Industrially produced trans-fatty acids (IP-TFA) is a significant and preventable contributing factor to the burden of cardiovascular disease, the leading cause of death in the Americas. June 2018 marked a decade since the Trans Fat-Free Americas: Declaration of Rio de Janeiro 2008 pledged cooperation between the public sector and industry to eliminate and replace IP-TFA in the food supply.
While significant progress has been made, the goal set out in the Declaration of Rio de Janeiro has not been achieved, indicating that voluntary means alone are not sufficient. Over time, the elimination of IP-TFA through regulatory measures has proven to be an evidence-based, low-cost approach that offers the most reliable path forward to end this public health problem.
The Plan of Action for the Elimination of Industrially Produced Trans-Fatty Acids 2020-2025 of the Pan American Health Organization proposes to complete the removal of this harmful product by fully scaling up the adoption and implementation of IP-TFA elimination policies throughout the Americas.
As part of the monitoring and evaluation component of this Plan of Action, an interactive tool to monitor the progress and achievements of indicators of the Plan of Action toward set target has been developed. This tool also includes the TFA Policy Implementation Status to track countries' performance on a continuous basis on the progress of implementing legislative and other measures to reduce and eliminate IP-TFA. The TFA Policy Implementation Status shows countries that have best-practice TFA policies, less restrictive TFA limits, other complementary measures, or a national policy commitment to eliminate TFA. It also shows countries that have adopted best-practice TFA policies that will come into effect at a later date, as well as the existence of monitoring mechanisms in countries with mandatory TFA limits.
This tool helps to share assessed progress toward the targets to Member State's national health authorities, health professionals, decision-makers and policymakers, and the public.
Progress Achieved
Strategic Line of Action 1: Enact regulatory policies to eliminate PHO from the food supply and/or to limit IP-TFA content to no more than 2% of total fat in all food products
Some Member States have advanced in the implementation of this important line of action. In addition to Canada, Chile and the United States of America, which had already implemented best practice policies for the elimination of IP-TFA prior to the adoption of the plan of action, Brazil and Peru have also enacted and started implementing the PAHO and WHO best practice policies. Paraguay and Uruguay have enacted regulations to implement best practices in line with the plan of action, due to become fully effective by 2024 and 2022, respectively. The Mexican senate has also approved a bill to eliminate IP-TFA from the food supply using PAHO and WHO best practices, and this is pending final approval and enactment. Member States, including Brazil, Mexico and Uruguay have enacted and/or implemented new labeling laws and regulations that support the enforcement of the elimination of IP-TFA.
Strategic Line of Action 2: Implement IP-TFA elimination policies by means of clearly defined regulatory enforcement systems
There has been little progress under this line of action, with one additional country having plans or mechanisms in place to ensure compliance consistent with the IP-TFA elimination policy they have adopted or intend to adopt. Nine countries and territories have these mechanisms or plans in place compared to eight that already had such mechanisms and plans in place prior to the adoption of the plan of action.
Strategic Line of Action 3: Assess the progress of IP-TFA elimination policies and their impact on the food supply and on human consumption
There has been some progress under this line of action, with five new countries and territories completing pre-regulation and post-regulation assessments of food products regarding their content of TFA and/or saturated fats.
Strategic Line of Action 4: Create awareness, through outreach and educational campaigns, of the negative health impacts of TFA and the health benefits to be gained from the elimination of IP-TFA, among policy-makers, producers, suppliers, and the public
There has been some progress under this line of action, with 11 countries and territories implementing education and communication strategies for the general public on the negative health impacts of TFA and benefits of IP-TFA elimination policies, compared to five countries and territories in the baseline.
Lessons Learned
TFA elimination policies gained momentum after 2018, when WHO set TFA elimination as a global priority, released recommended policies and strategies, and called on countries to act. This plan of action sustained and strengthened such momentum in the Region of the Americas. The synthesis of best practices and call to action, based on experiences and successes in several pioneering countries, has helped provide the evidence underpinning policy action in the Region. The COVID-19 pandemic may have driven resources and priorities away from the elimination of IP-TFA in some countries.
Conversely, it may also have intensified the recognition of the need to eliminate such substance from the food supply to help protecting populations from the ongoing epidemic of non-communicable diseases, which have further aggravated the impact of the COVID-19 pandemic
Action Needed to Improve the Situation
- Strengthen and expand technical and financial support to adopt the plan of action for developing landscape analyses and policy design, improving laboratory capacity, and monitoring and evaluating policy compliance and enforcement.
- Disseminate guidance and capacity-building tools for designing and implementing the policies and actions proposed in the plan of action by means of publications, webinars, and online courses.
- Support Member States in protecting the policy cycle from interference by industry and other actors whose products, practices or policies conflict with the implementation of the plan of action. This can be done by preparing technical briefs, questions and answers, and other publications with sound evidence to protect policy-making from opposing interests.
- Disseminate country experiences, success stories, and best practices to help Member States learn from each other, by means of webinars and publications.
- Strengthen advocacy efforts targeted at focal points at ministries of health, policy-makers, civil society, and PAHO country and sub-regional officers, by disseminating and encouraging increased uptake of the online course on the elimination of IP-TFA.
- Despite the current COVID-19 pandemic, it is essential that health programs in each country provide continuity for policies that can contribute to the prevention of non-communicable diseases (NCD), such as the elimination of IP-TA, as the epidemic of NCDs did not cease and, in addition, aggravated the risk of getting severely ill and die from COVID-19.
- The adoption and/or amendment of laws and regulations by Member States needs to be accelerated in order to fulfill best practices and policies, so that the implementation of IP-TFA elimination can meet the timeline committed under the plan of action.
