U.S. Says It Will Contest WHO Plan to Fight Obesity
But Claim of Faulty Science Is Rejected by Nutritionists

ROB STEIN / Washington Post 16jan04

The Bush administration announced yesterday it will demand significant changes to a major World Health Organization initiative to battle obesity globally, saying the plan is based on faulty scientific evidence and exceeds the U.N. body's mandate.

The move prompted intense criticism from U.S. and international health and nutrition experts, who charged that the U.S. objections are a thinly veiled attempt to placate the food and sugar industries and derail a vital international assault on one of the world's biggest health problems.

The WHO plan, which outlines strategies that nations can use to fight obesity, has been widely applauded by public health advocates but bitterly opposed by some food manufacturers and the sugar industry because it includes some controversial options, such as restricting advertising aimed at children and increasing junk food prices through taxes and adjustments in farm subsidies.

The U.S. delegation plans to seek significant revisions when WHO's governing board considers the proposal next week in Geneva, a key official said.

"There have been approaches that WHO has taken that we do not consider to be based on the best practices and the best science," said William R. Steiger, special assistant for international affairs at the Department of Health and Human Services. "What we want is a strategy that WHO can trumpet that is the product of the best possible scientific evidence."

Steiger said the revisions the United States will seek are still being finalized, but the goal will be to place much greater emphasis on the role of "personal responsibility" instead of government regulation.

"We have a whole series of potential changes we'd like to see," Steiger said in a telephone interview. "One overarching example is that any strategy that deals with this subject has to deal with individual responsibility. What's lacking is the notion of personal responsibility as opposed to what the government can do."

Steiger denied that industry concerns are behind the administration's position. The Grocery Manufacturers of America (GMA) and the Sugar Association acknowledged they oppose parts of the plan, but denied influencing the U.S. position.

However, GMA spokesman Michael E. Diegel echoed the administration's criticism. "There is no mention of what we consider to be the fundamentally important issue of individual responsibility," he said.

Although the report could not compel nations to act, international health experts said the comprehensive approach outlined in the draft version would provide a powerful weapon to governments and public health advocates seeking action against one of the most pressing public health problems.

"This document is fantastically important," said Philip James, chairman of the International Obesity Task Force, an independent London-based public health think tank. "It should have a big impact, unless it's sabotaged. And we know it's being sabotaged."

WHO estimates that perhaps 1 billion adults are overweight and at least 300 million are obese. In the United States, more than two-thirds of adults are overweight, and nearly one in three is obese. Researchers have blamed the skyrocketing rates largely on a combination of people getting less exercise and consuming more inexpensive, high-calorie junk foods.

In 2002, WHO's governing body, the World Health Assembly, voted to develop a strategy for combating the problem along with other chronic health problems influenced by lifestyle, such as heart disease. WHO issued a scientific report in June 2002 that provided the basis for the 18-page strategic plan, which would come before the assembly for final approval in May if the executive board endorses it next week.

"It essentially establishes a new standard with which all doctors and public health interest can now challenge the governments and say, 'What are you doing about this?' " said James, who is also vice president of the International Union of Nutritional Sciences.

On Jan. 5, Steiger sent a letter to WHO Director-General Jong-wook Lee with a stinging 28-page critique outlining "where the U.S. government's policy recommendations and interpretation of the science differ from those" of WHO.

Steiger repeated those concerns yesterday, adding that the current version exceeded the agency's purview. Asked specifically whether the United States would support the plan's suggestions about restricting advertising and manipulating food pricing, Steiger said: "We do like to think the WHO should stick to its mandate, which is science and health."

Steiger and others noted that Health and Human Services Secretary Tommy G. Thompson has made the fight against obesity one of his top domestic priorities and has launched a number of high-profile projects, including a campaign to lose weight himself.

WHO's supporters said the administration's objections were really an attempt to undermine the plan because of food and sugar industry influence.

"The negative comments have not come from scientists. They have come only from industry," said Kaare R. Norum of the Institute for Nutrition Research at the University of Oslo, who chaired the scientific panel that advised WHO. "It is ridiculous to say that the report is not valid. It is ridiculous to use these minor objections to throw over the global strategy. I think it's very tragic."

The U.S. criticism flies in the face of Thompson's domestic position, said Bruce Silverglade of the Center for Science in the Public Interest, a Washington-based consumer group.

"We're not surprised that the food industry has a knee-jerk reaction. What we're surprised about is that Secretary Thompson, who has espoused so much concern about obesity, is privately working with representatives of the food industry to derail a World Health Organization initiative," he said.

source: http://www.washingtonpost.com/ac2/wp-dyn/A21073-2004Jan15?language=printer 16jan04