That’s because noncommunicable diseases — heart disease, stroke, cancer, diabetes and emphysema — are deeply entangled with important global industries, not only tobacco but also food, pharmaceuticals, advertising, transportation and construction. And they are the globe’s biggest health problem, responsible for 63 percent of all deaths each year, with incidence growing steeply in the low-income, rapidly urbanizing nations of the world.
At issue are two questions: Will assaulting obesity-driven ailments require attacking the food companies the way assailing tobacco companies has driven efforts against smoking? What is the responsibility of rich countries, and the pharmaceutical companies located in them, to improve medical care in poor countries, where 40 percent of deaths from noncommunicable diseases occur before age 60?
The food industry, which is responsible for much of the sweet, salty, high-fat food that experts view as a problem, for the moment is considered a “partner” in the new campaign. It will not be treated as a pariah industry like tobacco, whose companies are barred from meetings like this.
The 13-page “Political Declaration” under intense negotiation since June and adopted Monday contains more than a dozen “partner” references. It telegraphs a message that voluntary changes in salt, fat and calories in food and in marketing directed at children are the preferred route to slowing the rise in obesity, hypertension, high cholesterol and inactivity that underlies many of the diseases.
Activists hungry for more
It is a position that has left many activists unsatisfied.
“Our position is that partnership isn’t the right word. It implies trust and respect,” said Patti Rundall, who helped run the campaign against infant formula sales in Africa 30 years ago and today is working to limit the marketing of processed food in the developing world. “The allegiance of the food companies is to create profits. Their voluntary commitments are only good for as long as they want to keep them,” she said.
Laurent Huber, 41, a Swiss exercise physiologist who works for an anti-smoking group, said, “The fast-food industry and the junk-food industry cannot be engaged in the policy process. They are part of the problem. This conflict of interest needs to be looked at.”
Nevertheless, many companies have agreed to slowly reduce salt in processed food, remove trans fats and remake restaurant dishes so they contain less fat. This month, the company that owns the Red Lobster and Olive Garden restaurants promised to take that last step.
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