Download Draft Summary of the 3rd OECD Food Chain Network meeting

Draft Summary of the 3rd OECD Food Chain Network meeting
Mobilizing the Food Chain for Health, 25-26 October 2012, Paris
The third OECD Food Chain Network meeting ‘Mobilizing the Food Chain for Health’, organized jointly
with OECD’s Health Committee brought together nearly 90 stakeholders from government, international
organisations, the private sector and non-governmental organisations to discuss how together they might
consider new approaches and partnerships to improve the food chain’s contribution to health.1 While the
food chain deals with the supply side of the food system, from farmers to retailers, consumers are
likewise important in determining what and how the food system produces and delivers its products.
Diet and health issues are rising in importance on the international policy agenda, as the economic burden
of nutrition related chronic diseases increases across the globe. At the 2011 High-level meeting of the
General Assembly of the United Nations on Non-communicable diseases, diet and nutrition were
identified as key factors for human health, affecting both the incidence of non-communicable diseases
and longevity in the population. Non-communicable diseases (NCDs) are projected to account for over 40
million deaths in 2015, a large majority of which in low- and lower-middle income countries. Overnutrition, in particular obesity, continues to rise middle and high income countries, while under-nutrition
still continues to afflict large numbers of persons in low income countries even if its incidence is
declining. Whole-of–government and whole-of-society approaches are likely to be important to the
success of health policies aimed at improving diets and nutrition and thus assist in preventing NCDs. But
a pre-requisite for their implementation is the breaking of cultural and budgetary barriers, especially
within government and public sector interventions. This is a goal not yet achieved in most countries.
Governments have so far taken relatively limited action to tackle the multi-factorial causes of the problem,
although prevention strategies are available that could generate improvements in population health at an
affordable cost. Solutions that are effective and cost-effective must be sought wherever opportunities arise,
including in areas such as agricultural policies and agri-food systems.
The meeting focused on what the different stakeholders’ along the food chain are doing and could do to
tackle the diet, nutrition and health issues. Though a wide range of issues was discussed, three themes
were woven into all sessions:
- Aligning a sustainable agriculture with diet, nutrition and health objectives;
- Governing the food chain: government and private sector responsibilities
- Facilitating healthy food choices through the consumer food environment: government, local initiatives
and private sector behaviours.
1
The initial meeting of the Food Chain Network, held in Paris on the 13th December 2010 and subsequent
discussions by Member countries identified diet health and nutrition as a topic for discussion at the food
chain network meeting.
The following sections summarize the discussions of the main topics addressed within these three themes.
The agenda and presentations as well as the keynote background note can be found at:
www.oecd.org/site/agrfcn.
Introduction: global trends in nutrition and health
Rising incomes, urbanization and technological change have brought about significant lifestyle changes
including a change in dietary habits. Not only is caloric intake now higher than ever but the diet
composition has changed with an increased consumption of fats, sugars and refined carbohydrates. In
addition technological advances have reduced energy requirements for work and daily tasks. This set of
changes, commonly referred to as the nutrition or dietary transition, characterize most countries across the
globe. Most high income countries have already completed the transition while it is currently underway in
many middle and low income countries. As a result of the nutrition transition approximately 1.5 billion
people are now overweight or obese and deaths from over-nutrition exceed those from under-nutrition at a
global cost estimated to 1.4 billion USD. Some 330 million or 4% of the world population are
nonetheless expected to remain undernourished by 2050 but some 1400 million or 15% will be obese by
then and by 2080 approximately 2% of the world’s population will still be undernourished while 21 % of
the world’s population will be obese. The importance of these figures is in their expected impacts on
monetary and human costs to society due to poor health. Furthermore, it the incidence of NCDs is
expected to be higher in low and middle income countries which must still combat under-nutrition and are
those least able to bear the costs from the public or private purse.
Slowing or reversing the trend in over-nutrition and obesity will require new approaches and cooperation
between all stakeholders along the food chain. These are now being challenged to find ways to align their
activities with health objectives. Governments, the private sector and non-governmental organizations are
being called upon to facilitate making healthy food choices through information provision and increased
availability and affordability of healthy food options.
-Aligning agriculture to diet, nutrition and health objectives.
Agriculture is the first link in the food chain and an important contributor to health through the nutritional
quality of food and its adequate supply. In developing countries strategies that promote not only overall
agricultural productivity growth in a sustainable manner but also focus on food nutrient content were
viewed as crucial to promoting better nutrition and health by the panellists. Food fortification programs
to increase specific nutrient intakes have proved successful in many instances. However these require not
only research and development of the specific food characteristics but also consumer acceptance
campaigns to effectively promote their intakes and improve health outcomes. International organisations
underlined the need to fund research and development of products with specific nutritional characteristics,
whether this is vitamin A, Omega-6, iron or other nutrients. To date this effort has mainly been the
responsibility of governments and international organizations, but public-private initiatives are now
emerging and these were considered important contributions to the emergence of a nutrition sensitive
agriculture.
While the contribution of agricultural research and development hold promise for remedying the poor
nutrition through food fortification and increasing supplies, the worldwide tendency towards overnutrition does not have clear or easy solutions according to the panel. Past agricultural support policies in
OECD countries have been incorrectly accused of contributing significantly to the over-nutrition/obesity
epidemic by making foods cheaper than they would have been otherwise. But agricultural support policies
have in fact taxed consumers and made their food more expensive as evidenced from OECD Consumer
support equivalent (CSEs) figures. These figures indicate that the cost of the support policies is borne by
the consumer. Consequently, these policies have tended to dampen consumption of support products that
is; dairy, meats and cereals due to their artificially higher prices.2 However an unintended consequence
may have been to lower world prices to importing countries with likely beneficial outcomes in terms of
food costs but not for long term supply incentives.
Sustainability in the agricultural production was also brought up as a crucial element in permitting
agriculture to meet food needs of a growing global population over time. This might however require a
different output composition than that of the past decades. Indeed, new alliances across business,
government and international or non-governmental organizations are searching for ways to meet foodnutrition needs and respect sustainability objectives. Some participants suggested that these may require
new governance mechanisms which explicitly include sustainability goals to accompany output growth.
This now frequently recognized as an important objective at the firm and sectoral levels. In fact, it
appeared from the discussion that many food producers are now pledging to meet voluntary
environmental objectives or production standards and some even are stepping forward to engage in
developing appropriate monitoring programmes. But it will be likewise important that consumers adopt
diets that are congruent with both health and environmental concerns.
- Incentives for fresh food consumptions
While traditional agricultural policies on staple commodities may have had very limited impacts health,
many health experts and food NGOs suggest that agricultural policies could be devised to stimulate the
consumption of health promoting foods such as fresh fruits and vegetables. Increasing fruit and vegetable
consumption can have a positive impact on health, but at what cost to the public purse? These questions
led to a discussion on what policy approaches could be envisaged to stimulate the provision and
consumption of a healthy and sustainable diet for a growing planet. A number of country experiences
were discussed some of which found that lowering the price of fruits did increase their consumption. But
for greater impacts these need to be accompanied by information campaigns according to researchers. In
the particular in France in context of advertising/information campaigns and lower fruit prices,
consumption was increased. According to some the EU school fruit scheme which subsidizes fruit
consumption in schools has increased fruit consumption and is seen as contributing to improving diets for
children from lower socio-economic backgrounds. This approach targets the specific consumers and thus
should not distort markets. Such a programme is an example of positive synergies between public health
and agriculture. It was however emphasized that these need to be sustained through time so that dietary
habits have sufficient time to change. Research in the United States finds that though healthy foods may
2
If food is a normal good, higher prices will dampen consumption, thus they have contributed to moderating
consumption levels of supported commodities such as dairy, cereals, and certain meats.
be more expensive on a calorie basis this is not necessarily so in terms of weight or portion size. Some
studies find that even low income families facing national average prices can satisfy fruit and vegetable
recommended consumption levels with a standard budget.
Assuming the affordability issue can be resolved, there are nonetheless geographical areas which do not
allow easy access to healthy food options on a regular basis. Initiatives by non-governmental
organizations have attempted to increase availability and reduce costs to consumers through programmes
that make fresh foods available and affordable. Preliminary evaluations of these programmes find that
these have increased fresh fruit consumption and have reduced obesity in children and even among adults.
Furthermore certain programmes in the United States found positive spill-over effects for farm viability
and economic activity in rural communities. With complementary investment programs regional
agriculture could be strengthened by catalysing efforts for the development of regional food
infrastructures to assist distribution and processing enterprises. These programmes which work through
the agricultural and local distribution system are also developing healthy food hubs to further expansion
of healthy food options in targeted low income and often remote rural areas. Future funding for healthy
food and agriculture promotion programmes may be included farm policy legislation in certain countries.
-Governing the food chain: government and private sector responsibilities
--Meeting dietary guidelines
Diets in industrialised countries include a substantial share of processed foods, making manufacturers
important players in ensuring diets meet national and/or international dietary guidelines. Given the
evolution of lifestyles and diets, both the industry and governments recognize the need to reformulate the
recipes for certain foods to reduce their content of salt, fat and sugar. The discussion raised important
issues such as, who should decide what changes are required and how should progress be measured and
monitored. Governments were seen as likely to retain a central role in determining guidelines/standards
but even here there are signs that governance in this area may be moving towards greater public-private
cooperation in their determination. The monitoring and measuring of progress in meeting guidelines or
government standards was an issue brought up several times by consumer organizations that underlined
the need to be able to measure progress in reformulation through independent observers for private
initiatives to be credible.
The food industry itself provided examples of its activities and presented its vision on making foods more
compatible with WHO and national guidelines A number of large firms, in particular multinational
enterprises (MNEs) reported that they are voluntarily committing to meet WHO guidelines for salt/sugar
and fats in their product lines. Reformulation of products to ensure they are not contributing to excess fat,
salt or sugar intakes requires substantial financial commitment by the private sector in terms of research
and development and marketing. When reformulating cannot be had without substantial change in flavour
or texture what are the firm options? How are governments to respond and/or to assist them?
Where the food manufacturing sector consists mainly of small and medium sized firms, some only with a
local reach, the issue of food composition and efforts of reformulation on a voluntary basis become more
difficult to manage. In certain countries for instance it was noted that the trade unions of food
manufacturers have been stepping in to engage continually with governments on food composition and
reformulation goals. The collaboration between private and public sector in food composition signals a
new approach that may be able to limit use of regulatory options which could be costly for all. However,
for public-private governance to succeed monitoring is necessary and again consumer organisations asked
for credibility and transparency in these efforts.
What firms do and how they specifically participate in food chain governance matters differs across
countries. For instance, reducing fats and in particular trans-fat by industry has been a response to
government recommendations and labelling requirements in countries such as the United States. These
government actions have also been successful in removing trans-fat from new products in a number of
countries. Certain local governments have simply opted for a ban on trans-fat. Salt reduction campaigns
are important for cardiovascular health and certain countries have elaborated programmes which operate
on several fronts simultaneously: consumer awareness campaigns, target for the food industry for specific
food categories and front of pack labelling. The impacts of these have been quite significant in reducing
cardio-vascular deaths in the short term of 5 years, for example in the United Kingdom. These
programmes remain voluntary even if they provide incentives for firms to comply. In some cases
regulating portion sizes of soft drinks has been suggested to limit sugar intake, impacts of these more
stringent proposals are not known. However there are already numerous regulations on food composition
in many countries some of which are forcing them to product reformulation. According to some
discussants, this option needs to be continued along with providing assistance for firms engaged in this
task.
Given the country experiences discussed, governments nonetheless appear increasingly to rely on
voluntary actions in reformulation even if guidance and certain requirements are set by governments. This
trend in the public-private governance of the food system generated much discussion by consumer
representatives and others as to what extent substantial changes could be expected with respect to
reformulation in a voluntary setting. Voluntary actions rather than regulation should not be interpreted to
mean industry can decide on its own as to what, how and when to conform to guidelines. Several
panellists suggested that non-compliance with voluntary measures could eventually force governments to
adopt regulatory measures, which might not be in the best interest of industry. But the role of government
is not only to provide dietary guidelines but also to provide an overall governance framework for the
operation of the food system which includes marketing, labelling, fiscal policies as well as school food
programmes. These multiple tasks were emphasized by international organizations in particular.
- Facilitating healthy food choice through the consumer environment: government, local initiatives and
private sector behaviours
Consumer food choices are often constrained by affordability, knowledge and access. The common
recommendations to remedy these are: nutrition labelling, advertising controls, public information
campaigns, regulation of school and workplace meals and fiscal measures that tax unhealthy food and
subsidize healthy foods.
Most OECD countries have mandatory nutritional labelling for processed foods and in many cases specify
how and where such information is to appear on the package. This was considered by public sector
representatives and NGOs as fundamental in providing information to consumers. According to some,
the UK retailers’ initiative of traffic lights to signal ‘healthy’ or ‘unhealthy’ foods could be a potential
powerful form of labelling that provides clear and simple information on products but leaves consumers
free to choose. No evaluations of the impacts of these ‘traffic light labels’ on diets or health are yet
available.
Food advertising particularly that which is directed to children generated significant discussion, Should
advertising be limited to children? If so, should this be done through voluntary agreements and self
regulation of the food industry or are government regulations and/oversight needed? Some private sector
voluntary trade association agreements provide for member firms to limit the type and amount of
advertising to children of their own accord. This type of behaviour signals new forms of governance in
the food chain that merits further discussion and research as to its effectiveness. Some discussants asked
if these self-regulation systems are done purely to pre-empt governments from setting advertising limits.
Self- set standards and self-regulation are the preferred option for industry, but some governments may
nonetheless decide to regulate food advertising particularly to children as reported by country
representatives. Consumer representatives reminded governments that they must be careful not to
abdicate both the standard setting and monitoring to industry. Their view was that responsibility remains
with the government even if different approaches to implementation of standards can be developed
Discussion on the use of fiscal measures as incentives to improve food choices raised issues of their
efficacy and their possible unintended consequences for markets and competition. Certain panellists noted
that in medium and high income countries food demand is price inelastic thus changes in price of a few
specific foods is unlikely to improve diets or reduce obesity and health risks to any extent. However they
acknowledged that tax receipts could be used to finance information campaigns or subsidize fruit
purchases to low income populations. However, using food taxes in a period of economic crisis would be
not advised given the regressive nature of these taxes and their disproportionate impact on low income
households.
The subsidizing of healthy foods such as fresh fruits for targeted populations could have positive impacts
on weight and health particularly of children. Furthermore these programmes would not distort markets.
The access to healthy food issue remains important for low income and often isolated regions. Local
initiatives that bring fresh healthy foods to low income areas through corner shops, farmers’ markets or
even supermarkets were seen as successful and could eventually be scaled up.
-Health and economic impacts in moving towards healthy diets
The impacts of moving to healthy diets including a reduction in total caloric consumption could have
implications for the food industry as well as for agricultural markets. The OECD Health division’s work
estimated the combined effect of set of small changes in different policy instruments on risks of chronic
disease for a number of OECD and non-OECD countries. They found that this policy mix was cost
effective in reducing health expenditures over the medium term as well as in substantially reducing risk of
chronic disease. An analysis of the impact of a 10% reduction in fat consumption using the OECD
AGLINK found that change in consumption had relatively small effects on prices and trade in agricultural
markets. Over the 2011-2021period the price difference under these policies was quite minimal,
approximately 2-3% for beef, vegetable oils with some slightly larger trade effects across regions.
Food Matters: an integrative approach to food policy-a synopsis
The keynote address by Professor Tim Lang provided a framework for reflecting on how to meet the
challenges of diet and health as well as environmental sustainability over the medium term. He underlined
that the developed world’s food system is under pressure from a combination: material, biological,
economic and societal forces. These forces are evidenced in among others climate change, water and land
use, eco-system damage, nutrition transition-increasing incidence of obesity and growth in noncommunicable diseases. These are the new fundamentals of the food system. Furthermore he notes that
the dominant paradigm of food and agricultural policy is that the food-health problems could be largely
resolved by producing more food through application of modern technology and capital. But this
framework is no longer appropriate to face present day health and environment challenges and proposes
that the direction and debate should focus on ‘what would the food system look like if it addressed
ecological public health, that is, one that combines emphasis on health, eco-systems and social
sustainability.
In spite of the growing evidence since 2000, the mainstream agenda for the food system remains anchored
in reducing government involvement; changing consumer behaviour through ‘nudges’ and information
availability and continuing to deliver internal supply chain efficiencies. Essentially this agenda says the
food system is fine but a huge increase in production is necessary if the world’s population with their
changed dietary habits are to be fed in the future. With data on rising health costs due unhealthy food
consumption patterns and costs of environmental externalities – such as water depletion, biodiversity loss,
water depletion- the question is whether food markets in ‘business-as-usual’ vision have been distorted.
For some the challenge is simply how to internalize these externalised costs such as diet-related
healthcare, damage to environmental public goods, etc. But there is also an emerging policy debate asking
whether or not an extensive use of diverse policy measures is now needed to get the dramatic change
required.
He concluded with thoughts on a new food policy that may require the food system to be re-engineered to
blend human and environmental health based on sustainable dietary guidelines. This would mean
educating people to be food citizens and not simply food consumers and building a food system which is
shaped by ‘values-for-money’ and not simply cheap food. This path requires better integrated food-health
systems analyses and modelling of total food systems which can provide for improved scenario analysis
to evaluate alternative policy options.
Policy roundtable
While there was no intention to provide policy recommendations, many issues with policy implications
were discussed in an open and frank manner. Two main issues were concluding panel were:
•
What can and needs to be done and by whom to move towards healthy and sustainable diets
across the globe?
•
How can the food system meet the challenges of double burden of over and under-nutrition?
Inclusion of health objectives in agricultural and environmental policies were viewed as necessary to meet
nutrition and food needs, but these need to go beyond words. Thus far there has been limited action by
government in agri-food areas but the experiences provided through grassroots initiatives could provide
opportunities for scaling up and integrating projects into general policy directions. Information provision
through labelling and healthy eating campaigns as well as guidelines in advertising particularly to
children was viewed as a policy area that has yielded positive results and should and can be pursued
further. In advertising the issue is whether there should be government guidelines for self regulation or
monitoring of activities and third party oversight. While reliance on industry voluntary programmes to
meet nutritional guidelines appears to be the trend, the outstanding issue is how to make them more
accountable.