The George Institute for Global Health is pleased to contribute to the Consultation for the development of the CFS Voluntary Guidelines on Gender Equality and Women’s and Girls’ Empowerment in the Context of Food Security and Nutrition.

The George Institute believe the Zero Draft is an important step in moving towards more equitable outcomes for women and girls.

To strengthen the Zero Draft, The George Institute has made a number of recommendations, including:

• An emphasis on nutrition for women and girls throughout the life-course
• The promotion of policies that support the ongoing recognition of women in the workforce and agricultural production
• Better inclusion of data

The consultation information can be found here.

The George Institute for Global Health is pleased to contribute to the public consultation of the National Obesity Preventive Strategy (NOPS).

The National Obesity Preventive Strategy (NOPS) will enable a more collaborative and comprehensive approach to addressing obesity nationally. It will also provide a way to identify actions and priorities for all levels of government as well as provide a focus for multi-sectoral partnerships and collaboration.

The George Institute for Global Health strongly supports the overall approach of the National Obesity Preventive Strategy (NOPS). The George Institute, however, believes there are several ways the NOPS could be improved to have greater impact on rates of overweight and obesity, and improve the health of Australians.

To ensure its objectives and ambitions are realised, the NOPS should be accompanied by:

• Strong targets that, at a minimum, align with the National Preventive Health Strategy (NPHS).
• A national governance committee to oversee implementation of the strategy, with representation from all governments, led by Health Ministers.
• A national implementation plan to be developed within six months of the strategy’s release and including:
  • agreed evidence-based actions for each strategy, with responsibility for each action assigned to federal, state, and territory governments or both, as appropriate.

• • a timeline for implementation and reporting, with the strategy’s 10-year timeframe divided into blocks at three, six, and nine years.
• A funding plan that identifies committed, ongoing, and adequate funding from all governments.
• A monitoring and evaluation framework, requiring regular reporting on implementation and outcomes from each jurisdiction and an independent evaluation of impact.
• A process free from conflicts of interest.         

The George Institute congratulates the Working Group on the development of the National Obesity Prevention Strategy. We look forward to reviewing the next iteration of the NOPS and participating in the development of its implementation. The Draft National Obesity Prevention Strategy 2022-2032 can be found here.

Worldwide, too few children are breastfed. Commercial promotion of breast-milk substitutes such as infant formula and toddler milks is one factor undermining breastfeeding practices globally.

The International Code of Marketing of Breast-milk Substitutes (BMS) was adopted by the World Health Assembly to protect and promote appropriate infant and young child feeding in 1981. While progress has been made in many countries, challenges to full and effective implementation remain. Over the last two decades, digital marketing practices that were not yet conceived when the Code was written have accelerated in use, reaching women and their families with messages that undermine breastfeeding practices.

In 2021, The George Institute was commissioned by the World Health Organization to conduct a systematic scoping review of academic and grey literature to understand the scope and impact of digital marketing of BMS.

This work has recently been published in Current Nutrition Reports (Digital Marketing of Breast-Milk Substitutes: a Systematic Scoping Review (springer.com)) and has already been cited extensively in the World Health Organization’s Report on the Scope and impact of digital marketing strategies for promoting breastmilk substitutes (who.int). The Report will be presented at the seventy-fifth World Health Assembly in May 2022, where it is anticipated that Member States will consider the need for further guidance from WHO to protect women and children from digital marketing of BMS.

By gathering the evidence on the topic in one place, the review builds a foundation for future work by the WHO, its member states and other stakeholders to help address the problem of harmful marketing of these substitutes by manufacturers and social media companies alike.

The ongoing impacts of climate and health crisis in Australia, such as catastrophic bushfires, floods, drought and the COVID-19 pandemic, remind us the world is rapidly changing. This presents challenges and consequences for human and planetary health, and the wellbeing of current and future generations. Social, environmental and economic imbalances pose a threat to all, but particularly people living on low incomes or experiencing disadvantage.

The imperative to ‘build back better’ creates opportunities for governments to look for new ways of working to better support the health and wellbeing of the community now and into the future. 

A wellbeing economy takes a sustainable development approach to economic development that addresses the social, environmental and health needs of a population by prioritising wellbeing over exponential growth. A wellbeing economy values indicators of wealth beyond gross domestic product, such as equity, happiness and environmental outcomes. It can provide society with a more holistic and balanced approach to development.

“Wellbeing economies have the power to reframe the human experience in the 21st century. By placing people and planet at the centre of policy making, social, environmental and health outcomes can all be improved. Countries like Wales and New Zealand have shown us what is possible – we now need to State, Territory and Commonwealth jurisdictions in Australia to step up” says Dr Alexandra Jones, Senior Research Fellow, Food Policy at The George Institute for Global Health.

2023

In February 2023, The George Institution contributed a written submission to the Commonwealth Treasury on the consultation for the ‘Measuring What Matters’ Framework (the Framework). The submission focused on providing contextually relevant feedback to proposed OECD Framework for Progress and Well-being and providing additional proposed indicators including the inclusion of chronic disease, injury and disability; access to quality, culturally safe healthcare; healthy, affordable and sustainable food and water supply; and, the inclusion of Aboriginal and Torres Strait Islander peoples wellbeing.

2022 

In October 2022, The George Institute and VicHealth released its toolkit to progress wellbeing economy approaches in Australia. This toolkit was created to support Australian policymakers to build healthier, more just and more sustainable economies for people and the planet. The toolkit builds upon the work of global thought leaders, including the Wellbeing Economies Alliance, the Organization for Economic Co-Operation and Development and the World Health Organization as well as individual country case studies, to provide practical guidance for governments to accelerate visionary action in Australia. Please refer to the toolkit on this page.

In July 2022, the Treasurer of Australia, the Hon. Jim Chalmers MP, announced the Albanese Government’s intention to include a wellbeing chapter in the October 2022 Federal Budget. This is the first time the Commonwealth Government will have implemented a wellbeing approach to economic policy in Australia.

In August 2022, The George Institute hosted over 300 people for a virtual panel discussion ‘Measuring what matters: What a wellbeing economy can do for all Australians’ with Dr Katherine Trebeck (Wellbeing Economy Alliance), Dr Richard Denniss (The Australia Institute), Cressida Gaukroger (Centre for Policy Development) and Dr Julieann Coombes (The George Institute). This event explored how a wellbeing economy might improve social, health and environmental outcomes and what should be the initial focus of the October 2022 budget.

2021

The George Institute, VicHealth and the Victorian Council of Social Service hosted a roundtable, bringing together experts from the health, community, environment, research and youth sectors to discuss the Report and workshop how this concept might be implemented in Victoria.

The ‘Integrating wellbeing into the business of government: The feasibility of innovative legal and policy measures to achieve sustainable development in Victoria’ Roundtable Communique summarises discussions from the roundtable, including participants’ feedback on what a wellbeing economy can do for the people of Victoria, potential barriers to its implementation and practical steps to moving the agenda forward.

Participants identified the following principles for moving the wellbeing economy agenda forward:

1. Base the wellbeing economy agenda on principles of equity and sustainable development
2. Advocate for transformation of the structural drivers that underpin a wellbeing economy
3. Engage widely and strategically with diverse stakeholders in the development of the wellbeing economy agenda
4. Build a coalition of community, sector and political champions around a coherent advocacy agenda
5. Embed diversity and community voices in campaigns
6. Employ qualitative and quantitative methods to find appropriate indicators for wellbeing priorities
7. Move beyond traditional cost–benefit analysis to assess policies in terms of their contribution to current and future wellbeing
8. Strengthen collaboration with existing networks working in this space in Australia and globally

2020 Report

The Victorian Health Promotion Foundation (VicHealth) commissioned The George Institute for Global Health to develop a report on how a wellbeing approach to policy could be incorporated into the business of government. The ‘Integrating wellbeing into the business of government: The feasibility of innovative legal and policy measures to achieve sustainable development in Australia' Report draws upon a number of international case studies to consider the feasibility of a wellbeing economy in Australia.

The George Institute for Global Health welcomes the opportunity to make submissions in relation to Australia’s Primary Health Care 10 Year Plan 2022-2032.

The two submissions were made in July and November 2021.

We believe primary health care should be at the heart of the Australian health system. It needs to be of high value, integrated, equitable and patient-centred. It should be readily available and accessible for people across their life course, responding to acute needs at critical life stages and proactive in the intervening periods to promote health and well-being.

In Australia there is a growing burden on individuals in the health system with chronic conditions, with many conditions largely preventable. The George Institute believes a business-as-usual approach to primary health care is not an option for the future, and have made recommendations to maximise opportunities to achieve better health and wellbeing outcomes for individuals, their families and communities.

To read our full submissions, please download the enclosed two documents.

The George Institute for Global Health made a submission to the Department of Industry, Science, Energy and Resources, and the Australian Competition and Consumer Commission (ACCC) on the Evaluation of Country of Origin Labelling for Food. The George Institute has been tracking Country of Origin Labelling (CoOL) data since 2016 using FoodSwitch, a database of nutrition and labelling information for packaged and restaurant foods.

Over the past five years, CoOL compliance has significantly increased. In 2019, we recorded 15,134 priority food products, with 91% exhibiting CoOL. We recorded a further 5,599 products that were classified as non-priority, with 42% exhibiting CoOL.

Type of CoOL displayed by ‘priority’ products:

• 12% of products displayed a ‘grown in’ or ‘produced in’ Australia label.
• 48% of products displayed a ‘made in Australia’ label. These products were made mostly from Australian ingredients but also sometimes from imported ingredients.
• 7% of products displayed a ‘packed in’ Australia label.
• 24% displayed a label indicating they were imported.
• 9% were not yet displaying CoOL. These may be genuine instances of non-compliance, or some of these products may be able to argue they are in ‘non-priority’ categories.

A large proportion of products in the non-priority categories of beverages, snacks and confectionery did not display CoOL.

Further research by The George Institute may include an analysis by company to provide more detailed insights into areas of compliance and non-compliance.

The George Institute for Global Health submission to the Australian Medical Research and Innovation Strategy and Priorities calls for ‘Equity’ to be at the heart of the Australian Medical Research and Innovation Strategy and Priorities. The Strategy and Priorities are determined by the Australian Medical Research Advisory Board (AMRAB). The new Strategy will be from 2021 to 2027, with new Priorities from 2021 to 2024. This will be finalised based on legislation passed by the Parliament before the end of 2021.

The George Institute believes equity is critical to the Australian health system. Equity is required for individuals and communities to reach their full potential in life. All individuals and communities in Australia and around the world should have access to quality healthcare services as a human right, regardless of sex and gender, ethnicity, disability, age, geography, intersectionality, and socioeconomic status. Disappointingly, inequity exists in the Australian health system, particularly in gender, ethnicity and geography. The lack of access by individuals and communities to quality healthcare creates barriers and risks. The next MRFF Strategy should play an important and strategic role to address inequities.

The George Institute has also called for:

• The Strategy should align with the Medical research Future Fund 10 Year Plan and Priorities, the National Health and Medical Research Council, the Australian Research Council, and Department of Health strategies.
• New priorities to include:
  • ‘Sex and Gender in Research’.
  • ‘Global health challenges’ separate from ‘Pandemic and health crisis preparedness’.
  • ‘Planetary and human health’.
• ‘Sepsis’ be acknowledged under the current priority, ‘Antimicrobial resistance’.
• A comprehensive review and report in relation to current Priorities.

The George Institute for Global Health has made a submission to the Australian Government’s Department of Health Public Consultation on the Healthy Food Partnership Voluntary Industry Best Practice Guide for Serving Sizes. The submission argues that the guidelines in their current form are not ‘best practice’ as they lack many important features that help to ensure they’re effective, such as:

• clear timeframes for implementation;
• plans for independent and transparent reporting on the uptake of the serving size guidelines; and
• details of monitoring and evaluation initiatives to assess the impact of the serving size guidelines on the food supply and on Australian diets.

Daisy Coyle, Dietitian and Research Fellow at The George Institute, said while setting portion and serving size goals may help reduce rates of diet-related diseases, they need to be properly developed and implemented to result in any meaningful change.

“We agree with colleagues at the Cancer Council and Heart Foundation that portion guidance and serving size goals are good for public health, but more work is needed to encourage food companies to reduce the size of their products,” she said.

“Our research on how the Government’s previous Food and Health Dialogue initiative performed, and our modelling work on the likely impact of its successor, the Healthy Food Partnership, indicate it’s unlikely these serving size goals will have a significant impact. This is concerning given many of the so-called discretionary foods included in the portion size guidelines are not subject to the government’s reformulation targets despite being high contributors to total sodium, added sugar and saturated fat intakes,” Daisy added. “Also, these guidelines are voluntary, which further limits their potential to significantly improve the health of Australians.”

While having national portion guidance and serving size goals is important for public health, The George Institute submission raises concerns that the proposed serving size guidelines  will not reduce intakes of excess kilojoules, sodium, added sugars and saturated fat enough to ease the burden of diet-related disease in Australia.

The George Institute for Global Health has partnered with the Walgett Aboriginal Medical Service and Dharriwaa Elders Group, and the Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases, to call for Traditional Knowledges and First Nations and Pacific Island priorities to be recognised at the UN Food Systems Summit, which will be held in New York in September. The Summit aims to launch bold new actions to deliver progress on the Sustainable Development Goals, each of which relies to some degree on healthier, more sustainable and equitable food systems. It calls on people everywhere to ‘work together to transform the way the world produces, consumes and thinks about food’.

However, The George Institute’s report highlights the challenges First Nations and Pacific Island communities face in engaging with the Summit, including a lack of consideration of Traditional Knowledges or what different paradigms of health and food and water systems mean for different cultures.

“Addressing food and water insecurity in Australia demands a considered response that privileges an Aboriginal paradigm of health and culture, including the continued connection between people and Country that has existed over many thousands of years and local Aboriginal community-led solutions crying out for investment and growth,” said Wendy Spencer, Manager of the Dharriwaa Elders Group, an Aboriginal community group operating in Walgett NSW for over 20 years, and Christine Corby, OAM, the Chief Executive Officer of Walgett Aboriginal Medical Service, an Aboriginal Community Controlled Health Organisaiton (ACCHO) operating since June 1986.

'Whose paradigm counts? An Australia-Pacific perspective on unheard voices in food and water systems’ reflects community-identified challenges and priorities in Walgett NSW Australia and the Pacific Islands, and explores the health, environmental and equity impacts of food and water systems in these contexts. Two case studies were submitted with the report, which highlight specific issues around climate change preparedness, systemic racism, threatened natural resources, under-resourcing of public health priorities, the burden of non-communicable diseases (NCDs) and gender inequalities. The case studies also showcase community-led solutions to food and water insecurity in the context of the COVID-19 pandemic.

“The COVID-19 pandemic in our region has threatened our livelihood, compounded poverty, and insecurity within social and health inequities. Many villagers have now invested in social capital (solesolvevaki) through locally-driven development projects to address these issues,” said Gade Waqa, Head of Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases, Fiji National University. 

The submission to the Summit – which is part of The George Institute’s ‘Triple P’ advocacy initiative focusing on preventing NCDs, protecting the planet and promoting equity – reflects on how this and future summits can be better governed and designed to support the inclusion of Traditional Knowledges, community priorities and voices that continue to go unheard (see recommendations below).

“We need to ensure Aboriginal and Torres Strait Islander Knowledges of cultural practices and the successful management of our lands are not only acknowledged and respected, but considered by global governments. One-off consultations that do not reflect the voices of all First Nations people will fail to deliver effective solutions for real change to our food and water security,” said Dr Julieann Coombes, Research Fellow, Aboriginal & Torres Strait Islander Health Program, The George Institute for Global Health.

The UN Food Systems Summit has been criticised for its failure to meaningfully engage Indigenous and Tribal communities around the world; its links with multi-national agribusiness firms; and a lack of governance transparency. These concerns have led some civil society organisations to boycott the Summit and organise counter events, with a focus on small-scale producers and solutions such as food sovereignty and agroecology.

“The UN Food Summit should provide an important opportunity to transition towards fairer food systems,” said Jacqui Webster, Professor of Food Policy at The George Institute. “By working with communities to understand barriers and opportunities, we can support local partners to strengthen implementation of policies that improve diets. In this way we can prevent NCDs, protect the planet and promote equity.”

Report recommendations

Based on consultations with key stakeholders, information from case studies included within the report and our research and advocacy expertise, we believe:

Organisers of multilateral summits should:

• Ensure First Nations voices are represented at all levels and in all aspects of governance structures from the earliest stages of summit conception.

• Recognise the diversity of global Traditional Knowledges and unheard voices and embed flexibility in engagement mechanisms to ensure these are captured.

• Ensure discussions of food systems include consideration of water systems as a default.

Health systems should:

• Recognise climate change and its impacts on human health in policy and practice and take responsibility for reducing their own climate footprint.

Governments should:

• Design food policy through a process of community-led policy development that recognises Traditional Knowledges and includes engagement with community leaders and Elders, and shared planning and decision making.

• Adopt a systems approach to developing policy, recognising the relationships and reciprocal links between food and water systems, the burden of non-communicable disease, climate change and equity.

• Support consumer demand for sustainable, fresh and healthy foods, and implement policies to ensure these foods are easily accessible, available and affordable over the long term.

Researchers should:

• Monitor the effectiveness of policies that aim to improve food and water systems and develop the evidence base on the impacts of implementation on equity, climate change and the disease burden.