Boatwright Monique, Lawrence Mark, Carriedo Angela, Slater Scott, McCoy David, Northcott Tanita, Baker Phillip
Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia.
Int J Health Policy Manag. 2024;13:8310. doi: 10.34172/ijhpm.8310. Epub 2024 Oct 14.
The importance of the international food regulatory system to global health, is often overlooked. There are calls to reform this system to promote healthy and sustainable food systems centred on the Codex Alimentarius Commission (Codex), the United Nation's (UN's) standard-setting body. Yet this presents a significant political challenge, given Codex has historically prioritized food safety risks over wider harms to public health, and is dominated by powerful food exporting nations and industry groups with a primary interest in trade expansion. To better understand this challenge, we examine who participates and contests Codex standards, using the development of the new Guidelines on Front-of-pack Nutrition Labelling (FOPNL) as a case study.
The study involved: () collecting Codex Committee on Food Labelling (CCFL) documents (2016-2023); () identification, categorization, and enumeration of actors involved in the development of the Guidelines; and () guided by a constructivist framework, analysis of how actors framed and contested key provisions of the Guidelines.
Country representation was skewed towards high-income (47.9%). Member state delegations were dominated by non-health ministries (59.8%) and industry actors (16.1%). Industry actors comprised the large majority of observers (84.2%) and civil society actors representing public health interests the least (12.2%). Commercial actors used frames supporting positive FOPNL messages (eg, low in salt) opposing negative ones (eg, "high-in" sugar warnings) and called for product exemptions (eg, sports foods and baby foods). Public health actors used frames supporting simplified FOPNL to reduce consumer confusion, that hold up public health goals, and prevent inappropriate marketing.
Participation in the Guidelines development process suggests stronger preferences for trade facilitation and commerce over public health. Ambitions to reform the international food regulatory system may require an examination of who participates and how to address this asymmetrical representation of interests. These results suggest the need to greatly strengthen public health representation at Codex.
国际食品监管体系对全球健康的重要性常常被忽视。有人呼吁改革这一体系，以促进以联合国食品法典委员会（食典委）为核心的健康且可持续的食品体系，食典委是联合国的标准制定机构。然而，鉴于食典委历来将食品安全风险置于对公众健康更广泛危害之上，且由主要关注贸易扩张的强大食品出口国和行业团体主导，这带来了重大的政治挑战。为了更好地理解这一挑战，我们以新的预包装食品营养标签指南（FOPNL）的制定为例，研究谁参与了食典标准的制定以及谁对其提出了质疑。
该研究包括：（1）收集食品标签法典委员会（CCFL）2016 - 2023年的文件；（2）识别、分类和列举参与指南制定的行为主体；（3）在建构主义框架的指导下，分析行为主体如何构建和质疑指南的关键条款。
国家代表性偏向高收入国家（47.9%）。成员国代表团中非卫生部门占主导（59.8%），行业行为主体占16.1%。行业行为主体构成了绝大多数观察员（84.2%），而代表公共卫生利益的民间社会行为主体占比最少（12.2%）。商业行为主体采用支持正面FOPNL信息（如低盐）的框架，反对负面信息（如“高糖”警告），并呼吁产品豁免（如运动食品和婴儿食品）。公共卫生行为主体采用支持简化FOPNL以减少消费者困惑的框架，坚持公共卫生目标，并防止不当营销。
参与指南制定过程表明，相较于公共卫生，对贸易便利化和商业的偏好更强。改革国际食品监管体系的目标可能需要审视谁参与其中以及如何解决这种利益代表不对称的问题。这些结果表明有必要大幅加强食典委中公共卫生代表的力量。
