In an age dominated by screens and sedentary lifestyles, the call for physical activity has never been more urgent, especially for our school-age children. The mental, physical and cognitive benefits of physical activity have been unequivocally proven. Yet there remains a glaring deficit in physical activity opportunities within schools, particularly in regions like the Caribbean, including Jamaica, where the burden of non-communicable diseases (NCDs) looms large over public health systems. If implemented as intended, the proposed Jamaica School Nutrition Policy could help to facilitate more physical activity opportunities for generations to come.

For school-age children, regular physical activity is crucial for their growth and development. It not only helps them maintain a healthy weight but also fosters stronger bones and muscles, improves cardiovascular health, and boosts mood and cognitive function. Too much sedentary behaviour – or periods of sitting or lying down with little to no movement- can also increase the risk of obesity and affect sleep duration. Active children are more likely to develop lifelong habits of physical activity, reducing their risk of developing NCDs later in life. 

Beyond the benefits, states also have an obligation to provide children with access to the highest attainable standard of health which includes opportunities to be active and to engage in play, as they are signatories to the Convention on the Rights of the Child (CRC). Yet, according to recent statistics, a significant percentage of school-age children in the region do not meet the recommended levels of physical activity as almost two thirds are insufficiently physically active, over 40% are sedentary, and over 20% are physically inactive, more frequent among girls than boys. Factors such as limited access to sports facilities, lack of physical education classes, and sedentary lifestyles exacerbated by excessive screen time contribute to this concerning trend. Thus, it is imperative that they are provided with multiple, diverse opportunities to be active. For instance, skipping, dancing, or cycling are examples of aerobic exercises. Playing on playground equipment is an example of a muscle-building activity; and engaging in sports like basketball or running and hopscotch are examples of bone-strengthening exercises.

Schools continue to be a critical environment for facilitating healthy habits. Children spend more time in school than in any other setting.  Thus there is a need for sustained and strategic physical activity interventions within the school setting. The Ministry of Health and Wellness (MOHW) deserves credit for actively promoting the increased level of physical activity through initiatives like Jamaica Moves in School, which started in 2018. One of the three components of the project, which is a collaboration between the Ministry and the Ministry of Education and Youth (MOEY) is to increase physical activity. In addition, a number of initiatives have been carried out under this programme, including the Jamaica School Ambassador programme, which selects teachers and students to support the message of fostering a healthier school environment, and National School Moves Day, which is scheduled for April 26 and encourages schools across the island to participate in one hour of physical activity for the day. 

However, there is more that can be done to facilitate a comprehensive approach to physical activity, elements of which are proposed in the National School Nutrition Policy Green Paper. The last available version of the policy includes the need to provide:

• Physical activities for children from early childhood to grade 13
• Three five-minute physical activity breaks per day
• A minimum of one hour of physical activity per week
• Physical education in schools as guided by the curriculum
• A safe, secure, and suitable play area for all students
• Access to safe and age-appropriate physical activity facilities and equipment  

Beyond these factors, the World Health Organisation (WHO) encourages member states to adopt a whole-of-school approach to promoting physical activity which includes active classrooms (movement during class), quality physical education, facilitation of physical activity opportunities before and after school, at playtime and active transportation.

The need to urgently prioritize proactive public health interventions, such as the School Nutrition Policies is critical given its wider impact on the public health system. NCDs such as diabetes, hypertension, and obesity are on the rise, placing an immense burden on healthcare resources and diminishing the quality of life for affected individuals. In Jamaica alone, NCDs account for a substantial portion of the country’s healthcare expenditure, diverting funds away from other crucial areas of health promotion and care.

In 2025, the Fourth High-level Meeting on NCDs will be held where heads of governments will assess the progress on 9 voluntary global targets for the prevention and control of NCDs, including physical activity. It is not too late for Jamaica and the wider Caribbean to shine in prioritizing strong comprehensive policy action as recommended by the Caribbean Moves which was recently endorsed by CARICOM, and the 2023 Bridgetown Declaration on NCDs and Mental Health. 

To address this pressing issue, action must be taken now, and it starts with prioritizing physical activity within schools. First and foremost, the government must urgently implement the proposed School Nutrition policy and consider collaboration between schools, communities, and healthcare providers to promote and sustain physical activity in and beyond the school setting.

In addition, priority should be given to:

•  Building Awareness: Continue with efforts such as Jamaica Moves as a physical activity awareness and promotion mechanism so that all, including teachers and parents should be educated about the benefits of physical activity to support and encourage children in their pursuits. As guided by the WHO and PAHO, the campaign to enhance awareness should also highlight the social, economic, and environmental co-benefits of physical activity. For example, facilitation of active transportation such as walking and cycling can reduce carbon emissions and help to mitigate climate change.  
• Active Environments: The government should be commended for its intention to establish parks across the island. Ensure that these are also safe and accessible spaces for children to engage in physical activity outside of school hours. 
• Continuous Monitoring and Evaluation: Regular monitoring and evaluation of physical activity programs and policies within schools are essential to assess their effectiveness and make necessary adjustments to ensure long-term success.

Finally, adults, including teachers, parents, and community leaders, should serve as positive role models by prioritizing their own physical activity and demonstrating its importance through their actions.

The time to act is now. By prioritizing physical activity within schools and communities, we can empower our children to lead healthier lives, reduce the burden of NCDs on our public health system, and pave the way for a brighter and more active future. 

We join our voices with other advocates in asking: Why delay the implementation of a policy crucial for the current and future health and wellness of the nation’s children?

Offniel Lamont is the Physiotherapist at the G.C. Foster College of Physical Education and Sport. He holds a Masters degree from University College London (UCL) in Sports Medicine, Exercise, and Health whose focus area is leveraging exercise as a powerful tool in the prevention and treatment of sports injuries and NCDs. Lamont’s commitment also extends to empowering Caribbean youth as a dedicated advocate within the Healthy Caribbean Coalition.

Danielle Walwyn is the Advocacy Officer for the Healthy Caribbean Coalition’s Childhood Obesity Prevention and Healthy Food Policy Programme. She holds a Masters degree from Queen’s University (Canada) with a specialization in Health Promotion and a focus on physical activity. 

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Using Big Tobacco’s Playbook

As a youth tobacco control advocate in the Caribbean, I see glaring similarities between the tactics of the tobacco industry and those of the food and beverage industry. The tobacco industry asserts itself as a stakeholder in policy development. They often lobby against comprehensive tobacco control policies under the guise of protecting jobs and economic interests, disregarding the toll of tobacco-related diseases on our communities.

They attempt to influence scientific research to cast doubt on the harms of their products. By funding studies that downplay the health risks of tobacco use or promote misleading claims, they seek to undermine the evidence base for tobacco control measures. The tobacco industry strategically targets youth by marketing flavoured vapes with attractive packaging while engaging in corporate social responsibility activities, such as sponsorships and scholarships, which improves their public image.

The food and beverage industry is clearly mimicking Big Tobacco’s playbook, evident in their persistent marketing to children and resistance to the Octagonal Warning Label. However, Caribbean youth won’t be silent bystanders. We demand transparent, evidence-based public health policies that prioritize our well-being, not corporate profits.

Dorial Quintyne
(Public Health Practitioner, Barbados)

Breastmilk Substitutes

A troubling trend in their marketing strategy involves portraying formula as a cure-all for common infant issues like fussiness and colic, which are natural developmental processes ideally addressed through breastfeeding. This not only fuels unwarranted anxiety around breastfeeding and infant care but also establishes a misleading equivalence between formula and breastfeeding. This narrative undermines women’s confidence in exclusively breastfeeding, potentially contributing to lower breastfeeding rates globally.

Here in CARICOM, implementation of the International Code of Marketing of Breast Milk Substitutes from the WHO is abysmal with only one country reported as having implemented any provisions – a critical measure to counteract the powerful breast milk substitutes lobby. For advocates, like myself, a first step is a call for full implementation of the Code supported by widespread transformations such as universal paid maternity leave. Governments, workplaces, and healthcare providers must collaborate to ensure unwavering support, offering unbiased information about infant feeding.
Additionally, implementing clear front-of package warning labels is crucial for empowering parents to make informed decisions about their children’s nutrition. Breast milk remains the paramount source of infant nutrition, and these labels can counteract the oversimplified messaging of formula marketing, emphasizing the unequivocal benefits of breastfeeding. This concerted effort aims to create a more informed and supportive global environment for parents and caregivers.

Rhianna Smith
Breastfeeding Advocate, Barbados

How can governments protect policies from industry interference – highlighting the CROSQ report

Being involved in the development of the newly published (March 2024) report, ‘Public health decision-making in CARICOM: Strengthening the Front-of-Package Nutrition Labelling Standardisation Programme’, which analyses and seeks to inform the strengthening of that standardisation programme, has underscored for me the importance of governments in protecting public policies.

The report highlights, for example, the labyrinth of actors involved and the multiple potential entry points for inordinate industry interference in the process to revise the CARICOM Regional Standard specification for the labelling of pre-packaged foods to include octagonal ‘high in’ warning labels as defined by the PAHO Nutrient Profile Model. From the lack of standardisation in the approach to commenting, voting and accepting evidence, to variations in committees’ composition, among other factors, it is evident that weak or absent rules to govern multisectoral engagement in policymaking create opportunities for commercial and other vested interests to usurp public health interests.

I am convinced that our CARICOM Governments must not only sit in the driver’s seat of the policymaking process but must also establish clear rules for legitimate stakeholders to navigate the policymaking space in ways that do not undermine the public interests at stake. As such, governments must adopt, implement and consistently monitor a suite of governance mechanisms, such as conflict of interest policies and access to information laws.

Kimberley Benjamin
Attorney-at-law, Barbados

The Jamaican FOPWL voting process

The 2023 Jamaican voting process for the Final Draft CARICOM Regional Standard–5, which included the Octagonal Warning Label and the PAHO Nutrient Profile Model, was marred by significant irregularities, suggesting interference from the food and beverage industry. As a member of the National Consumers League (NCL), I participated in this process, motivated by my expertise as a global health lawyer.

The process was supervised by the Bureau of Standards Jamaica (BSJ). Per BSJ standards, a 75% affirmative vote was required to approve the standard. However, the five stakeholder groups’ votes resulted in a deadlock: 40% in favour (NGOs and academia), 40% against (industry and government), and 20% undecided—both members of the consumer group (Consumer Affairs Commission-CAC and National Consumer League of Jamaica-NCLJ) could not reach a consensus.

Instead of reporting this deadlock to CROSQ and recording an abstention, NCL was invited to meetings under the guise of having the consumer stakeholder group (NCL and CAC) come to a definite decision i.e. consensus. NCL had originally voted in favour of the standard. This approach was inappropriate, as reaching the 75% requirement for approval was impossible at this stage. The only other objective would have been to secure a firm opposing vote as the national position. The interventions constitute significant irregularities, reflecting a pattern of industry interference seen in regulatory processes globally.

Urgent steps must be taken to improve public health governance such that standards-making/ policymaking processes such as these are safeguarded from undue influence by industry actors with conflicting interests.

Shajoe Lake
Global Health Lawyer, Jamaica

FOPWL 

As a major industrial hub in the Caribbean, Trinidad and Tobago guarantees a lucrative market for processed or ultra-processed products, crippling health systems. As a youth advocate in the healthy food policy space, there has been a lack of transparency in T&T’s consultative and voting processes around the hotly debated ‘high-in’ octagonal front of package warning label (FOPWL) standard. Food and beverage manufacturers and distributors continue to resist the adoption of the FOPWL standard, which reflects their willingness to sacrifice consumers’ health in pursuit of profits.

Even more concerning, is the shift of a public health strategy in combating obesogenic environments to a trade-focused debate. Under the guise of concerns over costs to consumers and manufacturers associated with mass reformulation or relabeling requirements, private sector has conducted studies to determine an appropriate FOPL scheme, hoping to undermine the scientific evidence highlighting octagonal warning label’s FOPL’s efficacy.

It is evident that food and beverage industries are well-connected politically, capitalizing on their resources to provoke fear and ignorance amidst the region’s economic vulnerabilities. We must keep pushing for the regional adoption of the FOPWL standard and unmask industry interference. We call on our governments to safeguard the region’s economic development but not at the cost to consumers’ health and wellbeing.

Simone Bishop Matthews
Public Health Practitioner, Trinidad and Tobago

The importance of COI free public health research in informing healthy food policies

As a public health researcher, it is important to scrutinise all aspects of research, including: the connections of the researcher(s), the funding source(s), the event(s) under observation, the overall research design, questions asked, how they’re asked, as well as the communities and individuals one speaks to.

Consider these two example questions:

• Do you think that the government should place restrictions on what you eat and drink?
• Can you describe ways in which the government could promote healthy eating practices?

One question is leading and biased, the other is objective. These questions may seem similar in focus, but the outcomes will be very different.

Too often, we see misleading research from ‘industry actors’ who produce, promote and distribute unhealthy food and beverages. These reports create a distinct conflict-of-interest. Instead of truly prioritizing the health and wellbeing of society, they downplay the health-harming effects of their products and distract the consumer with other focuses.
Octagonal Front-of-Package Warning Labels (FOPWL) are an effective solution to this issue. The Pan American Health Organization notes that the ‘High-In’ Octagonal label, modelled in countries like Chile and Mexico, is the best and most readily understood nutrition label. Consumers using this system can easily and accurately identify products high in nutrients of concern like salt, sugar and fats.

Despite this clear public health evidence, we see industry promoting other, less efficient and less effective labelling standards. Policy makers must avoid such research as it often prioritises the profitability of the business over the health and wellbeing of people.

Christopher Laurie
Public Health Researcher, Barbados

Marketing to Children

As the Advocacy Officer for Childhood Obesity Prevention and Healthy Food Policy at the Healthy Caribbean Coalition, I am responsible for monitoring conflicts of interest and industry interference in policy-making across the region. During the COVID-19 pandemic, I observed a troubling trend: the increased marketing of ultra-processed brands and products directly to children. This strategy, aimed at acquiring and retaining customers from a young age, disregards the well-documented physical and mental health risks associated with product consumption.

This insidious unhealthy food marketing, particularly when targeting children across the Caribbean and globally, takes various forms, from branded school sponsored events and the distribution of branded school items, to donations of ultra-processed products to vulnerable children by numerous food/beverage manufacturers and entities. These are deflective activities aimed at gaining public and policymaker favor while promoting products for profit.

By cultivating this collective favour, actors in the ultra-processed product industry gain privileged access to policymakers, entering “closed-door meetings” and policymaking spaces that lack clear guidelines for managing conflicts of interest and fostering transparency. Their gained public support and respect also discourages questioning of their presence in these influential spaces.

It is crucial to urgently address what may seem like innocent tactics as they evolve to threaten the development of mechanisms, like healthy food policies, that are designed to protect the region’s health.

Danielle Walwyn
Advocacy Officer, Antigua and Barbuda

SEE THE TRUTH: SOME FOOD INDUSTRY ACTORS WORKING AGAINST OCTAGONAL WARNING LABELS

There is an urgent need to protect our public health policy-making processes.

Since the start of consultations around the front-of-package labelling Regional Standard for pre-packaged food products in 2018, the ultra-processed food and beverage industry — supported by the wider private sector industry in the Caribbean — has become an overpowering actor in healthy food policy discussions.

Visit the campaign webpage

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