Last month in Ecuador, the government of President Daniel Noboa introduced a bill to fight against child malnutrition. Such a law could be a necessary instrument for the Ecuadorian government to act forcefully to solve this chronic social problem in the country. However, as it stands, the law is one more step toward the institutionalization of corporate influence on health and nutrition policy in Ecuador.
Child malnutrition and health risks in the region
Chronic child malnutrition is a public health problem. A recent UNICEF report shows the scale of the problem of child undernutrition globally. According to the report, one in four children under five years of age (more than 180 million worldwide and 5 million in Latin America) suffers from child food poverty. Middle-income countries suffer from a double nutritional burden (a simultaneous manifestation of malnutrition and obesity). Such is the case in Ecuador, where one in four children under the age of five suffers from chronic malnutrition. At the same time, more than half of the adult population is overweight and obese.
Corporate influence on nutrition and health policies
Social, political and economic dimensions are increasingly recognized as determinants of health. More recently, the role of corporate interests in the cycle of health and disease has been recognized. Commercial determinants of health encompass three dimensions: 1) products that are harmful to health (such as ultra-processed foods and beverages); 2) business, market and political practices that are used to sell such products and ensure a favorable regulatory environment for corporations (and rather harmful to health); and 3) an environment of market-driven economies and globalization, which facilitate the use of these harmful practices around the world.
Not surprisingly then, power over food systems is increasingly concentrated in a handful of multinational food and beverage companies. The top 10 global food and beverage companies control 80 percent of the food products market, with annual profits exceeding US$100 billion. They derive most of their revenues from the sale of highly processed foods and beverages. This oligopoly exerts a major influence on the diets and nutrition of children and adults around the world. In this context, it is not surprising that governments in Latin America are trying to regulate it in their national legislation, as is the case of the recently approved law regulating the human right to nutritious, sufficient and quality food in Mexico.
The expansion of corporate influence in Ecuador
Contrary to global and regional efforts to limit the influence of corporate interests in health and nutrition policy, the last three governments in Ecuador have taken steps in the opposite direction. In a recent study, we demonstrate how private interests are becoming increasingly institutionalized in public policy. We also show the changes that allow corporations to promote their brands, obtain fiscal benefits, influence public policy decisions, set priorities, allocate resources, and determine how the country’s child malnutrition strategy is implemented.
Following the framework of Bennet et al., we were able to identify how the ultra-processed food and beverage industry has co-opted “civil society” through industry front groups such as REDNI and has obtained direct participation in government agencies to combat child malnutrition (to the detriment of already established entities, such as the Ministry of Public Health — MSP). In this scheme, the private sector has effectively co-opted the government’s mandate to establish and monitor nutrition and health policies.
New government, same strategy
The recent change of government appears to be a continuation of this scheme. This is the only way to explain the introduction of a bill that clearly expands and institutionalizes a prominent role for the food and beverage industry. The text of the bill leaves aside the fundamental role that the constitution gives to the MSP (to guarantee the right to health of the population). Such a change may lead to a duplication of actions, and a poor utilization of existing human talent by not strengthening the personnel of the MSP.
In addition, the law explicitly mentions the promotion of tax benefits to private entities. Article 5 states that tax, tariff, and other fiscal policies should be adopted to encourage the private sector to generate actions and contributions. As a whole, this proposal has serious limitations in its articulation with principles established in the existing legal framework, including the 2008 Constitution, and other laws such as Ecuador’s food sovereignty and health laws.
Untangling corporate interests
The growing influence of the food and beverage industry has led entities such as UNICEF to establish clear guidelines to limit its role. In the Ecuadorian case, the increasingly close collaboration between the food and beverage industry and the national government raises serious concerns about the integrity and transparency of policies aimed at addressing chronic child malnutrition. There is a need to implement mechanisms that limit industry influence on nutrition and health policies, while improving transparency and accountability mechanisms.
There is a precedent in the current legal framework that prohibits shareholders of banks and the media from owning shares in companies in both sectors. In addition, the law restricts the exchange of information and revolving doors between public entities and the banking sector, and dictates that social responsibility initiatives cannot be used to promote their brand, products, or services. Last April, a civil society coalition succeeded in repealing decree 645 (which reduced taxes on cigarettes, liquor, and sugared beverages from 2023). Both legal precedents can guide the debate on the proposed law in the National Assembly, aimed at reducing the influence of the food and beverage industry on national nutrition and health policy.
*Translated by Janaína Ruviaro da Silva from the original in Spanish.
Autor
Profesor Asociado en el Departamento de Promoción y Políticas de Salud, Facultad de Salud Pública y Ciencias de la Salud, Universidad de Massachusetts Amherst, EEUU.
Nutricionista por PUCE y Salubrista Público por USFQ, diploma en Políticas Públicas por FLACSO. Ha coordinado proyectos de salud reconocidos por OPS y trabajado como consultor internacional. Actualmente, es docente en PUCE, enfocado en nutrición comunitaria y salud pública.
