Tackling the Obesity Epidemic: “the impact of Food trade and commerce”

1. Tackling the Obesity Epidemic: “the impact of Food trade and commerce” Tamu Davidson Sadler MD, MPH Leaders in International Health candidate - Jamaica

2. Selection of topic/Justification • Burden of disease: globally, regionally and nationally • 60% of deaths globally due to chronic diseases • Epidemiological shift in Caribbean towards CNCDs • 56% of deaths in Jamaica due to chronic diseases • Obesity and overweight pose major risk for CNCDs and are driving factors of epidemic which is spiraling out of control • Major public health, economic and developmental burden • Role of trade and commerce • Removal of barriers to trade has contributed to increased westernization of diet and lifestyles • Increased money spent on advertising • Increased consumption imported food and beverages, particularly high-energy manufactured foods • Review of international treaties/agreements • Caribbean Cooperation in Health (CCH) Initiative 1984 • Nassau Declaration 2001 • Health Agenda of Americas 2008-2012 • Port of Spain Declaration Sept. 2007 • St. Ann Declaration Oct. 2007

3. Purpose and Objectives

4. Key questions • What is the link between obesity and the food trade and commerce? • How does food trade and commerce affect efforts to address the obesity epidemic? • What is the link between obesity and the model of development? • How does the Government economic policy correlate with obesity as a health issue? • What could be the “ripple effect” of implementing the Port of Spain Declaration trade policies?

5. HYPOTHESIS The hypothesis is that food trade and commerce is linked to an increase in the obesity epidemic in Jamaica and hinders efforts to stem the epidemic.

6. Driving forces Chronic non-communicable Diseases e.g. CVD, Diabetes, Cancer Decreased quality of life Morbidity & Mortality Urbanization Modernization Obesity Increased cost Direct & Indirect Economic growth Driving factors Consumption of energy dense foods high in saturated fats and sugars Physical Activity Liberalization of Food Trade & Commerce Development Social CONCEPTUAL FRAMEWORK

7. International Relations International Cooperation WTO REGIONAL BILATERAL IMPORT DOMESTIC PRODUCTION EXPORT Increase investment in global production in LMICs Increase availability in novel and high energy foods and lower prices Rise of TFCs HICs lease land in LIMICs to grow crops for export to HICs Marketing of products Economic growth Urbanization Labour market conditions Displace food production with tobacco & other cash crops Housing development Increase consumption of high energy foods Food insecurity Increase access to high energy food; changing food demands & lifestyle Chronic disease Obesity Diabetes CVD Cancer Dental diseases Osteoporosis Malnutrition Increased burden on health systems Source: Framework: Trade, food and chronic disease Labonte et al

8. Methodology • A systematic review and analysis of literature, research, reports pertaining to food trade and obesity. • Review of international trade agreements • Analysis of secondary data were available • Environmental scan of Food promotion and marketing in media August – October 2009

9. Trade situation in the CaribbeanWorld Trade Organization and General Agreement on Tariffs and Trade (GATT)Caribbean Single Market Economy (CSME) Intra-regional trade: imports, common external tariff (CET) ratesTreaty of Chaguaramas which established the Caribbean Community including the CARICOM single market and economy Bilateral agreementsCARICOM/EU single market and economyCaribbean Forum (CARIFORUM) Trade situation in JamaicaNational industrial policy (NIP) 1996-2010How fits within framework of Caribbean Community and Common Market (CARICOM)Preferential trade agreements: Colombia, Cuba, the Dominican Republic, Costa Rica, and VenezuelaImports/exports of foodDegree of openness to foreign investment/Tariffs Industry: decline in agriculture, fisheries, forestryInitiatives in-country to increase food security (‘Eat What you Grow’ & ‘Buy Jamaica’ campaigns) Reviewed and analyzed…

10. Reviewed and analyzed… Transnational Food Companies Promotion and MarketingReviewed media marketing of products during the period Aug-Sept 2009 Food consumption patterns of Jamaicans and select behavioursConsumption patterns at home and outside home (fast-food)Where they get their information (TV)

11. CONCLUSIONS • What is the link between obesity and the food trade and commerce? • How does food trade and commerce affect efforts to address the obesity epidemic? • What is the link between obesity and the model of development?

12. EU-CARICOM CARICOM CSME WTO REGIONAL BILATERAL IMPORT DOMESTIC PRODUCTION EXPORT Increase investment in global production in LMICs Increase availability in novel and high energy foods and lower prices Rise of TFCs HICs lease land in LIMICs to grow crops for export to HICs Marketing of products Economic growth Urbanization Labour market conditions Displace food production with tobacco & other cash crops Increase consumption of high energy foods Food insecurity Increase access to high energy food; changing food demands & lifestyle Chronic disease Obesity Diabetes CVD Cancer Dental diseases Osteoporosis Malnutrition Increased burden on health systems Source: Framework: Trade, food and chronic disease Labonte et al

13. How does the Government economic policy correlate with obesity as a health issue? • Vision 2030 has promoted healthy lifestyle but food trade policies to date have not placed health on the agenda. • Tariffs and other taxes are a major income earner can facilitate or hinder efforts to address obesity

14. What could be the “ripple effect” of implementing the Port of Spain Declaration trade policies? • The domestic agriculture may not be able to compete with external producers if tariff removed from agricultural products. • Many of the exporters and importers of high fat, sugar and salt foods are CARICOM member states. • Transnational corporations make a considerable contribution to the economy and may not support the policies. • Trade conflicts with bilateral and regional partners

15. Recommendations