Last month, at the 79th United Nations General Assembly, the United Nations Special Rapporteur on the right to health (Rapporteur), Dr. Tlaleng Mofokeng, presented her thematic report “Harm Reduction for Sustainable Peace and Development.” The Global Health Advocacy Incubator (GHAI) together with the Campaign for Tobacco-Free Kids (CTFK) submitted a response to the call for inputs made by the Rapporteur to prepare this report.
In the report, the Rapporteur examines harm reduction policies and programs linked with sustainable peace and development and identifies gaps in adopting a rights-based approach to public health and harm reduction. The Rapporteur takes a broad view of harm reduction, including policies, programs and practices that aim to reduce the negative health and the social and legal impacts of different behaviors and related laws. This approach includes, for example, the role of private companies, like those in the food industry, in real or alleged harm reduction efforts.
GHAI and CTFK provided inputs from the lenses of our Overdose Prevention, Food and Nutrition and Tobacco Control programs and stressed the urgency of tackling corporate influence on harm reduction strategies. The Rapporteur acknowledges this influence in the report and states that harm reduction “means adequately and effectively regulating corporate actors.”
GHAI’s and CTFK’s submission also raised additional points related to the three programs mentioned.
Harm Reduction and Overdose Prevention
GHAI’s submission stated that real harm reduction, as applied to overdose prevention, is an approach that meets individuals with substance use disorder where they are, rather than using a punitive approach towards drug use. It focuses upon reducing the harms of substance use, such as unintended overdoses and the spread of infection through various programs and policies. In addressing these concerns, the Rapporteur’s report recognized the profoundly negative impact of a punitive approach in drug laws and policies on minorities, women and girls, LGBTIQA+ persons, migrants and other populations.
Given the focus of GHAI’s Overdose Prevention program, our submission focused on the specific context of this issue in the United States. It emphasized that the current opioid crisis and the surge in illicitly manufactured fentanyl have created an urgent need for comprehensive harm reduction measures across all levels of government. GHAI mentioned that effective initiatives for harm reduction include syringe service programs, naloxone distribution, overdose prevention centers and fentanyl testing strips. In her final report, the Rapporteur recommends that states implement the “full measure of drug harm reduction policies, including needle and syringe programs, (…) [and] opioid overdose management with naloxone.”
Harm Reduction and Food and Nutrition
GHAI’s submission highlighted the role of private companies in promulgating deceptive harm reduction narratives worldwide, particularly through their marketing strategies and product reformulation efforts. The ultra-processed products (UPPs) industry promotes the idea that moderation and variety in diets, including consuming their unhealthy products, can meet the requirements of a healthy diet. This approach ignores the fact that UPPs are inherently harmful, linked to non-communicable diseases (NCDs) and have negative environmental and societal impacts. Furthermore, the UPP industry runs marketing campaigns suggesting that simply reformulating their products (for instance, adding fiber, calcium, vitamins) is enough to reverse the harm they cause due to their high content in sugar, salt, saturated fats, etc. This approach is not effective as it does not provide consumers with the necessary information to make informed health-related decisions.
In this regard, the report states that to reduce harm stemming from diet-related NCDs, the food industry needs to provide accurate and easy-to-read information through front-of-package nutrition labeling, as well as other measures. Additionally, the report acknowledges that reformulation has been used as a technique to avoid labelling requirements, add nutrients and promote unhealthy products through nutrition or health claims that hide their harmful effects.
In its comments, GHAI mentioned that the industry also uses false harm reduction narratives in an attempt to address or divert from significant environmental harms associated with the UPP industry. For instance, soda companies claim their plastic bottles are recyclable, even though most communities lack adequate recycling infrastructure, or the bottles do not meet recyclable standards. Industry’s false claims about recyclability aim to position itself as part of the solution and environmental harm reducers, when in truth, UPPs’ packaging and production continue to cause significant environmental impacts that cannot be fixed by recycling. The report tackles the issue of greenwashing, underscoring that in the food and nutrition sector, "the environmental impact of ultra-processed products is well documented, as they have a high carbon and water footprint and produce large amounts of waste."
Government authorities worldwide need to recognize the strategies corporations use to minimize or obscure the harmful characteristics of their products. States should ensure that consumers have access to accurate, clear and timely information to make informed food choices. This is particularly true when diseases, such as NCDs are the result of preventable risk factors and where it is key for individuals to “fully understand health related risks and make informed decisions.”
Tobacco Control
The tobacco industry exemplifies how corporate actors can distort harm reduction approaches for profit and mislead the public – at the expense of public health. As part of its efforts to undermine global efforts to reduce tobacco use and nicotine addiction, the tobacco industry has for decades sought to appropriate legitimate harm reduction by using the term as part of its public relations, lobbying and corporate social responsibility tactics. On this specific topic, the report also affirms that “corporations exert their power by co-opting the harm reduction narrative or by seeking to position themselves as part of the solution to problems they have largely created, including through alleged harm reduction efforts.”
CTFK submission during the consultation phase of the report, through its International Legal Consortium (ILC), showcased how the world’s largest tobacco companies engage in activities to co-opt legitimate harm reduction approaches and to influence health policies in favor of their private corporate interests and in the detriment of people’s human rights. As acknowledged in the report, the tobacco industry has introduced so-called “reduced-risk products” into the market that are not proven effective for cessation and may renormalize smoking behaviors, act as gateways to tobacco use among youth and promote dual/poly-use of tobacco and nicotine products.
The tobacco industry’s version of “harm reduction” fails to meet the basic standards of true harm reduction and violates the rights to health and life recognized in global and regional human rights instruments. The tobacco industry’s approach promotes widespread and unrestricted access to its addictive and harmful products, which are marketed to young people as lifestyle aspirational products. True harm reduction does not promote the financial gain of an industry responsible for 8.7 million deaths globally.
Roundtable to spotlight report
GHAI welcomes the thematic report “Harm Reduction for Sustainable Peace and Development” and commends the Rapporteur for her valuable contributions. This work will also be spotlighted at a roundtable co-hosted by the O'Neill Institute for National and Global Health Law at Georgetown University, in which the Rapporteur will participate on Friday November 1st at 1:00 pm EST. Gianella Severini, ILC’s Legal Coordinator, will participate as a panelist and share insights on harm reduction in the context of tobacco control, food and nutrition and corporate accountability. To join the roundtable, RSVP here.
