A framework convention on obesity control?

1 Tuomilehto J, Lindström J, Eriksson JG, et al, for the Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343–50. 2 Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393–403. 3 Umpierre D, Ribeiro PA, Kramer CK, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA 2011; 305: 1790–99. 4 Bravata DM, Smith-Spangler C, Sundaram V, et al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA 2007; 298: 2296–304. 5 Church TS, Blair SN, Cocreham S, et al. Eff ects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial. JAMA 2010; 304: 2253–62. The legalisation of global health issues otherwise left in the political domain has the additional disadvantages of prioritising process over outcomes, consensus over diversity, generality over specifi city, states over non-state actors, and lawyers over health researchers. International law is often vague on specifi c commitments, slow to be implemented, hard to enforce, and diffi cult to update. It constrains future decision-making and crowds out alternative ap proaches. Confusing patchworks of issue-specifi c laws might also deepen challenges in global governance for health. Non-binding “soft laws” such as WHO’s codes on breastmilk and health worker migration could have similar eff ects, fewer costs, stronger language, and greater coverage. Before embarking on new solitary initiatives, research is needed on the full range of legal and other normative approaches and on how they can be integrated with existing mechanisms to avoid the proliferation of new governance platforms.