Christine Chin | Jamaicans have a right to know what’s in their food – protect this right!

An August 15 article in The Gleaner by the chair of the Heart Foundation of Jamaica (HFJ), Dr Andrene Chung, highlighted a disturbing development in Jamaica in which a Cabinet decision to vote against the black octagonal “High in” front-of-package warning label (FOPWL) and food-labelling standard proposed by the Caribbean Regional Organisation for Standards and Quality (CROSQ) appears to have placed sectoral interests over the health and lives of Jamaicans representing a denial of Jamaicans’ “right to know whether available products contain harmful levels of nutrients that can affect health”. This recent action, as described by Dr Chung, deviated from the standard procedures of the country’s decision-making Mirror Committee, and saw an overturning of the original majority vote which supported the proposed FOPWL model.

The Healthy Caribbean Coalition (HCC) fully supports the HFJ’s call for evidence-based food policies including easy to understand, black octagonal “High-In” front-of-package warning labels for unhealthy foods high in sodium (salt), fats, and sugars which are linked to obesity and non-communicable diseases (NCDs) when consumed in excess.

HCC notes, with concern, that the resulting denial of Jamaicans’ “right to know” and seemingly failure of the government to protect the basic right of Jamaicans to good health is troubling for a number of reasons.

First, even before the COVID-19 pandemic, Jamaica, like the rest of the Caribbean, has been grappling with epidemics of obesity and NCDs which are wreaking havoc on the lives of Caribbean people, draining individual household resources and limited national health budgets. The collision between the COVID-19 pandemic, and the associated vulnerabilities of those living with obesity and NCDs, have created a syndemic that highlights the failure of governments to create health-supporting environments, underscoring the urgent need to prioritise NCD prevention and control through strong evidence-based policies such as FOPWL.

Second, it is worth repeating that black octagonal “High-In” front-of-package warning labelling was introduced as a key evidence-based measure to tackle obesogenic environments linked to unhealthy diets and NCDs. It has been endorsed by notable public health authorities, including the UN Special Rapporteur on the Right to Health, the Pan American Health Organization (PAHO), the HCC, the Caribbean Public Health Agency (CARPHA), the World Cancer Research Fund, and a growing number of CARICOM ministries of health. There is also publicly demonstrated support for FOPWL among key Jamaican and Caribbean stakeholders evidenced by more than 300 Caribbean health professionals and over 40 regional organisations becoming signatories to an HCC-led FOPWL campaign.

GLOBAL EVIDENCE

The global and regional evidence, including recent research done by Jamaica’s Ministry of Health and Wellness in collaboration with PAHO and the University of Technology, Jamaica, shows that the black octagonal “High-In” FOPWL outperform all other front-of package models when it comes to empowering consumers to easily, correctly, and quickly identify health-harming foods high in sodium (salt), fat and sugar and make informed food choices. Selecting any other labelling scheme ignores scientific evidence which is free of conflict of interest and prioritises external – largely profit-driven – considerations at the expense of the health of all Caribbean people, especially those who are vulnerable or living with NCDs.

Third, it appears that the HFJ and possibly other stakeholders were blindsided by the last-minute revote called for by the National Mirror Committee. This highly irregular, eleventh hour switch in position after the CROSQ’s May 31 deadline also raises fundamental questions regarding transparency, impartiality, and accountability in the local standards development process. Food policy must be protected from conflicts of interest and the undue influence of vested interests.

Finally, there is the question of the authority, credibility, and legitimacy of the Ministry of Health and Wellness (MOHW) to issue public health recommendations which are received and actioned by the Government of Jamaica. In a July 4 Op Ed ‘Clarifying issues on front-of-package labels’, the Minister of Health and Wellness Dr Christopher Tufton stated the ‘position of the Ministry of Health and Wellness’ in clear support for the CARICOM/CROSQ Standard being proposed, emphasising that ‘research has shown that the front-of-package warning labels that are being pursued in our region is the right step for addressing the current ignorance around product choice’, and that the octagonal warning label ‘is contextual and relevant, and to refuse its introduction is to be insensitive to the plight of the Jamaican people.’

Yet, weeks later this sound, evidence-based guidance was ignored as Dr Chung observed: ‘the Government of Jamaica has opted to vote against its own public-health recommendations’, signalling that the ‘vested interests of a select few [were] being prioritised over the nation’s health’. The Ministry of Industry, Investment and Commerce (MIIC) in an article dated August 19 called for inclusion of a multitude of labelling options in the standard citing weak arguments of the food and beverage sector previously debunked by Minister Tufton in his Op Ed. The article ultimately undermined the MOHW – painting an awkward public-facing picture of policy incoherence at a time when it is critical that the public trust the guidance of the MOHW on public health matters such as COVID-19 vaccinations and related protocols.

NUMBER OF QUESTIONS

For the HCC, the regional public health community and many Caribbean governments that have voted in favour of the black octagonal “High-In” FOWPL, it is clear that all Caribbean people, including Jamaicans, have a right to know what is in their food. Denial of this right begs a number of questions. Who benefits from preventing consumers’ access to a proven, effective, and easily understood front-of-package warning labelling? Who stands to gain by keeping consumers unaware of high levels of sugars, salts, and fats in the foods they consume?

Why are we not following the science – the solid, conflict of interest-free research done by PAHO, the University of Technology and Jamaica’s own health ministry, showing the efficacy of the black octagonal “High-In” FOPWL? Whose interests benefit from changing a voting process to delay the adoption of effective FOPWL for Jamaicans? Why is the health of Jamaicans being sidelined in favour of profits and aggressive narrow sectoral interests? The Jamaican public must ponder these questions as Jamaican consumers stand to lose the most.

The best type of front-of-package labelling is not open for debate. Black octagonal “High-In” FOPWL represent one of a package of key policy measures to tackle unhealthy food environments which lead to obesity and NCDs. For this reason, the HCC supports and encourages stakeholders like the HFJ and Jamaica’s Ministry of Health and Wellness to continue fighting for the rights and health of Jamaicans and other Caribbean people through advocacy, public education, and implementation of strong nutrition policies like octagonal FOPWL.

We have a right to the highest attainable level of health and a right to healthy food environments so we can make the best choices for ourselves and our families which protect us from ill health.

We call on the Government of Jamaica to protect these rights and the health of the Jamaican people.

- Dr Christine Chin is an obesity specialist and member of the board of directors of the HCC. Send feedback to hcc@healthycaribbean.org