Stakeholder conflicts and food policies – partnerships strengthen governance

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Dear Editor

Is it possible for scientists, clinicians, activists, policymakers, and consumers to collaborate with the food industry to discuss key elements of food policy including food science, food manufacture, food security and food distribution, and for this is to be delivered through consultation, compromise, trust, and respect? The response from consumers to this question and from parents in relation to infant and child nutrition is likely to be, why is this question being asked? Surely it is the professional duty of all key stakeholders to collaborate effectively and provide consumers with the best advice and ensure that the best nutritional products are available to support the health and wellbeing of the population. And they may add that if this is not happening, then this is a failure of professional responsibility, that may reflect professional misconduct and if there are claims of possible harm, this could lead to criminal investigation.

The value and safety of ultra-processed foods is now the focus of the latest food controversy and already the conflicting views and discussions bear the hallmarks of the multi-decade stakeholder conflict involving the infant formula and young child food industry [1]. A key element of that conflict is that the World Health Organisation and breastfeeding activist groups have asserted that industry is excluded from the policymaking table and restriction is placed on parental and health professional contact with industry. This policy of exclusion has created a longstanding climate of acrimony, division and dysfunction. It is not surprising that similar issues are emerging from the ultra-processing controversy as there is stakeholder and activist overlap, with many of the usual combatants dominating the discussion through their assertions of “ties” with industry and reiterations of claims and counter claims of conflict of interest. The row that has blown up over the Science Media Centre intervention demonstrates how discussion on ultra-processed foods has already become highly polarised [2].

There must be a better way to address the relationships of dietary choices, food products, food policies and stakeholder opinion. There needs to be a balance between the wish to create a debate, which allows the most vociferous participants to express their polished one-liners, and the need to bring key participants to the table to collectively deliver a plan that will address the complexities relating to ultra-processing. This should be undertaken within governance structures to ensure that the emergent food policy will represent the evidence, knowledge and expertise of all of those responsible for delivering the policy. Conflict of interest can present in many guises and with all participants also being consumers and undoubtedly having views on food and ultra-processing, the potential for conflict should be managed through standard governance arrangements. More importantly it needs to be understood that active exclusion of evidence and opinion from potential contributors at the policymaking phase will create bias that may present as the forerunner of potential opposition and non-compliance at the implementation phase. The initiative should therefore engender a sense of ownership and inclusiveness and this should ensure that consumers are able to comprehend how evidence and policy relate to them as individuals.

Intelligent and capable leadership can successfully steer participants along the path of policy objectivity, with each of the stakeholders separating their “day job” priorities from the need to focus on achieving collective policymaking decisions. Partnerships strengthen governance and governance strengthens transparency, accountability, trust and respect. The continuing failure to reconcile conflict on infant feeding policy should provide learning and potential enlightenment to those addressing the health effects of food ultra-processing.

1. Forsyth S. The Wasted Years. A critique of infant and child nutrition. Policy, Practice and Politics Swan & Horn 2023. ISBN 978-1-909675-35-3.
2. Coombes R. Row over ultraprocessed foods panel highlights conflicts of interest issue at heart of science reporting. BMJ 2023;383:p2514.

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Electronic Publication Date: 
Wednesday, November 15, 2023 – 15:32
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Stakeholder conflicts and food policies – partnerships strengthen governance

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University of Dundee
Honorary Professor, University of Dundee, Retired Consultant Paediatrician and Medical Director
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