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"contents": "New regulations that will require unhealthy food and drink products to carry a warning label are being publicly opposed by the Beverage Association of South Africa (Bevsa), but they shouldn’t be. The <a href=\"https://www.factssa.com/Docs/2023_food_labelling_R3337_draft_regulations.pdf\">draft regulations</a> would require products to carry warning labels to inform consumers about the harmful nutrients in their products and also prevent companies from advertising these products.\r\n\r\nGiven <a href=\"https://link.springer.com/article/10.1186/s12889-022-12601-6\">rising rates of obesity and diet-related diseases in South Africa</a>, the need for measures like these labels is urgent.\r\n\r\nWarning labels like those currently proposed in the draft regulations <a href=\"https://www.sciencedirect.com/science/article/pii/S0950329322001665?casa_token=hIqWAdQchUYAAAAA:aJ8MGpNoO-XgrcAqzYsTOqd89z4wldpOgelnJIop4e_KX6o1IMl8JEmBTY3kn_8Oz9GVUIhN\">are increasingly being adopted around the world</a>, with Uruguay, Peru and Chile having already adopted similar systems. More importantly, <a href=\"https://www.sciencedirect.com/science/article/pii/S0195666322003749\">research in South Africa shows</a> that the proposed warning labels will be effective in helping consumers identify unhealthy products, and act on this knowledge by making healthier choices when buying food.\r\n\r\nBevsa recently published <a href=\"https://www.dailymaverick.co.za/article/2023-10-06-industry-calls-for-a-pragmatic-approach-on-the-implementation-of-the-draft-regulation-relating-to-labelling-and-advertising-of-foodstuffs/\">a sponsored article</a> outlining its views on the <a href=\"https://www.factssa.com/Docs/2023_food_labelling_R3337_draft_regulations.pdf\">draft regulations</a>. In the article, Bevsa claims that “consumer protection and public health must always be top priorities”. Given the potentially massive benefits of the proposed system, it should then be immensely supportive of the adoption of the regulation, not so?\r\n\r\nUnsurprisingly, it is not.\r\n\r\nDespite Bevsa’s claims, the purpose of its article is not to indicate its support for the timeous adoption of effective labels.\r\n<h4><strong>Out comes the industry playbook</strong></h4>\r\nInstead, Bevsa raises arguments previously used to oppose public health measures. Industries that sell harmful products, whether they be tobacco, alcohol or ultra-processed and unhealthy food, have relied on the same arguments consistently over the years (commonly referred to as the industry playbook). We should approach their views and involvement in the policymaking process with caution.\r\n\r\n<a href=\"https://link.springer.com/article/10.1057/s41271-021-00318-6\">Research has shown</a> that when faced with public health measures, the industry response consistently aims to achieve three things:\r\n<ol>\r\n \t<li>To delay the implementation of the measure;</li>\r\n \t<li>To dilute the strength of the regulation; and</li>\r\n \t<li>To deny that the measure is necessary.</li>\r\n</ol>\r\nThis playbook has <a href=\"https://www.dailymaverick.co.za/article/2021-10-15-delay-dilute-delegitimise-how-the-food-industry-shapes-what-you-eat-and-what-you-weigh/\">previously played out in the adoption of the sugary drink tax</a> and all three components of the playbook are evident in Bevsa’s response.\r\n\r\nBevsa’s first objection to the regulations is that government does not respect the industry’s intellectual property – and somehow this will result in job losses. It asserts that marketing and health claim restrictions in the regulations will infringe on intellectual property.\r\n\r\nHowever, what has been established is that intellectual property protections do not function in this way and <a href=\"https://journals.co.za/doi/abs/10.10520/ejc-esrrev-v23-n4-a5\">can rightly be limited to address public health concerns</a> – <a href=\"https://www.elgaronline.com/view/journals/qmjip/6-4/qmjip.2016.04.05.xml\">as is evident from the case of plain packaging laws for tobacco</a> products.\r\n<h4><strong>If it’s not healthy, don’t say so</strong></h4>\r\nBevsa also suggests that by preventing its members from using certain phrases, there will be job losses. It is unclear what this claim is based on.\r\n\r\nNotwithstanding, even if one accepts the claim, what Bevsa fails to acknowledge is that the restrictions on using health claims are tied to whether the products are unhealthy, and specifically whether they contain non-sugar sweetener, or too much salt, sugar or saturated fat.\r\n\r\nWhat Bevsa is essentially arguing for is that it should be allowed to use language that implies its products are healthy when they are, in fact, not.\r\n\r\nProducts that contain high levels of specific unhealthy nutrients ‒ sugar, salt or saturated fat ‒ should not be marketed as healthy because, simply put, they are not. More importantly, many ultra-processed products are created to have a particular mix of salt, sugar and fat, or contain non-sugar sweetener. Consequently, the amounts of these nutrients in a product are within the control of the producer and can be modified.\r\n\r\nIf the members of Bevsa want to use health claims they have to do only one thing – make their products less unhealthy, or at least reduce the amount of those nutrients to below the threshold.\r\n\r\nThere is thus a win-win option available to the industry.\r\n\r\nIf it reduces these key nutrients or produces products that do not contain excessive amounts of these nutrients to start with, it can use its intellectual property, prevent job losses and provide consumers with healthier product options.\r\n\r\nThe arguments on job losses also reveal something more troubling: that Bevsa thinks its profits should be prioritised over the health of South Africans, and this prioritisation should extend to allow it to misleadingly portray ultra-processed products as healthy.\r\n<h4><strong>Labels as an important educational tool</strong></h4>\r\nThe second objection is that the labels need to be coupled with education and consumer awareness, but that these are not accounted for in the regulations. We agree wholeheartedly that there should be an education campaign. While we cannot speak to the government’s intentions, we can confirm that education campaigns are not something that is regulated.\r\n\r\nRegulations are very particular legal instruments used to create mandatory standards – they are not used to implement education campaigns. Consequently, just because something isn’t in the regulation doesn’t mean it is not going to happen.\r\n\r\nIt should also be noted that <a href=\"https://www.sciencedirect.com/science/article/pii/S0195666322003749\">the results of the randomised control trial on the labels</a> showed that everyday South Africans could easily understand warning labels without any additional education. This shows that the labels, in themselves, are an important tool to educate the public.\r\n\r\nThe third objection is that there isn’t a sufficient scientific basis for the regulations because there is no adult dietary intake survey. This is not a novel argument from Bevsa – it made the same argument to delay the implementation of the sugary beverage tax. Here again, Bevsa wants to put off finalising the regulations under the national dietary intake survey even though there is <a href=\"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7254-7\">evidence</a> that the availability of unhealthy products can displace healthy food in diets.\r\n<h4><strong>Disregarding research</strong></h4>\r\nMore importantly, what its argument does not recognise is the <a href=\"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0257626\">extensive research that was done to develop the regulations</a>, including <a href=\"https://www.sciencedirect.com/science/article/pii/S0195666322003749\">a nationally representative, randomised control trial</a> which found that consumers were best informed about the unhealthfulness of products by the warning label.\r\n\r\nRelated to this, Bevsa’s desire to remove pictures from the labels is directly at odds with its claim to want a label design informed by consumers. It is more likely aimed at diluting the effectiveness of the label.\r\n\r\nSouth Africans speak a diversity of languages and there are also significant levels of illiteracy. If government adopted a label that consisted solely of English text <a href=\"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0257626\">the label would not effectively communicate its message to large portions of the population</a>. Industry doesn’t want consumer-friendly labels – it wants ineffective labels.\r\n\r\nThe fourth objection is to the time period for implementing the regulations, which is currently set at six months after their publication. It should be noted that the National Department of Health communicated the content of the labelling regime and research underpinning it to the public in 2021 – almost two years ago.\r\n\r\nA number of industry representatives were at this meeting and thus were aware of the proposed regulations. Moreover, the first draft of the regulations was published in March this year.\r\n<h4><strong>Bad planning</strong></h4>\r\nAt a minimum, the industry has been aware of the proposed labelling scheme for most of this year. A year can be plenty of time for industries to adapt if they want to – such as adding in promotions related to big sporting events or changing bottle sizes after the tax was passed. Its failure to plan accordingly should not come at a cost to South African consumers.\r\n\r\nThe most important thing to note is that despite the concerns raised by Bevsa, many countries have been able to successfully implement front-of-package warning labelling. Companies have adapted to the system, including by reformulating their products to reduce the levels of unhealthy nutrients. If the industry can go through the effort of making its products less harmful in Chile, Peru and Mexico, South Africans deserve the same.\r\n\r\nIt is apparent that the food industry is trotting out the same playbook it has used previously to weaken public health regulations. It is important to recognise that these strategies are designed to protect the industry’s bottom line and are not for the benefit of consumers – no matter what industry claims to the contrary.\r\n\r\nThe health of South Africans is more valuable than the industry’s bottom line. <strong>DM</strong>\r\n\r\n<em>The authors of this article were members of the National Department of Health’s Technical Working Group on Front of Package Labelling and provided technical input on the development of the draft regulations on labelling.</em>",
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