Volume 3, Number 8, August 2012
Journal of the World Public Health Nutrition Association
Published monthly at www.wphna.org
The Association is an affiliated body of the International Union of Nutritional Sciences For membership and for other contributions, news, columns and services, go to: www.wphna.org
Correspondence: Government. Obesity
The Australian example
Sir: I would like to add a postscript to the article I published in last month's World Nutrition on the need for government action to prevent obesity (1). EPODE is a leading international partnership whose purpose is to reduce childhood obesity. At an EPODE conference in New York City in June, its International Network (EIN) was launched as a platform for community-based initiatives on obesity prevention to exchange ideas and to expand the movement (2).
While this has grown from the EPODE community programmes which started in France, the EIN is aspiring to be a network for all major community-based initiatives globally, and it has tremendous potential to help countries secure the political commitment to act, especially on childhood obesity. Of course, it was wonderful having the conference in the very city which is leading the world on policy actions to reduce obesity. The presentations on the work being done in New York City were inspiring, and Mayor Michael Bloomberg is the living example of a political champion who can spearhead tremendous public health gains in a short space of time.
I also found it very valuable to put the Australian initiatives that I am familiar with into the global perspective. Two Australian states were outstanding. The OPAL (Obesity Prevention and Lifestyle) in South Australia (3), is based on the EPODE methodology, and the more recent Victoria Prevention Community Model (4) is taking a similar approach but with a more explicit systems-oriented perspective.
A number of aspects of these programmes stood out in clear distinction from the others around the world. Firstly, the budgets for these projects are substantial and continue at least medium term (combined investment of over $A200 million over 6 years). This gives these Australian states a real chance of securing a lasting legacy of an embedded, effective prevention system and changing local environments and norms to being more healthy. Secondly, almost all this funding is from government sources, which is as it should be. Many other community projects around the world are unable to secure government funding and are being forced to rely on private sector funding, much of which brings with it major conflicts of interest.
Indeed, the only negative of the conference was the overwhelming presence of the EPODE sponsors Nestlé and Coca Cola who, of course, want to shift the spotlight on to community programmes and away from what the food industry should be doing in other areas, such as reducing marketing to children, and is not. There is a clear vacuum being created in many countries by community needs for funding obesity prevention action and governments' reluctance to meet that need. Filling the vacuum with food industry money is understandable but dangerous.
Coming back to the Australian initiatives, the third major feature is the substantial investments in evaluation (combined investment for Victoria and South Australia of over $A12 million). This will provide a rich stream of evidence about programme effectiveness and cost-effectiveness, capacity building, environmental change, systems activation and much more. We need the answers from this research to allow us to understand how to effectively and efficiently apply interventions at large scale.
The EIN platform will perform a very valuable role in stimulating the grassroots community actions internationally. Hopefully, other political leaders can take a leaf from the books of Michael Bloomberg, and also the Ministers for Health in Victoria (Hon David Davis) and South Australia (Hon John Hill) and become the champions to secure significant government funding for community programmes and create some strong, supportive government policies to make the food environments healthier. By governments filling this vacuum of demand at the community level, the need to take conflicted money from the food industry will be reduced and the major players can take on their appropriate roles. This includes governments taking the lead in creating the policies for healthier environments and funding community capacity, and industry focusing on providing an affordable, healthy, safe food supply.
Department of Population Nutrition and Global Health
University of Auckland, New Zealand and
WHO Collaborating Centre for Obesity Prevention
Deakin University, Australia
- Swinburn B. Obesity. Why governments must act.[Commentary]. World Nutrition July 2012, 3, 7, 307-325
- EPODE International Network http://www.epode-european-network.com/en/een-news/225-epode-international-network-at-ific-conference-in-new-york.html
- South Australia's OPAL (Obesity Prevention And Lifestyle) program http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet
- Victoria's Prevention Community Model. http://www.health.vic.gov.au/prevention/community_level.htm
Please cite as: Swinburn B. Government. Obesity. The Australian example [Correspondence] World Nutrition, August 2012,3, 8: 373-375. Obtainable at www.wphna.org