The increasingly loony Lancet is on a roll this month. After causing global mirth two weeks ago by publishing the EAT-Lancet diet (no more than a quarter of an egg, a tenth of sausage a day, etc) the once great medical journal has now laid out how it expects the government to make us eat it.
Published today, a lengthy report from the Lancet Commission on Obesity gives a detailed overview of what it sees as the problem (capitalism), the solution (higher taxes, more state control) and the means by which the great transformation will take place (more money for activist groups to lobby the UN). It is explicitly modelled on the anti-tobacco blueprint and is the final vindication for those of us who have warned that the slippery slope of nanny state regulation is becoming a runaway train.
The lead author of the report is Boyd Swinburn, a New Zealand doctor and food campaigner who declared last week on Twitter that the EAT-Lancet report shows where diets need to get to while his report shows how to get there. They are two sides of the same coin and whilst there is no shortage of policy suggestions in the EAT-Lancet document, including rationing and the outright prohibition of certain food products, the Lancet Commission takes it a stage further by calling for a global treaty.
Swinburn is obsessed with the web of corporate interests he sees all around him, thwarting his efforts to get the public to eat their greens. In 2017, New Zealand’s Ministry of Health commissioned the New Zealand Institute of Economic Research to look at the pros and cons of taxing sugary drinks. When the economists concluded, accurately, that ‘the evidence that sugar taxes improve health is weak’, Swinburn wrote a furious article denouncing ‘economists steeped in last century’s economic theories’, ‘merchants of doubt’ and the ‘vested interests of the food industry’. It is a theme he returns to with tedious regularity in the Lancet report. The following list of examples is by no means exhaustive…
Industries with vested interests, such as transnational food and beverage manufacturers, are powerful and highly resourced lobbying forces that have opposed governments’ attempts to regulate commercial activities… the power of vested interests by commercial actors whose engagement in policy often constitutes a conflict of interest that is at odds with the public good and planetary health… transnational ultraprocessed food and beverage manufacturers often exert a disproportionate influence on legislators and the policy making process… the vested interests of powerful transnational corporations produce financial benefits that are maximally privatised… the concentrated power of the large food corporations is the most powerful source of policy inertia… the enormous commercial investments focused on promoting sales of obesogenic products… Interventions that target obesogenic food environments and food systems are frequently and systematically undermined by the coordinated efforts of powerful food and beverage industry groups… The enormous political power of the food and agricultural system industries has consistently overwhelmed individual and collective government efforts to promote the public interest… The large, powerful food and beverage corporations (Big Food) have used multiple strategies to obstruct obesity prevention… Many countries have been unable to achieve this goal because of the vested interest influence of transnational corporations… powerful lobbying by the beverage industries continues, requiring constant vigilance and defence… corporations continue to strongly oppose these types of government intervention, and commonly exert their significant political influence to prevent further regulation… The strategies employed by some large food and beverage corporations to oppose public health policies focused on obesity prevention —eg, fiscal policies, front of pack labelling, and regulating food and beverage marketing aimed at children – are similar to those used by the tobacco industry… The heavy-handed lobbying tactics by the processed food and beverage industries against the prevention efforts of communities and governments means that those companies are seen as the enemy…
You probably skipped most of that. I don’t blame you. Imagine reading 56 pages of it.
Swinburn et al. seem to believe that the only barrier to governments leaping headlong into an extensive systems of taxes, warnings, bans and restrictions is ‘Big Food’. Whilst it would be naive to think that the various food lobbies have no influence on government policy, the authors never consider the possibility that this is because the industry’s arguments about trade, jobs, choice and prices appeal to politicians and, ultimately, to the public. ‘Big Food’ may not want tobacco-style regulation, but it is a logical fallacy to infer from this that politicians who reject such an approach have only done so because of ‘powerful lobbying’.
Whether or not the authors actually believe this narrative, it serves two useful purposes. Firstly, it allows wealthy activist-academics in the multi-billion dollar ‘public health’ industry to view themselves as plucky underdogs fighting Goliath. Secondly, it absolves them from answering difficult questions about whether their demands are reasonable, fair, or even realistic.
It reduces the complexities, values and trade-offs involved in democratic decision-making to a crude power game. When the ‘public health’ lobby wins, it is because the government recognises the obvious wisdom of its proposals. When it loses, it is because politicians are bewitched, threatened or bribed by the food lobby. Even the most conspicuous failures, such as Denmark’s fat tax and Chicago’s soda tax – both repealed due to overwhelming public opposition – do not require any soul-searching. They were simply beaten by ‘Big Food’.
With the debate boiled down to a battle of power and money, Swinburn et al.’s solution is obvious: more power and money for them, less for ‘Big Food’. Rejecting the ‘structures, practices, and beliefs that underpin capitalism in its present form’, they call for ‘a more state anchored approach’ in which the government gives money to activists to lobby the least accountable governmental institutions while cutting the food industry out of the conversation. This is the model that has served the anti-tobacco movement well for many years and Swinburn et al. intend to copy it wholesale, starting with a ‘Framework Convention on Food Systems’ modelled on the World Health Organisation’s Framework Convention on Tobacco Control (FCTC).
Launched in 2003, the FCTC is a treaty which theoretically requires its 168 national signatories to ban tobacco advertising, raise tobacco taxes, impose graphic warnings and introduce various other neo-prohibitionist policies. There have always been concerns that the FCTC would open the door to similar treaties aimed at stamping out other legal products. Anti-smoking campaigners insisted that this would not happen because tobacco is a ‘unique product’, but while Swinburn et al. accept that ‘food clearly differs from tobacco because it is a necessity to support human life’ they nevertheless call for a tobacco-style war of attrition to be enshrined in a global treaty because ‘energy-dense snacks, confectionery, and sugary drinks’ are ‘not a necessity’. This is the sound of goalposts moving.
One clause in the FCTC particularly appeals to anti-smoking campaigners. Article 5.3 requires governments to exclude tobacco companies from involvement in health policy. A reasonable request on the face of it, this clause has been unofficially gold-plated over the years to prevent any organisation with any connection to the tobacco trade, including farmers and retailers, from discussing any aspect of tobacco policy with politicians. It has led to such absurdities as Interpol being banned by the World Health Organisation from attending a meeting as a spectator because it had received funding from Philip Morris to tackle cigarette smuggling.
To a single-issue campaigner, the prospect of locking your opponents out of the room is the stuff of dreams and it naturally appeals to those engaged in the growing war on food. Borrowing a phrase from the FCTC, Swinburn et al. claim that ‘a fundamental and irreconcilable conflict exists between some food and drink industries and those of public health’ and propose a global agreement ‘based on Article 5.3 of the FCTC which explicitly excluded the tobacco industry from policy development and implementation. An article as strong as Article 5.3 must be adapted to tackle unhealthy food systems’.
Aside from being patently undemocratic, the exclusion of the food and drink sector from ‘policy development and implementation’ would be wholly impractical. Swinburn et al. accept that there are many benefits from public–private partnerships, including ‘promotion of healthy workplaces, development of food and drinks low in salt, sugar, and fats, support for local, less processed foodstuffs, environmental protection (eg, organic production and reduced food miles), and social benefits (eg, investing through corporate social responsibility)’. They say that voluntary food reformulation schemes, of the kind currently underway in Britain, ‘could be important steps in achieving healthier food environments’. Nevertheless, their instinctive suspicion of capitalism and commerce leads them to conclude that ‘partnerships between the corporate food sector and the government are a risk to public health’ and should be abolished.
Abolishing them does not imply that madcap schemes to remove arbitrary quantities of sugar, salt, fat and calories from food will end. On the contrary, it means that they will become compulsory, with targets set without consulting the manufacturers and restaurants that will have to meet them. A system of free market competition in which businesses respond to consumer demand will be replaced by a top-down system of coercion in which bureaucrats and activists, neither of whom have any food manufacturing experience, create mandatory, low-calorie recipes for the masses.
Cutting businesses out of the conversation is the first of three planks of the Lancet plan. The second is to create a slush fund for ‘civil society’ campaigners to lobby for tobacco-style regulation of the food supply. In the world of global public health, ‘civil society’ is a collection of carefully vetted, mostly state-funded, full-time activists masquerading as citizen’s action groups. Ordinary consumers need not apply.
It is no wonder, then, that Swinburn et al. can boast that there is ‘extensive backing for a Framework Convention approach to food and obesity among civil society organisations’. No wonder, either, that they want philanthropists and governments to create a $1 billion slush fund to pay for the ‘social advocacy and social lobbying of civil society’ which, they say, ‘would greatly increase the demand for policy action’. They are particularly impressed with ‘Mexico’s approach of providing philanthropic funding to consumer and health nongovernmental organisations (NGOs), to create public pressure for healthy policies’. They omit to mention that obesity rates have risen significantly in Mexico since these ‘healthy policies’ were implemented.
Swinburn at al. seem to have no problem with the mega-rich buying influence in politics so long as they are on the right side. The billionaire behind the EAT-Lancet project is therefore one of the good guys. So too is Michael Bloomberg who contributed $16 million to the Mexican campaign and has spent millions more lobbying for sugar taxes in the USA. But even these wealthy benefactors do not have deep enough pockets to stump up $1 billion for ‘civil society organisations’ to ‘create greater demand for policy actions’ and Swinburn et al. explicitly call for more money from government.
Where should this taxpayer-funded lobbying should be directed? That is the third plank of the plan. Rather than deal with awkward politicians in liberal democracies – some of whom may foolishly believe in ‘market-based solutions that are grounded in neoliberal economic and governance models’ – they intend to bypass the electorate entirely and focus on the least accountable global institutions. The World Health Organisation is the obvious place to start, but Swinburn et al. also recommend that ‘UN agencies and regional bodies (eg, European Union and Pacific Forum) should use their constitutional provisions to develop legally binding agreements such as the Framework Convention on Food Systems’. The World Bank, World Economic Forum and World Trade Organisation are all name-checked as institutions that could drive political change and help overcome legal challenges.
And there you have it. Two reports in as many weeks from the Lancet, the first instructing people to adopt a peasant diet, the second instructing super-national organisations to bring it about by force. It is difficult to imagine a more blatantly elitist and undemocratic project, but there it is in black and white. As I said before, don’t say you haven’t been warned.