'Bad science' bogey

WHO has time and again said that the strategy is based on scientific evidence, successful campaigns against NCDs in several countries and on recommendations from health and nutrition experts from across the globe. But the sugar and food industry and their lobbyists have tried to discredit the strategy by saying that any link between obesity and diet is bad science. Civic groups say the same tactic is used by the tobacco industry, which says there is no clear evidence to show smoking affects health.

TRS 916 was based on epidemiological studies which said populations eating foods having little sugar and fat were healthier. The report cited South Korea, where communities eating traditional diet rich in vegetables had a lower incidence of chronic diseases. But though these studies of the WHO proved that high-density foods lead to obesity and NCDs, they didn't directly prove that sugar or fat cause these diseases.

Standing in support of the food and sugar industry is the US government, whose Department of Health and Human services in 2003 produced a 28-page response to TRS 916, which accuses the strategy of "lack of transparency in the scientific and peer-review process".

US Senators Larry E Craig and John Breaux, co-chairpersons of the Senate Sweetener Caucus and lobbyists for the Sugar Association, USA, last year wrote to Tommy Thompson, health and human services secretary, to persuade WHO to "cease further promotion" of the strategy. The two senators have even said that the US should stop making its annual US $406-million contribution to WHO unless it provided better evidence to link bad food with health.

"We recommend the strategy be voted against by members of the WHA. We are opposed to misguided health policies such as the existing draft WHO global strategy which is not supported by the totality of science," says Andrew Briscoe, president and chief executive officer of the Sugar Association. To weaken WHO's strategy, the sugar industry has touted a report by the Washington-based Institute of Medicine which says that sugar can form 25 per cent of daily diet. But Harvey V Fineberg, president of Institute of Medicine, has made it clear that this is a total misinterpretation of facts. The institute's report says that if a person takes 25 per cent or more added sugars daily, he or she may be not getting enough essential nutrients.

Continuing with this bad science tirade, William Steiger, special assistant to USA's secretary for international affairs, in February 2004 sent his comments on the strategy to WHO's director general. Steiger heavily edited and diluted the strategy and called for weaker and vague approaches like "better data and surveillance, and the promotion of sustainable strategies that focus on energy balance, individual responsibility, and strong public health approaches."

WHO strongly denies that its recommendations can't stand scientific scrutiny. "Those who say that the report is unscientific are themselves unscientific. In fact, several independent expert bodies have come to the same conclusions as the scientists behind TRS 916," says Kaare R Norum, chairperson of WHO's reference group for the global strategy on diet, physical activity and health. Faced by these criticisms, TRS916's

recommendations were dropped from the WHO strategy.

Industry creates scare
In this propaganda, the industry cries 'bad science' and then scares countries by reeling out the consequences of following WHO's strategy. Riaz Khan, director general of the London-based World Sugar Research Organisation (WSRO), at FAO's Rome meeting gave a presentation which said that if the strategy is accepted, sugar consumption would decrease by 20 million tonnes and world trade drop by 3.5 to 6.5 million tonnes.

But the truth is that if the world sugar market were to be opened up, net imports would increase by 15 million tonnes every year and create employment for nearly one million workers in developing countries. World sugar prices would increase by at least 40 per cent, and prices in countries like USA that protect their industry would drop. For example, Brazilian producers would earn US $2.6 billion per year from this open market. It's true that this open market would mean Brazilian consumers will have to pay one billion dollars more for sugar, but this still leaves the country with a profit of US $1.6 billion. If the US were to open its market, developing nations' annual export earnings would rise by about US $1.5 billion.

Oxfam, a British non-governmental organisation, in April 2004 claimed in a paper, The Great EU Sugar Scam, that the EU's common agricultural policy grants enormous subsidies (an estimated US $976 million) to European sugar companies, who then dump their excess production in poorer countries. EU sugar companies are guaranteed minimum price, which is two to three times the world market price, but developing countries are kept out of the European market.

Sweden has suggested a solution that the EU should decrease export refunds and tariffs on fruits and vegetables and open up the European market to the outside world. "The Swedish government has just sent a letter to the EU-Commission concerning this issue. We are now informing our public health colleagues all over the EU so that they discuss this with their ministries of agriculture ahead of the common agricultural policy reform in 2006," says Liselotte Schfer Elinder, research manager, National Institute of Public Health, Sweden.

But WSRO, which has Coca-Cola and Pepsi among its members, wouldn't like a debate on open markets. Experts say closed sugar markets hamper plans to control obesity and NCDs worldwide. "As the US refused to open its market during the trade talks, the Australian industry will now not allow its government to limit sugar intake in the country or in any other country which buys Australian sugar," says Geoffrey Leigh, clinical director, Australian Institute of Biological Medicine in a letter to the British Medical Journal.

What's the fuss
The US government is framing a new food pyramid which will suggest to its citizens that their daily diet should have 8 per cent sugar. WHO's strategy says it should be less than 10 per cent sugar. The US says fat should form 20-35 per cent of daily diet; WHO says 15-30 per cent. The US surgeon general has called for examining the marketing practices of the fast food industry, ensuring that healthy foods are available in schools, keeping students away from vending machines and creating laws and policies that promote healthy lifestyles. Why won't then the US government let WHO recommend similar strategies?

The reason, consumer groups allege, is that USA wants to keep its people healthy, but ensure that its industries can sell their junk food to developing nations (see box: Consumer Power). Developing countries is where the money is -- Coca-Cola earns over 70 per cent of its profits outside the US. The value of Coke's brands increased from US $68.95 billion in 2001 to US $69.64 billion in 2002 because of growing sales in developing countries. By the end of 1993, one third of McDonald's stores were overseas and accounted for half of its profits. Four out of every five new McDonald's restaurants are now opening abroad rather than in the US.

The world has lot to gain if it switches to a healthy diet. "If the strategy is accepted, diabetes is likely to decrease by forty to sixty per cent worldwide," says Nigel Unwin, medical officer, diabetes programme, WHO. "Traditional risk factors like smoking, unhealthy diet and physical inactivity explain 75 per cent of the cardiovascular diseases. If these risk factors are addressed, cardiovascular diseases can be halved within the next 10 years," says Shanti Mendis, coordinator, cardiovascular diseases, WHO. "The questions on what kind of food pyramids, what kind of nutrition education, what kind of food labelling will have to be decided on national levels. If the strategy will be adopted, further international work particularly on regional basis would be needed," says Puska.

Why then are developing countries like India spending their precious resources on treating these diseases and not following a plan which would prevent them? Because you don't just feed yourself, that sugar and fat in your food is making profits for nations and industries. They want you to keep eating.

With inputs from Lopamudra Banerjee Dhar in USA