This Lancet Commission, which started
out as a Commission on obesity and followed on from two previous Lancet
Series on obesity, is taking a very different approach from previous
attempts to address this important risk factor for human health.
Obesity is often framed as an issue of personal responsibility, such as people
don’t exercise enough, eat the wrong food or too much of it, and current attempts
to address obesity are therefore often focused on the individual. The real
problem is that we have created powerful economic systems that encourage
overconsumption to the detriment of health of people and the planet. This
Commission is linking obesity, undernutrition, and climate change and
highlights that it cannot be solved by focusing on the individual alone. We need
to look at the underlying drivers and systems and they need to be questioned
and changed. The same time people can be agents of change and as voters, workers,
business owners, family members, consumers, and policymakers we can act and have a
strong influence to fix these detrimental man-made systems. This Commission is an urgent wake-up call for all of us to do so. When Professor BoydSwinburn, my co-chair, and I began work on this we didn’t want another series of Lancet articles on obesity, there had already been two Series. But we recognised that malnutrition included obesity and undernutrition and both were associated
with climate change as a result of agricultural production. So we looked at
the intersection of undernutrition, obesity, and climate change, and called
this the Global Syndemic. A syndemic are two or more pandemics which interact
in time and place and are driven by societal or economic factors. For example,
meat production generates a lot of greenhouse gases,
and greenhouse gases increase climate change and catastrophic weather events
in the developing world, which impairs agricultural production and contributes
to undernutrition. The scale of a Global Syndemic can feel overwhelming. In fact malnutrition in all its forms is by far the biggest cause of ill health and premature death in the world and in every country. Meanwhile, climate change
will increase undernutrition and further deteriorate the environment. The
Global Syndemic is the paramount challenge for the 21st century for
humans, the environment, and the planet. The lack of government actions is what
we call policy inertia, which is industry opposition to policies, government
reluctance to implement policies, and a lack of public demand for those policies.
However the promise of the syndemic view of these problems is that there are
double- and triple-duty solutions or actions which can affect all of these
pandemics simultaneously. Our report provides a blueprint for how to
transform those systems that are driving the Global Syndemic, for example we
need a 1 billion dollar fund to support community activation to demand policy
action. Currently the 5 trillion dollars of subsidies that go into fossil fuels
and harmful agriculture need to be redirected towards sustainable
agriculture and sustainable transport. Another positive strategy is changing
the business plan from one focused on profit to one focused on sustainability.
We don’t pay the true costs of food, nor do we pay the true cost of
fossil fuels. We’re calling for Framework Convention on Food Systems similar to the one on tobacco control which reigned in the tobacco companies.
We’re also calling for a Seven Generations Fund, taking the view from the Iroquois
nation about thinking seven generations hence, to build traditional knowledge and traditional ways of trying to manage health and the environment together. We’re not going to turn this around without local and state and country involvement. Social movements start at the grassroots level and changing the Global Syndemic will require that kind of a shift.