Actors
- Pan American Health Organization (PAHO) – Provided evidence, technical support, and advocacy for octagonal warning labels.
- CARICOM Regional Organisation for Standards and Quality (CROSQ) – Led regional food labelling standards process; proposed QR code alternative in 2025.
- Civil Society Organisations (CSOs) – Advocated for strong, rights-based labels mobilised public campaigns and protests.
- Private Sector – Opposed octagons; lobbied, commissioned counter-studies, promoted weaker alternatives.
- Allies/Media – Amplified debates; exposed interference; supported public health messaging.
2017
Regional Partners
PAHO Project: Country Cooperation for Health
The Pan American Health Organisation (PAHO) facilitated a cooperation project between CARICOM and Chile under the Country Cooperation for Health (CCHD) framework, which focussed on nutrition policies such as front of package labelling. Chile was the first country to introduce the octagonal warning label.
2018
CROSQ
CROSQ Moves to Revise Food Labelling Standards with Octagonal High-In Warnings
As a part of the cooperation project, the CARICOM Regional Organisation for Standards and Quality (CROSQ) initiated the revision of the CARICOM Regional Standard for Specification for Labelling of Pre-packaged Foods (CRS 5:2010) to include octagonal ‘high-in’ warning labels and the PAHO Nutrient profile model based on existing and emerging scientific evidence free from conflicts of interest.
In 2018, extensive consultations were launched at the national level through the national bureau of standards via national mirror committees. These local bodies, managed by the Regional Technical Subcommittee, are responsible for disposing and consolidating comments on the CARICOM Regional Standard for Specification for Labelling of Pre-packaged Foods (CRS 5:2010) received from the National Bureaus of Standards in all CARICOM member States.
CSOs
National Mirror Committees Created
Civil Society organisations across the region represented on the National Mirror Committees. For more information about composition of the committees, visit the HCC FOPWL page.

2019
CROSQ
National Consultations Continued
CSOs
Civil Society organisations across the region were also raising public awareness on this issue
2020
Private Sector
CPSO and CARICOM Sign MOU
In 2020, the Caribbean Private Sector Organisation (CPSO) was formed as an Associate Institution of CARICOM, legitimising the engagement of commercial actors with vested interests and giving them direct access to decision-makers.
The CARICOM Private Sector Organization (CPSO), on the request of the Chambers of Commerce, Manufacturers’ Associations, and other Business Support Organizations, was asked to support the regional private sector’s participation in the process since June 2020.
2021
Regional Partners
PAHO, Ministry of Health and Wellness of Jamaica, the University of Technology, Jamaica Research
Superior Efficacy of Front-of-Package Warning Labels in Jamaica
PAHO in collaboration with the University of Technology and Ministry of Health, Wellness and the Environment launched a study, Superior Efficacy of Front-of-Package Warning Labels in Jamaica.

CROSQ
CARICOM Finalizes Draft Standard for Voting
In January 2021, the Regional Technical Sub-Committee completed a final draft of the pre-packaged food standard which retained the warning labels and PAHO Nutrient Profile. This draft was then submitted for voting to all CARICOM MS during 17 February- 14 April, 2021 and further extended to May 2021.
The voting process was facilitated by the National Bureaus of standards through consensus building with all stakeholders.
Vote Outcome: CARICOM Member States failed to reach the 75% threshold needed to escalate the draft to the CROSQ Council and then onto COTED. Nine (9) MS voted in all with six (6) approving the Standard, three (3) disapproving and six (6) abstaining.
This opened another regional consultative process.
CSOs
HCY Stage Silent Protest
On April 10th and 24th, 2021, Healthy Caribbean Youth (HCY), with support from local civil society organisations and allies hosted a Call to Action, in the form of a silent protest across a number of CARICOM territories including: Antigua and Barbuda, The Bahamas, Barbados, Grenada, Jamaica and St. Lucia.

Private Sector
Caribbean Private Sector Organisation (CPSO) Response
Throughout the process, the private sector sent communications to the National Standards Bodies detailing their lack of support for the octagonal warning FOPNL. They also hosted radio shows, webinars and lobbying meetings with high-level decision-makers to counter public health efforts. For example, their efforts in Jamaica, would have resulted in an unorthodox last-minute change against the final draft standard which raised concerns around voting irregularities and industry interference which was captured in TV Jamaica’s documentary – Food for Thought.
In 2021, the CPSO received approval by the Council for Trade and Economic Development (COTED) to launch its own study, “The CARICOM Impact Assessment (CIA) study on front-of-package Nutritional Labelling,”
Allies/Media
TVJ Documentary ‘Food for Thought’ Spotlights OWL Voting Process Discrepancies
Food for Thought Documentary TV Jamaica (October 24 2021).

CSOs
HCC and Partners Launch Campaign- Now More Than Ever Regional Campaign Promoting Front-of-Package Warning Labelling
In March 2021, HCC in collaboration with the Pan American Health Organization (PAHO), UNICEF and the OECS Commission launched Now More Than Ever Regional Campaign Promoting Front-of-Package Warning Labelling.

CSOs
The Heart Foundation of Jamaica launch the Right To Know Campaign
In March 2021, the Heart Foundation of Jamaica launched the “Right To Know” campaign, in an effort to build support for the introduction of front of package labelling.
Videos: Right to know and What’s in Our Food.

CSOs
HCC and Partners Webinar – A Conversation About the Urgency To Introduce Front-of-Package Warning Labeling in the Caribbean
In April 2021, HCC and the Pan American Health Organisation (PAHO), the Organisation of Eastern Caribbean States (OECS) Commission and UNICEF hosted a webinar – A Conversation About the Urgency To Introduce Front-of-Package Warning Labeling in the Caribbean

CSOs
HCC and Partners Webinar – A Conversation About the Urgency To Introduce Front-of-Package Warning Labeling in the Caribbean
In May 2021, CSOs sent shared local press releases with the media houses.
June 2021:Deborah Chen | Is evidence being ignored in front-of-package labelling
Follow up article: Sir Trevor Hassell | Jamaica cannot continue to ignore front-of-package labelling
CSOs
HCC and Partners Share Statement of Support for OWL
CSOs
HCC and Partners Launch the #WeSupportFOPWL Campaign
On October 14th 2021, the Heart Foundation of Jamaica, The Heart & Stroke Foundation of Barbados, The Healthy Caribbean Coalition, Pan American Health Organization, United Nations Children Fund and other partners launched the #WeSupportFOPWL (We Support Front-of-Package Warning Labels) mass media campaign.
After CPSO Launched their study, the HCC and a number of key stakeholders including the HFJ, PAHO, CARPHA, UNICEF, UWI LHRU, and the OECS Commission issued a statement to the joint COTED/COHSOD expressing concerns around conflict of interest research and flaws in the study methodology.

2022
CROSQ
Continuation of Regional Consultations on DCRS-5
Second Review of FCDRS: In 2022, the standard was relegated to a draft standard and sent out for further regional consultations. From November 2022, through their local Standards Bureaus, National Mirror Committees in eleven (11) Member States reviewed Draft CARICOM Regional Standard for Specification for labelling of pre-packaged foods (DCRS 5:2010) which incorporates specifications for the ‘high-in’ monochromatic octagonal front of package warning label system (OWL) and the PAHO Nutrient Profile Model to guide the thresholds for labelling of pre-packaged foods as ‘high-in’.
Private Sector
Study Launched by the CPSO
In February 2022 the CPSO study “Determination of An Appropriate FoPNL Scheme and the Identification of a Harmonized Approach for Implementation” was launched.
The study found that the US Facts Up Front and the UK Traffic Light FoPNL models, which are already included on the packaging of several products within the Region, are best suited for achieving the regional population’s health objectives, compared to the proposed Octagon Warning Label (OWL). The findings were presented to Ministers of Health and Trade later on that year during the 6th joint (Council for Trade and Economic Development) and COHSOD (Council for Human and Social Development) meeting.
CSOs
HCC and Partners Challenge CPSO Study
HCC, in partnership with public health and academia penned a joint statement to the COTED and COHSOD calling into question the CPSO study on the grounds of Conflict of Interest and methodological flaws.
2023
CSOs
“Now More Than Ever” Campaign Re-Launched with New Urgency
In February 2023, HCC in collaboration with the Pan American Health Organization (PAHO), UNICEF and the OECS Commission re-launched Now More Than Ever Regional Campaign Promoting Front-of-Package Warning Labelling.
CROSQ
Final Revised Draft Standard Put to Vote
On 21 July 2023 the final revised draft standard went out to Member States for voting with a deadline of 14 October 2023.
What did the national stakeholder voting forms say?
The national stakeholder voting forms in 2023 provide for three (3) options:
- We agree to the proposed presentation for Front of Package Labelling (FOPL) as set out in the Informative Annex D of the draft CARICOM Regional Specification for the Labelling of Pre-packaged foods (DCRS 5) with or without comments;
- We do not agree to the proposed presentation for Front of Package Labelling (FOPL) as set out in the Informative Annex D of the draft CARICOM Regional Specification for the Labelling of Pre-packaged foods (DCRS 5) with reasons for disagreement attached;
- We abstain from voting without or with reason.
Regional Partners
PAHO Study Shows Warning Labels Could Save Lives and Millions of Dollars in Barbados
In September 2023, PAHO released a FOPWL modelling study “Front-of-package warning labels save lives and resources: results from a modeling study in Barbados” highlighting the health and economic benefits of implementation. Findings showed that warning labels have the potential to avert 16% of the deaths caused by NCDs and save USD 732.8 million in Barbados.
CSOs
HCC and Partners Launch New Campaign “#ActonFacts”
In September 2023, HCC and partners launch The Octagonal Warning Labels Helps Consumers #ActonFacts campaign.

CSOs
HCY and CSOs Call for Octagonal Front of Package Warning Labelling Amidst 2nd Regional Vote
September 2023, Civil Society and Youth: FOPWL Call to Action.

Regional Partners
CARPHA, HCC, PAHO Host Webinar “Promoting Octagonal Warning Labels in CARICOM”.
On Monday 9 October 2023, CARPHA in partnership with the Healthy Caribbean Coalition (HCC) and the Pan American Health Organization (PAHO), hosted a webinar entitled Promoting Octagonal Warning Labels in CARICOM.
Private Sector
Private Sector Plans NCD Working Group for Coordinated Regional Action
In October 2023, the study findings were released publicly via the regional media. The study found that, “the US Facts Up Front and the UK Traffic Light schemes are best suited to achieve the regional population’s health objectives, in comparison to the CARICOM Regional Standards Scheme Octagonal Warning Label”.
Accordingly, the CPSO will establish a Working Group to address NCDs, with a focus on a comprehensive package of measures that address diets, education and awareness, exercise, and prudent public policy. This Working Group will facilitate a more ‘joined up’ response by the regional private sector to the challenges faced by NCDs.
CSOs
CSOs Issue Open Letter Urging CARICOM to Approve OWL
In October 2023, Open Letter to the National Standards Bodies of CARICOM reference to the FDCRS-5.
CSOs
HCC and Partners Host Webinar: What’s Happening with Food Labels in CARICOM?
During this same month, the HCC in partnership with PAHO, CARPHA, the OECS Commission, UNICEF and the Caribbean Public Health Law Forum hosted a webinar – What Is Happening With Food Labels in CARICOM?

2024
Allies/Media
Media Spotlight
CROSQ
CARICOM Votes to Remove OWL and PAHO Model from Standard
Vote Outcome: CARICOM Member States voted on the final draft standard which did not reach the required 75% support threshold. The decision was made to remove FOPWL and PAHO’s Nutrient Profile Model from the standard which was then approved by COTED in October 2024.
CSOs
HCC and Partners Launch CROSQ Report
In March 2024, HCC Launch and publication of PUBLIC HEALTH DECISION-MAKING IN CARICOM: Strengthening the Front-of-Package Nutrition Labelling Standardisation Programme.

CSOs
HCC Pennes Letter to CARICOM
HCC Submitted a letter to CARICOM Secretariat documenting concerns around regional standards process (April 2024).
Allies/Media
Media Spotlight
The Belize Chamber of Commerce and Industry (BCCI): Caribbean Says No to OWL at CROSQ- What Happens Now?
CSOs
HCC Requests Agenda Item at Ministerial Meeting
HCC Request CARICOM Secretariat for an HCC FOPL agenda item during Joint COHSOD-COTED meeting (meeting not held) (May 2024).
CSOs
HCY-Led Op-Ed Demands Accountability on FOPWL Vote Outcome
In July 2024, Healthy Caribbean Youth penned an op-ed – Are we hitting healthy food policies for a six? Demanding answers to the outcome of the FDCRS-5 Round 2 vote.

CSOs
FOPWL Raised During CARICOM Heads of Government Meeting
Submission of a statement during the 37th Conference of Heads of Government through CPDC.
2025
CROSQ
CROSQ Proposes QR Code-Based FOPWL
In an effort to advance the front of the package labelling process, CROSQ proposed an FOPWL embedded QR code to be placed on food labels across CARICOM.
From May – June 2025, CROSQ holds consultations with National Mirror Committees/bodies of key stakeholders to discuss the embedded QR code.
CSOs
HCC Flags Concerns About QR Code Approach
In May 2025, HCC shared correspondence outlining serious concerns about the FOPWL embedded QR code with CROSQ. HCC Raises concerns at the 33rd Chief Medical Officers Meeting.

CSOs
Youth Activists in Jamaica Launch ‘Fix My Food’ Campaign
Allies/Media
Media Spotlight
Jamaica Information Service: June 2025 Front-of-Package Warning Labels to Help Persons Make Healthier Food Choices
CSOs
CSOs Reject QR Code Label Proposal
CSOs engaged in National Consultations on the Embedded QR Code noting that the approach is not equitable, rights-compliant and undermines the original objective of empowering consumers to quickly, correctly and easily identify unhealthy foods as a key policy measure for CARICOM governments to tackle NCDs.
CSOs
HCC and Partners Host Webinar Global Updates on Front of Package Warning Labelling
On Friday 16 May 2025 the HCC in partnership with PAHO and CARPHA hosted a webinar entitled: Global Updates on Front of Package Warning Labelling showcasing progress and lessons learned, underscoring the efficacy of the evidence-based ‘high in’ octagonal warning label and the critical importance of a robust supportive nutrient profile model.

Resources:
- https://ncdalliance.org/sites/default/files/resource_files/Warning_Against_Harm-policy_brief-ENG.pdf

