A critical interrogation of the legitimacy of commercial actors in food policy partnerships.

Public-private partnerships (PPPs) between commercial actors and governments or other non-commercial organizations are widely encouraged as a way of achieving a range of policy objectives, including the creation of healthier food environments, despite the evidence of their limited effectiveness at doing so. The aims of this qualitative study were to critically interrogate the role and legitimacy of food industry actors as partners in policies to improve the food environment, and to explore related underlying issues that impede the design and implementation of effective policies. Qualitative interviews with 16 academics from 6 countries with expertise on population food policy, including public-private partnerships, to improve the food environment were conducted from January to March 2020. A manual thematic analysis of the data was employed, and theoretical lenses relevant to the commercial determinants of health were applied. Key themes constructed from the data have been conceptualized as 'fault lines', metaphorically used here to indicate underlying issues or factors that cause systemic problems or impede success of public health goals. The reported fault lines are categorized as (i) uninterrogated assumptions that partnership working is effective; (ii) the role of exclusive social networks; (iii) the voluntary nature of partnerships; (iv) data ownership; (v) control of narratives; and (vi) the centrality of political ideology. This paper calls for a systematic and critical interrogation of the mechanisms and extent of commercial actors' involvement in making decisions about healthy diets for the population.