[Answered] Examine Front-of-Package Labelling (FoPL) as an instrument of public health governance. Evaluate the challenges in transitioning from ‘star ratings’ to mandatory ‘warning labels’ to safeguard consumer rights and address India’s rising non-communicable disease burden.”

Introduction

With non-communicable diseases causing nearly 65% of deaths in India (WHO), and the ICMR-INDIAB 2023 study estimating 101 million diabetics, Front-of-Package Labelling (FoPL) emerges as a preventive public health governance tool.

FoPL as an Instrument of Public Health Governance

1. Constitutional and Rights-Based Framework: The Supreme Court’s recent directions to the Food Safety and Standards Authority of India (FSSAI) strengthen the interpretation of the Right to Health under Article 21. In Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996), health was recognized as integral to the right to life. FoPL thus becomes a regulatory instrument enabling informed consumer choice, linking food governance to constitutional morality.
2. Behavioural Economics and “Nudge Theory”: Traditional back-of-pack nutrition tables suffer from information asymmetry and cognitive overload. FoPL simplifies decision-making through visual cues. Drawing from Richard Thaler’s nudge theory, warning labels act as behavioural correctives. Global evidence supports this:

• Chile’s black octagonal warning labels reduced sugary drink purchases by nearly 24% (University of North Carolina study).
• Mexico and Israel have adopted similar High in Fat, Sugar, Salt (HFSS) warning systems.
• Such labels directly communicate health risks rather than offering ambiguous health halos.

3. India’s Double Burden of Malnutrition: India faces a dual nutrition crisis: Persistent undernutrition (NFHS-5 shows 35.5% stunting). Rising obesity and metabolic disorders. The 2023 ICMR data indicates: 35.5% hypertension prevalence, 39.5% abdominal obesity and 24% high cholesterol. Ultra-processed foods rich in sugar, salt, and saturated fats accelerate this epidemiological transition. FoPL integrates into a preventive continuum of care, reducing long-term healthcare expenditure on dialysis, insulin, and cardiovascular treatment.

Star Ratings vs Warning Labels: The Governance Debate

1. Indian Nutrition Rating (INR) – The “Summary Score” Model: FSSAI proposed an Indian Nutrition Rating (0.5 to 5 stars). However: Positive ingredients (nuts, fibre) may offset high sugar/sodium levels. Consumers may misinterpret 3-star products as “healthy.” Risk of health halo effect, where processed snacks appear nutritionally acceptable. This approach mirrors Australia’s Health Star Rating, which faced criticism for inconsistencies.
2. Mandatory Warning Labels – The “Risk Disclosure” Model: Warning labels adopt a precautionary principle: Direct black symbols stating “High in Sugar” or “High in Sodium.” Simple, binary communication and Effective in low-literacy contexts. India’s successful green/red vegetarian symbol demonstrates the effectiveness of visual regulatory cues.

Challenges in Transitioning to Warning Labels

1. Industry Resistance and Regulatory Capture: Food conglomerates argue warning labels create a “fear factor,” affecting sales and requiring costly reformulation. There is risk of regulatory capture, where economic lobbying dilutes public health objectives.
2. Defining HFSS Thresholds: Setting scientific cut-offs for “high” sugar or sodium requires alignment with WHO standards. Industry lobbies often push for lenient thresholds, creating normative ambiguity.
3. Federal and Implementation Complexity: Food regulation operates under a shared constitutional space (Entry 18, Concurrent List). Uniform implementation across States and MSMEs demands capacity building and transition timelines.

Way Forward

1. Align thresholds with WHO and Codex Alimentarius guidelines.
2. Phase-wise implementation to support MSMEs.
3. Integrate FoPL with the Eat Right India campaign.
4. Strengthen surveillance and enforcement mechanisms.

5. Warning labels must be supplemented by mass awareness campaigns. Without public education, labels may fail to shift entrenched dietary habits.
6. FoPL should evolve from voluntary disclosure to mandatory public health intervention.

Conclusion

As President A.P.J. Abdul Kalam emphasised in Indomitable Spirit, prevention is the foundation of national health; FoPL represents governance that protects citizens before disease overwhelms both families and the State.