’t the mix of advertising across the Sydney train netework be better aligned with a healthy diet?
This Bill illustrates a sometimes neglected aspect of public health law: use of law to build new institutions, to encourage partnerships, and to create a clear legislative mandate to address health challenges.
The Healthy Futures Commission was an election commitment by the Palaszczuk Labor Government.
Increase levels of physical activity by 20% (p 15/28).
The Bill would establish the Healthy Futures Commission Queensland, a portfolio agency within the Health Ministry.
Its purpose is to “support the capacity of children and families to adopt a healthy lifestyle”, and contribute to the reduction of health inequalities for children and families (s 3).
The functions of the Committee include: advocating for the social conditions and environments necessary to support healthier lifestyles and reduce health inequalities, and developing partnerships (s 9).
The Commission has power to make grants on matters relating to its functions, to industry or community organisations, universities, local governments, and business entities. The source of funding for these grants would be the Healthy Futures Queensland fund established by the Bill (s 41), which is also the funding source for the Commission’s own costs and expenses.
The Bill requires that at least 55% of total funding shall be paid out as grants (s 41(4)). This reflects the importance of the Commission’s grants function, and appears to be intended to ensure that the majority of funds are expended on “real world” interventions and projects addressing healthier eating and physical activity. This funding requirement also creates a natural check on the size of the Commission itself.
The Commission must prepare an annual project funding plan each year for approval by the Board and the Minister (s 42).
In performing its functions, the Commission is required to take into account the social determinants of health, as understood in the Rio Political Declaration on Social Determinants of Health, as well as the needs of vulnerable groups experiencing health inequity including Aboriginal and Torres Strait Islander communities.
The Commission is not entirely independent of politics and must comply with any direction given by the Health Minister about the performance of the Commission’s functions (s 10). The Minister may request reports from the Commission on relevant matters but may not give directions about the content of any such report (s 11).
Queensland’s Healthy Futures Commission would be governed by a 6-member Board appointed by the Governor in Council on the recommendation of the Minister. Board members must have qualifications or experience in business, law, leading partnerships, or assessing the impact of social conditions on health equity. Board members are appointed to 4 year terms (and may be re-appointed) (s 16).
The Board is empowered to establish committees, whose membership could include appropriate external experts, to assist it to perform its functions (s 29).
However, according to Fairfax Press, Dr Nabarro has “stepped into the ring to slap down calls for sugar taxes, saying there is not enough evidence on what drives over-eating to justify blunt levies on the ingredient”.
According to Fairfax Press, Dr Nabarro cautioned against “blunt regulations” like a sugar tax and noted that the state should only intervene where the intervention has a proven effect in changing behavior.
Well that would depend on the rate of the tax. A growing body of research – examples here, and here – argues that dietary taxes could both raise revenue and improve health outcomes. In ways that subsidised gym memberships, education, personal responsibility and good intentions are unlikely to.
Dr Nabarro also distinguished between contagious epidemics, which engage the “pure health sector” and non-communicable diseases, which require inter-sectoral responses across a number of sectors.
The suggestion is that special caution is warranted with non-communicable diseases.
I’m not sure I take the point. Outside of sub-Saharan Africa, the world overwhelmingly dies from non-communicable diseases.
People are not less dead, and prior to death they are not less disabled because the condition crept up on them slowly, due to lifestyle factors that have multiple determinants.
So can we put this down to WHO politics, or is Dr Nabarro foreshadowing a softer line on “big food” and “big soda” if he is elected Director-General?
These are questions he may be asked when he is in Australia later this month.
By the way, in a recent report the Australian Institute of Health and Welfare has estimated that 7% of the burden of disease in Australia is attributable to overweight and obesity (63% of which is fatal burden). Overweight and obesity are responsible for 53% of Australia’s diabetes burden, and 45% of the burden of osteoarthritis.
The Grattan Institute report estimates that such a tax would reduce the consumption of sugary drinks by about 15% and generate up to half a billion dollars that could help to pay for a broad array of obesity-related programs.
Imagine! A public health policy that fights obesity, diabetes and tooth decay AND generates revenue.
The National Party hate the idea. Deputy Prime Minister and Leader of the Nationals, Barnaby Joyce told reporters:
“If you want to deal with being overweight, here’s a rough suggestion: stop eating so much, and do a bit of exercise. There’s two bits of handy advice and you get that for free. The National Party will not be supporting a sugar tax”.
Well that’s what he said.
But here’s what I heard: “We know that obesity and diabetes are out of control. But we have ideological objections to being part of the solution”.
The same day that Minister Joyce shared these thoughts with reporters, the Australian Food and Grocery Council issued a press release saying that it was seeking a “constructive response to obesity”.
“Obesity is a serious and complex public health issue with no single cause or quick-fix solution”, explained the AFGC, but “it is not beneficial to blame or tax a single component of the diet”.
With most complex issues, you start somewhere. You come up with evidence-informed policies and you try them out. You rigorously evaluate their performance, and learn by doing.
But not with obesity. “Complexity” is the new enemy of action. Since the causes of obesity are complex, every “single” policy advanced in response can be dismissed as a dangerously simplistic solution to a complex problem.
Welcome to obesity, the problem we’re not allowed to start to fix.
Except with personal responsibility, of course.
Personal responsibility…the answer to obesity, traffic accidents, terrorism, Zika virus, perhaps everything?
In a limited sense, Barnaby Joyce is right.
The only cure for personal obesity is personal responsibility.
But personal responsibility has turned out to be a spectacularly poor solution to “societal obesity”.
By societal obesity, I am referring to the trend towards overweight and obesity that has arisen over the past few decades and now affects the majority of adult men and women (and more than one in four children).
Since each of us is an individual, and because we live in a culture that prizes individual autonomy, it’s easy to fall into the trap of believing that individual effort, personal motivation, is the solution to the world’s ills.
But just as the global epidemics of obesity and diabetes were not caused by a catastrophic, global melt-down in personal responsibility, personal responsibility is equally unlikely to provide the magic solution.
That’s where public policies come in.
Governments know all this, but with the exception of tobacco control, they seem reluctant to apply their knowledge in the area of preventive health.
The fact is, from road traffic accidents to terrorism, smart governments:
acknowledge the complexity of the factors that contribute to societal problems;
They acknowledge that multiple interventions are needed, in many settings;
They acknowledge that possible solutions need to be trialled now, under conditions of uncertainty, instead of handing the problem to future generations.
They monitor the actions they take, because healthy public policy is a dynamic, ongoing process; and finally
They give a damn. Meaning that they recognise they are accountable to the community for helping to solve difficult, societal problems, and for the performance of the public policies they administer.
Imagine if Australia’s government took that approach with obesity.
The debate about a sugary drinks tax is here to stay: it will never go away
A tax on sugary drinks will get National Party politicians in trouble with sugar producers, and Liberal Party politicians in trouble with big food.
Despite batting it away, a tax on sugary drinks is on the public agenda, and it’s here to stay. I don’t see the sugary drinks industry winning on this issue indefinitely.
Partly because Australian health researchers will keep it on the agenda.
It will come back, and back. Especially as evidence of its success accumulates overseas.
One conversation worth having is how revenues from a sugary drinks tax might support agricultural producers in rural Australia, helping to cushion them from the adverse effects (if any) of the tax and creating incentives for the production of a sustainable and healthy food supply.
In the meantime, Australian health advocates need to broaden their base.
Advocacy for public policy action on obesity needs to become more closely integrated with advocacy on food security. And advocacy in both areas needs to be linked more closely to action on reducing health inequalities.
But enough about all that. You really came here for Barnaby, didn’t you?
Governing Food will bring together researchers and practitioners from a range of disciplines to explore the role of law, regulation and policy in promoting a healthy, safe and sustainable food supply. The conference will be opened by a public keynote address on Tuesday the 1st of November, to be delivered by Professor Corinna Hawkes from the Centre for Food Policy at City University London. The main days of the conference will be Wednesday the 2nd of November and Thursday the 3rd of November.
The call for abstracts and further details about the conference can be found at this address. You can also contact Dr Belinda Reeve in relation to any questions about the conference: email@example.com.