Over the last two years, COVID-19 has dominated global health as the world’s most dangerous disease. Notwithstanding, chronic non-communicable diseases (NCDs) have also posed serious health risks that are no less fatal. NCDs include cardiovascular, cerebrovascular, and respiratory diseases, as well as cancer and diabetes. Currently, NCDs are the leading cause of death globally. According to the World Health Organization (WHO), NCDs kill more than 40 million people each year. In 2019, NCDs caused 74 percent of global deaths.
The situation is even more worrying in Latin America and the Caribbean. According to the 2019 Global Burden of Disease study, more than half of the region’s population were categorized as overweight or obese with 10 percent of adults living with diabetes. There is a close link between poor diet and NCDs. Poor eating habits have not only been linked to obesity but also other diseases. Of particular concern is the high intake of products with high calorie, sugar, fat, and sodium content, but low in nutritional value.
NCDs affect individuals and impact public health services by generating high costs of treatment and care. In particular, low and middle-income countries suffer the cumulative economic losses caused by NCDs, estimated to have cost more than USD $7 billion during 2011-2025. Unsurprisingly, the commercial food industry plays a very important role in promoting unhealthy eating habits. Food companies heavily market processed and ultra-processed foods without considering the impact their intake may have on a population’s health.
Food Labeling in Latin America
Similar to global statistics, NCDs also make up the leading cause of death in Argentina. Argentina’s 2018 ‘National Survey of Risk Factors for Chronic Diseases’ shows that of its 45 million inhabitants, 66 percent are overweight, 42 percent suffer from high blood pressure, 32 percent are obese, and 30 percent suffer from high cholesterol levels. The most alarming figure shows that 41 percent of Argentine children, aged between 5 and 17, are overweight, and 13.6 percent of those children are under five.
To safeguard the nation’s health, governments are obligated to place regulatory measures that mitigate the growth of NCDs. Front-of-package warning labels represent a popular measure for policymakers. Following the lead of Chile, Uruguay, Peru, and Mexico, the Argentine Congress ratified a law obliging companies in the food industry to include front-of-package labels that warn the consumers of products that may pose a long-term health risk.
The Argentine law covers the entire food production supply chain, including manufacturers, distributors, retailers, and others involved in the value chain. A black octagonal label, occupying not less than five percent of the package surface, must be placed at the front indicating the product’s ingredients. The label must warn the consumer of excessive sugar, sodium, saturated fat, total fat, and calories and warn the consumer of caffeine or sweetener ingredients.
Chile implemented front-of-package food labels in 2016 with positive results. Impact assessments show that this law contributed to healthier consumer habits alongside a considerable reduction in the sale of ultra-processed products. Mexico ratified a similar law in 2020 inspired by the Chilean legislation. However, unlike Chile’s law, Mexico will require products containing any sweetener or caffeine to show front-of-packing warning labels to deter child consumption.
Nonetheless, similar examples elsewhere show the limitations of labeling. In Uruguay, food warning labels became effective in 2021, though originally ratified in 2018 under Decree 272 because Congress altered the original resolution. Reportedly, the food industry ensured its interests by challenging state regulations to effectively change the Pan American Health Organization (PAHO) nutrient profiling system “to the obvious detriment of public health.” Therefore, companies in Uruguay can sell “seal-free” products which contain excess fat, sugar, and sodium contents
Front-Package Regulation: An Effective Regulation or Not?
Undoubtedly, warning labels positively contribute to the fight against NCDs. However, policymakers need to address several other aspects to safeguard and regulate public nutrition and health:
Evolving social trends have drastically impacted consumer habits. For example, the popularity of takeaway meals, street food vendors, and growing fast-food chain restaurants have facilitated the consumption of processed foods. Primarily in urban contexts, these accessible, cheap, and highly palatable alternatives are more suited to the faster-paced lifestyles of cities. According to PAHO, 75 percent of the world’s population will live in major cities by 2050.
Another important development within the fast-food industry that curtails front-of-package label laws is the global growth in e-commerce. Driven by the pandemic, the popular use of food delivery services, promoted through mobile apps and social networks, vastly reinforced unhealthy consumer habits during lockdown measures. So much so that consumer behavior post-lockdown shows a continued reliance on food delivery services.
Unfortunately, the warning label law has little to no impact on e-commerce food advertising or delivery services, lest on commercial fast-food suppliers or small-scale vendors. In general terms, this porous regulation and political complacency have strengthened the position of multinational food corporations. The fast food industry’s rapid growth and increased capitalization demonstrate the power of food corporations.
Additionally, food donations to the vulnerable have long been at the hands of public and private organizations, whereby the quality and nutritional value of donated food is inconsequential. Although the Argentine law specifies that companies cannot donate food with front-of-package labels, it does not mention whether it prohibits the state or NGOs from donating these unhealthy products.
The quality of food consumed by the most vulnerable, as individuals with less autonomy over their consumption decisions or health, should by no means be compromised. Therefore, it is ethically imperative to regulate food donations that respect the food insecure and ensure that donated food maintains its nutritional value. Not least, as such, regulation guarantees the accountability of actors and therefore encourages healthier donations.
What About Companies’ Trademark Rights?
In 2010, three subsidiary companies of multinational tobacco company Philip Morris International (PMI) filed a suit before the International Center for Settlement of Investor Disputes (ICSID). The plaintiffs alleged that large warning labels covering 80% of cigarette packets, required under Uruguayan law, expropriated their property rights of trademarks without compensation. However, the tribunal dismissed their claim arguing that “the measures had no substantive effect in depriving the claimants of the value of their investments in general” and underlined the state’s right to “regulate in view of the common good.”
Similarly, Argentine society’s right to health, which is under judicial review, should also be more important than a company’s investment rights. Could we see a similar situation unfold against front-of-package food labeling? The expropriation argument is relevant to generic labeling. One might argue that a company’s right to property is infringed upon, whereby food companies could argue the violation of their trademarks. However, as evinced by PMI’s case in Uruguay, front-of-package labeling seldom deprives a company’s ability to sell processed products in instances where labels do not directly impact investment value.
The COVID-19 pandemic has underlined the danger of non-communicable diseases. These underlying health conditions pose a higher risk of serious illness and fatality when compared to COVID-19. Therefore, multi-sectoral and comprehensive health policies, which view health holistically and not as isolated compartments, are crucial. As urbanization grows and more citizens migrate to cities, the development of cities must incorporate “health in all public policies” and identify consumption habits and their impact on society as a long-term solution to combatting all NCDs.
Policymakers should also adjust the price controls that include carbonated drinks and alcohol according to the progressive objectives underscored by its front-of-package label law. The government must also cement front-of-package legislation so that future governments cannot veto. In addition, governments must take a stronger stance against aggressive marketing strategies of ultra-processed products, regulate the growth and expansion of fast-food chains, and adapt to evolving consumer habits driven by unregulated e-commerce laws.
Building progressive eating habits and behavior is a long-term goal. The government must reach consumers with reliable information through conventional and unconventional channels. After all, people will not stop consuming unhealthy food unless the viable alternatives are palatable and accessible.
Ezequiel Carman is a former consultant with Global Americans. Delfina Scagliotti and Ryan Arenas are former interns with Global Americans.