For us in nutrition, the normative clarifications achieved with General Comment 12 are now, better late than never, actually to be operationalized --not voluntarily!
The People's Health Movement has, from early on, been critical of any voluntary guidelines, including the report on Voluntary Guidelines to Support the Progressive Realization of the Right to Food, issued by the UN Food and Agriculture Organization. For PHM and others, voluntary guidelines do not work. We are all aware of the situation with the marketing of breastmilk substitutes and its sorry record over the last two decades.
Let me here look at the many shortcomings of voluntary guidelines, be they for governments and/or for industry:
As relates to the control the food and drink industry, the word here must be statutory regulation. (We just have to convince ourselves that this is a reasonable possibility). Voluntary guidelines here make no sense. Take an example: Industry has ‘volunteered’ to reformulate junk food to make it les harmful. The case against product reformulation, particularly when used as a main strategy to curb NCDs, has recently been summarised in The Lancet. Reformulation is not of healthy foods. It is of inherently unhealthy products. These are usually identified in dietary guidelines as products to be consumed only occasionally. They are made merely somewhat less unhealthy by manipulation of their ingredients. Reformulation of the type volunteered by manufacturers or suggested by government officials, usually results in relatively small and sometimes even trivial adjustments in nutrient profiles of products that remain basically unhealthy. Therefore, voluntary product reformulation is a distraction from public health actions that will certainly have much more significant benefits. As with tobacco and alcohol products, such actions include statutory regulations. These need to include pricing and other statutory measures designed to promote healthy food, such as those that remove price support for unhealthy commodities, tax unhealthy products and restrict their advertising and availability especially to children, and thus protect the public interest and promote well-being. Such policies, analogous with those that control the use of toys, cars, guns and drugs --and use of tobacco and alcohol-- are now being considered by a number of governments and have been actually enacted by others.
As things are now, voluntary guidelines on reformulation of inherently unhealthy ultra-processed food products are agreed or confirmed by ‘public-private partnerships’. In these, the public ‘partners’ include officials from UN and other international organizations, and politicians and officials from national governments, with just a notional presence of public interest organizations. The private ‘partners’ are predominately marketing and publicity executives of transnational corporations whose sales and profits derive mainly from unhealthy products, together with their hired, representative, associated, and supportive organizations. Use of the term ‘partnerships’ implies that the corporations are sharing in responsibility for the public interest, notwithstanding their duty to maximize their bottom lines, share price, sales volume, and market presence.
Let me give another two examples: The reliance on voluntary agreements on labeling instead of statutory prohibition, is a long-running public health scandal in the US, one of the worst in our history. Also in the USA, the bottle feeding culture continues to resist strenuous breastfeeding promotion efforts by voluntary and professional groups, probably because of continued provision of free samples, still allowed in most states, and the continued offering of free supplies of infant formula to babies born in the country participating in WIC.
I think the point is that, when industry is involved, if everything relies only on voluntary guidelines, it simply is not working. Thus there always needs to be a push for legally binding guidelines.
Similarly, for governments, we need strong movements to lobby for legally binding obligations. Unless public interest civil society and movements can exercise adequate pressure for their implementation, not much will happen. So, nutritionists and their allies must push for legally binding regulations.
For an example here, fiscal policies can be used to control NCD risk factors by reducing tobacco consumption and fat, alcohol and salt intake, preventing obesity, and promoting physical activity. But this has to be on a mandatory rather than on a voluntary basis.
Over the last 40 years, efforts at building consensus on binding international systems of responsibility and accountability for what ultimately amounts to human rights violations by transnational actors and in particular transnational corporations, as well as other business enterprises have been undermined by strategies of corporations and complicit and/or corrupt States. The result has been non-binding, voluntary approaches that provide “guidance” and recommend good corporate practice, but avoid sanctions and thus allow corporate abuses to continue.
With voluntary guidelines, more often than not, there is a lowering of the bar and emphasis is put on small incremental changes that fulfill industry (and government) criteria and needs.
Voluntary guidelines do not offer an important opportunity to revitalize the development of food and nutrition policy frameworks and do not help to structure nutritional governance from an entitlements perspective. This is why many NGOs were and are skeptical about the voluntary nature of the FAO document.
Take the Codex Alimentarius recommendations; they are not endorsed by either WHO and/or FAO, as they are best practice guidelines. Whether they are followed is on a voluntary basis; is this good enough?
Bottom line, we need to forcefully renew our calls to ensure that the commitments required by General Comment 12 to achieve desired nutritional goals supersede the voluntary guidelines.
Claudio Schuftan, Ho Chi Minh City