Earlier this year, the Lancet Commission on Obesity called for “a radical rethink of business models, food systems, civil society involvement, and national and international governance” to address the interlinked crises of obesity, undernutrition, and climate change. We agree, and suggest that international human rights law, institutions and mechanisms provide important opportunities for norm setting, advocacy and accountability which are currently underutilised.

We welcome calls for exploration of international agreements on global health—including to promote healthy diets and regulate harmful products, including alcohol. However, opportunities already exist to transform food systems and create healthier food environments by clarifying existing international obligations to progressively realize the right to food and the right to health. Authoritative and evidence-based guidance is available on effective measures to tackle these challenges. For example, in this UN Decade of Action on Nutrition (2016-2025), a UN Panel of Experts recommended State actions to address malnutrition in all its forms. Yet these recommendations are often resisted by industry, and governments remain insufficiently accountable for their implementation.

The global AIDS response demonstrated the power of a human rights approach. The United Nations “International Guidelines on HIV/AIDS and Human Rights” have been highly influential in developing a global consensus on the need for human rights and evidence-based approaches to the HIV epidemic. The Guidelines informed the language of resolutions of the UN General Assembly and its Human Rights Council. The Guidelines’ impact continues to be visible through initiatives such as the reports of the Global Commission on HIV and the Law and strengthened health systems far beyond HIV. Human rights norms can drive action: with HIV they contributed to more affordable medicines, an unprecedented increase in people on treatment, less stigmatizing health services, the empowerment of marginalized groups, and the institutionalization of norms, including “no one left behind.” We acknowledge differences between the obesity and food systems communities and the more cohesive AIDS movement. We recognise the impact of human rights on other global responses, such as tobacco control and reproductive health.

We commend the leadership of the High Commissioner for Human Rights, Michelle Bachelet, and the Director-General of the World Health Organization, Tedros Ghebreyesus, for their commitment to a human rights approach to global health, and call on them to initiate an inclusive process to develop guidelines on human rights, healthy diets and sustainable food systems. This could include convening a committee of human rights, public health, food systems and nutrition experts, States, UN entities such as UNDP and FAO, and civil society organizations, similar to the committee which developed the HIV Guidelines now championed by UNAIDS and OHCHR.

The proposed guidelines could be tabled at the Human Rights Council and the World Health Assembly, inform the development of general comments and recommendations by relevant human rights treaty bodies, and inform monitoring of States’ actions through the Universal Periodic Review.

As we approach the midpoint in the UN Decade on Nutrition, the status quo is untenable and bold actions are needed. Market forces, alone, are failing to deliver healthy diets and sustainable food systems. Human rights guidelines can help mobilize multisectoral action, strengthen State and private sector accountability, and deepen community engagement in the urgent task of achieving the relevant Sustainable Development Goal targets in Agenda 2030. We have identified possible areas of focus for the guidelines as well as key steps in the process of developing guidelines, and potential impacts. One hundred and eighty experts in 38 countries from all regions of the world are signatories to this call for international guidelines.

Kent Buse, PhD, Chief, Strategic Policy Directions, UNAIDS, Geneva, Switzerland.

David Patterson, LLM, Global Health Law Groningen Research Centre, Faculty of Law, University of Groningen, Netherlands.

Roger Magnusson, PhD, Professor of Health Law and Governance, Sydney Law School, University of Sydney, Sydney, Australia.

Brigit Toebes, PhD, Professor, Health Law in a Global Context, Global Health Law Groningen Research Centre, Faculty of Law, University of Groningen, Netherlands.

Competing interests: None declared