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Introduction. The use of corporate power to undermine public health policy processes is increasingly well understood; however, relatively little scholarship examines how advocates can leverage power to promote successful health policy decisions. The objective of this paper is to explore how advocates leveraged three forms of power – structural, instrumental and discursive – to promote the successful passage of the Promotion of Healthy Eating Law (Ley 27,642) in Argentina, one of the most comprehensive policies to introduce mandatory front-of-package (FOP) warning labels and regulate the marketing and sales of ultra-processed foods (UPFs) adopted to date.
Methods. We conducted seventeen semi-structured interviews with advocates from different sectors, including civil society, international agencies, and government. Both data collection and analysis were guided by Milsom’s conceptual framework for analyzing power in public health policymaking, and the data was analyzed using hybrid deductive and inductive thematic analysis.
Results. Advocates harnessed structural power through informal networks and formal coalitions, enabling them to convene discussion spaces with decision-makers, make strategic use of limited resources, and cultivate the diverse expertise (e.g., research, nutrition science, advocacy, law, political science, activism and communications) needed to support the law through different phases of the policy process. Advocates wielded instrumental power through amassing an armada of localized evidence to promote robust policy design, conducting targeted advocacy, and exposing conflicts of interest to harness public pressure. Adopting a rights-based discourse, including of children and adolescents and of consumers to transparent information, enabled advocates to foster a favorable perception of the law amongst both decision-makers and the public. Key contextual enablers of success include a political window of opportunity, the COVID-19 pandemic, securing of international funding for advocacy purposes, and the ability to learn from the regional precedent of similar policies.
Conclusions. Public health policymaking, particularly when encroaching upon corporate interests, is characterized by stark imbalances of power that hinder successful policy decisions. The strategies identified in the case of Argentina provide important insights as to how advocates might harness and exercise structural, instrumental, and discursive power to counter corporate influence and promote the successful adoption of comprehensive UPF regulation.
Key Words. Power analysis, Food governance, Ultra-processed foods (UPFs), Political economy of health
