Health through the backdoor

The European Commission’s powers are limited when it comes to healthcare policies.

Like every other Commission department, the directorate-general for health and consumer protection (DG Sanco) often has to deal with powerful multinational industry groups wary of new legislative proposals. But more than the environment or trade departments, DG Sanco also has its competences restricted by the EU treaty.

In an attempt to get around this difficulty, DG Sanco is trying out a new approach to developing healthy lifestyle strategies. Instead of legally binding targets and commitments, groups of stakeholders, known in the jargon as ‘platforms’, are asked to devise voluntary codes and strategies to encourage changes in consumer behaviour.

The first of these platforms was launched in 2005. Officially called the EU platform on diet, physical activity and health, it is often referred to as the obesity platform. A second platform on alcohol and health is to be set up before the summer along the same lines.

The obesity platform has its second birthday today (15 March). The Commission has devised no great celebrations but is instead concentrating on finalising a follow-up white paper, which will look at progress so far and suggest future action.

Interest groups which have sat on the platform for two years are less reticent.

Patti Rundall from Baby Milk Action, a non-governmental organisation, said she was ambivalent about the effectiveness of the obesity platform from the beginning. "In our 20 years’ experience, introducing properly monitored legislation is the best way to change things. At the start the idea was to go along with things and hope the Commission saw the flaws," she said.

"The platform presupposes that on a voluntary basis industry will do the right thing," she said.

In particular, Rundall was unhappy that many of the school nutrition education programmes agreed through the platform were being run by food companies. "I don’t want the platform to send out the message that it’s appropriate for industry to do this kind of thing," she said.

Baby Milk Action and other public health groups argue that an independent monitoring code is needed to ensure obesity platform commitments do not mask industry self-promotion campaigns.

Noelle Von Thron of Eurocommerce, a retail federation, said that government involvement was needed to make sure food education programmes were run properly. She said the obesity platform had been very successful in changing company behaviour, with a new nutrition manifesto and healthy labelling commitments. But she warned that: "Labelling alone will never change consumer behaviour, only education can do that. That is a job for governments."

She added that national health ministries should be encouraged to get involved with platform activities. "This is supposed to be a model for national action and some member states are not even aware of the platform. We rarely have more than three or four government representatives at meetings," she said.

Von Thron congratulated the Commission on its management of the platform but said it was too early to know if it would have an impact on obesity levels.

Lisette Tiddens-Engwirda of CPME, the European doctors group, also said the platform had increased European awareness of obesity. "Look around you: everyone is talking about obesity," she said. "The sheer fact of taking this up to EU level has made a difference," said Tiddens-Engwirda.

But she warned that results might take a while to become clear. And she added that Commission fora would always have limited influence.

"The US was years ahead of us with obesity campaigns," she said, "but it was only when [American chat-show host] Oprah Winfrey decided to lose weight that people started to try the same."

The European Commission’s powers are limited when it comes to healthcare policies.