The Limits to Food and Beverage Industry Influence over Fiscal and Regulatory Policy in Latin America

Abstract

Context: Little is known about the political, institutional, and social contexts contributing to a decline in food and beverage industry power and influence over fiscal policy (soda taxes) and regulatory policy (sales/advertising restrictions and food labels). This article addresses this issue by exploring why Mexico and Chile eventually saw such a decline in the food and beverage industry's influence, whereas a similar decline did not occur in Brazil. The article argues that in Mexico and Chile, these outcomes are explained by presidential, congressional, and bureaucratic interests shifting to pursue policies that went against industry preferences.

Methods: This article took a qualitative methodological approach to comparative historical research.

Findings: Policy makers’ interest in pursuing stronger food and beverage regulations were shaped by economic and public health concerns, new electoral contexts, epidemiological information, and normative beliefs. In Mexico, the infiltration of nutrition researchers within government facilitated this process. By contrast, Brazil's government was divided about pursuing regulatory policies, with presidents favoring partnerships with industry to implement a popular antihunger program; industry's power endured there with limited progress in policy reforms.

Conclusion: Governments can eventually overcome industry power and policy influence, but it depends on a whole-government commitment to reform.

In recent years, major soda and ultraprocessed food industries have been successful in influencing the design and implementation of fiscal and regulatory policies restricting their commercial activities and profitability, such as advertising and sales restrictions, improved food labels, and soda taxes. Industries’ influence has often been facilitated by their structural power and government dependence on industry for economic growth. The food and beverage industry leverages this dependence and engages in lobbying efforts to block and weaken policy actions they oppose (Fairfield 2015; Madureira Lima 2023; Przeworski and Wallerstein 1988). Researchers in the corporate political activity literature have revealed the political and social strategies that industries use to influence policy in their favor (Hillman and Hitt 1999; Lawton, McGuire, and Rajwani 2013; Savell, Gilmore, and Fooks 2014). Most of this literature has provided case studies highlighting instances in which industries have hampered the policy agenda setting and implementation process (Hillman and Hitt 1999; Lawton, McGuire, and Rajwani 2013; Savell, Gilmore, and Fooks 2014). However, we know little about the political circumstances in which food and beverage industries sometimes fail to achieve their policy objectives, and where government interests in regulating industry and safeguarding the public from disease prevail. What are the political, institutional, and social contexts that may be contributing to the erosion of these industries’ policy influence?

This article addresses this question via an in-depth comparative historical analysis of the specific contexts contributing to a decline in the food and beverage industries’ ability to influence fiscal and regulatory policies such as soda taxes, sales and advertising restrictions, and improved food labels. I examine the cases of Mexico, Brazil, and Chile, nations that have seen the rise of several multinational soda and ultraprocessed food industries and their influence over noncommunicable disease (NCD) policy, politics, and society (Gómez 2023). However, as Mexico and Chile illustrate, these industries eventually saw a decline in their ability to thwart the adoption of these policies, although this did not occur to the same extent in Brazil. I argue that these differences in outcomes reflect differences in shifting policy maker interests and institutional change processes, rather than major economic shocks and political changes (Babic et al. 2022; Pierson and Hacker 2002; Vogel 1987) or international and civil societal pressures (Fairfield 2015; Gómez 2018). In Mexico and Chile, simultaneous increased presidential, bureaucratic, and congressional interest in fiscal and regulatory reform was shaped by economic (Carriedo et al. 2021) and health concerns,¹ shifting electoral contexts and political goals (White and Barquera 2020), human rights beliefs (re: Chile, see Boza, Polanco, and Espinoza 2019), and the emergence of nutrition scientists within the bureaucracy (Mexico). Conversely, in Brazil, presidential partnerships with industry for alternative policy objectives (Gómez 2023), divided congressional interests captured by corporate lobbying,² and contrasting bureaucratic preferences hampered policy reforms. Despite recent tobacco and alcohol taxation (Fernandes 2023) and the delayed introduction of improved food labels, increased taxes on soda and beverage manufacturing have not been pursued (Bridge, Groisman, and Bedi 2022; Mathias 2022b), while there have been no effective advertising regulations (Barbosa, Leite, and Brito 2022). Thus, industry power and policy influence did not erode as much in Brazil, unlike Mexico and Chile.

Methodology

This article employs qualitative research methods. First, I analyzed primary and secondary qualitative documents—including peer-reviewed journal articles, books, book chapters, and policy reports—located through several search engines, such as PubMed, Web of Science, Google Scholar, and Academic Search Ultimate. For each of these search engines, several keyword search terms were used to find documents, such as “[name of country],” “president,” “politics,” “NCD,” and “policy”; or “[name of country],” “Congress,” “Senate,” “NCD,” and “policy.” Based on an analysis of these articles and new information obtained from them, I then conducted additional searches in these search engines on the topics of interest for each country. The criteria for selecting documents were their empirical relevance to the article and evidence of peer review. Articles not meeting these criteria, such as blogs or unreputable news and/or organizational sources, were excluded. A total of 45 qualitative documents were analyzed. I analyzed the data obtained from these documents in a deductive manner to assess empirical and causal claims made for each case study.

Next, I obtained qualitative data from several 30-minute interviews with former health officials, academic researchers, and activists from Mexico, Chile, and Brazil. A total of six interviews (two for each country) were conducted via Zoom during summer and fall 2022. I chose interviewees based on their scholarly reputation and the recommendations of initial interviewees. Some interviewees also were selected based on their participation as authors in related publications.

I selected Mexico, Chile, and Brazil as cases for several reasons. These countries are arguably the largest, most diverse free markets in Latin America, and in 2021 they led the region in total foreign direct investment (ECLAC 2022). Foreign multinationals in the food and beverage sector have a historical presence in these nations and have benefited from favorable trade and regulatory policies. These countries were also selected because of their similar presidential systems, with a separation of powers between executive, congressional, and judicial branches and an autonomous national health care bureaucracy, which provide several points of access and influence for industries. I also selected these countries because of the ample amount of empirical data and peer-reviewed literature discussing their experiences in nutrition and NCD policy, reflecting their comparatively earlier efforts to implement these types of policies in the region.

Nevertheless, this study has limitations. Only three countries were analyzed, thus limiting the generalizability of the article's claims, and industry power and influence decreased in only two of the three cases. Future researchers should strive to compare more cases in Latin America to better understand if the food and beverage industry in general has been less influential.

Revisiting the Political Contexts of Industry Power and Influence

In recent decades, researchers have emphasized the various political and policy tactics that industries use to influence the creation of NCD policies, often entailing fiscal and regulatory measures (Hillman and Hitt 1999; Savell, Gilmore, and Fooks 2014). Major food and tobacco industries, especially in low- and middle-income countries, have exhibited a considerable amount of power during the formulation of these policies (Lauber, Rutter, and Gilmore 2021; Madureira Lima and Galea 2018). Yet researchers have not often considered the political, institutional, and social contexts that can decrease industries’ power and influence over time. Have industries and their representative interest groups always been successful in manipulating fiscal and regulatory policies in their favor? Or are there limits to their policy influence?

For the most part, these questions have been ignored in the literature on corporate political activity and the commercial determinants of health. Spurred by the 2008 global financial crisis, political scientists have rejuvenated their interest in understanding the various forms of corporate structural power and policy influence (Culpepper 2015). While Dahl (1982) and Dahl and Lindblom (1976) argued that corporations benefited from privileged political positions, were undemocratic in nature, and wielded considerable political influence (more so than any other interest group), Vogel (1987) argued that corporations should be studied as just another interest group and that their structural power and influence was never guaranteed. Since Vogel's work, scholars have addressed the political, economic, and social contexts accounting for variation in corporate power and influence over long periods of time (Pierson and Hacker 2002; Babic et al. 2022).

Other scholars have instead emphasized the importance of individual elite preferences and civic activism in explaining a reduction in business power and policy influence. Fairfield (2015) explores the importance of carefully describing and operationalizing the structural sources of business power and claims that industries have the most policy influence when structural and instrumental power are strong. Examining the case of Chile's 2014 tax reforms, Fairfield (2015) also explains how electoral incentives and civic mobilization (more significantly) can at times counter industry's power. With respect to structural power, Fairfield (2015) argues that the strength of business structural power depends on the perceptions of governing elites during the policy agenda-setting phase (Babic et al. 2022). When elites perceive a credible threat, such as policy reforms leading to reductions in corporate investment and economic performance, business structural power is strong and the converse situation holds (Fairfield 2015). Fairfield (2015) also explains how, in the case of Chile, civic mobilization and protest outweighed business power and provided an opportunity for progressive policy makers to enact tax reforms that were opposed by the business community.

Finally, pressures from international organizations and civil society may be perceived as important for policy reform. The Pan American Health Organization (PAHO) and the World Health Organization (WHO) have encouraged and supported nations to create prevention and regulatory policies focused on NCDs, childhood obesity, and a protective and healthy food environment (Gómez 2018; PAHO 2020; WHO 2010).

Below I explore the evolution of the food and beverage industry's power in Mexico, Chile, and Brazil, investigating the key factors that have shaped the maintenance and erosion of their influence and variations in that influence across these countries.

Mexico

Industry Emergence and Power

In Mexico, the ultraprocessed food and sugary-beverage industries had a great deal of policy influence throughout the 1990s and 2000s. After the introduction of the North American Free Trade Agreement in 1994, access to Mexico's markets prompted an increase in the production and distribution of these foods. During the early 2000s, as discussions emerged surrounding the idea of a soda tax, awareness of the soda industry's influence began to increase. Beginning in 2007, the idea of a soda tax arose but was successfully opposed by industry, while the Mexican Congress eventually failed to take on the proposal (Vilar-Compte 2018).

During this period, several contextual and institutional factors aided industry's policy influence. Under former President Vicente Fox (2000–2006), who had previously been a Coca-Cola executive, the soda industry had a considerable amount of power and influence over fiscal and regulatory policies (Gómez 2018). There were no federal representative institutions, such as national government councils, that effectively represented nutrition activists’ interests. In 2015 Mexico's Ministry of Health (MoH) created the Observatorio Mexicano de Enfermedades Crónicas No Transmisibles (Mexican Observatory for Non-Communicable Diseases, or OMENT)—managed by the Autonomous University of Nuevo León, and in coordination with an advisory council comprising state and nonstate actors (MMH 2015)—as a platform to evaluate the government's 2013 National Strategy to Prevent and Control Obesity and Diabetes by developing indicators measuring its impact, monitoring, and evaluation (Carriedo et al. 2023). However, national institutes, consumer groups, and activists were poorly represented within OMENT (Aceves et al. 2020; Gómez 2018). The advisory council's most influential representatives were from the food and beverage sector (Aceves et al. 2020).

Contextual and Institutional Change

Nevertheless, the international and domestic context appeared to gradually shift away from supporting the interests and influence of big industry. The international community began to impress onto Mexico the need to start taking their obesity situation more seriously. For instance, in 2011, according to James, Lajous, and Reich (2020: 7), “the United Nations Special Rapporteur on the Right to Food called on Mexico to declare a state of emergency in response to the obesity epidemic.” In addition, James, Lajous, and Reich (2020: 7) claim that “the Organization for Economic Cooperation and Development highlighted the scale of the obesity epidemic in Mexico and urged action.” Under the administration of President Enrique Peña Nieto (2012–18), international organizations such as PAHO and UNICEF were vocal about Mexico's need to adopt food industry regulations (pers. comm., Ana Larrañaga, June 14, 2022; pers. comm., Angela Carriedo, June 21, 2022). While the Peña Nieto administration did not give into these pressures, the subsequent presidency of Andrés Manuel López Obrador (henceforth Amlo) (2018–24) was much more receptive (pers. comm., Ana Larrañaga, June 14, 2022). Under Amlo, the collaboration between UNICEF, PAHO, and the Food and Agriculture Organization of the United Nations was stronger (pers. comm., Ana Larrañaga, June 14, 2022). This change in receptivity to the international community's recommendations seemed to reflect the president's and the bureaucracy's shift in earnestly pursuing regulatory policies against industry.

At the presidential level, during the Peña Nieto administration a change in political and policy context and interests also emerged. The presidency began to recognize Mexico's simultaneous fiscal and NCD challenges. The governing coalition of the PRI, PAN, and PRD parties, a.k.a. Pacto for Mexico, introduced several fiscal reform efforts with the goal of increasing government revenue in a context of waning international oil prices (James, Lajous, and Reich 2020). While Peña Nieto did not take a public stance against the soda industry and its effects on public health, he strove to garner more fiscal revenue and pushed for taxes that went against the soda industry's interests (pers. comm., Ana Larrañaga, June 14, 2022; AFP 2013). Indeed, Peña Nieto introduced the soda tax to Congress as part of a broader fiscal reform package in September 2013, and he supported the tax (James, Lajous, and Reich 2020; Vilar-Compte 2018). In October 2013, the effort obtained support among three political parties in the House (the PRI, PRD, and PVEM), providing 317 votes in favor, while the Senate passed the bill later with the PRI, PAN, PRD, and PVEM parties providing 73 votes in favor (James, Lajous, and Reich 2020). Yet, perhaps because of his concern over industry's reactions to the soda tax, Peña Nieto appeared to offer a compromise by offering major soda companies a seat at the policy table through OMENT (pers. comm., Ana Larrañaga, June 14, 2022).

In addition, during Peña Nieto's presidency, Mexico's NCD situation—burgeoning levels of obesity and type-2 diabetes—could no longer be ignored. An extensive amount of data had emerged from national surveys analyzed and conducted by the National Institute of Public Health and Ministry of Health, that show dietary behaviors were changing and there was an increase in obesity and overweight (Barquera, Campos, and Rivera 2013). Researchers also began to highlight the problematic relationship between soda consumption and obesity (James, Lajous, and Reich 2020). With the introduction of the National Strategy for Prevention and Control of Overweight, Obesity, and Diabetes in 2013, Peña Nieto's views had shifted in favor of addressing Mexico's worsening NCD challenges, and he created OMENT (pers. comm., Ana Larrañaga, June 14, 2022; Secretaría de Salud, 2015). Peña Nieto also recommended a cultural shift in favor of living a healthier lifestyle, calling on citizens to devote one hour a day to exercise (Bosely 2013).

In contrast to Peña Nieto, Mexico's next president, Amlo, displayed an interest in publicly addressing the harm of unhealthy food products. Amlo consistently vocalized his distaste for soda products, publicly stating how harmful they are (pers. comm., Ana Larrañaga, June 14, 2022; see also El Financiero2022). However, Amlo was careful not to openly resist industry and even met with Coca-Cola's CEO on occasion (pers. comm., Ana Larrañaga, June 14, 2022; see also Meli Vera de la O 2020). Thus Amlo appeared reluctant to engage in a direct conflict with major soda companies. Nevertheless, Amlo's public shift against harmful food products appeared to create a favorable climate for introducing new food regulations.

Indeed, for several years, the government's GDA (guideline daily amount) food labels were contested as a result of their lack of clarity and accuracy in providing information. Efforts to improve these labels were thwarted by industry opposition; however, Amlo was committed to fighting corruption (White and Barquera 2020). As White and Barquera (2020) explain, this commitment, which comported with activist calls for greater transparency and revealing conflicts of interests, facilitated the eventual introduction of new front-of-label packaging, which entailed the usage of large black octagon stop-sign images warning of high levels of sugar, salt, and fat.

Mexico's federal bureaucratic institutions also began to shift in favor of introducing legislation that would improve the country's NCD situation and go against industry's preferences. With respect to the soda tax and policies towards sugary beverages, while the Secretariat of Health (SoH) was committed to addressing this issue, introducing several prevention programs and policies, other federal agencies were also on board at an early stage. In particular, the Ministry of Finance (MoF) emerged as a key actor. The MoF became interested in pursuing policies on sugar sweetened beverages as early as 2007, which triggered resistance from legislative members due to their potentially negative affect on jobs (Moise et al. 2011). The MoF framed the discussion about the need to introduce a tax as a matter of fiscal and economic importance (Carriedo et al. 2021), which comported with President Peña Nieto's commitments.

In recent years, the SoH and other federal agency heads have also become increasingly vocal about the need to resist the unhealthy food industry and the importance of effective food labels and marketing regulations. The impetus for regulatory change has mainly emerged at the bureaucratic level (pers. comm., Angela Carriedo, June 21, 2022). This shift against industry arose under the Peña Nieto administration and further intensified under Amlo. For instance, recently an undersecretary for health publicly stated that Coca-Cola was no longer welcome in the southern state of Chiapas, a historic stronghold for the company because of its production facilities in the area and local popularity (pers. comm., Ana Larrañaga, June 14, 2022). This same undersecretary also recommended (without evidence) that people refrain from drinking sodas during the COVID-19 pandemic to strengthen their immune system (pers. comm., Ana Larrañaga, June 14, 2022). The director general of standards for the Ministry of the Economy (MoE), Alfonso Guati Rojo Sánchez, has expressed his support for regulating food industries (pers. comm., Ana Larrañaga, June 14, 2022), while under Amlo, the MoE has also supported the idea of introducing the new GDA food labels (pers. comm., Ana Larrañaga, June 14, 2022). Indeed, the MoE and the MoH approved the new labels (Montalvo 2020). While in the MoE, Rojo Sánchez worked on reforming the Mexican Standard NOM-SIFI/SSA1–2010, associated with introducing the aforementioned new black octagon nutrition warning labels and forbidding the usage of cartoon characters on packaged foods (Expansion2022). The MoE has been concerned about how the ongoing rise in NCD cases will impact economic sustainability (pers. comm., Ana Larrañaga, June 14, 2022).

A key ingredient of this shift in bureaucratic views was the institutional permeation of nutrition scientists within the SoH. Beginning under the Peña Nieto administration, a coalition of scientists from Mexico's National Institute of Public Health took up important positions within the SoH, while others accepted important political positions within government (pers. comm., Angela Carriedo, June 21, 2022). Furthermore, these individuals were strongly committed to the importance of NCD policies, and they introduced new views that went against industry interests (pers. comm., Angela Carriedo, June 21, 2022).

The national bureaucracy has also repositioned the food industry out of policy advisory groups. In 2019 the Grupo Intersectorial de Salud, Alimentación, Medio Ambiente y Competitividad (Intersectoral Group on Health, Food, Environment and Competitiveness, or GISAMAC) emerged (Elizondo 2020) and appeared to replace the OMENT. In sharp contrast to OMENT, however, ministry leaders have not invited industry representatives onto GISAMAC, which is co-owned and managed by the SoH and the Ministry of Environment (pers. comm., Ana Larrañaga, June 14, 2022). GISAMAC's leadership is fully committed to avoiding any conflict of interest (pers. comm., Ana Larrañaga, June 4, 2012). In fact, a recent article notes that according to Simón Barquera Cervera, who directs the National Institute of Public Health's Center for Research in Nutrition and Health, GISAMAC's recent food guideline recommendations were based on strong scientific information devoid of any conflicts of interest and were not related to the food sector (Poy 2023). In another instance, GISAMAC decided in 2020 against the usage of glyphosate, an herbicide used in crop production, despite industry resistance (Melgoza and Rincón 2021).

Congressional institutions also mattered and further augmented the institutional context and interests in favor of regulatory policies. Under Amlo, the historically dominant political party in the congress and senate, the PRI, lost its majority in both houses and was replaced with Amlo's party, Morena (pers. comm., Ana Larrañaga, June 14, 2022; Ferri 2023). With many congressional representatives lacking previous political experience, Morena party members displayed unity and were obedient to what party leadership wanted (pers. comm., Ana Larrañaga, June 14, 2022). Morena's leader, Representative Mario Martín Delgado Corrillo, urged fellow congressional members to resist industry opposition and to support the new GDA front-of-package labeling policy (pers. comm., Ana Larrañaga, June 14, 2022), which Congress approved in 2019 and which was implemented via regulation NOM-051 the following year (White and Barquera 2020). Many in Congress were in favor of adopting this new label (pers. comm., Angela Carriedo, June 21, 2022), with nearly unanimous support, according to congressional member Carmen Medel Palma of Morena (GPM 2020).

Civil Society

During the 1990s and early 2000s, civil society organizations such as nongovernmental organizations (NGOs) and activist groups had a limited presence around fiscal and regulatory policy making. In large part this reflected the history of political elitism in the health policy-making process, which was driven by political elites rather than civil society (Gómez and Méndez 2021). Civic activism in this arena of good nutrition and awareness about the health implications of soda and ultraprocessed foods gradually began to increase, however, with activists having greater interest in pursuing new regulations and fiscal measures several years before any formal legislation was pursued (pers. comm., Ana Larrañaga, June 14, 2022). Civil society's interests therefore had nothing to do with the broader international and domestic political transformations kindling government interest in policy reform (pers. comm., Ana Larrañaga, June 14, 2022).

Right around the time that the soda tax was seriously being considered, the situation began to change, providing NGOs and activists with the means to further mobilize and voice their concerns. International philanthropic support was critical to this process (James, Lajous, and Reich 2020). For example, by 2012, the Bloomberg Foundation provided a considerable amount of financial support for research supporting the tax, public advocacy, and awareness, which in turn provided credibility to the endeavor (Carriedo Lutzenkirchen 2018; James, Lajous, and Reich 2020). As Carriedo Lutzenkirchen (2018: 117) explains: “This meant that for the first time, the coalition of actors supporting the soda tax was well funded and had wide support of strategic groups and public-interest lobbying firms . . . .” At the same time, in 2012 activist organizations began to adopt lobbying strategies that had been used by industry for several years (Vilar-Compte 2018). Having greater access to resources provided activists and NGOs with the means to pursue their long-held policy interests (pers. comm., Angela Carriedo, June 21, 2022).

Yet a critical component of amplifying the voice and policy influence of activists and NGOs was their increased access to government institutions. In contrast to his presidential predecessor, Amlo's administration has been committed to reaching out to and incorporating activists’ policy views (pers. comm., Ana Larrañaga, June 14, 2022). When it came to introducing the new GDA food labeling laws, activists finally had a seat at the policy making table (pers. comm., Ana Larrañaga, June 14, 2022).

At the same time, in recent years nutrition activists and NGOs have been better organized and have been more vocal about the need to introduce more effective food warning labels. Researchers note that the recent introduction of the black octagon-shaped front-of-package food warning labels also benefited from a context where NGOs, such as La Alianza por la Salud Alimentaria and El Poder del Consumidor, coordinated and provided information campaigns about the importance of effective food warning labels (White and Barquera 2020). These efforts were also facilitated by support from major philanthropists, governments, and international agencies, such as Bloomberg, IDRC Canada, and UNICEF (White and Barquera 2020).

Decreasing Industry Power

The introduction of Mexico's 2014 soda tax marked a substantial political change. Industry's efforts to curtail this endeavor had failed. The government's achievement drew a considerable amount of international support, especially because the tax had been introduced despite strong industry opposition (Fraser 2018). Fraser (2018: 3) captures this achievement nicely: “One outcome of the Mexican sugar tax, then, is that it has raised hopes among critical subjects that legislation could begin to unravel central facets of corporate domination.” Furthermore, subsequent industry efforts to reduce the tax had no influence: “The proposal to reduce the Mexican soda tax ultimately passed in the Chamber of Deputies but failed in the Senate, leaving the original tax policy in place” (Pedroza-Tobias et al. 2021). The introduction of the black octagon front-of-package labels also signaled a decline in industry power and policy influence. For years, food and beverage industries strove to obstruct and delay this initiative, going so far as to use the COVID-19 situation as an excuse not to meet and vote on the matter (GHAI 2020). But this resistance was to no avail. Once again, the government's policy interests eventually prevailed over industry.

Chile

Industry Emergence and Power

Since the introduction of free-market reforms in the 1970s, facilitated by a centralized authoritarian government, Chile has seen an increase in foreign direct investment (FDI). Chile also saw a considerable change toward dietary consumption patterns high in fat intake, with the nutrition transition occurring in fewer than 20 years (Albala and Vío 2000). Chile now joins Mexico, Brazil, and Argentina in having one of the region's highest rates of obesity and type-2 diabetes.

Chilean presidents have also displayed a strong level of support for industry growth. Even under former President Michelle Bachelet (2006–10, 2014–18) of the Socialist Party, the government actively encouraged an increase in FDI (President's Press Office/InvestChile 2016). Bachelet attended international meetings to emphasize opportunities for FDI across several sectors (including food), underscoring how important FDI is for the nation's economic success (President's Press Office/InvestChile 2016). She even led an international launch of InvestChile in France, which is a public agency that promotes greater investment in Chile (President's Press Office/InvestChile 2016). During his first term in office, President Sebastián Piñera (2010–14) of the conservative National Renewal party also supported industry by vetoing proposed food regulations on marketing, sales, and labels (Jacobs 2018).

Contextual and Institutional Change

Efforts by the international community to address NCDs seem to have motivated Chilean health officials to initiate discussions about the importance of NCD legislation, but they did not play an important role in the emergence of specific regulatory policies. Corvalán and colleagues (2013) found that in 2002 a joint WHO/Food and Agriculture Organization expert meeting introducing a call for action in response to NCDs motivated Chilean researchers to work with the Senate to introduce several potential policies in response to obesity and NCDs. There is no evidence, however, that PAHO or other international organizations pressured Chile's government to adopt specific regulatory policies before Chile's landmark 2012 legislation introducing these measures (congressional law 20,606). This law required the introduction of front-of-package food labels for products high in sugar, salt, calories, and saturated fat; regulated the marketing of these products, with a focus on prohibiting their advertisement to those under the age of 14; and prohibited the sale of products exceeding critical nutrients within schools (Dintrans et al. 2020). It was adopted by Congress in 2012 but not enforced until 2016, a delay caused by several years of industry opposition and negotiation (Dintrans et al. 2020). A Chilean researcher that the author interviewed claims that no international agency was involved in the idea of introducing more effective food labels before the law's introduction (pers. comm., anonymous source, August 3, 2022). Nevertheless, later in 2016, PAHO showed support for efforts by Chile and other countries (e.g., Ecuador and Peru) to introduce NCD policies (Gómez 2021; PAHO 2016). Chile's law also adopted the PAHO/WHO policy recommendations on influencing nutritional behavior and food purchasing decisions (FAO and PAHO 2017).

In addition, there was no major domestic economic or political crisis that motivated the government to pursue policy reforms. The political crisis of 2019 (after the 2012 reforms) was prompted by increased transportation ticket prices, escalating to broader social welfare demands, and took many by surprise because the country's previous socioeconomic situation was stable (Mendez, Greer, and McKee 2020).

In Chile, presidential interests in NCD regulatory policies emerged gradually and were not a response to crisis conditions. Despite her commitment to FDI, Bachelet eventually supported policies that went against food industry interests (Jacobs 2020). Why did this occur? First, the president overcame concerns about the political consequences of resisting big business. Initially, it appears that Bachelet's fears of the potential return of the conservative political right and business dominance during her first term in office motivated her not to aggressively pursue policies that went against the business sector's interests (pers. comm., anonymous source, August 3, 2022). It was a time of economic crisis, and her government wanted to avoid additional disagreements in the economic sphere (Ramírez 2014). In this context she removed the idea of introducing an improved “traffic light” food label warning system and proposed an alternative bill suggesting that the MoH determine and label which foods were “high in fat” or “high in calories” (Ramírez 2014). Other scholars believe that Bachelet was interested in regulating the food sector during the initial stages of the 2012 food law and that she supported the bill's ideas while advocating for more exercise and nutrition education in schools (Corválan et al. 2013).

Her successor, conservative President Sebastián Piñera (2010–14), despite showing initial resistance to NCD policies, also eventually supported these measures (Corválan et al. 2013). So many prominent individuals within the MoH and the Senate, as well as academics, were in favor of the proposed regulations that Piñera's potential policy veto would have been an unpopular move (pers. comm., anonymous source, August 3, 2022). Nevertheless, after Bachelet was reelected as president for a second term following Piñera's stint in office, she no longer had any fear of the business sector's political retaliation and the return of the conservative right, and consequently she felt free to pursue additional food regulations (pers. comm., anonymous source, August 3, 2022).

Second, during both of Bachelet's terms in office, the MoH consistently met with her to emphasize the importance of NCD policies and to explain the alternative business arguments against food regulations (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022). During her first term, Bachelet was concerned about the economic implications of the proposed food policies that would regulate labeling and advertising and would impose soda taxes (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022). This consistent dialogue between MoH officials and Bachelet helped to convince her of the need to support regulatory policies (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022). Notably, Bachelet had a medical background as a pediatrician, and she had been the minister of health from 2000 to 2002 under President Ricardo Lagos (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022).

Chile's MoH has for many years also been committed to broader health promotion and education (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022; Salinas and Vio del Rio 2002). During the period when the 2012 proposed regulations were being introduced, the MoH changed its views in favor of increasing the regulation of unhealthy products while underscoring the importance of the social determinants of health (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022). In fact, by the early 2000s, the MoH's National Health Promotion Plan had already highlighted the the regulation of unhealthy products, such as tobacco (Salinas and Vio del Rio 2002). While the 2012 legislation was being formulated, nutrition researchers seeking to prevent obesity and other NCDs underwent a normative shift in views, away from focusing on individual responsibility and toward addressing broader social contexts, such as poverty, education, and infrastructure (pers. comm., anonymous source, August 3, 2022).

The MoH also believed in using taxes (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022). Despite segments of the academic community arguing against these regulatory ideas because of their perceived infringement on individual liberties, and the opposition of other federal agencies, such as the Ministries of the Economy, Agriculture, and Foreign Affairs, as a result of their concerns about the regulations’ impact on the economy and international relations (Dintrans et al. 2020), all tiers of the MoH's leadership supported the need to pursue policy regulations and taxes (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022).

Within the Congress, increased information, awareness, and charismatic leaders espousing human rights views appeared to play an important role in transforming congressional interests and increasing support for food regulations, rather than political party unity in favor of policy reform (as seen in Mexico). With respect to political party interests, initially there were divisions between the conservative Senate that supported industry versus more leftist groups that proposed new regulatory ideas (pers. comm., anonymous source, 2022); furthermore, there were initial divisions that occurred within the Congress, although there were more congressional members in support of food regulations than opposed to them (ONUAA/OPS 2017).

While there were those in Congress who argued against the proposed regulations on advertising and food labeling, MoH officials periodically visited and provided information to these skeptics (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022). Influential senatorial leaders, such as Senator Guido Girardi, were vital to emphasizing the importance of these regulatory measures. Girardi ardently believed in access to good nutrition and food and knowing about the nutritional content of food as a human right (Girardi n.d.). A medical doctor by training, Girardi increased the Senate's awareness of the importance of these regulatory policies and organized public demonstrations to alert the public to the same information (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022). Indeed, in public he even referred to major food companies as “21st-century pedophiles” and demonstrated in front of the presidential palace with placards accusing the Sebastián Piñera government of harming the public's health by vetoing earlier versions of the food regulations (Jacobs 2018). As president of the Senate in 2011–12, Girardi was in a strong position to build consensus for the 2012 law's adoption. His efforts therefore underscored the critical role that a policy entrepreneur with strong normative beliefs can play in raising awareness and strengthening regulatory interests that had already emerged within the MoH.

Civil Society

There were no activist groups or NGOs working on nutritional food and beverage issues before the formulation of the 2012 policy measures (pers. comm., anonymous source, August 3, 2022). This finding corroborates other scholars’ views that civil society did not play an important role in several of the policies implemented since 2014 (Corválan and Reyes 2016). Instead, during the policy formulation process, MoH officials mainly worked directly with families, teachers, and schools (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022). There were no public debates (pers. comm., anonymous source, August 3, 2022). Rather, there were activists, such as Cecila Castillo, from a Chilean consumer organization, who worked with Senator Girardi on promoting the first draft of the 2012 regulatory bills (pers. comm., anonymous source, August 3, 2022).

Today there is greater awareness in Chile about good nutrition in society, and activist networks and groups are starting to emerge (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022). Their delayed emergence in large part reflects the history of Chilean military authoritarianism during the 1960s and 1970s, when social movements were suppressed, and the ongoing difficulty of creating social movements from scratch (pers. comm., Lorena Rodriguez-Osiac, September 29, 2022). At the same time, however, major industries have collectively responded to the new regulations by creating the Food and Drinks Chile coalition, requesting meetings with MoH officials, using the press, and launching a campaign in December 2016 with famous sports personalities ridiculing these policies (pers. comm., anonymous source, August 3, 2022; see also Vega 2018). Also known as AB Chile, this coalition represents major companies such as Coca Cola, Nestlé, Evercrisp, and Bimbo, and was led by Rodrigo Álvarez, former undersecretary of finance and the minister of energy under the Sebastián Piñera administration (Vega 2018).

Decreasing Industry Power

In Chile, eventually the major soda and ultraprocessed food industries lost their battle against increased government regulation. Over time their political power and especially their policy-making power substantially declined, as evidenced by the introduction of several fiscal and regulatory policies and the enactment of a restrictive law. This reflects gradually changing social norms and acceptance of a regulatory state intervening on behalf of the general public (pers. comm., anonymous source, August 3, 2022).

Brazil

Industry Emergence and Power

Brazil joined her Latin American counterparts in experiencing a sharp increase in FDI from the beverage and ultraprocessed food sectors. In the 1990s, FDI and domestic investment in these sectors grew considerably, coupled with the emergence of fast-food restaurants (Farina and Viegas 2003; Gómez 2023). This period also saw the emergence of a nutrition transition, with the country moving away from traditional food staples and relying more on ultraprocessed foods. Middle-class and poor people were particularly affected by this situation, seeing themselves in an improved financial position as a result of increased employment, welfare programs, and greater access to fast food (Phillips 2016).

Beginning with the conservative presidential administration of Fernando Collor de Mello (1990–92), these industries also found a hospitable political environment. Mello began to accelerate preexisting efforts to privatize industries and was the first Brazilian president to encourage the foreign purchase of public enterprises (Arraes 2010). Despite a slowdown in privatization under the following administration of President Itamar Franco (1992–94), it was under the Fernando H. Cardoso administration (1994–2002) that privatization efforts restarted, and the economy became more open for investment (Arraes 2010).

Even under the more leftist democratic presidency of Luiz Inácio Lula da Silva (2002–10) of the Workers' Party, major industries found a favorable political environment. Lula viewed major food companies, such as Nestlé, as important partners in not only providing jobs but also tackling hunger, undernutrition, and unemployment (Gómez 2023). The subsequent conservative presidential administrations of Michel Temer (2016–18) and Jair Bolsonaro (2018–22) have also been supportive of the business sector, with the latter prioritizing economic opening and growth amid the COVID-19 pandemic.

Contextual and Institutional Change

By the early 2000s, Brazil was subject to increased international attention and pressure to introduce policies in response to rising obesity cases. The international community and media highlighted this worsening situation, and the government was generally concerned about its reputation for being an overweight and unhealthy nation—especially in light of the 2016 Olympics, which Brazil hosted (Gómez 2018). In 2012, at a conference in Mexico City, representatives from Mexican, Brazilian, and Chilean university institutions, in collaboration with PAHO, met and agreed to the importance of implementing interventions and policies within schools while emphasizing that government authorities need to defend the human right to health, healthy food, and information, and to use the law and policy to achieve these ends (Gómez 2021; Jacoby et al. 2013).

However, this shifting international context does not appear to have had an impact on presidential interest in and commitment to introducing policies regulating soda and ultraprocessed food. Since 2001, these industries have had a considerable amount of influence over presidential views and interests related to these policies (pers. comm., Renato Godoy, August 19, 2022; Bächtold 2018; Mathias 2022b). Under the Lula administration, there was presidential support for policies on improving children's nutrition and regulating the food sector through a presidential advisory council, the Conselho Nacional de Segurança Alimentar e Nutricional (National Council for Food and Nutrition Security, or CONSEA).

But Lula never showed any interest in aggressively regulating the soda and ultraprocessed food industry (pers. comm., Marcello Baird, September 29, 2022). Furthermore, Lula's presidential successor from the leftist Workers' Party, Dilma Rousseff, also expressed no interest in pursuing these kinds of regulations (pers. comm., Marcello Baird, September 29, 2022). After her election to office, Rousseff was accused of appointing a former attorney for the food industry as head of the federal Agência Nacional de Vigilância Sanitária (Brazilian Health Regulatory Agency, or ANVISA), appearing to fulfill a campaign promise to “clean house” within ANVISA after receiving extensive complaints from the food industry (Marcello Fragano Baird, quoted in Jacobs and Richtel 2017; Gómez 2023). An activist interviewed by the author claimed that Lula's and Rousseff's need for broad-based governability motivated them to work with industry because they needed these major political players on their side (pers. comm., Renato Godoy, August 19, 2022).

Under the conservative administration of Jair Bolsonaro (2018–22), this ongoing lack of interest in pursuing industry regulations continued (pers. comm., Marcello Baird, September 29, 2022), an apathy that persisted even in the run-up to the 2022 presidential elections, when Bolsonaro's campaign (and others) failed to respond to survey questions from the investigative news outlet O Joio e o Trigo asking if they would pursue regulations like those seen in other Latin American countries if they were elected (Mathias 2022a). Furthermore, neither President Lula (first term) nor President Bolsonaro proposed the idea of introducing new soda taxes. In May 2022 the Senate Committee on Social Affairs succeeded for the first time in introducing a bill in support of a tax on sugary beverages, their marketing and imports, but it has not received any additional support, hampered by industry lobbying and resistance from other committees (Mathias 2022b). The federal government had previously introduced a tax on these manufactured beverages through the Tax on Manufactured Products, but after 2016, it sought to reduce the tax on several of them (Bridge, Groisman, and Bedi 2022). And yet, the government has not moved on this critical issue despite other governments in the region, such as Mexico and Chile, recently introducing these taxes. Under the recent conservative administrations of Temer and Bolsonaro, the focus instead was on the economy and safeguarding business interests, rather than pursuing new regulatory policies going against industries’ preferences.

Importantly, in fall 2023 the House of Representatives approved an initially proposed amendment to the constitution (PEC 45/2019), Constitutional Amendment 132/2023 (Bonfanti and Graner 2024), which reforms the government's tax structure and includes a new tax, the “Selective Tax” (a.k.a. “sin tax”), on the production, marketing, and import of unhealthy products, such as tobacco and alcohol, with the possibility of being applied to high-sugar food and beverage products (Fernandes 2023). The selective tax is focused on products harmful to health and the environment and is intended to regulate the market and punish the consumption of these products rather than to collect revenue (Máximo 2023). The tax reform appears to have started under the previous Bolsonaro administration, based on a fiscal model designed by the Ministry of Finance, with the participation of consultants (Bifano 2023).

At the bureaucratic level, interest in and commitment to pursuing industry regulations have been varied. The minister leading the MoH—a politically appointed individual, and arguably the most powerful agenda-setting actor within the ministry—has been repeatedly reluctant to publicly critique and confront industries, preferring instead to allow smaller MoH agency subdivisions and ANVISA to do this (pers. comm., Marcello Baird, September 28, 2022). These presidentially appointed ministers have been afraid to confront industry because they rely on industry for political support (pers. comm., Marcello Baird, September 28, 2022). However, mid-level MoH officials have been committed to pursuing regulations and have built supportive civil societal coalitions; nevertheless, they often faced resistance from other coalitions supporting industry (pers. comm., Renato Godoy, August 19, 2022). These midlevel officials have operated within small MoH agency subdivisions, such as the Coordenação Geral de Alimentação e Nutrição (General Coordination Office for Food and Nutrition Policy), but on their own they have not had enough influence (pers. comm., Marcello Baird, September 29, 2022). Despite this, these midlevel officials have worked behind the scenes with larger agencies, such as ANVISA (pers. comm., Marcello Baird, September 29, 2022). ANVISA officials have also consistently been supportive of industry regulations (Mathias 2022b).

In fact, since 2005, ANVISA has emerged as a global pioneer in labeling ultraprocessed foods as harmful (pers. comm., Marcello Baird, September 29, 2022). Beginning in 2014, ANVISA also became fully committed to regulating advertisements on food packages through front-of-package warning labels for products that are high in sugar, saturated fats, and sodium, which was eventually approved in 2020 (pers. comm., Marcello Baird, September 29, 2022; GHAI 2020). This new regulation, RDC 429/2020, became effective on October 9, 2022 (GHAI 2020). Manufacturers had a grace period of three years to comply with this ruling (Ingredients Network 2024). In September 2023 ANVISA introduced RDC 819/2023 as an amendment to RDC 429/2020, which mandated that companies had until October 8, 2023, to purchase foods with the old labels, with a deadline of October 9, 2024, to use the entire stock (BMH 2023). However, beginning on October 9, 2023, 819/2023 required that any new products purchased must have the improved front-of-package labels as stipulated in RDC 429/2020 (BMH 2023).

Nevertheless, in 2024 an NGO called the Instituto de Defesa de Consumidores (Institute of Consumer Protection, or IDEC) sued ANVISA in federal court in São Paulo for granting the RDC 819/2023 extension until 2024 (Ingredients Network 2024). IDEC claimed that ANVISA's decision was not based on independent scientific evidence but on biased information provided by industry sources (Ingredients Network 2024). The São Paulo federal court ruled in support of IDEC's complaint and issued an injunction on RDC 819/2023 (Ingredients Network 2024; JFSJSP 2024). ANVISA's senior lawyer, Leonardo Pillon, criticized the agency for giving in to industry's interests and thereby harming ANVISA's reputation (Ingredients Network 2024).

Within Congress, lawmakers’ interest in food regulations also gradually emerged, although few concrete legal actions have been taken. In recent years, analysts note that congressional members have become increasingly aware of and interested in addressing food regulations (pers. comm., Marcello Baird, September 29, 2022), with senatorial members pursuing new tax initiatives (Mathias 2022b). This is reflected in several congressional bills that have been proposed to discourage the consumption of these products, such as the 2017 soda tax bill (no. 8541), introduced by Congressman Paulo Teixeira (pers. comm., Marcello Baird, September 29, 2022; ACT Promoção da Saúde 2023). In May 2022, a social affairs subcommittee of the Senate supported a proposed bill to create a tax on sugary beverages (pers. comm., Marcello Baird, September 29, 2022; Mathias 2022b). Activists have consistently met with congressional leaders to provide information, promote bills, and organize seminars, which, in turn, has helped place obesity and food regulations on the national agenda (pers. comm., Renato Godoy, August 19, 2022).

Despite these recent initiatives, however, Congress has yet to pass these bills into law, such as regulations limiting advertising to children (pers. comm., Renato Godoy, August 19, 2022) and specific federal laws on the marketing of unhealthy food and beverage products (Barbosa, Leite, and Brito 2022). Several commissions in the Senate and the Chamber of Deputies reviewed bills on marketing regulations but never approved them (Renator Godoy, pers. comm., August 19, 2022), with legal researchers finding the same problem (Barbosa, Leite, and Brito 2022). While a strong consumer code on marketing exists (Renato Godoy, pers. comm., August 19, 2022), it is not effectively enforced (Gómez 2023), while the code's broad applicability may provide leeway for judicial decision makers and space where different types of judicial decisions over alleged code violations may emerge (Barbosa, Leite, and Brito 2022). These limitations largely reflect the incessant power and influence of food industry lobbyists (pers. comm., Renato Godoy, August 19, 2022).

Civil Society

Since the transition back to democracy in the late 1980s, families and activists have been committed to raising attention to the importance of good nutrition and food as a human right. In the specific area of soda and ultraprocessed food regulations, however, civic interests and NGO efforts were small and slow to develop. Nearly 20 years ago, there appeared to be only two NGOs that worked on this issue: IDEC and the Instituto Alana (pers. comm., Marcello Baird, September 29, 2022). IDEC was small and underfunded, and its work on food regulations was minimal (pers. comm., Marcello Baird, September 29, 2022). Nevertheless, these two NGOs were the key leaders in pushing for ANVISA's regulation of food advertisements (pers. comm., Marcello Baird, September 29, 2022). However, with increased international attention and mandates with respect to ultraprocessed food regulations, activists’ interest in this issue increased, as did the number and size of NGOs working on this topic (pers. comm., Marcello Baird, September 29, 2022). A rise in university research addressing the politics of the food industry also aided in the growth of the activist community (pers. comm., Renato Godoy, August 19, 2022). Over the years, IDEC has grown substantially, with its food policy program now being the largest of its advocacy programs (pers. comm., Marcello Baird, September 29, 2022); moreover, ACT Promoção da Saúde's food program is now larger than its prestigious tobacco program (pers. comm., Marcello Baird, September 29, 2022). Other influential NGOs have emerged focusing on food regulations, such as the Instituto Desiderata (pers. comm., Marcello Baird, September 29, 2022). All throughout, domestic and international donor assistance has been provided to these organizations, including the Instituto Alana and IDEC (pers. comm., Renato Godoy, August 19, 2022). The Bloomberg Foundation is also funding ACT Promoção da Saúde and other organizations (pers. comm., Marcello Baird, September 29, 2022).

However, for several reasons the power and influence of the activist community has been limited. First, there have been no federal political and/or bureaucratic institutions that activists can consistently rely on to voice their concerns and have policy influence (Gómez 2021; Zocchio 2019). While activists have had access to congressional committees (pers. comm., Renato Godoy, August 19, 2022) and have helped shape national agenda-setting processes—with IDEC also playing an important role since 2014 in working with ANVISA through its working groups to identify problems with existing food labels and working with researchers from the Federal University of Paraná during this process to propose improved labels (IDEC 2022)—activists have not had regular and consistent access to other influential policy making committees operating within the executive branch, such as in the office of the presidency. Indeed, the one committee that activists had access to for several years within the office of the presidency, CONSEA, was closed under the previous administration of Jair Bolsonaro (2018–22) (pers. comm., Renato Godoy, August 19, 2022; Zocchio 2019). In the past, CONSEA was instrumental helping the Lula and Rousseff presidential administrations create their national food security and nutrition policies. However, shortly after his reelection in 2023, Lula reinstated CONSEA, giving hope that these policies will be a priority and that civil society will have influence. Even though activists have access to congressional institutions, their efforts to create federal laws have been repeatedly undermined as a result of the presence of powerful lobbying tactics and supportive congressional members. This context has made it nearly impossible for the activist community to work with other reformers within government to overcome industry's ongoing power and influence.

Ongoing Industry Power

Despite efforts to introduce fiscal and regulatory policies, the soda and ultraprocessed food industries in Brazil remain well organized and powerful (pers. comm., Marcello Baird, September 29, 2022; pers. comm., Renato Godoy, August 19, 2022; Rede Brasil Atual 2022). These industries have been repeatedly successful in undermining the proposed introduction of congressional regulatory laws through their lobbying efforts (pers. comm., Marcello Baird, September 29, 2022; see also Baird 2015). Nevertheless, as the activist community grows, and as more interest and debate surface among them as well as in social media and within congressional halls, industries will have a difficult time undermining future regulatory policy (pers. comm., Marcello Baird, September 29, 2022). Some activists also believe that Brazil is going through a deindustrialization phase and that because of this, there is a chance that industry's policy influence, especially with respect to taxes, will decrease (pers. comm., Renato Godoy, August 19, 2022). With the return of the Lula administration, it is possible that industry power will decline and Brazil will embrace new policies to regulate the food and beverage industry.

Conclusion

Recent research on corporate political activity and the commercial determinants of health has provided little insight into the political, institutional, and social contexts that can contribute to a decline in major food and beverage industry power and policy influence. As this article shows, even in emerging middle-income countries, where historically these industries have been very influential (Gómez 2023), at times governments can overcome industries’ power and influence. This occurs when there is a simultaneous alignment of interests and commitment to pursuing fiscal and regulatory policy reform. As we saw in Mexico and Chile, policy makers’ simultaneous interests derive from fiscal (taxation) and health concerns (seen mainly at the presidential and bureaucratic levels) and normative human rights beliefs within legislative bodies.

Therefore, with respect to fiscal and regulatory policy responses to the food and beverage sector, there have recently been considerable differences in corporate power and policy influence among the three countries discussed in this article. Over time, Mexico and Chile saw a decline in these sectors’ ability to thwart the implementation of policy. Despite efforts to obstruct the policy-making process, presidents and health officials in these countries succeeded in implementing their preferred fiscal and regulatory policies. In contrast, as a result of aggressive lobbying practices and in the absence of presidential commitment, Brazil has seen the ongoing influence of industries obstructing these fiscal and regulatory policies. Although improved food labels were introduced, a sign of Brazil's progress in this area, they were substantially delayed.

However, it is important to note that industries in these countries have remained influential in other policy areas. Business leaders have been able to influence policy in their favor with respect to natural gas pipelines (re: Mexico, see Graham 2019), COVID-19 (re: Chile, García-Montoya and Manzi 2023), and Indigenous and environmental issues (re: Brazil, see Al Jazeera 2023).

Moreover, while scholars have emphasized the importance of individual agencies’ and policy makers’ perceptions of business retaliation in response to proposed regulatory policies (Fairfield 2015), the cases of Mexico and Chile suggest that policy makers do not have to believe that retaliatory threats will be weak in order to pursue reform. Instead, policy maker convictions and interests, fueled through concomitant fiscal and health concerns, changing political contexts, new epidemiological information, and normative beliefs can be sufficient to motivate them to resist industry preferences and pursue regulations. Furthermore, these case studies revealed that major economic crisis and the government's decision to recentralize policy authority (Pierson and Hacker 2002) is not necessary for a decline in industry power and policy influence. In fact, as seen in Mexico and Chile, this outcome can emerge during stable economic times, when policy maker interest and commitment to reform is strong.

Institutions also matter and can aid the emergence of these interests and the pursuit of reform. As seen in Mexico, institutional permeation processes, where nutrition researchers assume important policy positions within government, can facilitate the creation of a unified regulatory policy coalition. While this finding confirms others claiming that institutional permeation processes facilitate gradual health policy reform (Falleti 2009), the case of Mexico further reveals that permeation can also serve to reinforce government convictions to pursue controversial regulatory policies.

The case of Chile also reveals that well-organized, proactive civil societal pressures are not necessary for reducing industry's power and policy influence, as other scholars contend (Fairfield 2015). In Chile, in the absence of a strong social movement demanding soda taxes and regulations on food sales, advertising, and labeling, there was sufficient presidential and bureaucratic elite interest and commitment to adopting these policies. While the case of Mexico suggests that civil society is important for helping set the policy agenda, eventually it was President Amlo and congressional members who provided the venue through which civil society could have this influence. Furthermore, international pressures played no role in motivating policy makers in Mexico and Chile to pursue reform. These case studies therefore suggest that centralizing policy-making powers away from big business is a product of presidential, congressional, and bureaucratic elite interests rather than pressures from above (international) or from below (civil society).

That said, a key lesson that emerges from Mexico and Chile is that overcoming industry's power and influence requires a whole-of-government interest and commitment to reform. That is, there need to be simultaneous presidential, bureaucratic, and congressional interest and support for pursuing fiscal and regulatory policies confronting industry opposition. In contrast, as seen in Brazil, when particular segments of the government are alone and do not have broader support in seeking soda taxes and regulatory policies, these policies will not be aggressively pursued. Big business will have the ability to remain influential.

Finally, more research needs to be done on understanding whether policy-maker interest in and commitment to regulatory reforms is sustained, or whether this reversal of fortune for the food and beverage industries is itself reversed over time. This is especially the case in countries such as Mexico where there is no presidential reelection and where, consequently, government interests can radically change with the arrival of new presidential administrations. While some governments have succeeded in overcoming businesses’ power and influence, their pursuit of the public's health is not destined to endure.

Acknowledgments

The author wishes to thank the editor and two anonymous reviewers who provided excellent comments and suggestions during manuscript revisions.

Notes

References