Governments have weakened their commitment to addressing non-communicable diseases (NCDs) after pressure from “big tobacco, alcohol, junk food, and fossil fuels”, according to civil society.

Their claim centres on the draft political declaration due to be adopted at the UN High-Level Meeting (HLM) on NCDs in September, which no longer calls on countries to implement high taxes on these unhealthy products.

Countries are due to wrap up negotiations on the declaration this week, with the final declaration due to be adopted at the HLM on 25 September. 

“It looks like health-harming industry fingerprints are all over this,” said Alison Cox, director of policy and advocacy at the NCD Alliance. 

“At a time of fiscal pressures, shrinking global health funding, and increased emphasis on domestic resource mobilisation, health taxes are a golden opportunity to both generate revenue and reduce the burden of NCDs and associated healthcare costs,” she added.

“Yet as it stands, the declaration’s text contains weaker language around taxes and lets industry off the hook, prioritising profits over public health,” added Cox, describing the draft as “a backslide”.

The language in the current draft has been watered down, and targets have been “flattened”, with active commitments to ‘implement’ and ‘enact’ replaced with the “far more passive language of ‘consider’ and ‘encourage’,” according to the NCD Alliance.

‘Reinstate commitment to taxes’

Vital Strategies, a global public health organisation, urged the negotiators to “reinstate explicit commitment to health taxes” on tobacco, alcohol and sugar-sweetened beverages. 

“These taxes should increase prices sufficiently to reduce affordability, prevent initiation and support reduction or cessation of use,” said Vital Strategies in a media release.

“As outlined by the Task Force for Fiscal Policy on Health, a 50% price increase on tobacco, alcohol, and sugary beverages could raise $2.1 trillion in five years for low- and middle-income countries, revenue equal to 40% of their total health spending,” added the organisation.

NCDs, including heart disease, cancer and diabetes, account for 43 million deaths annually, 75% of all deaths worldwide. The burden of NCDs is growing in low- and middle-income countries, driven primarily by smoking and poor diets.

Vital Strategies also raised alarm about the removal of references to the World Health Organization’s (WHO) “Best Buy” policy recommendations for reducing alcohol consumption and related diseases, including raising taxes, restricting marketing and regulating availability. 

“The conspicuous deletion of these proven policies from the text strongly suggests undue alcohol industry influence aimed at weakening public health protections. We urge governments to immediately reverse these deletions and fully restore WHO’s recommendations in the final text,” said Vital Strategies.

Harmful commercial practices

It also wants the declaration to “explicitly tackle harmful commercial practices and strengthen conflict-of-interest protections to safeguard public health policymaking from industry interference”, strengthen commitments to “proven tobacco control measures” including effective taxation, and “recognise unhealthy diets as an urgent priority”.

The WHO attributes some 2.8 million deaths a year to obesity and overweight, and Vital wants the declaration to “explicitly state that rising obesity rates are primarily driven by unhealthy diets, emphasising clear interventions like front-of-pack labelling and marketing restrictions targeting children”.

The NCD Alliance is also unhappy about “significant backsliding” around social participation and the role of civil society, which is only referred to once. 

“History has taught us that ignoring the integral role of civil society, communities and people living with diseases weakens any meaningful public health response,” said Cox.  

With just a week of negotiations remaining, the NCD Alliance is calling on governments to “demonstrate true leadership and resist last-minute compromises that prioritise commercial interests over public health and reflect a genuine commitment to protecting lives”.

Image Credits: Leo Zhuang/ Unsplash, Stanislav Ivanitskiy/ Unsplash.