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Obesity should be considered a disease rather than a symptom of sloth and human self-indulgence, according to the The Lancet report on the Great Global Syndemic. Photo: Alamy
Opinion
David Dodwell
David Dodwell

Say hello to the new trio of dangers that threatens the world: obesity, undernutrition and climate change

  • The British medical journal The Lancet warns of coming challenges that will be know as the Great Global Syndemic
  • The epidemics of obesity, undernutrition and climate change loom over us

As if there were not enough plagues and pestilences looming over humankind, we have now been introduced to the mother of all threats – the Great Global Syndemic – which will undoubtedly soon be reduced to the neat acronym GGS.

The once-fusty British medical journal The Lancet, joining forces in a “Lancet Commission” with the University of Auckland, the World Obesity organisation, and the Milken Institute School of Public Health, has just released an awesome but virtually unreadable expose on the Great Global Syndemic – the grave combination of the epidemics of obesity, undernutrition and climate change that now looms over us.

While I am certain the 44 commissioners who authored the Syndemic report are wholly right to throw a spotlight on the crisis, and call for urgent action, I confess I have found the small print of life insurance policies easier to read.

It reminded me of the recent shocking report from the Intergovernmental Panel on Climate Change (IPCC), which probably accurately warned us that we have just 12 years to take serious steps to curb CO2 emissions, but then blinded us with so much obscure and academically caveated science that most political leaders will almost certainly have flopped back into policy inertia.

The Lancet report boggles us with horrid language like “obesogenic” and “consumptogenic”, and presents us with governance challenges that “are contextualised against a backdrop of contemporary changes in global, national and local governance systems”. It then rallies to action around six principles, nine recommendations, four essential strategies, and 20 actions – and I confess that by now I have forgotten every single one of them. If the GGS really is a crisis, we need a much crisper way of getting our adrenaline running.

A nurse checking the blood pressure of a patient at a government-run hospital for Buddhist monks in Bangkok. Followers have been showering monks, who are deeply respected in Thailand, with foods loaded with sugar, fat and oil, contributing to a brewing health crisis. Photo: AFP

What I remember is definitely alarming. The accelerating crises of obesity, undernutrition and climate change certainly seem to stewing up into a perfect storm that has the potential to exterminate humankind. I am not so sure about their argument that the three are integrally linked, but the argument that “big food” plays a malevolent part in all three is well made.

That is probably why the world’s leading food multinationals got together to condemn the report as “deeply irresponsible”.

The main concern of the report is obesity, which the commissioners insist is a disease rather than a symptom of sloth and human self-indulgence, and is being force fed by a global food industry that cares more about bottom line profit than global nutrition.

“Large food corporations and their industry-interest associations have a dominant political role and are explicitly driven by a fiduciary duty to prioritise financial returns to investors,” it argues. “The greatest returns come from large-scale, ultra-processed products marketed around the globe – mass produced, long shelf life food products that are typically high in fat, salt and sugar.”

Cosseted by annual subsidies amounting to more than US$500 billion, such companies sit at the heart of a global obesity crisis that is causing diseases costing us more than $2 trillion a year. Obesity among girls has jumped eight-fold in the past four decades, and 10-fold among boys, the report says. This means that 14.9 per cent of all women, and 10.8 per cent of all men (about 2 billion people altogether) are today clinically obese, with about 9 per cent of the world’s population suffering from diabetes. Disease linked with obesity is costing 4 million deaths a year and 120 million “disability-adjusted life-years”, or “DALYs”.

High consumption of colas is a driver of obesity in the Philippines, according to the World Health Organisation. Photo: File

This means that obesity is now almost as serious a global problem as poverty and undernourishment, which costs US$3.5 trillion annually, and leaves 155 million children stunted, 52 million wasted and 815 million chronically undernourished.

And at the heart of both problems The Lancet commissioners find a mischievously-motivated “big food” industry riven by vested interests and conflicts of interest that are “at odds with the public good and planetary health”, and generate “a constant barrage of appealing inducements to overeat and live sedentary lives”.

It is these companies that are behind the massive growth of meat consumption (up from 71 million tonnes a year in 1961 to 318 million tonnes in 2014), and “ultra-processed foods” like chips, crisps, ready-to-eat cereals, sugary drinks and confectionery which are energy-dense, nutrient-poor, with excessive amounts of energy, fat, sugar or sodium, and which by design are highly palatable, cheap and ubiquitous.

“Industries with vested interests such as transnational food and beverage manufacturers, are powerful and highly resourced lobbying forces that have opposed governments’ attempts to regulate commercial activities or modify them through fiscal policies such as imposing a tax on sugary drinks or changing agricultural subsidies.

“The sugary drinks sector (now taxed in over 30 countries) spent almost US$50 million in 2016 to 17 to lobby against US government-led initiatives to reduce soda consumption,” the report says. It adds that research funded by the sector “is five times less likely to find an association between sugary drinks and obesity compared to other studies”.

For this reason, the commission argues that governments should shackle food manufacturers’ lobbying and “research”, and keep them well clear of food policymaking: “Arguably the single largest contribution that corporations could make to addressing the Global Syndemic is to stop investing enormous efforts and resources into opposing the enactment of regulations and fiscal policies for the public good.”

It calls for a global Framework Convention on Food Systems that builds on, and adds to, the 1948 Universals Declaration of Human Rights. Added to the original list of “inalienable” human rights should be rights to “well being”- the rights to human and environmental health, the right to food, child rights and cultural rights.

As I put the report down, I found myself in agreement with all of its concerns, and most of its complaints, both against “Big Food” and governmental “policy inertia”. But I found its long lists of principles, recommendations, strategies and actions both “energy dense and nutrition poor”.

Pious calls for a “shift away from narrow, profit-maximisation models into broader models better able to deliver for people, planet and prosperity” seem light years from the real political world of Trumpian America or Brexit Britain. Something more is needed if the Great Global Syndemic is to be averted.

David Dodwell researches and writes about global, regional and Hong Kong challenges from a Hong Kong point of view

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