The Illusion of Choice
A groundbreaking WHO report dived into power imbalances that are killing us
This week, I look at a WHO report that dived into powerful actors, including food and beverage companies, and the tactics they deploy to maximise profits and undermine public health, while positing their activities as supporting freedom and consumer choice.
Fact is, we live in an extremely unequal society where a few people and companies have a lot of power (check out my recent interview with Austin Frerick). The freedom we’ve been sold is really an illusion, like how all those choices you see at the supermarket actually come from the same handful of corporations.
Still, I believe enough of us have now taken the red pill - yes I’m showing my age with this reference - that we might soon reach the top of the Bell Curve to really push for change. Here’s me hoping.
Every day, we are confronted with both subtle and overt messages to buy, consume, and live life to the fullest. Here’s a new phone. Treat yourself to a steak for dinner! How about a new outfit for the weekend?
We are then told our choices are killing the planet and in some cases, ourselves. Also, we have only ourselves to blame, because we couldn’t resist eating/drinking/smoking/driving/flying too much.
The framing is that it’s our fault we are obese, anxious, and struggling to quit bad habits, that it’s our choices and behaviours that are causing climate change.
It is insidious and very problematic but highly effective.
It has also been successfully used by Big Tobacco, Big Oil, Big Pharma, and Big Ag, and this narrative has taken hold in many societies, even though the playing field is stacked against us ordinary citizens, even if/when we have the money, time, energy, and desire to live and eat sustainably. A vast majority of us don’t.
That’s why I believe that understanding power dynamics and exposing the vested interests within our food systems is crucial and essential to build better systems.
In that sense, it was very refreshing to read a report - a U.N. one no less - that not only spelled this out in detail but also served as a clarion call to governments to implement mechanisms to identify conflicts of interest, resist disproportionate influence of commercial actors, and protect public policies from industry interference.
But the publication of the report is just one step, albeit a massive one. Now we need to make sure it reaches far and wide and both policymakers and citizens take up its messages and recommendations.
The Key Messages
Four corporate products – tobacco, ultra-processed foods, fossil fuels and alcohol - kill more than 7,400 people every day in the WHO’s Europe Region, which covers Europe and Central Asia. This amounts to 2.7 million deaths a year. The figures are likely an underestimate.
They cause 19 million deaths per year globally, or 34% of all deaths.
This is mainly due to “harmful commodities and practices driven by commercial industry” which are causing non-communicable diseases (NCDs) such as cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes.
NCDs are responsible for 90% of deaths and 85% of years lived with disability in the Region. Two thirds of all deaths before 70 years of age in the Region are caused by the four major NCDs cited above.
None of the countries in the Region are on track to halt the rise in obesity.
The Report
On Jun 12, the World Health Organisation’s (WHO) regional office for Europe published a pioneering report, “Commercial Determinants of Noncommunicable Diseases in the WHO European Region”.
Don’t be put off by the unwieldy title. At its core, this is a report about how four powerful industries - tobacco, alcohol, food and beverage (including meat), and fossil fuels - are driving ill-health and premature mortality across Europe and central Asia.
It detailed how companies hawking these products interfered in and influenced efforts to prevent and control NCDs. It provided cases studies and examples also from the pharmaceutical industry.
By the way, a 2016 paper in The Lancet defined Commercial Determinants of Health as “strategies and approaches used by the private sector to promote products and choices that are detrimental to health”.
I think this report is AMAZING. I have read hundreds of reports in my two-decade career as a journalist and wish others would be as clear in explaining the power dynamics and why the wolves should not guard the henhouse or be part of the committee writing policies on how to keep the henhouse safe.
It’s 156 pages long and there doesn’t seem to be an executive summary, so if you want something much, much shorter, here’s the press release. But I’d urge you to at least read the Introduction, Chapter 3 (don’t miss the case study on meat), and the case study on sugar-sweetened beverages in Chapter 4.
How The Bad Actors Wield Their Influence
“Big industry spends significant resources to oppose public interest regulation, shape scientific evidence and public discourse, and externalize the cost of the harms they cause onto people and their environments, thereby fuelling the burden of NCDs,” the WHO said in the report.
“This ensemble of tactics, referred to collectively as the “industry playbook”, is designed to influence entire systems – health, political, economic and media – for their own interests, leading to significant health and social harm. To date, actions by individual governments, and intergovernmental organizations have been insufficient to prevent or restrict these harmful commercial practices.”
For example, they often:
Blame the public
They consistently promote the idea that individuals and their “poor” or “irresponsible choices”, rather than businesses, are the problem.
“The scale of the problems belies the fact that these are not the problems of a few individuals”, considering 53% of the world’s population have overweight or obesity. But according to PepsiCo’s chief executive, “If all consumers exercised, did what they had to do, the problem of obesity wouldn’t exist”.
Also, changing individual behaviour is hard, particularly without population-level policy interventions, which means their sales and profits, which are often backed by billion-dollar marketing campaigns that obfuscate the science and mislead consumers, are safe.
Meanwhile, we internalise these messages and then blame those least responsible for the choices available to them, including the unhealthy environments in which they live or work, and place the burden of addressing it on their shoulders.
Claim government intervention = nanny state & push for self-regulation
Regulation is often equated with red tape and bureaucracy and portrayed as an infringement of personal freedoms and a slippery slope to complete rule by government.
Of course, commercial actors then portray themselves as credible and able to self-regulate, but voluntary codes of practice have often been found to be ineffective, said the report.
“There is a clear conflict of interest when industries write the rules and enforce regulations for marketing practices that drive their profits and stakeholder returns.”
“Voluntary or multistakeholder partnership approaches do not work where conflicts of interest exist.”
“In the current mood where governments are accused of nannying the population and where international organizations are accused of taking over national sovereignty, little opportunity is being taken to demonstrate to the public how their NCD-related choices and sovereignty are being determined by a small group of transnational corporations acting in their own interests.”
Engage in lobbying to shape policies in their own interests
The report said there is now “overwhelming evidence” that these actors work to prevent, weaken, and delay the implementation of government policies that will improve public health but hurt their private profits.
“What is less well known is that they have also successfully shaped upstream policies… in their own interests.”
For example, they worked together to secure the implementation of a system of policy-making known in the EU as Better Regulation which has “a built-in a requirement for early consultation with affected actors and requires a form of business impact assessment”.
This then allowed “well-resourced commercial actors… to exploit this assessment to exert significant influence, thus weakening and delaying policies”.
The WHO pointed out the approximately 25,000 lobbyists in Brussels alone as a “critical point of concern” and said governments need to recognise “that the primary interest of all major corporations is profit and, hence, regardless of the product they sell, their interests do not align with either public health or the broader public interest.”
“Any policy that could impact their sales and profits is therefore a threat, and they should play no role in the development of that policy.”
Co-opt academics, scientists, and civil society
From 1959 to 1971, the sugar industry funded research into enzymes that break up dental plaque and a vaccine against dental caries to divert attention from interventions aimed at reducing sugar intake, according to internal industry documents.
Similarly, when evidence began to show the health hazards of smoking, tobacco companies in the U.S. created a research council that funded research on other potential causes of cancer and heart disease.
We’ve seen the same tactics from Big Ag and Big Meat. This is just one example and Marion Nestle has plenty more of industry-funded research and their often-questionable conclusions.
All of this is possible because these industries are heavily consolidated - they’re either monopolies, oligopolies, or oligopsonies. The case study on meat companies (page 32) is a perfect example.
Ten very large companies with headquarters in just five countries or regional blocks - Brazil, China, EU, Japan and the U.S. – have outsized power not just in terms of supply chains but also in farmers’ livelihoods and public health policy.
For example, by imposing low producer prices and forcing farmers to sell below their cost of production, farmers must raise large numbers of animals to keep satisfying the demand of Big Meat. They then have to rely heavily on public subsidies to survive. In the EU, at least 50% of income for cattle farmers come from direct subsidies.
In addition, more than two-thirds of the ambitious Farm to Fork Strategy “will likely remain unimplemented before a new European Commission takes office in November 2024” after falling victim to an intensive political campaign by industrial pressure groups.
“Evidence suggests that multinational meat giants, together with companies, such as petrochemical or pharmaceutical companies, have played a pivotal role in these efforts.... For instance, meat lobby groups, including the Liaison Centre for the Meat Processing Industry in the European Union (Clitravi) and the European Livestock Voice, have commissioned studies that attack the Farm to Fork strategy.”
What Can Be Done?
The report has a lot of suggestions - see Chapter 12 - but I’m quoting the below paras because they are succinct, if a little a generic.
“Commercial influence is exercised at different levels: the individual, the environment, public policy and the political economic system. The present report has noted the many ways through which that influence is exercised. Hence, actions to address the (Commercial Determinants of Health) need to target these different levels.
“Existing attempts to address the (Commercial Determinants of Health), for a great part, narrowly focus on the individual level and do not do enough to address systems and the environment. Moreover, public policies and population-level interventions often target individuals with the aim of changing behaviours, for example, with warnings on the front of packs of cigarettes and food products or social marketing campaigns.
“Public policies that target the environments in which people live can include marketing restrictions and taxation on harmful products. The health, social, and environmental impacts that result from commercial activities could also be subject to taxation. Decreasing the subsidies for harmful products or practices is another important action. These actions on the environments in which people live are of utmost importance to address the (Commercial Determinants of Health), particularly from a health equity perspective.”
More Key Quotes
“We really have to re-think. For too long we have considered risk factors as being mostly linked to individual choices. We need to re-frame the problem as a systemic problem, where policy has to counter ‘hyper-consumption environments’, restrict marketing and stop interference in policy-making.” - Belgian Deputy Prime Minister and Minister of Social Affairs and Public Health, Frank Vandenbroucke, at the report’s launch
“The insidious practices of powerful industries did not appear overnight, and they will not go away easily. This is a long-term effort that requires political will, first and foremost.” Dr Gauden Galea, Strategic Advisor to the Regional Director on Non-Communicable Diseases and Innovation, WHO Regional Office for Europe, at the report’s launch
“Governments need to recognize and address the system problems that are simultaneously driving ill health and making it harder to develop and implement effective solutions to it. This will require, inter alia, that they start to regulate in the public interest rather than the corporate interest.” - The Report
“Governments, civil society actors and researchers should exercise great caution when engaging with (health harming industries) and develop policies for managing such engagements and avoiding perceptions of (conflict of interest).” - The Report
“The root causes of ill health are linked with the current political economic system, which privileges and is influenced by the interests of powerful commercial actors over those of public health. Hence, the importance of addressing that political economic system, and rethinking capitalism, cannot be ignored.” - The Report
“There is a crucial need to question power asymmetry and the current political economic system as the root causes of ill health.” - The Report
Thin’s Pickings - Extended Edition
There were none last week so you’re getting twice the recommendations this week!
Corn - Last Week Tonight with John Oliver
John Oliver brings his usual magic, dissecting the financial and environmental impacts of corn in the U.S., including a jaw-droppingly misguided analogy an agri official made comparing corn and Pearl Harbour.
Denmark to charge farmers €100 a cow in first carbon tax on agriculture - The Financial Times
You’ve probably seen this already, but thought it was still worth including, given this week’s topic. Attracta Mooney, Susannah Savage, Alice Hancock, and Emma Agyemang detailed Danish efforts to reduce emissions from agriculture, the country’s largest greenhouse gas emitter.
“After months of fraught negotiations with trade bodies and environmental groups, Denmark’s ruling coalition on Monday night agreed an effective tax rate of DKr120 (€16) per tonne of carbon dioxide equivalent emissions from livestock, including cows and pigs,” they wrote.
A recent study called beer and fries part of a plant-based diet. That’s problematic for more reasons than you’d think - Fast Company
If you’ve recently seen lots of headlines rubbishing plant-based meats with “early death”, read this. Brian Kateman delved into the study that prompted these headlines, which have been gleefully used by Big Meat advocates to promote factory-farmed meat as “natural”.
In general this is a good piece that also explains why nutritional science is so fraught with “flawed methods and archaic assumptions”.
Meat: The Four Futures - Feminist Food Journal
Fascinating piece from TABLE’s Tamsin Blaxter on the gendered dimensions of meat and the four different futures they have come up with after extensive discussions with farmers, tech investors, food scientists, nutritionists, sociologists and more.
Smoke, mirrors and money: how big ag hoodwink farmers, the public and politicians - Slow Food
Journalist Marianne Landzettel’s piece for Slow Food brings together our most recent investigation on farmers protests with what’s happening in the U.S..
The Chef Is Human. The Reviewer Isn’t. - The New York Times
Pete Wells is one reviewer I consistently read, even if I may never be able to afford or eat at a majority of of the restaurants he visits. But this piece is about using A.I. for restaurant reviews and what this could mean for both reviewers and diners.
As always, have a good weekend, and please feel free to share this post and send tips and thoughts on mastodon @ThinInk@journa.host, my LinkedIn page, twitter @thinink, or via e-mail thin@thin-ink.net.