Overweight and obesity have reached epidemic proportions among all age groups in the Caribbean and Chile, including children under five. This increases the risk of non- communicable diseases (NCD), mortality and morbidity, and imposes enormous financial strain on individuals, families, communities and societies at large. Addressing this epidemic requires effective laws and regulations that target the current obesogenic environment, as reflected in numerous global and regional mandates, including the Pan American Health Organization/World Health Organization (PAHO/WHO) Plan of Action for the Prevention of Obesity in Children and Adolescents, and the Caribbean Public Health Agency (CARPHA) six- point core policy package.
Towards a Solution
The project, ”Advancing public health policies to address overweight and obesity in Chile and the Caribbean Community”, was developed by the Caribbean Community (CARICOM) and the Government of Chile within PAHO’s Cooperation among Countries for Health Development (CCHD) framework, a new approach to PAHO’s delivery of technical cooperation intended to foster horizontal alliances and cooperation between countries. The project was endorsed by the Ministries of Health of the Caribbean during the 33rd meeting of the Council for Human and Social Development (COHSOD) in September 2017, conferring a strong mandate to achieve its objectives.
This initiative aims to support the development and implementation of effective laws and regulations to address the current obesogenic environments in the Caribbean Community while helping to systematize, internationalize and consolidate Chile’s experience as State policy. More specifically, the project focuses on Chile’s innovative front- of-package labelling (FOPL) legislation, which consists of nutritional warnings with a ”high in” message to facilitate healthier choices by allowing consumers to quickly and easily identify pre-packaged foods high in sodium, saturated fats, sugar and/or total calories.
To that end, the project includes a combination of complementary sub-regional and country-specific activities for greater impact and reach. At the sub-regional level, efforts are focused on revising the current CARICOM standard for the labelling of pre-packaged foods to include mandatory nutritional labelling and FOPL and expanding research to support evidence-based policy-making. This sub-regional approach will benefit multiple countries and avoid duplication of efforts, optimizing the use of national resources that could be directed towards actual implementation. Country-specific work consists of direct technical assistance to Barbados, Jamaica and Suriname to operationalize a roadmap for a step-wise approach for developing and implementing FOPL legislation.
This work also involves providing seed funds to stimulate action and investment at the country level, as a strategy to sustain efforts. Additionally, the initiative contributes to the
development of tools and resources to advance FOPL regionally, such as systematizing available evidence, taking a step-wise approach to developing and implementing FOPL, compiling frequent arguments and counter-arguments, defining research sufficient to support the development of FOPL legislation, both from a scientific and legal perspective, and creating a harmonized research protocol to produce such research. Deliverables from this work will contribute to the sustainability of the project, while benefiting other countries and subregions in the Americas.
To facilitate implementation of the lines of work outlined above, as well as systemic cross-country transfer and participation and coordination among partners, a CCHD project team was established to provide general oversight and direction. The CCHD project team’s terms of reference and work plan were agreed during an initial site visit to Chile, which offered the opportunity to engage and establish partnerships between Chilean and Caribbean stakeholders. This approach has been critical to ensure buy-in and adequate coordination with related ongoing projects. Through these exchanges, stakeholders have learned from Chiles experience with the policy development process and implementation of front-of-package labelling regulations.
Additionally, the project includes an objective aimed at facilitating exchanges between the Ministry of Health of Chile and CARICOM to identify future collaboration in the area of strengthening nursing capacity to address NCDs. In this regard, the partnerships and lessons learned from this South-South collaboration are now being leveraged to address other areas of joint interest, with an upcoming visit of a Caribbean delegation to Santiago de Chile in 2018 to discuss a potential second phase of the CCHD project.
In terms of replicability, other regional integration mechanisms, such as the Council of Ministers of Health of Central America and the Dominican Republic (COMISCA) of the Central American Integration System (SICA), are using the sub-regional approach to advance the FOPL proposed under this project. Political commitment is a key factor in the success of the initiative, as is an understanding that measures must be tailored to the context in which they will be implemented.
Sustainable Development Goal target(s): 2.2, 3.4
Countries/ territories involved: Caribbean Community (CARICOM), Chile
Supported by: PAHO/WHO
Implementing entities: PAHO, CARICOM Secretariat Health Desk, Caribbean Regional Organisation for Standards and Quality (CROSQ), CARICOM Office of Trade Negotiation (OTN), Caribbean Public Health Agency (CARPHA), Healthy Caribbean Coalition (HCC), University of the West Indies (UWI), Caribbean Law Institute Centre (CLIC), Ministry of Health of Chile, Ministry of Health of Jamaica, Ministry of Health of Suriname, and Ministry of Health of Barbados.
Project period: June 2017-October 2018
URL of the practice: www.paho.org/cchd/; goo.gl/MEH4As
Name: Country and Sub-regional Coordination Office, PAHO