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Heart Health and Covid-19: Why Uganda Needs to Regulate Trans Fatty Acids

COVID-19 has brought to centre stage the most important health issue of our era, largely ignored by policymakers and the public to date: non communicable diseases (NCDs), the cause of 71% of global deaths per year. People living with NCDs, and particularly those living with cardiovascular disease (CVD), are at higher risk of severe symptoms and death from COVID-19. As a result, the urgent need for policy measures to protect cardiovascular health is more apparent than ever.

Industrially-produced Trans Fatty Acids (TFAs) common in baked goods, pre-packaged foods and some cooking oils, are a major contributor to cardiovascular diseases (CVD) and other non-communicable diseases (NCDs) worldwide, contributing to more than half a million deaths each year (WHO). 33% (97,000) of deaths in Uganda were due to NCD in 2016 and 10% of NCD deaths were due to cardiovascular diseases (MoH).

TFAs have no known health benefits and can be replaced in foods without impacting their consistency or taste.

The elimination of industrially produced trans-fatty acids from the global food supply by 2023 is a priority target of the World Health Organization (WHO). Industrially Produced trans-fats is a toxic chemical used mostly in packaged foods to extend shelf life and for deep frying that increases your risk of heart disease and death. Further, about 540,000 deaths (WHO) annually have been ascribed to the consumption of trans-fats; with high intake raising the risk of death generally by 34% and specifically deaths from cardiovascular disease, by 28%. In Uganda, cardiovascular disease accounts for 10% of all deaths, making it the most common non-communicable cause of death in the country. The Global Burden of Disease Collaborative Network indicates that the burden of cardiovascular disease in Uganda also appears to be increasing, with the number of deaths attributed to ischemic heart disease increasing by 13.4% between 2007 and 2017.

Trans-fatty acids are common in foods that contain ingredients such as margarine, shortening, and hydrogenated or partially hydrogenated oils. Foods such as French fries, doughnuts, cookies, and crackers are often high in trans-fatty acids.

So, why are Ugandans still consuming this hidden poison in our food? Simply put, the government has not taken interest in regulating this dangerous component in processed foods.

In May 2018, the World Health Organisation (WHO) introduced an action package for the elimination of industrially-produced trans-fats globally by 2023. The action package, called REPLACE Trans Fat, is in keeping with the Sustainable Development Goal (SDG) 3.4, which aims to reduce non-communicable diseases (NCDs).

The aforementioned evidence necessitated the WHO REPLACE policy to ban trans fats globally. The REPLACE action package provides a strategic approach to eliminating industrially produced TFA from national food supplies, with the goal of global elimination by 2023. The WHO REPLACE Trans Fat action package serves as a guide for all countries to follow and has an ambitious timeline of just five (5) years. It comprises six steps: REviewing the current trans-fat landscape; Promoting healthful replacement fats and oils; Legislating to institute a ban/mandatory limits; Assessing trans-fat content of foods; Creating awareness about the dangers of trans-fat consumption and Enforcing the law/regulations.

A few Non-Governmental Organisations like the Uganda National Health Consumers’ Organisation have initiated advocacy campaigns for strong regulations against trans-fats, not only in Uganda, but the East African Community. This has been done through targeted engagements with Members of Parliament, the Ministry of Health and the Uganda National Bureau of Standards.

Trans fat bans/mandatory limits are not entirely novel as up to 20 countries – mainly in the upper middle and high income bracket – have instituted policies regulating the trans-fat content of foods. They include: Denmark, Canada, Argentina, South Africa and Iran, amongst others. As most countries without such regulations are Low and Middle Income Countries (LMICs) like Uganda, the issues of health equity has also been raised in several stakeholder engagements.

It is against this background that a public custodian of health must take center stage to eliminate TFAs in line with the REPLACE Package. The responsibility lies on the Ministry of Health which should take up the legal and policy leadership working with Uganda National Bureau of standards to develop a National regulatory framework for the elimination of trans-fats. This is especially critical as Uganda’s efforts are behind schedule to achieve the global target to eliminate trans-fats by 2023.

By Aziz Agaba

Program Officer – Uganda National Health Consumers’ Organisation (UNHCO)



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