Governmental institutionalization of corporate influence on national nutrition policy and health: a case study of Ecuador

Regarding the article “Governmental institutionalization of corporate influence on national nutrition policy and health: a case study of Ecuador”¹ published on November 29, 2023, in The Lancet Regional Health—Americas, I would like to make clarifications and insights into the topic, addressing the influence of the ultra-processed food and beverage industry on nutrition and health policies in Ecuador.

The article mentions that the National Strategy “Ecuador Grows without Infant Malnutrition” (ENECSDI) has institutionalized the influence of the ultra-processed food industry through public-private partnerships. In this regard, it is relevant to clarify as a first point that Ecuadorian legislation, specifically the Internal Tax Regime Law, amended by the Organic Law for Economic Development and Fiscal Sustainability after the Covid-19 Pandemic, in its article 19 establishes tax deductions for sponsorships and contributions aimed at educational and non-profit entities focused on eradicating infant malnutrition and caring for pregnant mothers.²

For this purpose, on September 13, 2022, an inter-institutional agreement, MIES-MSP-MINEDUC-MAATE-STECSDI-2022-001, was issued to regulate the qualification of programs and projects of non-profit entities focused on eradicating child malnutrition. It should be clarified that this agreement, subsequently amended and published in the fourth supplement of Official Registry No. 236 on January 24, 2023,³ establishes viable parameters for implementing projects that consider evidence-based strategies contributing to the population's health. Since the promulgation of this reform until the present date, 44 projects have been reviewed, of which ten were approved. Two of these projects, proposed by the REDNI Foundation and DIAKONIA, focus on the delivery of food packages approved under the Food-Based Dietary Guidelines (GABA) for the Ecuadorian population. The content of these packages was approved by the health regulatory authority include 15 foods, of which 12 are natural or minimally processed products such as quinoa, amaranth, corn, lentils, and barley rice, among others. Additionally, it includes tuna, sardines, and UHT skimmed milk. These processes aim to protect the health of the population and respect the cultural diversity of food in intervention areas.

As a second point, within the framework of ENECSDI, a Consultative Council was implemented through Agreement No. STECSDI-STECSDI-2022-0003-A.⁴ This council comprises representatives from seven civil society organizations, three representatives from chambers, associations, small, medium, and/or large companies, or non-profit organizations with a demonstrated capacity for private sector articulation, four representatives from the academic sector with experience in research, training, or the development of programs and/or projects addressing chronic child malnutrition, there are also four delegates from the media with knowledge of prevention and reduction of chronic infant malnutrition, and one delegate from the United Nations system to ensure transparency and plurality in decision-making. This council has a role of consultation, dialogue, agreement, and coordination with civil society organizations, academia, international cooperation, and the private sector to accompany and evaluate the implementation of the aforementioned State policy. It is crucial to emphasize that any decision is non-binding for the government. In order to conform the council's, a public call was made to various sectors of organizations,⁵ from this process, 54 applications were received, of which 19 were selected and distributed as follows: four representatives from academia, one representative from the United Nations, three representatives from associations, small, medium, and/or large businesses, two representatives from the media, two representatives from multilateral and international organizations, and seven representatives from civil society.

At this point, it is vital to highlight that, in Ecuador, citizen initiatives are supported by the Constitution and the Law of Citizen Participation, ensuring active societal participation in the development of public policies, considering that each entity manages its protocols for inclusion of recommendations and internal regulations for declaring conflicts of interest of participants in technical discussions.

In conclusion, Ecuador's current public policy for preventing and reducing chronic child malnutrition was formulated and is being implemented by public and international cooperation entities free from conflicts of interest. It is based on the best available evidence from successful cases in combating stunting childhood. Food industry do not exert direct influence, nor dictate or influence the allocation of fiscal resources, as mentioned in the article. The use of these funds is publicly accessible to the entire population. Finally, it is essential to highlight that public-private partnerships are tools to have additional economic resources. However, in Ecuador's case, they comply with the law and are duly reviewed and monitored by the different implementing institutions of the current ENECSDI, coordinated by the Technical Secretariat Ecuador Grows Without Infant Malnutrition, as an articulating instance attached to the Constitutional Presidency of the Republic of Ecuador.

Contributors

Y-MT. Conceptualised the manuscript, drafting and editing the manuscript.

Data sharing statement

Documents reviewed in this article are publicly available.

Declaration of interests

I declare no competing interests.