Strengthening of accountability systems to create healthy food environments and reduce global obesity

B. Swinburn, V. Kraak, H. Rutter, S. Vandevijvere, T. Lobstein, G. Sacks, F. Gomes, T. Marsh, R. Magnusson

Research output: Contribution to journalArticlepeer-review

277 Citations (SciVal)

Abstract

To achieve WHO's target to halt the rise in obesity and diabetes, dramatic actions are needed to improve the healthiness of food environments. Substantial debate surrounds who is responsible for delivering effective actions and what, specifically, these actions should entail. Arguments are often reduced to a debate between individual and collective responsibilities, and between hard regulatory or fiscal interventions and soft voluntary, education-based approaches. Genuine progress lies beyond the impasse of these entrenched dichotomies. We argue for a strengthening of accountability systems across all actors to substantially improve performance on obesity reduction. In view of the industry opposition and government reluctance to regulate for healthier food environments, quasiregulatory approaches might achieve progress. A four step accountability framework (take the account, share the account, hold to account, and respond to the account) is proposed. The framework identifies multiple levers for change, including quasiregulatory and other approaches that involve government-specified and government-monitored progress of private sector performance, government procurement mechanisms, improved transparency, monitoring of actions, and management of conflicts of interest. Strengthened accountability systems would support government leadership and stewardship, constrain the influence of private sector actors with major conflicts of interest on public policy development, and reinforce the engagement of civil society in creating demand for healthy food environments and in monitoring progress towards obesity action objectives.
Original languageEnglish
Pages (from-to)2534-2545
Number of pages12
JournalLancet
Volume385
Issue number9986
DOIs
Publication statusE-pub ahead of print - 19 Jun 2015

Bibliographical note

Swinburn, Boyd Kraak, Vivica Rutter, Harry Vandevijvere, Stefanie Lobstein, Tim Sacks, Gary Gomes, Fabio Marsh, Tim Magnusson, Roger eng 1U48DP001946/DP/NCCDPHP CDC HHS/ U48/DP00064-00S1/DP/NCCDPHP CDC HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. Research Support, U.S. Gov't, P.H.S. Review England 2015/02/24 06:00 Lancet. 2015 Jun 20;385(9986):2534-45. doi: 10.1016/S0140-6736(14)61747-5. Epub 2015 Feb 19.

Keywords

  • Environmental Health/*organization & administration Food Industry/methods/organization & administration Food Supply/*standards Global Health Health Policy/*legislation & jurisprudence Health Promotion/*organization & administration Health Services Needs and Demand Humans International Cooperation Obesity/epidemiology/*prevention & control Policy Making Social Marketing Social Responsibility

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