http://www.wphna.org/2012_dec_hp1_mexico_meeting.htm

The leaders from civil society, universities, research centres, UN agencies

and national governments, who met in Mexico City on 25-26 November 2012

Stop childhood obesity

Access the Declaration in Spanish here

Mexico City, 26 November 2012

THOSE WHO HAVE SIGNED BELOW, DECLARE:

The epidemics of poor diet and physical inactivity cause obesity and chronic diseases like diabetes, cardiovascular diseases and cancer. These together are the leading cause of hospitalisation, disability and preventable deaths in the hemisphere. Particularly, obesity affects one in four school children and one in two adults. This situation constitutes a public health crisis that needs to be prevented and controlled, especially among children. Describing the damage and alerting individuals and families has been insufficient. We are facing a major systemic crisis, which as such requires an equally systemic answer. This needs to include leadership from public authorities, governments that guarantee the rights to health, healthy food and appropriate information, and the use of public policy mechanisms and law, such as the experience on fighting malaria, dengue, road and street safety, tobacco, alcohol and other epidemics and public health issues.

The scientific evidence on the basic, direct and underlying causes of obesity is sufficiently strong to generate effective measures to help control the epidemic. Among these measures are the following:

Create an optimal health-promoting food environment in schools, to include:

Ensuring access to free drinking water and availability of minimally or unprocessed foods (such as fruits and vegetables), preferably produced locally, and healthy, nutritious and low energy-dense meals, controlled portion sizes and restrictions on salt/ sodium, sugars, saturated and trans fats, consistent with the recommendations of the World Health Organization Global Strategy.

Restricting availability, sale and advertisement of sugary drinks and industrialised products high in energy density, sugars, salyt/sodium, saturated and trans fats.

Providing nutrition education and knowledge on local and national agricultural and culinary traditions in basic school education programs.

Examples of initiatives in schools that include several of the above elements, are being conducted in Mexico, Brazil, Costa Rica and Ecuador. Examples are:

Ensuring the preservation or implementation of physical education programmes as a mandatory part of the school curriculum.

Providing free access to drinking water in schools, places of public congregation and workplaces.

Favouring availability of fruits and vegetables, and limiting availability and access to sugary drinks and foods high in calories, sugars, saturated and trans fats and salt/sodium, in government workplaces.

Protecting children from advertising of sugary drinks and packaged food products, using effective regulatory measures. These should refer to recommendations from the World Health Assembly (2010), the framework for the implementation of such recommendations (2012), and the Pan-American Health Organization/WHO expert consultation (2012).

Promoting breastfeeding and ensuring full and effective implementation of breastmilk substitutes codes that countries are required to implement.

Establishing front of package labelling that clearly identifies packaged food and drink products not recommended due to their high content of salt/sodium, sugar, saturated and trans fats and calories, to include textual and/or pictorial warnings of the high levels of these ingredients. This should be accompanied by measures to promote unprocessed natural foods.

Adopting effective fiscal policies, such as subsidies to encourage increased consumption of fruits and vegetables, and taxes that discourage consumption of sugary drinks and food products high in calories, sugars, saturated and trans fats, as well as salt/sodium. When possible, allocate tax revenues to purposes related to public health issues.

Developing information and communication strategies, with the support of experts, and in partnership with the media and education and civil society organisations. These should be permanent programmes that help the public to become familiar with healthy ways of life, including healthy diets, and that warn against dangers of regular consumption of processed products that increase the risk of obesity and chronic diseases.

National authorities that decide to act to protect children from the obesity epidemic should do so by government decrees or laws, so that the implementation of standards becomes mandatory and effective.

Progress in the prevention of obesity in children is only part of a larger initiative to assure populations of the right and real access to healthy food supplies and thus diets. This requires the engagement of various national public sectors, such as agriculture, food security, education, health, trade and finance. It also requires participation of organisations from civil society, professional institutions, academia, and all industry sectors whose commercial interests and practices are in the interests of public health and the public good, as set out here.

Products whose consumption or advertising should be restricted need to be identified and defined. This work needs to be done for Latin America as a whole, at continental level. This will also be a guide for other continents and countries.

Specific areas where action is needed also at continental level include the following. Sales regulations for food products in schools. Guidelines for school food programmes. Regulation of advertising of packaged foods and sugary drinks, and front labellling of unhealthy processed food products. We recommend that the PAHO/WHO assembles one or more groups of experts to undertake this and the task in point (5) above.

It is essential to ensure effective independent monitoring and evaluation of public policies. This is work in which social movements, academia and public interest non-government organisations should effectively participate.

The recommendations of the meetings of experts referred to in points (5) and (6), should be acknowledged, submitted to consultation with member states and intergovernmental organisations, and endorsed by UN agencies responsible for health (PAHO/WHO), education (UNESCO), children (UNICEF), food and agriculture (FAO), and food aid (WFP). Non-UN organisations such as the World Cancer Research Fund and the Latin American Parliament, among many others, should also be engaged. The ideal mechanism will be a Framework Agreement for the Health of Children and against Obesity. This will facilitate concerted regulatory action, and will also protection national governments against the intense lobbying of transnational and other food and drink corporations to maintain a state of deregulation or self-regulation.

UN and other public agencies and institutions, and national governments, need to avoid conflicts of interest, during public policy development. This means that conflicted industry, such as transnational food and drink corporations and their associates and representative organisations, should not be involved in the framing of public policies and regulatory measures. They may be invited to comment as this work progresses, and necessarily will be part of the process of implementing these policies and measures.

We will maintain coordination of those attending this meeting. We request PAHO/WHO or another UN agency concerned with food, nutrition or health to be the body responsible for this coordination. This will include a mechanism of electronic communication to help in networking and building information.

These recommendations will now be made public and sent among others to the relevant officials of the agencies and organisations listed in point (8).

Signed