Arising out of a multisectoral regional meeting “Accelerating Nutrition Policies in the Caribbean: Creating Supportive Environments for Healthy Children”,1 17-18 September 20191 in Bridgetown, Barbados, the Board of Directors and the Members of the Healthy Caribbean Coalition (HCC) has issued a Civil Society Call to Urgent Action for the Caribbean Region to Accelerate Nutrition Policies for the Creation of Healthy Environments for Caribbean Children and to address the epidemic of overweight and obesity among Caribbean children2.
View/Download the our Civil Society Call to Urgent Action document here.
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Civil Society Call to Urgent Action
1. THE CALL
The HCC is calling on the Caribbean region to work across sectors in partnership to achieve the urgent implementation of the following 3 priority nutrition policies:
- Mandatory Front of Package Nutrition Warning Labelling (FOPL) to empower consumers to make healthier food choices.
- Banning the sale and marketing of sweet beverages in school settings and ensuring the availability of free drinking water to reduce the consumption of these beverages among children.
- Taxation of sweet beverages of at least 20% to reduce the consumption of these beverages among children.
Although the HCC recognises that a holistic package of policy interventions is needed to effectively address overweight and obesity as identified in the WHO Report of the Commission Ending Childhood Obesity Implementation Plan: Executive Summary3, the PAHO Plan of Action for the Prevention of Obesity in Children and Adolescents4 the CARPHA 6-Point Policy Package and the HCC Civil Society Action Plan 2017-2021: Preventing Childhood Obesity in the Caribbean (CSAP)5, it is critical to prioritize policy interventions given the limited resources available.
2. THE HIGH-LEVEL COMMITMENT TO ADDRESS THE PROBLEM
CARICOM Heads of Government and State have acknowledged the scale and severity of the problem and the need for an urgent response.
In 2016, at the 37th Regular Meeting of CARICOM Heads of Government and State, a pledge was made “to address issues such as banning advertisement of potentially harmful foods which specifically target children; and elevating taxes on foods high in sugar, salt and trans-fats”. One year later, at the 38th CARICOM Summit, on the 10-year anniversary of the Port of Spain Declaration, Heads of Government and State “noted with concern that obesity in children represented the greatest threat to the health of future generations with the level of overweight and obesity being more than 30% in both primary and secondary school populations in many Member States”. In 2018, at the 39th Summit, CARICOM Heads of Government and State endorsed a number of priorities for the 3rd UN High Level Meeting on Noncommunicable Diseases (NCDs) including: “implementing policies geared to preventing childhood obesity, including health-promoting school environments and Front of Package (FOP) labelling”.
3. THE CONTEXT
Unhealthy diet is one of the major modifiable risk factors for NCDs and the primary contributor to overweight and obesity. Unhealthy diets alone pose a greater risk to morbidity and mortality than do unsafe sex, and alcohol, drug, and tobacco use combined6. Small Caribbean states are particularly vulnerable and urgent action is needed in this region to dramatically shift diets away from unhealthy ultra-processed foods towards healthier, ‘real’ foods. Policies with population-level impact are required to modify the food system and create environments in which healthy choices are easy choices and the major responsibility for such choices shifts towards governments and away from individuals. Governments are ultimately responsible for creating the environments that ensure that the health and wellbeing of their citizens comes first.
In the fast tracking of these policies the following must be remembered:
- Childhood overweight and obesity is a social justice issue and represents at its core a violation of “the right of the child to the enjoyment of the highest attainable standard of health” under Article 24 of the United Nations Convention on the Rights of the Child7. All CARICOM Member States have ratified this Convention.
- It is vital to view the issue of childhood obesity and the need to urgently implement policy solutions through a rights-based lens, one which acknowledges that the current environment in which children are conceived, born and grow is inherently obesogenic and consequently places them on a trajectory for unhealthy weights and early onset NCDs from the womb.
- There is clear evidence both from within and outside of the region to support the implementation of these policies as effective tools to modify behaviours towards the consumption of healthy foods and making healthier choices.
- A multisectoral, whole-of-government and whole-of-society approach is fundamental and must be at the centre of this work to ensure policy coherence across sectors and policy success.
- A food systems approach is required to reorient Caribbean diets away from ultra-processed foods high in fats, sugars, and salt, towards healthy food from sustainable food systems.
- There is need to identify and leverage linkages, co-benefits and synergies across other key issues such as climate change, taking advantage of resources available through those linkages.
- Citizens must be provided with access to information to improve their health and nutrition literacy, and to better appreciate the justification for relevant policy development.
- Governments, the main duty bearers in the rights-based approach, must establish transparent and accountable governance systems.
- Systems must be put in place to identify and manage conflicts of interest, counter industry obstruction, and, ultimately, safeguard nutrition policy and the health of the region’s children.
4. KEY ACTIONS ACROSS SECTORS
Against the background of the above, the HCC is calling on the following key actors to play their respective roles:
1. WE RECOGNISE THE PRIMARY RESPONSIBILITY OF GOVERNMENTS AS THE CUSTODIANS OF PUBLIC HEALTH AND CALL ON THE CARICOM POLITICAL LEADERSHIP TO:
- Move beyond the rhetoric and ‘walk the talk’ by fulfilling stated high-level commitments to tackle childhood obesity.
- Support the establishment and strengthening of National NCD Commissions to play their role in achieving multisectorality.
- Work with regional and international partners to build the technical capacity in key ministries (including health, education, trade, finance, agriculture, and commerce) and ensure policy coherence.
- Work with regional and international partners to build the capacity of governments to design, implement, enforce, and monitor policies, and enact supporting legislation and regulations.
- Safeguard nutrition policy and wider public health from private interests through the implementation of processes to manage, and avoid where possible, conflicts of interest and counter industry interference and obstruction in healthy nutrition policy development.
2. WE AS CIVIL SOCIETY COMMIT TO:
- Support the multisectoral effort aimed at improving nutrition in the Caribbean.
- Build capacity for civil society actors to advocate for healthy nutrition policies.
- Promote the formation of National NCD Alliances and/or Childhood Obesity Coalitions to support the amplification of voices through collaboration.
- Work with partners to implement national and regional awareness campaigns in order to create strong social movements supportive of healthy nutrition policies.
- Share and make easily accessible evidence for policy action.
- Support cross-country sharing of experiences in policy development, implementation, and monitoring.
- Contribute to strengthening surveillance systems to ensure data for monitoring.
- Play a watchdog role and monitor progress towards, and post, policy implementation.
- Hold political leadership accountable to their commitments publicly through various strategies, including open letters.
- Pressure governments to be transparent in their processes.
- Protect the policy process by identifying and highlighting instances of conflict of interest, industry threats or interference, and the undermining of the policy development process.
3. WE RECOGNISE THE ROLE AND INFLUENCE OF THE FOOD AND BEVERAGE SECTOR AND CALL ON THE PRIVATE SECTOR TO:
- Commit to supporting the multisectoral effort aimed at improving nutrition in the Caribbean.
- Adopt inclusive business models that complement policies, legislation, and regulations that enable healthy food environments.
- Hold the food and beverage sector accountable for respecting the right of children to access healthy foods and beverages, including:
a. Halting the sale and marketing of sweet beverages in school settings and other settings where children frequent.
b. Halting interference with evidence-based, effective nutrition policy, in particular taxation of sweet beverages and front of package labelling.
- Recognise and manage the inherent conflict of interest as it relates to the food and beverage sector, specifically:
a. Avoid sitting on the boards of companies or entities involved in nutrition policy development.
b. Avoid entering into contractual arrangements with institutions (especially in school settings) to provide unhealthy foods or beverages.
Download the HCC Civil Society Call to Urgent Action here.
2 HCC is using the Convention of the Rights of the Child (CRC) definition of child as anyone below the age of eighteen (18) years. https://www.ohchr.org/documents/professionalinterest/crc.pdf
6 The 2019 Lancet Report: Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems