1. Sharon Friel National Centre for Epidemiology and Population Health The Australian National University 3 rd People’s Health Assembly, Cape Town 8 th July 2012 Trade, food and health inequity

2. What do we want?

3. People-centred food systems Amended, Lang and Heasman (2004) Food Wars: the global battle for mouths, minds and markets Fairness in

4. What have we got

5. IFPRI, Global Hunger Index 2010 1 billion undernourished people in the developing world

6. two billion people are overweight

8. 1.Liberalisation of international food trade 2.Increased foreign direct investment 3.Globalised advertising and marketing 3 drivers of dietary change

9. Bilateral Investment Treaties explode Slide: Richard Baldwin

10. Proliferation of new generation RTAs – broader scope and deeper integration UNESCAP 2010, Asia Pacific Trade Investment Report 2011

11. 1.Nutritional quality and quantity of imports 2.Foreign direct investment – convenience creep 3.Limitations on domestic policy instruments 4.Reduce tax-revenue base of governments to fund nutrition health and social programs Four trade-related pathways of concern for nutrition and health equity

12. In 2004 mutton flap consumption was about 600 g per week per adult and comprised 18% of total meat consumption Draft legislation for import quota to any product that had >40% energy from fat Under WTO trade rules quotas are perceived as highly trade distorting WTO accession negotiations resulted in postponement of legislation Quantity of mutton flaps imported into Tonga, 1980–2007 Thow et al 2010 Food Policy 35: 556–564

13. 1.Nutritional quality and quantity of imports 2.Foreign direct investment – convenience creep 3.Limitations on domestic policy instruments 4.Reduce tax-revenue base of governments to fund nutrition health and social programs

14. Per capita sales of unhealthy food and beverage commodities, 1997–2010, projected to 2016 Stuckler et al (2012) Manufacturing Epidemics: The Role of Global Producers in Increased Consumption of Unhealthy Commodities Including Processed Foods, Alcohol, and Tobacco. PLoS Med 9(6): e1001235. doi:10.1371/journal.pmed.1001235

15. Soft Drink Consumption (volume per capita) 1% higher GDP per capita0.90% *** (0.19) 1 percentage point higher urban population (% of total) 0.018% * (0.0068) Free Trade Agreement with the United States 55.4% * (24.2) Number of Countries35 R2R2 0.74 FTAs, Soft Drink Consumption, 35 low- and middle-income countries, year 2010

16. Top 10 manufacturers of packaged foods Stuckler et al (2012) Manufacturing Epidemics: The Role of Global Producers in Increased Consumption of Unhealthy Commodities Including Processed Foods, Alcohol, and Tobacco. PLoS Med 9(6): e1001235. doi:10.1371/journal.pmed.1001235 Three quarters of world food sales involve processed foods, for which the largest manufacturers hold over a third of the global market.

17. 1.Nutritional quality and quantity of imports 2.Foreign direct investment – convenience creep 3.Limitations on domestic policy instruments 4.Reduce tax-revenue base of governments to fund nutrition health and social programs

18. Thailand Snack Food Labelling Technical Barriers to Trade Dispute 2006 Proposed Traffic Light SystemX Proposed Warning Label 2007 Label: “Should consume small amounts, and exercise for a better health.” changed to “Should take less, and exercise for a better health”

19. 1.Nutritional quality and quantity of imports 2.Foreign direct investment – convenience creep 3.Limitations on domestic policy instruments 4.Tariffs: reduce tax-revenue base of governments to fund nutrition health and social programs

20. Pacific Agreement of Closer Economic Relations (PACER PLUS) Oxfam 2009 Elimination of substantially all import tariffs between PICs and Australia and New Zealand Most of the increase will be in PIC imports not exports EducationHealthPACER revenue loss Cook Islands14116 Fiji29143 Kiribati14915 PNG1062 Samoa221712 Tonga131419 Vanuatu231118 Government Expend as % Total Budget

21. Global food prices, 1990-2012 FAO 2012 2002-2004=100

22. Food commodity speculation Trends in rice futures (2000–08) Pace and Costello (2008). Food commodity derivatives: a new cause of malnutrition. The Lancet Vol 371 May 17

23. Thank you