Marisa Macari knows that behind every policy win is a story of advocates’ collaboration, commitment and perseverance. As Senior Advisor for the Global Health Advocacy Incubator’s (GHAI) Food and Nutrition Advocacy Fund, she supports civil society partners in 16 countries across Latin America, Asia and Africa to develop and implement advocacy strategies that promote healthier food policies. Starting her public health journey early in life, she is passionately committed to tackling the root causes of obesity and chronic disease, confronting powerful structural and commercial forces head-on to drive lasting policy change.
What is your favorite part about working with civil society organizations and advocates?
Most of what I know I have learned from advocates who were kind enough to show me how policy advocacy works. Civil society organizations and social movements are the catalysts of political change, and for that reason, I feel very fortunate to work in this space. I love the collaborative spirit of advocates and their commitment and persistence to move the needle on policies that work—even when policy wins may take years to materialize. I also really appreciate the blend of both technical and strategic know-how that civil society organizations bring to policymaking processes.
How did you get involved in public health?
In my late teens and early twenties, I volunteered at a cancer hospital, and that experience really stuck with me, sparking my interest in public health. Shortly after that, I worked at the archives of a cancer research institute where I carried out projects documenting the history of research at the lab. These experiences drew my focus to the social dimension of health and illness and led me to pursue my master’s and, eventually, my PhD in medical anthropology.
When I started my PhD, there was a growing interest in the study of obesity. Anthropologists and public health experts were beginning to critique individual-based theories of obesity in favor of articulating the environmental, economic, commercial and political origins of obesity. I was really struck by this work, ultimately informing the focus of my doctoral thesis, which explored food practices and nutritional change among Mexicans living in Queens, New York. To challenge how migrant health and nutrition was characterized in the public health literature at the time, I looked at how these practices were shaped after migration due to political-economic constraints and inequalities.
It became evident to me that policy change was the most effective tool for addressing the structural and commercial determinants shaping obesity and chronic disease, and I knew I wanted to work on food policy, using research to inform policymaking processes.
After completing my PhD, I moved to Mexico and soon began working with the consumer rights organization, El Poder del Consumidor, where I was fortunate to work as research coordinator for 10 years. During that time, I worked on Mexico’s sweetened beverage tax, a front-of-pack warning labelling policy, school food policy, marketing restrictions and comprehensive food systems policy, as well as issues of conflict of interest and corporate capture.
What is unique about the food policy advocacy work under the Advocacy Fund?
The Advocacy Fund supports locally led campaigns to pass evidence-based healthy food policies, with each successful policy reinforcing the global proof of their effectiveness and empowering advocates worldwide in their efforts. I think one unique aspect of the Advocacy Fund is how it has allowed GHAI to expand its support to civil society organizations in Asia, East and West Africa and Central America – places where this program did not previously work. Another significant component of the Advocacy Fund is that each campaign can draw on GHAI’s legal, research, communications and industry interference teams to learn best practices from across settings and to build a collaborative community of practice.
What is the biggest advocacy challenge you have faced in as an advocate for healthy food policies and how did it get resolved?
The Codex Alimentarius, or Codex for short, is an international set of food standards that protect public health by ensuring food safety and promoting fair trade practices. It is produced by an international commission that formulates voluntary international standards, codes of practice, and guidelines that inform policy at the national level and have implications for trade disputes in the World Trade Organization. During the international development and negotiations of the Codex Guidelines on Front-of-Pack Nutrition Labelling (FOPNL), food industry actors and some industry-friendly governments attempted to exclude “high-in” warning labels from the definition of FOPNL, which could have caused a “chilling effect” by discouraging countries from using such evidence-based labels in their national policy.
To prevent this, advocacy organizations commented on the draft Guidelines over many years. We organized responses within national and international Codex groups, developed a civil society position paper and conducted a briefing for member states ahead of a key 2019 negotiation. In the end, advocates successfully beat out the voice of industry actors ensuring that the Codex Guidelines on FOPNL do not thwart countries from implementing front-of-pack warning labels.
