Global call for joint action on obesity, undernutrition and climate change

The Lancet Obesity Commission report was authored by 43 world-leading experts co-chaired by Professor Boyd Swinburn from the University of Auckland and Professor Bill Dietz from George Washington University. It argues that to address the three interconnected pandemics – which it calls ‘The Global Syndemic’ - leaders must take a hard line against powerful vested commercial interests, and overhaul regulations and economic incentives within the food system.

Professor Swinburn says Aotearoa New Zealand could became a trailblazer if the principles behind the Government’s new wellbeing budget were applied across all government policies and spending. The Commission also recommends that all countries enshrine in law an overarching Right to Wellbeing, which would include the existing human rights, along with a new right to a healthy environment.

“This would ensure that both human and environmental wellbeing underpin not only all government actions, but also the priorities society sets for itself,” says Professor Swinburn.

Common drivers, shared solutions

The report follows the publication earlier this month of the separate Lancet-EAT Commission, which provided the first scientific targets for a healthy diet within planetary boundaries.

Professor Swinburn, who also led two previous Lancet reports on obesity, said malnutrition in all its forms, including undernutrition and obesity, was by far the biggest cause of ill-health and premature death in every country.

“Obesity, undernutrition and climate change are usually viewed as separate, but we show that not only do they share many key drivers, they fuel each other via multiple feedback loops.

“For example, food systems not only drive the obesity and undernutrition pandemics but also generate more than a quarter of global greenhouse gas emissions and about half of New Zealand’s emissions.

“Car-dominated transportation systems, like we have in New Zealand, promote sedentary lifestyles and generate up to a quarter of global emissions.

“And climate change will increase undernutrition through greater food insecurity from extreme weather events, droughts, and shifts in agriculture.”

But Professor Swinburn said the strength of highlighting the shared drivers of the three pandemics is that this points to shared solutions.

“These double-duty or triple-duty actions, as well call them, focus on the underlying causes rather than the symptoms to create multiple wins.”

Blueprint for change

The report’s recommendations include:

• A new global treaty on food systems – similar to existing ones on tobacco control and climate change - to mobilise national action for healthy, equitable and sustainable food systems and to restrict the enormous influence of the food industry in government policy-making.
• Re-directing subsidies towards healthy and sustainable foods and energy. Swinburn: “Globally, the food and fossil fuel industry receives over US$5 trillion per year to produce products that damage health and/or the environment.” 
• A global philanthropic fund of US$1 billion to support social movements demanding policy action. Swinburn: “This will help to break the current policy inertia by shifting the balance of power in political decision-making towards citizens and away from large corporations.” 
• A ‘7-generations fund’ to research and apply indigenous and traditional knowledge and worldviews on living well within and nurturing our environments. This is based on the principle of the Iroquois Nation of making decisions today for seven generations ahead.

In the report, Dr Ihi Heke, an indigenous health and outdoor specialist, outlines a Māori approach to healthcare grounded in the local environment called ‘Atua Matua’.

Dr Heke, an Honorary Research Fellow at the University of Auckland, has presented internationally on the model, and developed virtual reality tours of different rohe that connect eating well and exercise to local produce and natural features of cultural significance such as awa and maunga. In common with many indigenous cultures, knowledge about the close interconnections between tangata and whenua is embedded in Māori histories and practices, especially whakapapa, he says.

Dr Heke describes the early deaths of both his father and brother due to preventable diseases. “Institutional attempts to provide health-enhancing opportunities…are often met with contempt because the underlying suggestion is that the institution knows what’s better for Māori more than they do themselves,” he writes.

“It’s likely that the answers to indigenous health problems already exist in their communities, but have been forsaken for the new brand of medical autonomy that has sidelined indigenous ways.”
 

Aotearoa New Zealand could be leader in wellbeing for people and planet

Professor Swinburn says New Zealand’s first-ever wellbeing budget could provide a platform for bringing a “triple bottom line” approach to policy across all parts of Government. That would require policymakers to weigh the health and environmental impacts, as well as the economic impact, of all government activities, including budgets, trade deals, treaties and other policies.

“Prime Minister Jacinda Ardern challenged world leaders at Davos to be ‘on the right side of history’ over climate change. Talking about the wellbeing budget, she also signalled that ministers who want more money for their portfolio will have to show the spending will improve intergenerational wellbeing. Our report is all about how to apply this philosophy across governments, business and societies in general. New Zealand is well-placed to be an international leader, especially in the area of healthy, sustainable, equitable and prosperous food systems.”

• The full report, a policy brief and video clip and other resources are available on The Lancet Obesity Commission website.