Five things we learnt from WHO’s 150th Executive Board meeting

WHO Director-General, Dr Tedros Adhanom Ghebreyesus addresses the opening of the 150th session of the Executive Board. Credit: WHO/Christopher Black

The Policy and Public Affairs team participated in the World Health Organization’s (WHO) 150th Executive Board (EB), which sets the agenda ahead of the World Health Assembly (WHA).

The week-long meeting had a bumper agenda relating to noncommunicable diseases (NCDs) – which has implications for our work in cancer prevention.

As we are in official relations with WHO, we were able to make important interventions on several issues. Here are our main takeaways from the busy week.

1. Towards a global approach on obesity

The WHO’s new and unanimously adopted obesity targets and recommendations draw together recommendations for governments, civil society, academia, and economic operators across a range of areas including the food system and physical activity to improve global outcomes on all forms of malnutrition and halt the rise of obesity.

They recommend fiscal, marketing and nutrition labelling policies as well as the implementation of the WHO Global Action Plan on Physical Activity 2018-2030.

The WHO recommendations, recognising the power of civil society to mobilise the public, is hoping to increase public demand for policies to prevent obesity – which would help pressure governments into acting.

Many member states supported the obesity recommendations and recognised the links between obesity and NCDs. Norway called for a holistic approach to reduce the NCD burden by addressing the social determinants of health and restricting the marketing of unhealthy diets.

Slovenia called for the implementation of the NCD Best Buys, Philippines called for nutrition promotion through taxation and labelling, as did Argentina who took the opportunity to highlight its new Healthy Eating Law.

WCRF International and World Obesity Federation, with support from NCD Alliance, welcomed the recommendations and urged Member States and the WHO to develop a Global Action Plan on Obesity, and turn it into a strategic priority.

This would be a vital contribution to a monitoring and evaluation accountability framework and support the implementation of recommendations.

2. Pushing back on promoting breastmilk substitutes

The WHO progress report on maternal, infant and young child nutrition showed child overweight and obesity continues to rise. Progress in implementing the International Code of Marketing of Breastmilk Substitutes also remains off track, with manufacturers of breast-milk substitutes capitalising on the COVID-19 pandemic to promote their brands and products .

WCRF International led a constituency statement with six other organisations, highlighting the need to protect and promote breastfeeding as a powerful and cost-effective way to boost the health of infants and mothers.

We also urged for the enforcement of the Code and implementation of strategies to tackle digital marketing of breastmilk substitutes. Encouragingly, Member States agreed to ask for WHO guidance on this.

WHO Director-General, Dr Tedros Adhanom Ghebreyesus addresses the opening of the 150th session of the Executive Board.
WHO Director-General, Dr Tedros Adhanom Ghebreyesus addresses the opening of the 150th session of the Executive Board. Credit: WHO/Christopher Black

3. Alcohol – always a risk of harm

Member States unanimously decided to adopt an Action Plan for 2022–2030 to reduce the harmful use of alcohol. This includes the recognition of the global disease burden attributed to alcohol, which is unacceptably high. The Action Plan outlines policy options to tackle the availability, affordability and marketing of alcohol.

France, in representation of the EU, supported the Plan and spoke about alcohol as an important risk factor for the development of NCDs, noting the need to prevent undue influence and conflict of interest when developing alcohol policy.

However, we’re concerned by the language of Member States who use the phrase “harmful use of alcohol” – as we believe all alcohol has the potential for harm – and countries like the US, who supported the role of the alcohol industry in policy development.

Civil society’s strong chorus of voices highlighted there is no safe level of alcohol consumption for cancer risk and heart disease. WCRF International together with UICC delivered a statement reiterating how the use of the word ‘harmful use of alcohol’ creates confusion as there is no safe level of alcohol consumption for cancer risk.

We further urged that the action plan does not assign alcohol industry any role, action, or measure in the policy response given the harm that their own products and practices cause.

Movendi International, a social movement that works to prevent alcohol harm, have written a blog post on the alcohol action plan.

4. Industry lobbying holds WHO back

It’s encouraging to hear Member States address conflict of interest, urge more protection, and acknowledge the negative effect it has on policy. Uruguay made a powerful plea for clear guidelines on preventing conflict of interest in the development of public policies. Slovenia added that introducing cost-effective measures such as rising taxes and bans on advertising is difficult due to aggressive lobbying.

However, we were concerned to hear the WHO Director-General use industry language around drinking alcohol “in moderation”, as our evidence clearly shows it is best not to drink alcohol for cancer risk.

Moreover, our Constituency statement explicitly called for Member States to put the health of mothers and children ahead of commercial interests, reinforcing the benefits of breastfeeding for both mother and child.

The World Obesity Federation requested that the WHO work with Member States to strengthen the reference to commercial and social determinants within the obesity recommendations which, if not addressed, undermine the ability to achieve meaningful change.

5. Civil society participation at the WHO

The WHO has proposed reforms to non-State actor engagement in governing body meetings, through increased informal discussions and the trial use of constituency statements.

We’ve been concerned by these changes, which challenge transparency and may threaten to shrink civil society space. The UK, US and Canada highlighted the value of non-State actor engagement.

We were delighted that the Executive Board approved our next three-year collaboration with WHO by renewing our Official Relations status.

We’ll be working hard over the next few months ahead of the next WHO World Health Assembly in May to ensure that, even amid a continued focus on the pandemic, the WHO does not lose focus on the millions of people at risk of, and living with cancer – and doing all we can to reduce this burden.