Q: How does legislation play a role in preventing and controlling noncommunicable diseases?
Laws and legislation are an effective means through which to implement population-level interventions which prevent or minimize tobacco use, unhealthy diets, and physical inactivity. They can help to address risk factors for noncommunicable diseases through: banning unhealthy behaviours, such as smoking in closed public places; discouraging unhealthy behaviours (by imposing taxes on unhealthy products); encouraging healthier behaviours (by subsidizing healthy food products); and requiring healthy behaviours (by affecting laws mandating minimum daily physical activity requirements for school students) (1).
Q: What types of legal interventions exist?
The spectrum of legal interventions includes:
- binding laws (hard laws) which are legally mandated, including taxes and/or mandatory limits for the salt content of processed foods;
- non-binding (soft laws) which are non-binding co-regulatory interventions, such as voluntary compliance by industry to meet government-set standards;
- non-legal interventions, such as health prevention and promotion policies and/or strategies, including public education campaigns and mass media campaigns (1).
Q: Why are non-legal interventions important?
Non-legal interventions are important because:
- Laws are more effective when implemented as part of a comprehensive package of noncommunicable disease interventions. Evidence in the tobacco control field, for example, shows that taxes and price increases most effectively reduce smoking rates when implemented as part of a comprehensive package of interventions.
- Non-legal and non-legally binding interventions can lay the foundation for subsequent legal mandatory requirements. In some cases, non-legal interventions and co-regulatory schemes (private companies undertaking to comply with government-set standards) can lay the foundation for effective enforcement of legally binding interventions by expert and civil society engagement to generate public demand and political will.
- Enshrining policies, strategies, and programmes in law may lead to more effective outcomes. Some interventions can only be implemented through laws, for example, taxes on cigarettes and sugar-sweetened beverages. Some interventions need not be implemented through law to be effective. However, enshrining an intervention in law may improve effectiveness because laws typically include compliance and enforcement mechanisms. Interventions based in law tend to be accorded more esteem than non-legal interventions, which may result in additional and sustained resources to facilitate effective implementation.
Q: What is WHO’s level of commitment in supporting legislation and laws?
Regionally, WHO is committed to resolution EM/RC59/R.2 on the United Nations Political Declaration on Noncommunicable Diseases and commitments of countries:
“Develop model legal instruments to guide the development of national legislation for implementing the commitments of the United Nations Political Declaration on Noncommunicable Diseases”; and resolution EM/RC59/R.3 on health systems strengthening in countries of the Region: “Review and update public health laws and develop norms and standards in order to ensure the right to health, health equity, and quality and safety of care”.
Q. What is a ”sin tax”?
A “sin tax” is simply another name for a tax imposed on certain products that are deemed unhealthy and harmful to consumers. Harmful products may include tobacco, alcohol, fat and sugar. Other products which have high fat, sugar or salt content may also be included, such as fast food and sugar-sweetened beverages. Sin taxes on unhealthy products result in a price increase for the consumer which deters consumption.
Tax increases will most likely be successful in decreasing consumption of unhealthy products when implemented in combination with other interventions and could generate revenue for health development. These might include restricting availability, limiting portions and bans or restrictions on advertising, and public education campaigns.
Q: What are the priority legal interventions to address noncommunicable diseases in the Region?
The Regional Office, in partnership with the O’Neill Institute for National and Global Health Law, Georgetown University Law Center, delivered a comprehensive dashboard of options of potentially effective legislative and regulatory interventions drawn from international experiences in noncommunicable disease prevention to date. The mapped legal interventions address governance, unhealthy diet; physical inactivity and tobacco use based on evidence of effectiveness, regional relevance, cost-effectiveness, affordability, feasibility and suitability for implementation as binding law. Ten key noncommunicable disease legal interventions addressing governance, unhealthy diet; and tobacco use were identified following a regional extensive consultation process involving global and regional experts. The ten key legal interventions will be supported by guidelines and tools for country-level implementation based on national context (2,3).
Looking forward, WHO is currently developing the guidelines and tools to support implementation of national governance and population prevention initiatives for noncommunicable diseases, including capacity-building through the creation of multidisciplinary teams of public health experts and legislators (2).