Events

On 18 March 2019, the UK Department of Health and Social Care (DHSC) and the Department for Digital, culture, Media and Sport (DCMS) launched a joint consultation on the introduction of more robust restrictions on the marketing of unhealthy food to children. This policy was announced as part of the UK Childhod Obesity Action Plan published on 25 June 2018, following extensive pressure from various public health actors to protect children effectively from the harmful impact that unhealthy food marketing has on their diets and therefore their health.

On Thursday 25 April 2019, Dr Emma Boyland (Department of Physical Sciences) and Prof Amandine Garde (School of Law & Social Justice) convened an interdisciplinary workshop at the University of Liverpool London campus to support and coordinate the public health community's response to the consultation.

• Find out more about the programme of workshop sessions and participants

Non-communicable diseases (NCDs) are responsible for almost 70% of all deaths worldwide. Almost three quarters of all NCD deaths, and 82% of the 16 million premature deaths, occur in low- and middle-income countries. NCDs have devastating consequences for individuals, families and communities; they threaten to overwhelm health systems; and they hinder development.

Since the first UN High Level Meeting on NCDs in 2011, the international community has acknowledged the scope of the problem and undertaken to take coordinated and coherent action to reduce the burden of NCDs. In particular, the WHO Global Action Plan on the Prevention and Control of NCDs for 2013-2020 lays down the foundation for the adoption of effective strategies intended to reduce the availability, acceptability and affordability of tobacco products, alcoholic beverages and unhealthy food, which include the adoption of marketing restrictions, labelling rules and fiscal measures. More recently, States renewed their commitment to “ensure healthy lives and promote well-being for all at all ages” and “reduce premature deaths from NCDs by one-third by 2030” (Sustainable Development Goal 3). In September 2018, the third UN High Level Meeting on NCDs assessed the progress that States have made towards their commitment to reduce the burden of NCDs.    

Over the last thirty years, globalisation and economic liberalisation have greatly increased foreign direct investment in the tobacco, alcohol and food industries. Foreign investors enjoy certain protections under international investment agreements which empower them to bring compensation claims against host states for any measure that interferes with foreign investment. Thus, state efforts to regulate the tobacco, alcohol and food industries to prevent NCDs and promote public health could give rise to expensive arbitrations, as illustrated by recent claims challenging tobacco control legislation in Australia and Uruguay. The regulation of alcoholic beverages and unhealthy food could face similar challenges under international investment law. This raises important and timely questions about how international investment law can affect state regulatory autonomy in designing and implementing measures for preventing NCDs.

The Law & NCD Unit at the University of Liverpool organised a one-and-a-half day conference to discuss these questions and explore the relationship between the NCD prevention policies and international investment law. The conference took place in London on 10 and 11 May 2018.

This event was intended for a mixed audience of international investment law specialists and public health experts, as well as for academic colleagues and policy actors alike. In line with its objective to engage in academic research of direct relevance to policy development and implementation, the Law & NCD Unit encouraged the participation of members of the public health community: international organisations, governments, public health agencies, and non-governmental organisations.

Organised by Anne-Christine Fornage, University of Lausanne, Marine Friant-Perrot, University of Nantes, and Amandine Garde, University of Liverpool.

On 1 April 2016, the General Assembly proclaimed the United Nations Decade of Action on Nutrition, 2016-2025, thus recognising the need to end hunger and prevent all forms of malnutrition worldwide. Over two billion people suffer from micronutrient deficiencies, 1.9 billion people are affected by overweight of which around 500 million are obese, and 793 million people remain chronically undernourished. The UN Decade of Action on Nutrition will provide an umbrella for a wide group of actors to work together to address these pressing nutrition issues in order to achieve the goals set out in the 2030 Agenda for Sustainable Development, and in particular SDG 2 (greater food security and improved nutrition) and SDG 3 (a reduction by one third of premature mortality from noncommunicable diseases).

The provision of nutrition information to consumers, particularly via food labels, has become a privileged regulatory strategy to promote healthier diets and therefore address obesity and other diet-related diseases. Encouraging consumers to make informed food choices through the provision of food information, ultimately allows the responsibility for healthier food choices to be shared between, on the one hand, consumers, who are expected to process the information made available to them when purchasing food, and, on the other, regulatory authorities which must ensure that this information is sufficient, clear and neither false nor misleading.

This conference, organised jointly by the Universities of Lausanne, Liverpool and Nantes, focused on the role that nutrition information can play in promoting healthier food choices (food being defined broadly to include alcoholic and non-alcoholic beverages). It set out to adopt an interdisciplinary – or even transdisciplinary – viewpoint; welcoming contributions by lawyers but also by economists, public health experts, psychologists. Contributors were invited to focus on specific case studies – looking at the experience gathered in countries that have evaluated the effectiveness of their food information rules in promoting healthier diets.

The conference aimed to cover the following questions:

- What is the evidence base supporting the provision of nutrition information to consumers as part of effective nutrition strategies? In particular, what role can nutrition information play in promoting healthier diets? (Evidence)

- What contribution have existing nutrition information measures made to improve diets? (Empirical Analysis)

- What information should be covered by the notion of ‘nutrition information’? In particular, how far should food claims and other promotional information fall within its scope? (Definition)

- How do the fields of nutrition, food safety and advertising regulation relate to each other? (Boundaries)

- What type of information should be provided to improve nutrition? How personalised should this information be? (Effectiveness)

- How should nutrition information measures – if adopted – be designed to be as effective as possible? In particular, what is the potential of interpretive front-of-pack labelling to facilitate consumer choices? (Design)

- Who should the main policy actors be in the development of nutrition information policies at national / regional / global level? (Policy Actors)

- How does international economic law – and World Trade Organization and European Union internal market law more specifically – affect the regulatory autonomy of Member States in designing their own national nutrition information schemes? (Legality)

- How far should Codex and other relevant international bodies contribute to the standardisation of food information? How far should the European Union harmonise the laws of Member States on nutrition information? (Harmonisation)

- Who should be entrusted with implementing nutrition information rules? What sanctions should be envisaged to ‘encourage’ compliance with nutrition information rules? In particular, what could the role of litigation be in promoting such compliance? (Implementation)

- What can researchers in law learn from other disciplines in ensuring that consumer food information rules are fit for purpose? (Multidisciplinarity)

Guest lecture given by Garrath Williams, Lancaster University

This paper summarised a longer piece of research that Gareth undertook as part of the EU-funded I.Family Study. 

Garrath presented and defended the following claims:

(1). corporations are not free market actors, but arise thanks to a specific form of state intervention;
(2). contemporary food markets are structured by corporate activity (e.g. the well-known ‘hour-glass’ between producers and consumers);
(3). the resulting markets are bound to promote processed foods, which are invariably less healthy than whole foods;
(4). though very powerful in some regards, corporations are powerless to resist this logic; hence
(5). the only tenable way to uphold public health is greater statutory regulation of corporate activity;
(6.) such regulation should not be understood as restrictive, but rather as enabling corporate actors to respect important public goods.

At a more philosophical level, Garrath set out to make this overarching argument: we should resist the careless (or disingenuous) assumption that government interventions (e.g. to create or modify corporate markets) are opposed to freedom; any sensible ‘restriction’ will uphold some sort of freedom; the crucial question is always what sorts of freedom we should value.

A Senior Lecturer in Philosophy at Lancaster University, Garrath Williams' research interests fall across ethics, political theory and applied ethics. One of his main interests, in all three of these areas, is responsibility – both conceptually and in terms of its practical aspects. For the past ten years he has been involved in collaborative research on children, health and public policy, including the EU-funded I.Family study, which investigates diet and health-related behaviours in a large cohort of families across Europe.

His recent interest in corporations touches on all of these areas: corporate responsibilities and accountability, their relation to political authority, and their impact on public health.

Discussants

• Neville Rigby , International Obesity Forum
• Professor Simon Capewell , University of Liverpool
• Professor Amandine Garde, University of Liverpool

Amandine Garde Liverpool Roundtable Discussion on Conflicts of Interest and Food

Healthy food provision - stranded between corporate power and corporate powerles

Organisers: Professor Amandine Garde, University of Liverpool, and Professor Alberto Alemanno, HEC Paris.

Governments across the world increasingly recognise the urgency of lowering the alarming rates of non-communicable diseases (NCDs) resulting in large part from the consumption of commodities such as tobacco, alcoholic beverages and unhealthy foods. As evidence shows price is a major determinant of consumption choices, and taxation and other economic measures may act as a disincentive to the consumption of these commodities, policy makers have started to use these instruments as part of their NCD prevention strategies.

Tax measures on tobacco products and alcoholic beverages have been used for years to raise revenue. It is only more recently that they have been presented as public health measures. Most notably, the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) explicitly acknowledges that “price and tax measures are an effective and important means of reducing tobacco consumption by various segments of the population, in particular young persons”, and calls on State Parties to adopt price policies on tobacco products so as to contribute to the health objectives aimed at reducing tobacco consumption. Similarly, the WHO Global Strategy to reduce the harmful use of alcohol states that “pricing policies can be used to reduce underage drinking, to halt progression towards drinking large volumes of alcohol and/or episodes of heavy drinking, and to influence consumers’ preferences. Increasing the price of alcoholic beverages is one of the most effective interventions to reduce harmful use of alcohol”. Tobacco and alcohol taxation are considered as two of the WHO’s NCD prevention “best-buys” – providing significant health benefits at a relatively low cost for governments. They have been widely adopted across the world, sometimes in connection with other measures such as minimum unit pricing.

More recently, food taxes have also appeared on the public health agenda. As the access to, and in particular the affordability of, healthy foods is a major and recurring concern, a growing number of governments are exploring the use of taxation and price incentives to alter consumption patterns. A 2016 report devoted to “Using price policies to promote healthier diets” by the European Regional Office of the WHO concluded that price policies have the potential to influence consumer purchasing in the desired direction. Moreover, the UK Government has recently announced to enact a soda tax, whilst the Scottish Government is defending its recent legislation mandating minimum unit pricing of alcoholic beverages before law courts.

It is against this backdrop that this conference focused on the role that taxation and other price measures can play in NCD prevention strategies – in particular by increasing the price of commodities such as tobacco, alcoholic beverages and unhealthy foods. It set out to adopt an interdisciplinary – and where possible transdisciplinary – viewpoint, particularly welcoming contributions by lawyers, economists, public health experts, and psychologists. Contributors were invited to focus on specific case studies – looking at the experience gathered in countries that have recently experimented – or are thinking of experimenting – with minimum unit pricing and/or food taxes.

The conference aimed to address the following questions:

-          What is the evidence base supporting tax and economic incentives as part of NCD prevention strategies? In particular, what is the importance of price in influencing consumer choices? (Evidence)

-          How can / should price be affected to limit the consumption of tobacco, alcoholic beverages and unhealthy food? (Effectiveness)

-          What are the respective advantages or disadvantages of taxation and minimum pricing measures? (Cost Effectiveness)

-          What do we know of the contribution which existing price-related measures have made (or are likely to make) to NCD prevention? (Empirical Analysis)

-          How should price measures – if adopted – be designed to be as effective as possible? (Design)

-          When will a price measure be considered incompatible with international economic law – and international trade law and European Union internal market law more specifically? (Legality)

This Conference marked the launch of the Law and Non-Communicable Diseases Unit

Watch a video of Olivier De Schutter (University of Louvain) delivering the keynote lecture at our inaugural conference:

Childhood obesity, the prevalence of which has increased at alarming rates over the last 30 years in many countries worldwide, has become one of the most significant public health challenges for the 21st century. In 2014, the World Health Organization (WHO) estimated that 41 million children under 5 years of age were overweight or obese, as a result of being raised in ‘obesogenic environments’ in both high-, low- and middle-income countries, cutting across all socio-economic groups.

At the 66th World Health Assembly in 2013, Member States adopted the WHO Global Action Plan on the Prevention and Control of Non-Communicable Diseases (NCDs) for 2013-2020, and agreed a voluntary target to halt the rise in diabetes and obesity by 2025. The Director General of WHO subsequently appointed a Commission on Ending Childhood Obesity (ECHO Commission) to produce a report specifying which approaches and combinations of interventions are likely to be most effective in tackling childhood and adolescent obesity in different contexts around the world. The Commission’s final report, which was published on 25 January 2016, proposes a range of recommendations for governments to reverse current childhood obesity trends. The UN Sustainable Development Goals (SDGs), adopted by the UN Assembly in 2015, also call on Member States to achieve improved nutrition and promote sustainable agriculture (SDG 2), and to ensure healthy lives and promote well-being for all at all ages (SDG 3).

As the ECHO Commission has explicitly acknowledged, the law can play an important role in helping change food environments with a view to promoting healthier lifestyles. For example, the Commission has identified priority areas which Member States should consider as part of effective prevention strategies, not least the regulation of food labelling and other sources of food information; the regulation of food marketing; and the use of economic instruments such as food subsidies and food taxes. While such legal tools for building healthy environments are clearly available to States, their actual implementation and practical effectiveness may be limited by other legal rules, both international and domestic, which can sometimes have contrary or inhibiting effects. A drive to maximise the utility of the law in combatting childhood obesity demands a clear understanding of these actual or potentially limiting legal regimes and the manner in which their effects are realised. For example, a Member State wishing to regulate the food industry needs to understand precisely how it may do so within the constraints of existing international trade rules. This, in turn, requires a clear grasp of the extent to which these rules afford discretion to Member States to limit the free flow of goods on grounds of public health. Clearly public health regulations and human rights do not exist in a vacuum. If a State should invoke the right to health and other children’s rights to justify tighter regulation of food markets and marketing, it will need to assess the probable legal response from food industry operators and other market actors with competing rights under domestic and international law, including the right to property, the right to ‘fair and equitable treatment’, or the right to freedom of expression. In addition, a State wishing to regulate the food industry to prevent childhood obesity may be faced with difficult questions of allocation of powers, demanding answers as to whether, in federalist or quasi-federalist systems, a given rule should be adopted at the local, national or regional (e.g. EU) level. The resolution of all these issues requires engagement with a range of rules and complex legal arguments, which have, overall, tended to be underexplored to date.

This conference addressed the challenge of these intertwining rules and arguments, and aimed to provide a clearer picture of the role of law in the fight against childhood obesity, as well as finding ways of maximising its beneficial effects. More specifically it explored the extent to which international trade and human rights law should interact to allow States to effectively protect children from growing obesity rates. The conference focused on a range of overarching issues, including:

-          whether, and if so to which extent, World Trade Organization (WTO) rules and International Investment Agreements (IIAs) have contributed to growing childhood obesity rates;

-          whether, and if so how, the WTO and IIAs could accommodate childhood obesity concerns;

-          what a ‘human rights approach’ entails and how it could contribute to reversing childhood obesity trends;

-          how the Convention on the Rights of the Child could be invoked, with a specific focus on the relevance of the child’s right to health and the principle of the best interest of the child;

-          whether international trade and human rights law really stem from different premises and pursue arguably irreconcilable objectives;

-          what responsibilities international human rights law imposes on both States and non-State actors (including the food industry) in the global fight against childhood obesity;

-          how international human rights law should be invoked in relation to childhood obesity and what remedies it could provide;

-          whether harmonisation through the adoption of a global convention on healthy diets or through the adoption of labelling standards provides the most effective way forward to durably reverse current childhood obesity trends.

ECHO Conference - brochure.pdf