WHO Response to WTO Member State Challenges on Tobacco, Food and Beverage Policies
In 2013, the World Health Assembly endorsed the World Health Organization’s (WHO) Global action plan for the prevention and control of noncommunicable diseases 2013–2020 to achieve a 25% reduction in mortality from noncommunicable diseases by 2025. Two years later, all the world’s governments committed to reducing the global burden of noncommunicable diseases as part of the sustainable development goals. The rationale for these commitments is clear: in 2016, noncommunicable diseases caused almost three-quarters of all deaths worldwide, and this burden has significant economic costs. The World Economic Forum estimates that, without concerted action, cumulative economic losses from noncommunicable diseases will exceed 7 trillion United States dollars over the period 2011–2025 in low- and middle-income countries.
WHO’s Global Action Plan is ambitious, as it aims to achieve a world free of the avoidable burden of noncommunicable diseases. The plan recognizes that this aim can only be achieved through determined action by Member States and international partners. The contribution of WHO is its ability to convene, set norms and standards, and offer technical support. For example, WHO has developed cost–effective interventions for preventing noncommunicable diseases that include labelling regulations on unhealthy food high in salt,fat and sugar, soft drinks, tobacco and alcoholic beverages.
Trade debates on tobacco policy
WHO used its treaty-making powers to address the issue of tobacco use, leading to the Framework Convention on Tobacco Control (FCTC). The FCTC has enabled WHO to have a greater presence at World Trade Organization (WTO) meetings, supporting countries in their efforts to protect their populations against the harms from tobacco. Governments might need this support when other members invoke WTO rules to challenge their public health policies based on their purported trade costs. Such challenges may arise even if the policies do not necessarily conflict with WTO requirements, for example if novel approaches are proposed, the application of the rules is uncertain or governments misrepresent WTO rules.
According to an analysis of the archives of tobacco and nutrition policy discussions at WTO’s Technical Barriers to Trade Committee, where WHO has an observer status, there were 93 informal trade challenges proposed by WTO members, between 1995 and 2016. It was found that the number of challenges per year increased from zero in 1995 to a high of 14 in 2014.
At least 15 debates about policies affecting trade in tobacco products were raised at WTO meetings, although only one escalated to a formal dispute under WTO dispute settlement rules (and a WTO panel eventually ruled in favour of the policy). WHO has attended WTO debates about tobacco and defended challenged or disputed tobacco control measures by citing the FCTC.
Trade debates on nutrition policy
While WHO was present when tobacco trade may conflict with public health concerns, this was not the case in WTO discussions concerning nutrition policy. Our analysis showed that between 1995 and 2016 there were 82 challenges to regulations affecting food and beverage products at the Technical Barriers to Trade Committee. Some health measures challenged included those in WHO’s list of cost–effective interventions for preventing noncommunicable diseases. Forty-seven (57%) of these challenges were against labelling regulations, with 24 (29%) on quality standards and restrictions on certain products or ingredients.
Increasing WHO participation
Even though the Global action plan for the prevention and control of noncommunicable diseases, 2013–2020 fully recognizes the need for action on trade in certain foods and beverages, the researchers were unable to find any evidence of WHO participation in nutrition-related trade challenges, such as those related to unhealthy food high in salt, fat and sugar, alcohol, soft-drinks and infant milk formulae. WHO can learn from its past successes in championing tobacco control at the WTO. WHO has a responsibility to refute false claims, especially those that challenge the adequacy of evidence supporting particular policies, such as alcohol beverage labelling regulations, marketing and labelling requirements for energy drinks and regulations for front-of-pack nutrition labelling for food products. For example, some governments have argued that daily meal guides and education campaigns are effective in preventing obesity. Yet there is extensive evidence that these approaches have very little, if any, impact.