PAHO. Partnerships with transnationals

Open letter to new UN agency chief:
No more deals with Nestlé please

Mirta Roses Periago, the previous PAHO director (left). Seven distinguished nutrition scientists pictured above, have sent an open letter to her successor

Access Spanish version of the letter to PAHO director here
Access Portuguese version of the letter to PAHO director here

Our news team reports. Seven Association members, four from Latin America, three from North America, have sent an open letter to Carissa Etienne (below, left) who took over as director of the Pan American Health Organization this month. The letter is published here for the first time, as Box 1, below. It requests that PAHO ceases to accept funding or other support from transnational and other food product manufacturers whose commercial interests are in direct conflict with those of public health. Writers of the letter (pictured starting second from the left, above), are Carlos Monteiro of the University of São Paulo, Brazil; Marion Nestle of New York University, USA; Barry Popkin of the University of North Carolina at Chapel Hill, USA; Juan Rivera of the National Institute of Public Health, Mexico; Ricardo Uauy of the University of Chile; César Victora of the University of Pelotas, Brazil, and Walter Willett of the Harvard School of Public Health, USA

Coke and Nestlé fund PAHO

News broke late last year that the Pan American Health Organization had accepted money from transnational food corporations, including Coca-Cola and Nestlé, to support its work to prevent and control obesity and chronic non-communicable diseases. The report, available here, was issued by the global news agency Reuters. It began:

'The Pan American Health Organization not only is relying on the food and beverage industry for advice on how to fight obesity. For the first time in its 110-year history, it has taken hundreds of thousands of dollars in money from the industry'.

Identifying PAHO as the regional office of the World Health Organization for the Americas, the report continued: 'Accepting industry funding goes against WHO's worldwide policies. Its Geneva headquarters and five other regional offices have been prohibited from accepting money from the food and soda industries, among others. "If such conflicts of interest were perceived to exist, or actually existed, this would jeopardize WHO's ability to set globally recognized and respected standards and guidelines", said spokesman Gregory Härtl.

'But…PAHO, based in Washington and founded 46 years before it was affiliated with WHO in 1948 – had different standards allowing the business donations. Even so, not until this February did PAHO begin taking industry money. Reuters found $50,000 from Coca-Cola, the world's largest beverage company; $150,000 from Nestlé, the world's largest food company; and $150,000 from Unilever…

'The recent infusion of corporate cash is the most pointed example to date of how WHO is approaching its battle against chronic disease. Increasingly, it is relying on what it calls "partnerships" with industry, opting to enter into alliances with food and beverage companies rather than maintain strict neutrality'.

Interviewed by Reuters, Association member Boyd Swinburn, co-director of the International Obesity Task Force, said: 'Food and beverage companies exert a huge influence on policies that affect the health of millions. Industry is buzzing all around… Even in things like nutrition guidelines, they're usually in the room at the policymaking table or buzzing around it and putting all sort of pressure on, bringing their huge conflicts of interest and their huge resources to it – and we're wondering why we don't get much public interest policy coming out'.

Carissa Etienne, the new director of the Pan American Health Organization
(left), and (right) Margaret Chan, director of the World Health Organization
The WHO response

A prompt public response, available here, came from Margaret Chan (above, right), director-general of WHO Geneva. She stated: 'The Political Declaration of the High-level Meeting of the United Nations General Assembly on the Prevention and Control of Noncommunicable Diseases, agreed by global leaders at the UN General Assembly in 2011, called on the international community to undertake a series of actions. One of these actions was to call on the private sector to promote measures to implement WHO recommendations to reduce exposure to the risk factors which contribute to NCDs. The WHO Global Strategy on Diet, Physical Activity and Health commits WHO to hold discussions with the private sector'. But, she stated categorically: 'the Organization will not take money from private companies active in food and beverage production for work on NCD prevention and control'.

Margaret Chan explained that formally, the branch of WHO for the Americas is AMRO, the Regional Office for the Americas, whereas PAHO, a separate legal entity, 'may have variations in policy'. Thus, she confirmed, 'In its capacity as PAHO, food and beverage manufacturers have contributed financially as part of a multi-sector forum to address NCDs'.

Many public health and nutrition professionals were shocked and even scandalised by the Reuters report. So where did this leave the Pan American Health Organization? The report coincided with the final months of the term of office of Marta Roses Periago (above, left) as PAHO director. In the words of one of the signatories of the open letter below 'It seemed more appropriate to send a message of strong support and encouragement to the new director Carissa Etienne. Our letter also asks her on behalf of the public health and nutrition communities to state that the previous practice of accepting money and all other forms of support from conflicted industry and its associated organisations is now at an end'.

Box 1

Open letter to the new Director of the
Pan American Health Organization

February 6, 2013

Dr. Carissa Etienne
Director of the Pan American Health Organization
525 Twenty-third Street NW, Washington, DC 20037
United States of America

Dear Dr. Etienne,

Congratulations on your appointment as director of the Pan American Health Organization. We write this open letter to you as dedicated supporters of the UN System and UN principles. As UN advisors collectively for many years, we represent a large group of concerned public health scientists from the Americas

Your appointment provides a great opportunity to celebrate the achievements of PAHO in addressing the pressing public health problems in the Americas. We respectfully suggest that it is also time to reconsider recent steps that have moved PAHO away from the path of promoting better nutrition and health status in the Americas and, in your words, by 'ensuring that the organization continues a path of excellence'.

The nature of engagement of PAHO with multinational corporations whose interests are in conflict with those of public health, which recently became widely known, is one of the issues that should be urgently addressed. The fact that PAHO received money from the Coca-Cola Company and other food and beverage corporations has damaged its reputation as the leading UN organization concerned with nutrition and public health in our Hemisphere. It has signaled that PAHO policies might be constrained in advancing policies and public health actions in conflict with the commercial interests of these corporations.

With your renewed leadership, PAHO now needs to agree and enact effective public policies to prevent and control the epidemics of obesity, and related diseases such as diabetes, cardiovascular disease and cancer; which, as you know, are engulfing the Americas. These policies need to be independent, and to be perceived as such. By creating evident dependence on inappropriate corporate funding and other forms of support, we believe PAHO has seriously weakened its ability to protect and promote public health nutrition. We encourage you to review and revise PAHO's position on the formulation of its policies that are designed to prevent and control diseases that are related to unhealthy diet and physical inactivity.

We hope that you will act to safeguard the reputation and effectiveness of PAHO by establishing public policies that are developed and agreed independently of commercial or private interests. Thus, the importance of not accepting funding or any other type of support from industries whose revenue and profits are largely derived from alcohol or from food and drink products, or from organizations whose core funding largely comes from such products. We also request that you state a policy that such industries will not be invited to participate in PAHO initiatives or other work designed to formulate public health and nutrition policies.

With this letter, we place ourselves at your disposal, and commit ourselves to support you as you take actions to invigorate PAHO public health commitments, ensuring its independence, and to protecting and promoting public health interests in the Americas. We are sure that the majority of public health professionals in the Americas will support you in this.

With our kind regards

Carlos Monteiro
University of São Paulo
Marion Nestle
New York University
Barry Popkin
University of North Carolina
Juan Rivera
National Public Health Institute, Mexico
Ricardo Uauy
University of Chile
César Victora
University of Pelotas
Walter Willett
Harvard University

2013 March HP1. Partnerships with transnationals

Open letter to new UN agency chief:
No more deals with Coke or Nestlé, please
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