To the 64^th Meeting of the Regional Committee of WHO regarding Item 14 on NCDs

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Medicus Mundi International and the People’s Health Movement thank you, Mr. Chair, for the opportunity to contribute to this important debate on NCDs.

We congratulate WHO WPRO for the work which it has been doing with the countries of the Western Pacific but much more is needed.

Three issues which are not adequately addressed in the draft Regional Action Plan are: price relativities, marketing controls and trade agreements.

One of the main drivers of high energy diets has been the price differences between high energy snack foods and fruit, vegetables and quality protein. It is also the case that cheap highly processed commercially available convenience foods are replacing home cooking to some extent.

The Action Plan should include a package of policies (taxation, subsidies, marketing restrictions, social marketing campaigns) which make healthier diets cheaper and more convenient and which make meal preparation and eating together cheaper, more attractive and easier.

Aggressive marketing of snack foods, high energy drinks, and convenience foods is having a powerful effect in changing diets in the countries of the region. We urge the Committee to strengthen the provisions in the Action Plan regarding the regulation of marketing, including strong provisions regarding food labelling. There is an urgent need for international collaboration to identify the legal and trade implications of such policies and to ensure that appropriate ways are found to achieve public health objectives in these areas.

In this context we note the comment in the draft Action Plan that, “Trade agreements should not hamper public health efforts to protect people from NCDs”and highlight in particular the dangers to public health associated with the proposed Trans Pacific Partnership Agreement (TPPA).

It has come to our attention that some countries are negotiating to include ‘investor state dispute settlement’ provisions (or ISDS) in the proposed TPPA. If the TPPA is agreed to and ratified, other countries in the region will come under great pressure to join up. We note that the Distinguished Representative from Malaysia identified this yesterday, with particular reference to tobacco.

ISDS provisions give transnational corporations power to threaten all nation states, as is illustrated by the use of these provisions by the tobacco companies to unduly influence countries seeking to implement the provisions of the Framework Convention on Tobacco Control.

The TPPA is negotiating for longer patent terms, extended data protection and new restrictions on price setting in national pharmaceutical reimbursement schemes. These would all increase the price of medicines to families and to developing countries in the region, including for non-communicable diseases.

WHO has to do more action on this because the TPP negotiations have started and are almost finished.  We urge the Regional Committee to include, in the finalised Action Plan, warnings about the implications for public health of ISDS provisions and higher levels of IP protection in trade agreements and to reiterate the commitment in WHA59.26 to work towards trade policies which do not prevent action on urgent public issues such as non-communicable diseases.

Submitted by:  Edelina P. Dela Paz, MD

October 22, 2013