I get around
I get around
In this issue here, we begin our regular 'I get around' series. Every month, Association members will tell stories of where they are, what they are doing, who they have met, and why they believe or hope they are doing valuable work. This month it's Vivica Kraak on – yes, you have guessed – her time at Rio2012
Vivica Kraak writes: By staying at the hotel Novo Mundo right by Flamengo beach, where the invited speakers were accommodated, I was easily able to network both professionally and personally, and to be part of discussions on the presentations. Informal conversations during breakfast, lunch and dinner were as important as the formal presentations.
For me the conference was a fabulous opportunity to renew and strengthen past professional relationships, and to develop new relationships and future collaborations with seasoned and experienced public health nutrition luminaries from around the world. These included senior officials working for UN agencies such as the World Health Organization, the Pan American Health Organization, the Food and Agriculture Organization, and scholars from many distinguished academic centres.
There were many insightful plenaries over the course of the congress, available through simultaneous translation in both English and Portuguese. There were also literally hundreds of smaller parallel sessions for participants to discuss their work, mostly in Portuguese. The conference presentations and list of speakers are still available at the congress's dedicated website.
Session on public-private partnerships and
managing conflicts of interest
Here I am with Modi Mwatswana from the National Heart Forum and Patti Rundall from Baby Milk Action, co-presenters at Rio2012 on the complex issue of public-private partnerships and managing conflicts of interest
My own presentation, available here, addressed public-private relationships and conflicts of interest. I focused on accountability of public-private partnerships with transnational food, drink and fast food restaurant corporations, to address global public health nutrition challenges, including hunger and undernutrition as well as the other end of the nutrition spectrum with obesity and non-communicable diseases.
There are weak or absent corporate accountability mechanisms for industry within two existing, voluntary, global corporate governance systems. One is the United Nations Global Compact, launched in 2000, which offers corporations ten guiding principles to demonstrate best practices to support social outcomes. These principles lack explicit language to promote consumer health, nutrition and wellbeing goals. The other voluntary system is the Global Reporting Initiative, whichlacks clear indicators for companies voluntarily to disclose their collective actions to protect public health nutrition, healthy lifestyles and wellbeing goals.
A number of transnational corporations, including Kraft, Mars, McDonald's and Yum! Brands, are not signatories to the U.N. Global Compact. Along with Nestlé (that awarded itself an A+ for GRI/corporate social responsibility (CSR) self-reporting in 2012), PepsiCo, Unilever and Kellogg's (all Global Compact signatories) these companies receive global recognition through corporate social responsibility ratings as 'best corporate citizens' for meeting environmental sustainability and good governance goals. But there are no indicators to monitor their impact on dietary patterns and human health, even though these corporations are primarily in the 'calories in' production and marketing business.
I recommended that CSR reporting systems should be strengthened; that the Global Compact should have three additional principles addressing nutrition and health; and that the next version of the Global Reporting Initiative (G4 Sustainability Framework) should include explicit indicators for nutrition, diet and health.
The second presenter in the session was Modi Mwatswana from the National Heart Forum in London. She discussed the Conflicts of Interest Coalition, which evolved out of the UN high-level meeting on prevention and control of non-communicable diseases (NCD) last September. The Coalition calls on the UN to distinguish between public interest NGOs and business interest NGOs, and also to develop a code of ethics and greater transparency for engaging industry. See: http://www.phmovement.org/sites/www.phmovement.org/files/COIC.pdf.
Then Patti Rundall from the International Baby Food Action Network and Baby Milk Action based in Cambridge, discussed the weaknesses and failure of global health governance mechanisms, including the UN Global Compact, and OECD guidelines because they lack mechanisms to act on complaints raised by public interest NGOs to suspend corporations' (such as Nestlé) signatory status over egregious industry practices that chronically violate the International Code of Marketing of Breast-milk Substitutes. More information about IFBAN (http://www.ibfan.org/) and Baby Milk Action (http://www.babymilkaction.org/).
The picture above is of the three of us together after the session.
I gained many insights from Rio2012, and I will share them here. They included:
Barrie Margetts,Association President, from Southampton University in England, (originally Australian, from Perth), raised several important issues in the opening plenary session. If most of a country's food system is driven by outside forces, how can it be influenced? And, how can civil society organisations ever be strong enough worldwide to hold governments to account that have signed written treaties and resolutions (such as the UN Convention on the Rights to the Child)?
Marion Nestle from New York University said during this plenary that governments must regulate businesses. She underscored the need effectively to address powerful economic and political forces. She said: 'If we public health professionals are not in trouble all the time, we are not doing our job'.
Sharon Friel from the Australian National University, Canberra, discussed the triple E crisis – energy, eating, economics. The global food system relies on petroleum, and uses fossil fuels in every aspect of food production which is unsustainable. Industry is involved in all phases of the food system from controlling seeds and agriculture (for instance, Monsanto and Cargill) to food processing and marketing (Nestle, PepsiCo, Kraft Foods, etc).
Walter Willett from the Harvard School of Public Health stated that translating science into policy is often unpredictable so we need to be working at many simultaneous levels of intervention, including education, labelling, using economic strategies, promoting or eliminating the availability of unhealthy foods, fortification and eliminating unhealthy food constituents (for example trans fats) and foods or beverages (for example salty snacks and sugar-sweetened beverages).
David Sanders from the University of the West Cape, South Africa, spoke about the medicalisation and commodification of approaches to child undernutrition in low-income countries. For instance, Plumpy'Nut™that was developed by the French company Nutriset, which tastes a lot like Italian company Ferrero's Nutella, is a favoured treatment for child undernutrition. But this patented product displaces local solutions and introduces an energy-dense product into the marketplace where obesity rates are rising without adequate planning for anticipated long-term consequences.
Boyd Swinburn from Deakin University in Burwood, Australia and the University of Auckland, New Zealand, spoke at an evening plenary,and was a leader in a working group that developed a position statement on how to manage 'public-private partnerships' and related conflicts of interest. See Box 2.
Relations with industry
Some conclusions of the working group on 'public-private partnerships' and conflicts of interest were:
There are multiple types of relationships. It is a mistake to overuse the term 'partnerships', which implies interactions and joint governance.
There are several ways that corporations influence public policies. Formal processes include with governments (through 'public-private partnerships', committees, taskforces, electoral funding); through joint work with public interest NGOs, and by providing funding to researchers and academics. Informal processes include lobbying, buying silence, by influencing or calling the shots with research agenda, and by spinning communications.
Potential solutions include:
Develop clear rules of engagement: no commercial interests at the policy-making table.
Engage with businesses and commercial interests only for policy implementation (not policy development).
Allow only public funding of election campaigns.
Compel corporations to disclose all their lobbying activities.
Strengthen the capacity and funding of civil society.
Monitor, evaluate and expose all private sector actions, including those that impact on public health.
Claudio Schuftan spoke about the Peoples Health Movement in a session on human rights and equity. He said that we need to mount a major initiative within the public health nutrition community, in order to understand and to use a human rights framework in our work. Access: http://www.phmovement.org/.
Corinna Hawkes, previously with the International Food Policy Research Institute in Washington DC, shared lessons from successful intersectoral partnerships.She emphasised that we need to align nutrition with more powerful sectoral interests. We need to be innovative and should not be afraid of pursuing outrageous ideas. What might sound outrageous to some, may have broad appeal in another sector.
Philip James from the International Association for the Study of Obesity in London emphasised the need not to focus on ministries of health. These are weak government departments. Go for ministries of finance: these operate at the most powerful levels of government
Yes, Rio2012 was a productive time for me, and I know also for many of the people that I met at the Congress, for the first time or to renew friendships. And like so many of us now, I have spirals on my mind! Here is a luscious tropical one I found at the university where the congress was held. Well, it has spiral tendencies…