Voices Wednesday, May 20, 2015 - 05:30

The debate is neither new nor resolved and both sectors of society – media and public health – have arrived at the same point from different angles.  As the World Health Assembly (WHO) finds itself in knots after inviting large corporations to provide inputs to developing global health policy, the raging debate is reminiscent of large corporations telling editors in newsroom what to write and what to spike.

A spiked story will not kill. Bad food can cause a range of diseases from diabetes to strokes, cancers to cardiovascular diseases. We in India seen how large infusions of money into a public good that is the media has resulted in journalism going down the drain, replaced by noise and infotainment masquerading as news and current affairs.  At a time when western countries are eating healthy, giving up smoking and fighting obesity on all fronts, what sense does it make for the WHO to give new life to the food and beverage industry at the high table? (see story) and call for “trust” and “inclusiveness” from all?

The results are there for all to see. Over sixty percent of deaths in India are brought about by non-communicable diseases (NCDs) such as the ones listed above. In a short span of one year, our offices in Bangalore is surrounded by eateries that sell donuts, pizzas and sugar water with one for the prize of two sometimes three. Profit is the only motive and aggressive marketing is hugely rewarded.

There is a more fundamental problem. The WHO’s constituents are countries and within that people with little or no access to primary health care. In a company, especially the listed ones, shareholders decide what can be sold, where and how much with monetary profit being the only incentive. Throw in a few academic institutions that study data from developing countries and come up with theories which sustain this market driven need to be more profitable. To keep civil society happy, a few crumbs are thrown at them either through Corporate Social Responsibility (CSR) projects, academic chairs or book contracts. Food companies, for example, set sugar and saturated fat items in full knowledge of the health damage that can occur and then provide health and wellness foods on the other end.

The responsibility to protect their people, especially in public health, lies with governments. There is a moral angle to working in public health as opposed to selling computers. In this context, it is rather alarming that a parliamentary committee in India tasked with proposing larger pictorial warnings on tobacco products actually took a step back arguing that there was no link between tobacco (cigarettes and chewing tobacco) and cancer. This led to a massive uproar in the country, but the final word on that is yet to be pronounced. It is important to recall that in the early 1950s, Sir Richard Dole established beyond an iota of doubt that tobacco use causes cancer. But the parliamentary committee in India claimed there was no Indian evidence to prove tobacco causes cancer. What is to prevent an Indian company to say it is okay to splurge on sugar even when you have diabetes?

Before the WHO embarked on negotiating the world first treaty devoted entirely to public health – the Framework Convention on Tobacco Control (FCTC) – a small group of people of which I was a part were asked to investigate if the organization had been penetrated by the tobacco industry. It was, especially in the area of second-hand smoke.  The Global Health Council (GHC)’s list is a mixed bag – it has some of the best minds in the world on the list, but there are others for whom profit is the only motive. How is the WHO going to differentiate between chalk and cheese when it comes to involving the industry? How will the health body ensure that people who come from universities to WHO meetings do not have grants from the tobacco, food, alcohol and other harm-causing industries?

Member-states simply do not have the wherewithal to conduct due-diligence. In fact, it is not their job in the first place. The next few weeks and months will show if the WHO has bitten off more than it can chew.

Also read the related article: Did the WHO just invite corporates to set health policy?