The politics of food in the Pacific: coherence and tension in regional policies on nutrition, the food environment and non-communicable diseases

Abstract

Objective:Our study analysed evolving regional commitments on food policy in the Pacific. Our aim was to understand regional priorities and the context of policy development, to identify opportunities for progress.Design:We analysed documentation from a decade of regional meetings in order to map regional policy commitments relevant to healthy diets. We focused on agriculture, education, finance, health, and trade sectors, and Heads of State forums. Drawing on relevant political science methodologies, we looked at how these sectors ‘frame’ the drivers of and solutions to non-communicable diseases (NCD), their policy priorities, and identified areas of coherence and tension.Setting:The Pacific has among the highest rates of non-communicable diseases in the world, but also boasts an innovative and proactive response. Heads of State have declared NCD a ‘crisis’ and countries have committed to specific prevention activities set out in a regional ‘Roadmap’. Yet, diet-related NCD risk-factors remain stubbornly high and many countries face challenges in establishing a healthy food environment.Results:Policies to improve food environments and prevent NCD are a stated priority across regional policy forums, with clear agreement on the need for a multi-sectoral response. However, we identified challenges in sustaining these priorities as political attention fluctuated. We found examples of inconsistencies and tension in sectoral responses to the NCD epidemic that may restrict implementation of the multi-sectoral action.Conclusion:Understanding the priorities and positions underpinning sectoral responses can help drive a more coherent NCD response, and lessons from the Pacific are relevant to public health nutrition policy and practice globally.

Ultra‐processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers

“…Far fewer have implemented more upstream actions targeting food supplies and food environments including, among others, taxes on SSBs (38%) and unhealthy foods (6%), front‐of‐pack labelling schemes (25%; with just over half being mandatory), elimination of industrially produced trans‐fats (37%), portion‐size controls (16%) and school food standards (43%) 184,185 . The majority of these actions have been taken in HICs in Europe, 183 although UMICs with high obesity and diet‐related NCD burdens in Latin America and the Pacific Islands are world leaders 88,186,187 . Weak worldwide policy responses and the skew towards lifestyle‐behavioural interventions at least partly reflect the nature of food regulatory paradigms in many countries.…”

“…184,185 The majority of these actions have been taken in HICs in Europe, 183 although UMICs with high obesity and diet-related NCD burdens in Latin America and the Pacific Islands are world leaders. 88,186,187 Weak worldwide policy responses and the skew towards lifestyle-behavioural interventions at least partly reflect the nature of food regulatory paradigms in many countries. For example,…”

Health in Food Systems Policies in India: A Document Review

“…This may be explained by the larger neglect of social and commercial determinants of health, which include, among others, the strong influence of corporations on food environments and consequently on NCDs. [79][80][81][82] The gap in health consideration in trade policies is also related to similar factors, such as the primary objective of trade policies being economic development, neoliberal ideology, and power disparities between actors, 83 and shifting the health responsibility to the consumer. 84 These aspects have also been reflected in multi-country trade deals involving high-income countries.…”

Scaling-Up Food Policies in the Pacific Islands: Protocol for Policy Engagement and Mixed Methods Evaluation of Intervention Implementation

“…Both Fiji and Samoa undertake regular surveys of the school food environment and compliance with healthy school food policies. In Samoa, data is collected on food availability and the food environment within each school at least annually and reported through a multisectoral coordination mechanism [30]. In Fiji, the Ministry of Education, Cultural Heritage and Arts is responsible for implementation and monitoring the Policy on School and Food Canteen.…”

“…Signi cant barriers potentially stand in the way of effective implementation of these policies [13,30].…”