Combining traditional ‘command and control’ instruments with nudging will help prevent the rise of chronic diseases

The best way to tackle the rise of chronic diseases and the challenges they pose to health systems worldwide is that authorities make use of a regulatory mix, according to Alberto Alemanno, professor of law at French business school HEC Paris, and global clinical professor at NYU School of Law, NY, USA. What are also known as non-communicable diseases (NCD) can therefore be tackled by applying a set of different policy interventions ranging from more traditional ‘command and control’ instruments–such as taxation, restrictions and banning, all the way to education-based approaches–to more innovative and unconventional approaches, such as nudging, a field in which Alemanno has a particular expertise.

Nudges are forms of intervention that can “steer the opinion of our citizens by changing the environment of choice but not limiting the freedom to choose,” as Alemanno puts it. A good example of it is reducing the size of dishes or relying on peer pressure. This means subtly inducing a choice for citizens. Indeed, neither of the two strategies cited, really restrains individuals’ freedom, be it to eat more food or to go less to the gym. Yet, “these are interventions that empower the consumers”, notes Alemanno.

NCDs are rising in every country but the “good news”, Alemanno says, is that they are preventable by adopting healthy habits. He believes authorities should encourage them by wisely combining different regulatory approaches. For example, “tobacco control has been one good example of combining different policy interventions”, says Alemanno. By means of taxation, product presentation, warnings, information schemes on tobacco, it has been possible to finally “change the social norm, the acceptance of the product in society”.

Regulators can also rely on labelling, a system “deferential to [the] market,” as Alemanno puts it. But this relies on the assumption that the consumer will read and understand the label, and that it will act in consequence. “But researches show that this is not true,, he warns. However, labelling might have a more subtle positive effect: “it might lead manufacturers to reformulate their products,” as was the case with some food whose improved health benefits can be used for promotional activities.

Finally, Alemanno thinks that one way to convince policy makers of the strategic importance of regulating chronic diseases is by “making an economic case,” meaning mentioning the enormous financial impact that chronic diseases will have on national incomes. This will make it easier for health ministers “to be heard or at least speak the same language as most of the governments today”.

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Featured image credit: Alberto Alemanno