The 2019 Lancet Commission report on The Global Syndemic showed how obesity, undernutrition and climate change constituted a synergy of pandemics which negatively interact with each other and which have common underlying drivers. These macro-system drivers are the food system, transport, land use and urban design along with the policy, economic, and social norm settings they are based upon. The corollary of The Global Syndemic concept is that there are double- and triple-duty actions that can influence all three pandemics. What are the implications of this joined-up thinking for Australia and New Zealand?
The first major implication is that ‘malnutrition in all its forms’ is by far the biggest risk for health loss in all countries and this is widely under-recognised. Food insecurity should be viewed as the main undernutrition problem in Australia and New Zealand.
The second implication is the understanding that the ‘policy inertia’ that is stalling action on implementing WHO-recommendations for reducing obesity is caused by the power imbalance of: dominant opposition by the ultra-processed food industry; reluctance by governments to do battle with this industry lobby, and; the low level of demand for policies from civil society.
Thirdly, lifting the level of demand from civil society for action is the only plausible way to redress the power imbalance creating policy inertia. Joining forces with the climate change movement or with advocates for action on other harmful commodities (tobacco, alcohol) is one pathway to action. Another is implementing the ‘Bloomberg approach’ of targeted funding for mobilising civil society, which has seen food policy successes in several Latin American countries.
Other implications include; taking systems approaches to research and community action; focusing on key triple-duty actions (eg healthy sustainable dietary guidelines, national food systems strategy), and; increasing monitoring for accountability.