Portuguese Interministerial Strategy for the Promotion of Healthy Eating Based on ‘Health in All Policies’

Key Contextual Factors

• The Ministry of Health plans, regulates, coordinates and supervises all health promotion activities, including food and nutrition programmes. However, other important areas on food and nutrition fall under the scope of other ministries.
• EIPAS was published as a law by Order no. 11,418/2017 of December 29, 2017.
• Seven different ministries integrated the working group that elaborated the EIPAS, namely Finance, Internal Affairs, Education, Health, Economy, Agriculture, and Sea ministries. The Ministry of Health led the working group and is responsible for the follow-up and monitoring of the implementation process.
• EIPAS includes several measures to promote a more equitable food system.

Key Components/Steps

• On September 15, 2016, the Portuguese Council of Ministers, through the Deliberation of the Council of Ministers no. 334/2016, determined the creation of an interministerial working group on the promotion of healthy eating.
• This working group was created to elaborate the EIPAS, gathering contributions and commitment from all Ministries with responsibilities in the area of nutrition.
• The working group, led by the Ministry of Health, developed this strategy for over a year.
• Following 6 months of work since the first meeting of this working group (5 December 2016), the first draft of the strategy was sent to the Government.
• The framework produced was based on WHO and European Commission recommendations as well as on relevant data from the last Portuguese dietary intake survey (2015/2016).
• EIPAS also reflects the results of a public hearing, including the food industry, among others, and the experience gathered, since 2012, through the National Programme for the Promotion of Healthy Eating.
• Following strategy approval by the Portuguese Government, a public consultation was launched (August 2017) in order to collect the views of all interested parties.
• Following the suggestions and recommendations obtained through the public consultation, the strategy was revised by the working group and, in October 2017, the final proposal was sent to the Government.
• After 1 year of work, EIPAS was published as a law by Order n.° 11,418/2017 of December 29, 2017.
• The EIPAS working group is responsible for monitoring the implementation progress of this strategy and for delivering biannual reports to the Portuguese Government. All the actions implemented under the EIPAS scope should include an impact assessment.

Main Impacts / Added Value

• For the first time, Portugal has a nutrition policy based on the WHO concept of ‘health in all policies’. Several actions have already been implemented, including (1) the definition of standards for food availability at public settings; (2) the implementation of a sugar tax on sweetened beverages; (3) improvement of the nutritional quality of the national food aid programme for low-income groups; (4) implementation of a voluntary agreement with the food industry sector for food reformulation; and (5) regulation of marketing of unhealthy foods to children.

Lessons Learned

• Key success factors in the implementation of this policy were the intersectorial collaboration and the commitment from seven different ministries.
• The challenge of creating a real intersectorial programme was overcome by identifying interventions that have the capability to combine the interest of several ministries and identify economic and social gains that can be obtained with investments on prevention and promotion of healthy eating.
• For example, the promotion of the Mediterranean diet, which is widely represented along the 51 actions of EIPAS, is a transversal area of work that can aggregate the interest of almost all government sectors.

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