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US to seek changes to major WHO obesity effort

WASHINGTON -- The Bush administration announced yesterday it will demand significant changes to a major World Health Organization initiative to battle obesity globally, saying the plan is based on faulty scientific evidence and exceeds the UN body's mandate.

The move prompted intense criticism from US and international health and nutrition experts, who charged that the US objections are a thinly veiled attempt to placate the food and sugar industries and derail a vital international assault on one of the world's biggest health problems.

The WHO plan, which outlines strategies nations can use to fight obesity, has been widely applauded by public health advocates but bitterly opposed by some food manufacturers and the sugar industry, because it includes some controversial options, such as restricting advertising aimed at children and increasing junk-food prices through taxes and adjustments in farm subsidies.

The US delegation plans to seek significant revisions when WHO's governing board considers the proposal next week in Geneva, a key official said.

"There have been approaches that WHO has taken that we do not consider to be based on the best practices and the best science," said William Steiger, the Health and Human Services Department's special assistant for international affairs. "What we want is a strategy that WHO can trumpet that is the product of the best possible scientific evidence."

Steiger said the revisions the United States will seek are still being completed, but the goal will be to place much greater emphasis on the role of "personal responsibility" and not government regulation.

"We have a whole series of potential changes we'd like to see," Steiger said in a telephone interview. "One overarching example is that any strategy that deals with this subject has to deal with individual responsibility. What's lacking is the notion of personal responsibility as opposed to what the government can do."

Steiger denied industry concerns were behind the administration's position. The Grocery Manufacturers of America, or GMA, and the Sugar Association acknowledged they oppose parts of the plan, but denied influencing the US position.

However, GMA spokesman Michael Diegel echoed the administration's criticism. "There is no mention of what we consider to be the fundamentally important issue of individual responsibility," he said.

Although the report could not compel nations to act, international health experts said the comprehensive approach outlined in the draft version would provide a powerful weapon to governments and public health advocates seeking action against one of the most pressing public health problems.

"This document is fantastically important," said Philip James, chairman of the International Obesity Task Force, an independent, London-based public health think tank. "It should have a big impact, unless it's sabotaged. And we know it's being sabotaged."

WHO estimates that perhaps 1 billion adults are overweight and at least 300 million are obese. In the United States, more than two-thirds of adults are overweight, and nearly one in three is obese. Researchers have laid the skyrocketing rates largely to a combination of people getting less exercise and consuming more inexpensive high-calorie junk foods.

In 2002, WHO's governing body, the World Health Assembly, voted to develop a strategy for combating the problem along with other chronic health problems influenced by lifestyle, such as heart disease. WHO issued a scientific report in June 2002 that provided the basis for the 18-page strategic plan, which would come before the Assembly for final approval in May if the 32-member executive board endorses it next week.

"It essentially establishes a new standard with which all doctors and public health interest can now challenge the governments and say, `What are you doing about this?' " said James, who is also vice president of the International Union of Nutritional Scientists.

WHO's supporters said the administration's objections were really an attempt to undermine or gut the plan because of food and sugar industry influence.

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