Big food and the World Health Organization: a qualitative study of industry attempts to influence global-level non-communicable disease policy

Abstract

IntroductionThere is an urgent need for effective action to address the over 10 million annual deaths attributable to unhealthy diets. Food industry interference with policies aimed at reducing non-communicable diseases (NCDs) is widely documented at the national level but remains under-researched at the global level. Thus, this study explores how ultra-processed food industry actors have attempted to influence NCD policy at WHO.MethodsA combination of inductive and deductive thematic coding of internal industry documents, academic literature and interviews with key informants from international organisations and global civil society was used to identify action-based strategies ultra-processed food industry actors employ to influence global-level policy.ResultsUltra-processed food industry actors have attempted to influence WHO and its policies through three main action-based strategies: coalition management, involvement in policy formulation, and information management. Coalition management includes the creation and use of overt alliances between corporations—business associations—and more covert science-focused and policy-focused intermediaries, the hiring of former WHO staff and attempted co-option of civil society organisations. Industry involvement in policy formulation is operationalised largely through the lobbying of Member States to support industry positions, and business associations gaining access to WHO through formal consultations and hearings. Information management involves funding and disseminating research favourable to commercial interests, and challenging unfavourable evidence.ConclusionWe provide novel insights into how ultra-processed food industry actors shape global-level NCD policy and identify a clear need to guard against commercial interference to advance NCD policy. In their approach, the political behaviour of multinational food corporations bears similarities to that of the tobacco industry. Increased awareness of, and safeguarding against, commercial interference at the national as well as the global level have the potential to strengthen the crucial work of WHO.

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“…90 Of particular concern, is the influence of vested corporate interests on the activities of the World Health Organization and UN bodies. 91 92…”

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“…Being a normative body, WHO poses a major threat to the alcohol industry. Harmful industries are well known to pay close attention to, and seek to undermine, WHO activities that threaten their interests 1314. The alcohol industry draws on a cross-industry playbook to combat these threats.…”

Lacking Clarity or Strategic Ambiguity? Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-Communicable Diseases"

“…T he increasing prominence of multi-stakeholder fora and partnerships in global health [1][2][3][4] raises questions about how to identify and manage potential tensions between private sector and public heath interests. In their analysis of stakeholder influence on the United Nations (UN) Political Declaration of the 3 rd High-Level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases (HLM-NCDs), Suzuki et al highlight how the drafting of the Political Declaration was marked by ambiguity and confusion about the participation of nonstate actors in health governance.…”

“…These commercial actors have consistently used similar policy frames to push for their economic interests that rarely align with health-related outcomes. [4][5][6] We need to better understand how public health mandates are discussed and decided upon, and how policies are developed to ensure transparency and equity in such governance arrangements, where non-state actors interact at different jurisdictional levels. 4,7 Collaboration and Partnership: The Logic of Multistakeholderism In reviewing the UN HLM, Suzuki et al make a conceptual distinction between 'whole-of-government' approaches to public health -which they describe as coordination across government agencies -, and differentiate this from 'wholeof-society' or 'multi-stakeholder' governance in which nonstate actors (including the private sector) are consulted over the development of policy instruments and solutions to address public health issues.…”

“…[4][5][6] We need to better understand how public health mandates are discussed and decided upon, and how policies are developed to ensure transparency and equity in such governance arrangements, where non-state actors interact at different jurisdictional levels. 4,7 Collaboration and Partnership: The Logic of Multistakeholderism In reviewing the UN HLM, Suzuki et al make a conceptual distinction between 'whole-of-government' approaches to public health -which they describe as coordination across government agencies -, and differentiate this from 'wholeof-society' or 'multi-stakeholder' governance in which nonstate actors (including the private sector) are consulted over the development of policy instruments and solutions to address public health issues. However, while the authors are clear about the distinction between state-centred and multistakeholder approaches, they note that the language of the UN HLM Political Declaration blurs the contrast between non-state actors.…”