European Union

Yemen is on the brink of collapse, with Houthi rebels having taken over large parts of the country, including the capital, Sanaa.

After months of tightening control and the resignation of former President Hadi in January, the Houthis have dissolved parliament and announced plans for a new interim assembly and five-member presidential council, which will rule for up to two years.

This, combined with internal tensions between north and south, upheavals fueled by the Arab spring and the presence of Al Qaeda, has made the situation unsustainable.

In this video-interview, FRIDE senior researcher Barah Mikaïl analyses the country’s future prospects.

 Photo Credit: Richard_Messenger

Dijsselbloem, left, speaks with Varoufakis during a finance ministers' meeting in February

During a 45-minute interview in his Dutch finance ministry office in The Hague, Jeroen Dijsselbloem, chairman of the eurogroup, offered up a detailed recounting of his month-long negotiations with Athens to secure last week’s agreement extending Greece’s €172bn bailout by four months – as well as his views of what might come next.

Portions of that interview have been be published on the Financial Times website here and here, but as is our normal practice at the Brussels Blog, we thought we’d offer up a more complete transcript of the interview since some of it – including previously undisclosed details about the three eurogroup meetings needed to reach a deal – was left on the cutting room floor and may be of interest to those following the Greek crisis closely. The transcript has been edited very slightly to eliminate cross-talk and shorten occasionally long-winded questions from the interviewer.

The interview started on Dijsselbloem’s decision to travel to Athens to meet Greek prime minister Alexis Tsipras just days after the January 25 elections – a visit that was overshadowed by a tension-filled press conference between Dijsselbloem and his Greek counterpart, Yanis Varoufakis, which spurred a market sell-off:

Europe’s Judgement Day came on Monday, when Member State representatives, international health officials and medical experts met at The High Level Conference on Healthy Lifestyles held to discuss the state of childhood obesity in Europe.  Are our children’s waistlines getting larger? Are existing initiatives helping us get healthy? What more do we need to do?

As in all conferences, papers and discussions about obesity, no clear cut answers were provided.  While International Organization such as the WHO, OECD and EU Commission pointed to overwhelming amounts of data indicating the gravity of the obesity pandemic, Member States provided a number of enlightening examples of good practice, both at national and local level.

So how well are we actually doing?  

The Commission and World Health Organization were fairly fatalistic.

John F. Ryan, a veteran of EU health policy and Director of the Public Health division at DGSANTE, noted that chronic diseases are responsible for 80% of deaths in Europe, hampering social cohesion and economic growth, despite being easily preventable. He called on the food and drink industry, NGOs, governments, parents and schools to help reduce childhood obesity by ensuring access to balanced and healthy meals and helping children engage in regular physical activity.

Dr Gauden Galea (Director of the Division of Noncommunicable Diseases of the WHO) used similar language to explain the importance of creating healthy food and drink environments in schools, as well as incorporating more physical activity in the curricula and funding infrastructure for this to occur.

But is it all doom and gloom?

Member states portrayed the situation in a more positive light. Latvia, Estonia and Hungary presented their own projects to ensure free, healthy meals in schools. The common denominator was the setting of national standards which list a number of allowed or required products in school meals such as fruit and vegetables, while excluding all confectionary and sugary or fatty foods. Under regulation 610, the government of Latvia also restricted the marketing and distribution of salty snacks and sugary drinks in schools – bringing a 10% reduction in consumption. For more examples on the Estonian and Hungarian models, you can watch the presentations here.

And how significant are these initiatives?

The national food schemes presented at the conference seemed extremely similar to the prescriptions laid out in the  WHO European Food and Nutrition Action Plan launched in 2014, which demands 4 (or in truth, 5) key policy changes:

• Implementing mandatory standards for school meals
• Providing nutritional education in schools
• Offering free fruit and vegetable schemes
• Imposing strong controls on the marketing of food and non-alcoholic beverages in schools
• …as well as adopting initiative for physical activity.

Yet international organizations were all but satisfied. Dr Joao Breda of the WHO – who was defined throughout the conference as the guru on obesity policy – pointed to the strong disparity among schools even within single countries to conclude that more work needs to be done on the process of implementation – as also argued by Mr. Goof Buijs of the Schools for Health in Europe Network.

So if member states got a scolding, how did industry perform?  It’s not looking good…

Although Stephan Loerke from the World Federation of Advertisers made a convincing argument to illustrate the value of industry efforts, it seems that there is a lack of trust in industry self-regulation among international organizations, and that industry commitments are deemed insufficient.

Stephan illustrated the efforts made under the European Platform for Action Diet, Physical Activity and Health to showcase industry’s proactive involvement. He reasoned that while the direct effect of marketing on children is only “modest”, as noted in most scientific literature, the food industry has recognized that marketing impacts family food choices, preferences and behaviours, and has therefore acted accordingly.  Stephan mentioned the new initiative of the International Food and Beverage Alliance, due to come into force in 2016, which imposes thresholds for all marketing platforms, creates a single nutritional model to be used among all countries and bans the use of celebrity personalities.

In a final attempt at convincing his medical public, he decried the low levels of recognition for industry self-regulation… and he was certainly correct.

His most ardent critic was Tim Lobstein of the World Obesity Federation, who diplomatically defined the EU Pledge as not strong enough… to avoid using the term ‘useless’. He noted that, on marketing commitments, the 35% threshold of children watching television (which is necessary to prevent food promotion under the pledge) is very rarely reached. In addition, advergames such as on Nestle’s website are not included in the provision.

Even new developments were easily discarded. Lobstein mentioned that the new nutrient profiling system is still too lenient, especially on the threshold for salty snacks, such as crisps, and sugary products, including cereals. The WHO had other concerns, questioning whether third party auditing is reliable, with Joao Breda suggesting that the scientific community should be integrated in the monitoring of the commitments. He also called for the recently released WHO nutritional criteria for marketing to children to be taken into consideration.

Unfortunately, it seems that International Organizations will remain forever skeptical.

When asked what the biggest obstacle to an effective, coherent policy on obesity is today, Joao Breda pointed the finger at industry, saying that their influence on policy makers is to blame for the lack of effective policy measures being taken… a fairly simplistic answer for a guru, in this blogger’s opinion.

Nonetheless, the Commission was kinder in its approach. Philippe Roux, the head of Unit for Health Determinants at DGSANTE even praised the work of the EU Platform, noting that the commitments made under the EU Pledge (and specifically the responsible advertising measure which classifies schools as protected environments) have made an important difference.

Mr Artur Furtado from DGSANCO also adopted a more balanced position, taking into account the role of government structures in preventing effective policy measures. He claimed that changing representations prevent long term plans from being made and that government systems which separate policy provisions on health from agriculture and education inhibit the development of integrated and holistic solutions. His resounding message: there needs to be greater policy cohesion.

Since we’ve done pretty poorly, what’s next?

In line with the more market-oriented objectives of the new Commission, future work on healthy lifestyles will be aimed at abating health inequalities. The Commissioner has asked the private sector to do more on reformulation in the context of the EU Platform. Better mapping of Member State capabilities and resources to tackle obesity and endorse preventative measures also made the top of the to-do list.

However, the real shift in obesity policy will be a global move to a more comprehensive approach that takes into account the social and economic context of obesity prevention. Prescriptive approaches to obesity no longer make the cut. Providing information in terms of labelling is not a determinant to health in the same way that engaging in physical activity is not a determinant of active lifestyles.

Taking a more holistic approach which encompasses an understanding of how information shapes behavioral choices and how urban environments influence our levels of physical activity, will be crucial to tackling this problem of the modern age – a system has been defined as health in all policies.

Alessia Mortara and Lindsay Hammes

During the last week, I marked the one year anniversary of my arrival in Australia. I spent it down in Gippsland (about 4 hours east of Melbourne) where I had some of the best cheese and wine I’ve had since I got to Australia. Then at the weekend I helped my partner out with a work event, a rally for owners of Moody, Hanse and Dehler yachts in the bay. You can see from the attached photos what a hardship that was…

An anniversary is often a good moment for reflection and so it seemed the right time to look back over the last year and see what I have learnt about myself.

Retaking the controls of my own life

When I was telling people that I had decided to leave work and go to university in Australia, I generally got two comments: “You’re so brave” and “I’m so envious”. Looking back I don’t feel I was brave: I had just reached a point where something had to change and I couldn’t go on the way things were. It didn’t feel brave at all; it was almost inevitable. So I suppose the first lesson is, if you feel trapped or unhappy, the only real agent of change is yourself. However scary it is, the benefit of feeling you have control over your own destiny far outweighs the scary factor.

Learning is a great joy

Another big lesson of the last year has been that education is wasted on you when you’re young. I have got so much more out of this experience for having been away from education for a while, so much more than if I had done this straight out of university, or even 5 years later. I was so hungry for it when I arrived, and I have approached it as a privilege. I’ve taken many opportunities to learn in the broadest sense of the word, doing new things from sailing to start-up weekends.

Let it go

One of my favourite lessons has been the realisation that I don’t have to get things right first time. Any idea I have can be improved by working with other people, who will come at it from different angles and bring different perspectives that I could never have achieved. It’s not a sign of incompetence to let your work be improved by others. In fact, it’s a sign of strong emotional intelligence, and good sense.

Actually, I don’t always have to *have* an idea. Sitting back and letting things grow can also work well. I’ve taken that approach with setting up the Bayside Women’s Business Network – I had a view of what it should do, but I made an effort to let the group have its say and put forward its own ideas. In the end, the two are broadly similar, but I think it makes a difference both to me and them that it is a collaborative effort.

Happiness has a real value

Obviously I’m living on much less than I had when I was working full time, but I really don’t feel any difference in terms of material things. I still do the things I love, though I’m just a bit more careful about it. I have a comfortable home, I go out. But I am much much richer in personal terms and that makes a real difference to my life. I do work I enjoy, I set my own terms, I have a strong, supportive partner. It’s so easy to undervalue the importance of being happy. I’m so grateful that I had a chance to realise that while I still (touch wood!) have time to act on it. I’d be even happier if my dear friends and family were here with me, and maybe I should have valued them more when I was unhappy. That’s part of the perspective too, I suppose.

I don’t know what the future holds

Since I left school I’ve been on a path. One I chose, and was happy with for the most part. Year off, uni, European Fast Stream, Commission. But the path dwindled away and now I’m thrashing through the forest undergrowth trying to find a new one. That’s scary, but very exciting and it does seem that the new path is going to be in a different direction to the old one. Not radically different, I’m not going to run away and join a circus, but different enough. And its form is going to be different – I think for a while at least I’m going to try to develop the portfolio-type work I’ve been doing while I’ve been here. It suits my popcorn machine of a brain to have different projects going on! Doing things the way that works for me and keeps me fulfilled is much more important to me at the moment than having a ‘proper job’ with a title I can put on a business card. If I’m making it up as I go along, well, that’s fine by me.

With a few days to go before the High Level Conference on Healthy Lifestyles called by the Latvian Presidency, delegates and experts will be making their way to Riga to enjoy a glass of Kvass before discussions begin.

The industry, for its part, awaits the conference’s verdict(s) with baited breath. Will certain products be targeted? Will reformulation need a boost? The answers (or lack thereof) will be revealed on Monday 23rd of February. 

In the meantime, let’s recap where the discussion on nutrition and physical activity currently stands….

Let’s begin the story in early 2014, at the High Level conference hosted by the Greek Presidency. The Hellenic crowd focused on non-communicable diseases (NCDs) among vulnerable populations including the elderly and, of course, children. Today, the Latvians have decided to hone the discussion down to the most important and most contentious of issues; one that Latvia’s Health Minister, Guntis Belēvičs, has described as the ‘taste of childhood’[1].

As is often the case with Council Presidencies, the decision to focus on childhood obesity reflects Latvia’s own public health aims. With obesity rates slightly above the European average[2], Latvia has implemented one of the most radical prevention schemes in the region. In 2006, the government limiting the distribution of foods containing additives, colourants, sweeteners and preservatives in schools, while also launching a National Sporting Development Program to increase physical activity among children[3].

But not all countries have endorsed the Latvian approach. With a wide variety of dietary styles and cultural particularities, defining a single, regionally applicable solution to obesity is all but simple. Nonetheless, the EU Action Plan on Childhood Obesity, drawn up under the Greek Presidency will be used as a solid common ground on which to base the discussions and will act as a ‘guide for effective action’[4].

By 2020, the plan aims to help Member States achieve 6 core objectives, each associated to a number of precise targets [5]:

1. Support a healthy start in life
2. Promote healthier environments, especially in schools ƒ
3. Make the healthy option, the easier optionƒ
4. Restrict marketing and advertising to children ƒ
5. Inform and empower familiesƒ
6. Encourage physical activity ƒ

While the nominal purpose of the conference is to “assess the implementation progress of strategic documents on nutrition and physical activity in the EU”, measuring success will be done in true EU style. To avoid any pointing of fingers at high or low achievers, the agenda of the High Level Conference[6] will focus on sharing best practice among member states – in full respect of subsidiarity and proportionality. We expect much chit chat on who did what and very little practical information.

However, some data does exist and it looks like Europe isn’t doing too badly. The WHO’s country reports reveal that 100% of Member States have adopted policies limiting the marketing of food and beverages to children and over 90% have acted on salt reduction[7]. They’ll need to work a little harder on trans-fat reductions and physical activity recommendations, but there is reason to believe that Europe is moving in the right direction. The 2014 Health at a Glance report also noted that education to consumers, availability of healthy food options and encouraging physical activity are the strongest areas of progress[8].

Now one question remains: will current progress be enough? What further recommendations can be expected? In line with the Global Status of NCDs Report[9], it is likely that the WHO will demand stronger political engagement towards encouraging physical activity. This may happen through social marketing and mass media campaigns. Other recommendations could focus on the re-activation of the fruit and milk scheme, recently suspended by the Juncker Commission under its new Work Programme. Only time will tell…

Either way, we expect that the High Level Conference will directly influence the EPSCO preparatory meetings and the final Council Conclusions later this year. If we were academics we would ask… To what extent? Well, to the extent that scientific opinion is taken into account in EU policy making. While experts will likely call for the need for social involvement programmes of adequate dietary guidelines and of perfectly nutritious school meals, country budgets will still be limited, political and cultural approaches to food will still diverge and in the end… humans will be humans… and we do love our culinary delights!`

Our policy analysis on the conference will be coming soon … watch this space!

Alessia Mortara, Adriano Addis and Lindsay Hammes

[1] https://www.theparliamentmagazine.eu/articles/opinion/latvian-presidency-will-promote-healthy-lifestyle

[2] http://ec.europa.eu/health/reports/docs/health_glance_2014_en.pdf

[3] http://www.who.int/fctc/reporting/party_reports/latvia_annex2_public_health_strategy_2011_2017.pdf

[4] http://gr2014.eu/sites/default/files/Nutrition%20and%20Physical%20Activity%20Press%20Release%202%20EN.pdf

[5] http://ec.europa.eu/health/nutrition_physical_activity/docs/childhoodobesity_actionplan_2014_2020_en.pdf

[6] https://eu2015.lv/images/Kalendars/VM/Draft_Agenda_100215_FINAL.pdf

[7] http://www.euro.who.int/__data/assets/pdf_file/0005/243419/Summary-document-28-MS-country-profile.pdf?ua=1

[8] http://ec.europa.eu/health/reports/european/health_glance_2014_en.htm

[9] http://www.who.int/nmh/publications/ncd-status-report-2014/en/