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Nicole Foster | Front-of-package warning labels: Choose the side of health

Published:Monday | December 6, 2021 | 12:05 AM

Ask any Caribbean citizen and they probably have at least one family member or friend who has a chronic non-communicable disease (NCD) such as type 2 diabetes or high blood pressure. The Caribbean has the highest burden of NCDs in the Americas, with seven out of every 10 deaths being NCD-related. The current regional outlook is even more troubling when one considers the serious and growing problem of childhood obesity.

As early as 2007, the CARICOM Heads of Government, in their historic Port of Spain Declaration, recognised NCDs as a serious development challenge and the need to act to reverse these disturbing trends. In recognition of the fact that the primary driver of the NCD burden is a poor diet dominated by large quantities of ultra-processed foods high in salt, sugar and fat, the effort to adopt front-of-package warning labelling (FOPWL) for pre-packaged foods sold in the region has emerged as a key initiative aimed at improving the nutritional choices of consumers.

Over the past three years, CARICOM member states have been engaged in negotiations for the revision of the existing CARICOM standard on pre-packaged foods, with the current draft featuring a black, octagonal ‘High in’ warning label, indicating when products are high in either salt, sugar or fat. The standard has been the subject of significant industry pushback against adoption of the black, octagonal ‘High in’ warning labelling scheme. Trade arguments have featured prominently in the industry’s attacks on this warning scheme, and it is these arguments that I wish to address.


While the food industry has chosen to characterise the choice of front-of-package labelling scheme as one to be driven purely by the considerations of trade impact, this, while important, is not and cannot be the decisive consideration. As with all problems, ‘framing matters’. To put it simply, while the choice of front-of- package labelling scheme may have trade implications, the problem which front-of-package labelling is seeking to address is not a trade one, but rather, a public health one. When viewed through a public health lens, it is clear that the type of front-of-package labelling scheme ultimately adopted must be one that most effectively responds to the public health problem. To do otherwise would be to set ourselves up for failure.

The validity of this reasoning is borne out by the text of the World Trade Organization’s (WTO) Agreement on Technical Barriers to Trade, which permits WTO member countries to deviate from trade rules to implement measures to achieve a defined and established public health goal – in this case, NCD prevention. The agreement also makes it clear that the determining factor of whether the measure is in keeping with WTO rules is not its trade impacts, but rather, whether it is the most effective means of achieving the identified public health goal.

There is compelling scientific evidence globally, as well as locally in Jamaica, pointing to the superior performance of the black, octagonal ‘High in’ front-of-package warning labelling scheme when it comes to helping consumers make quick, simple and accurate choices about foods that are high in salt, fat and sugar (results of recent study conducted by the Ministry of Health and Wellness, the University of Technology, Jamaica, and PAHO). In addition, existing evidence clearly demonstrates that including multiple options for front-of-package labelling is not in consumers’ best interests, and, in fact, only serves to confuse them. It is clear that there is really only one option – and that is to choose the superior-performing front-of-package labelling scheme from a nutrition/public health perspective, which is the black octagonal, ‘High in’ front-of-package warning labelling scheme currently in the CARICOM revised draft standard.

Besides the trade considerations outlined above, the black, octagonal ‘High in’ warning labelling scheme has the added benefit of being a human-rights compliant response to the NCDs epidemic. This was specifically recognised by the former UN special rapporteur on the right to health in their July 2020 statement on the issue, which highlighted the role of front-of-package warning schemes in helping consumers make informed nutrition decisions.


As a party to international human-rights treaties such as the Convention on the Rights of the Child, the Jamaican Government has binding international obligations to respect, protect and fulfil rights such as the right to health, the right to freedom of expression (which includes the right to information), etc. The implementation of the black, octagonal ‘High in’ warning labelling scheme is one way of meeting these obligations. This is particularly relevant from a health equity perspective. Many of the alternative FOPWL schemes being proposed require interpretation of the various symbols in a way that will limit the ability of some sections of the society to effectively use them to make healthier choices, such as persons with only basic levels of education or young children.

As the CARICOM region seeks to respond to its NCD challenge in a holistic and effective manner, it is important that it does so in a manner consistent with both its international trade and international human-rights obligations. While only one tool in the NCD-response toolkit, the black, octagonal ‘High in’ front-of-package warning labelling scheme is a critical part of that response; and one with potentially catalytic effects in terms of the other measures being proposed. Let us be guided by science and the law, and make the choice that the evidence clearly demonstrates is in the interest of the public health of the citizens of our region. The law and science are on the side of health. Let us put the health of our people first!

Nicole Foster is deputy dean and head, Law and Health Research Unit, Faculty of Law, UWI Cave Hill, and a former World Trade Organization negotiator. Send feedback to