Development, implementation and outcome of standards to restrict fatty meat in the food supply and prevent NCDs: learning from an innovative trade/food policy in Ghana

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.

The nexus between international trade, food systems, malnutrition and climate change

“…These programs have built-in international networks to exchange and share information, and created an enabling environment to strengthen health officials' capacities to focus on trade-related issues 85 . In Ghana, collaboration between the trade and health sectors was also found to be a key driver in the successful food standards policy 86 . In response to rising imports of low-quality and high-fat meats in the 1990s, Ghana implemented standards that applied to all domestic and imported meats, thus ensuring their policy was compliant with Ghana's trade commitments at the WTO to be non-discriminatory and evidence-based 86 .…”

Strengthening of accountability systems to create healthy food environments and reduce global obesity

“…57 The Ghana Standards Authority has prescribed a maximum percentage of fat for various cuts of meat, 58 with the intention of reducing the availability of turkey tails, chicken feet, and other animal products of low nutrition value in the national food supply. In 2013, South Africa introduced regulations that impose maximum permitted salt concentrations in 13 food categories, including breakfast cereals, butter and fat spreads, bread, and processed meat.…”

Is trade liberalisation a vector for the spread of sugar-sweetened beverages? A cross-national longitudinal analysis of 44 low- and middle-income countries

“…For example, two case studies researching trade liberalisation policies in Central America, including the Central American-USA Free Trade Agreement, showed that lower tariffs and less restrictive non-tariff barriers (NTBs) had increased imports and overall availability of foodstuffs implicated in the nutrition transition (Hawkes and Thow, 2008; A. M. Thow and Hawkes, 2009). Similar studies have examined the North American Free Trade Agreement (Clark et al., 2012) and trade agreements involving Pacific islands (Hughes and Lawrence, 2005, Snowdon and Thow, 2013; A. M. Thow et al., 2011) and Ghana (A. M. Thow et al., 2014), among others. These case studies yield important insights into the potential mechanisms involved, but may not be generalizable to different national contexts.…”