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Can Public Health Advocates in Europe and the United States Together Protect Public Health Regulation?

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Nicholas Freudenberg speaks on corporations and health at DeBalie, a public lecture hall in Amsterdam.

In both Europe and the United States, public health regulation is under attack.  Despite the Volkswagen Dieselgate emission cheating scandal, the European Union has not yet developed guidelines to prevent future cheating.  Monsanto continues to block stronger regulation of glycophates in Europe and North America. In the United States, President Trump and the Republican Congress are slashing funding and rescinding public health regulations at several federal agencies.  Can public health professionals and advocates in  two of the world’s largest markets join forces to resist these trends?

At a recent series of lectures in Brussels, Amsterdam and The Hague, Nicholas Freudenberg, Distinguished Professor of Public Health at the City University of New York School of Public Health and author of Lethal but Legal: Corporations, Consumption and Public Health examined some of the issues confronting those seeking to reduce corporate practices that harm health.  In his lectures, he suggested five broad goals for a transatlantic agenda to protect public health against corporate efforts to roll back regulations.  These included:

  1. Remove corporations from public health and trade policy decisions
  2. Protect science from corporate manipulation and conflicts of interest
  3. Revitalize public sector in food, medicines and transportation to provide an alternative to corporate control
  4. Protect democracy from corporate interference
  5. Challenge the view that no other world is possible

The lecture and trip was sponsored by Wemos Foundation, a Dutch global health foundation, the European Public Health Alliance and Corporate Europe Observatory, timed to coincide with the translation of Freudenberg’s book into Dutch, Legaal Maar Fataal. Each of these organizations provides useful resources for North American public health professionals who want to better understand recent developments in Europe.

The Wemos Foundation, for example,  sponsored a forum on the interactions between the European Medicines Agency (EMA) and the pharmaceutical industry and explored strategies for reducing conflicts of interest.  A summary of the event is available here.

The European Public Health Alliance(EPHA), an organization of public health NGOs, patient groups, health professionals and disease groups, works to improve health and strengthen the voice of public health in Europe. Several recent reports focus on issues also of concern in the United States:

  • In another recent  report, EPHA and other groups call for the United Nations Institute for Training and Research (UNITAR), to end a newly formed partnership with the world’s largest beer producer, AB InBev.
  • The Unhealthy side effects of CETAexamines the Comprehensive Economic and Trade Agreement (CETA) between the European Union and Canada, the first trade agreement  between  the  EU  and a  major  world economy and  the  most far-reaching  bilateral  trade and  investment  agreement negotiated  to  It concludes that the agreement “limits the  policy  space of  governments  in the  area  of public health, tariff elimination, market access commitments, negative listing of services, its  lack  of recognition  of  the health-relevant  aspects  of the  Sustainable  Development Goals (SDGs) and ignoring key health risk  factors  and threats  such  as alcohol-related  harm  or antimicrobial  resistance.  In short, CETA fails to ensure policy coherence between trade and public health.”

The Corporate Europe Observatoryis a research and campaign group working to expose and challenge the privileged access and influence enjoyed by corporations and their lobby groups in EU policy making.

For public health advocates in the United States, these organizations and their reports can be useful resources for developing strategies to resist deregulation and reduced enforcement.  “As the U.S.  government dismantles the public health regulatory agencies developed over the last 50 years,” said Freudenberg, “researchers need to document the impact of these changes and develop new strategies to protect public health.  By partnering with European scientists and advocates, we can accelerate this process.”

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90% of calories consumed by U.S. residents come from the commercial food sector

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Source:  USDA, 2018 from 2012-13 data.

This chart recently released by the USDA’s Economic Research Service shows that more than 90 percent of the calories consumed by U.S. residents come from the commercial food sector: supermarkets and other food stores, restaurants and other food service outlets.  Fewer than 10 percent of calories come from those sectors of the food system controlled by the public (e.g., school food), individuals or nonprofit organizations.  Since the composition of commercial sector food is highly controlled by giant food corporations, these products are more likely to be the high in fat, sugar and salt. The global food system is built on the more profitable highly processed products that are easier to store, ship and market, even though they are the primary causes of the global epidemics of diet-related diseases.

Nutrition and public health researchers and food advocates should be asking: what would it take to increase the less than 10 percent of calories that comes from sources other than Big Food to 15 or 20 percent?  And how can the non-commercial food sector—food systems controlled by public and civil society groups– serve as both a healthier alternative to and a competitive pressure on transnational corporate food producers?

Judge: Assault weapons ban doesn’t violate 2nd Amendment

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Assault weapons and large-capacity magazines are not protected by the Second Amendment, a federal judge said in a ruling upholding Massachusetts’ ban on these weapons, reports the Washington PostU.S. District Judge William Young dismissed a lawsuit challenging the 20-year-old ban, saying assault weapons are military firearms that fall beyond the reach of the constitutional right to “bear arms.” Regulation of the weapons is a matter of policy, not for the courts, he said. 

U.S. Shootings: Gun Industry Killing More People Overseas

In every measurable way, the U.S is head honcho of the global violence industry.

I live next door to the world’s biggest gun manufacturer, writes Tamara Pearson for Common Dreams. Here in Mexico, the murder rates are close to civil war levels. They broke records last year, for a total of 41,217 homicides, with 25,339 first degree murders over the course of the year. And those are the official figures – which if anything, tend to under report reality.

President Trump has labeled Mexican migrants heading to the U.S. as “criminals” but has ironically overlooked the fact 70% of the guns coming into Mexico originate in the U.S. With the recent shooting in the YouTube headquarters, the inspiring movements of young people demanding gun control, and Black Lives Matter protesting police impunity – the issue of systemic, deathly violence in the U.S. is receiving important attention. But the impact of of that violence outside U.S. borders is largely going under the radar.

Juul: Does new e-cigarette save or cost lives?

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Source

The rapid growth of a new brand of e-cigarette known as Juul has attracted media and public health advocates’ attention.  According to The New York Times, school officials, struggling to control an explosion of vaping among high school and middle school students across the country, fear that the devices are creating a new generation of nicotine addicts.

Since launching about two years ago, reports BuzzFeed News, Juul has become one of the hottest e-cigarettes on the market. It’s been called “the iPhone of e-cigs” and it has gained somewhat of a cult following among young adults. Shaped like a USB device and easy to conceal, Juul is made by a San Francisco-based company that has received venture capital money.

Following the playbook of cigarette and alcohol manufacturers, who long ago learned that the best way to market their products to children and young people was to claim they were only for adults, Ashley Gould, the chief administrative officer of Juul, told the Times that the company’s products are intended solely for adults who want to quit smoking. Among the flavors Juul markets are fruit medley and crème brulee.

A new study published in PLOS One assesses the net gains and losses from the spread of  vaping.  The authors calculated the expected years of life gained or lost from the impact of e-cigarette use on smoking cessation among current smokers and transition to long-term cigarette smoking among never smokers for the 2014 US population cohort.  Their conclusion: “e-cigarette use currently represents more population-level harm than benefit. Effective national, state, and local efforts are needed to reduce e-cigarette use among youth and young adults if e-cigarettes are to confer a net population-level benefit in the future.”

To counteract the rapid spread of e-cigarettes, seven public health and medical groups, and several individual pediatricians, filed suit in federal court in Maryland challenging a U.S. Food and Drug Administration (FDA) decision that allows electronic cigarettes and cigars – including candy-flavored products that appeal to kids – to stay on the market for years without being reviewed by the agency. According to Industrial Safety and Hygiene News,  The lawsuit was filed by the American Academy of Pediatrics and its Maryland chapter, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, Campaign for Tobacco-Free Kids, Truth Initiative and five individual pediatricians.

Although the groups strongly support the FDA’s new efforts to reduce nicotine levels in cigarettes to minimally or non-addictive levels, they also believe that the FDA’s August 2017 decision to exempt e-cigarettes and cigars from agency review for years to come is unlawful and harms public health.

Alcohol, Cancer and the Right to Know

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Credit  Source  Based on UK survey

There is a “direct link between alcohol and fatal cancers” — that’s what Irish health officials want their country’s drinkers to know each time they look at a bottle of alcohol, reports the European edition of Politico.  Even as producers of wine, beers and spirits fret about any European Commission regulation that would force them to list ingredients and calories on their products, health officials in Dublin are making a big push for what the alcohol industry considers a nightmare scenario: mandatory cancer warnings on liquor. “Reducing alcohol intake is an important step in reducing the burden of cancer,” Irish Health Minister Simon Harris said in February, ahead of submitting to the parliament a bill with proposals that include some of the toughest provisions on alcohol labeling on the Continent, including a label stating the link between drinking and cancer. “This is a landmark piece of public health legislation which will make a real difference when it comes to reducing the harm caused by alcohol,” Harris added.

In this five minute video, Michael Greger summarizes the evidence on alcohol’s role in cancer.  And in a March 2018 article in Drug and Alcohol Review, the authors conclude that the alcohol industry “appears to be engaged in the extensive misrepresentation of evidence about the alcohol-related risk of cancer. These activities have parallels with those of the tobacco industry. This finding is important because the industry is involved in developing alcohol policy in many countries, and in disseminating health information to the public, including school children. Policymakers, academics, public health and other practitioners should reconsider the appropriateness of their relationships to these alcohol industry bodies.”

In NAFTA Talks, U.S. Tries to Limit Junk Food Warning Labels

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Source: OECD Obesity Update 2017

Urged on by big American food and soft-drink companies, reports the New York Times,  the Trump administration is using the trade talks with Mexico and Canada to try to limit the ability of the pact’s three members — including the United States — to warn consumers about the dangers of junk food, according to confidential documents outlining the American position.

The Mexican government support for such restrictions “is one of the most invasive forms of industrial interference we have seen,” Alejandro Calvillo, the founder of El Poder del Consumidor, or Consumer Power, a health advocacy group in Mexico told the New York Times. Heading off pressure for more explicit warnings through the NAFTA negotiation is especially appealing to the food and beverage industry, writes the Times, because it could help limit domestic regulation in the United States as well as avert a broad global move to adopt mandatory health-labeling standards.  “It kind of kills a law before it can be written,” said Lora Verheecke, a researcher at the Corporate Europe Observatory, a group that tracks lobbying efforts. “And once you put it in one trade agreement, it can become the precedent for all future deals with future countries.”

Sustain, an alliance of advocates in the United Kingdom working for better food and agriculture policies and practices, summarizes some of the ‘”barriers to trade” that a 2017 report by the  US Office of the Trade Representative identified:

  • Additional nutritional labelling such as traffic light labels in the UK and Ireland. The US is arguing that these initiatives must remain voluntary.
  • South Africa’s plans to introduce a sugary drinks tax in 2016. The US raised concerns that the tax would effectively discriminate against sugary drinks. The move jeopardizes $5m of US sugary beverage exports
  • Proposals by six Gulf states to regulate energy drinks, including introducing labelling statements about recommended consumption. (One estimate puts this market at $2bn.)
  • Efforts by Chile to clearly label products high in sugar, salt and saturated fat and restrict junk food marketing on packaging to children. The US has referred the Chileans to the WTO saying delays and repackaging has cost the US firms ‘millions of dollars’ in lost sales
  • A food act in Peru introducing mandatory front of pack warnings for pre-packaged foods high in sugar, salt and fat and restrictions on junk food advertising to children and young people
  • Indonesia’s attempts to introduce nutritional labelling for pre-packaged and fast food along with and regulations to limit advertising and health claims aimed at children.