Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, United Kingdom.
Menzies Centre for Health Policy, School of Public Health, Charles Perkins Centre (D17), The University of Sydney, NSW, 2006 Australia.
Soc Sci Med. 2021 Mar;273:113761. doi: 10.1016/j.socscimed.2021.113761. Epub 2021 Feb 11.
Unhealthy diets are increasing contributors to poor health and mortality in low- and middle-income countries (LMICs). Government interventions targeting the structural drivers of unhealthy diets are needed to prevent these illnesses, including nutrition labelling regulations that create healthier food environments. Yet, implementation remains slow and uneven. One explanation for slow implementation highlights the role of politics, including powerful ideological discourse and its strategic deployment by economically powerful actors. In this article, we advance research on the politics of nutrition policies by analysing political discourse on nutrition labelling regulations within an influential and under-studied global institution: the World Trade Organization (WTO). We identified WTO Technical Barriers to Trade (TBT) Committee meeting minutes with reference to nutrition labelling policies proposed by Thailand, Chile, Indonesia, Peru, Ecuador, Bolivia, and Uruguay (2007-2019; n = 47). We analysed the frames, narratives, and normative claims that feature in inter-country discourse within TBT meetings and examined how actors mobilize ideological and material sources of power via these statements. We find that informal government challenges to nutrition labelling proposals within the Committee featured a narrative that individualized the causes of and solutions to poor diet, downplayed harms from industrialised food products, and framed state regulation as harmful and unjust. These non-technical claims mobilised neoliberal ideology and rhetoric to contest the normative legitimacy of members' proposals and to de-socialize and de-politicize poor diets. Furthermore, high-income countries (HICs) re-framed policy goals to focus on individual determinants of poor nutrition whilst calling for their preferred policies to be adopted. Patterns of discourse within TBT meetings also had striking similarities with arguments raised by multi-national food corporations elsewhere. Our findings suggest that non-technical and ideological arguments raised during TBT meetings serve as inconspicuous tools through which nutrition labelling policies in LMICs are undermined by HICs, industry, and the powerful ideology of neoliberalism.
不健康的饮食是造成中低收入国家（LMICs）健康状况不佳和死亡率上升的主要因素。需要采取政府干预措施，针对不健康饮食的结构性驱动因素，包括营养标签法规，以创造更健康的食品环境，从而预防这些疾病。然而，实施进展缓慢且不均衡。一种解释是政治在其中发挥了作用，包括强大的意识形态话语及其在经济实力强大的行为者中的战略部署。在本文中，我们通过分析有影响力但研究不足的全球机构——世界贸易组织（WTO）内的营养标签法规的政治话语，推进了营养政策政治方面的研究。我们确定了 WTO 技术性贸易壁垒（TBT）委员会会议记录，其中提到了泰国、智利、印度尼西亚、秘鲁、厄瓜多尔、玻利维亚和乌拉圭提出的营养标签政策（2007-2019 年；n=47）。我们分析了 TBT 会议中国家间话语中的框架、叙述和规范主张，并研究了行为者如何通过这些声明调动意识形态和物质权力来源。我们发现，委员会内对营养标签提案的非正式政府挑战的叙述将不良饮食的原因和解决方案个体化，淡化了工业化食品的危害，并将国家监管描述为有害和不公正的。这些非技术性主张利用了新自由主义意识形态和言论，对成员提案的规范合法性提出质疑，并使不良饮食去社会化和去政治化。此外，高收入国家（HICs）重新调整政策目标，将重点放在不良营养的个体决定因素上，同时呼吁采用他们偏好的政策。TBT 会议中的话语模式也与跨国食品公司在其他地方提出的论点惊人地相似。我们的研究结果表明，TBT 会议中提出的非技术性和意识形态论点是一种不显眼的工具，通过这些工具，HICs、行业和新自由主义的强大意识形态破坏了 LMICs 的营养标签政策。
