New Zealand officials are under pressure for placing trade in unhealthy meat cuts ahead of the health of Pacific Island nations. Geoff Cumming reports
They are meat cuts affluent New Zealanders feed only to their pets: lamb and mutton flaps laden with fat.
Yet for decades, our sheep farmers have been free to maximise returns by selling these potentially harmful cuts to Pacific and Third World markets, where they've become a human staple.
It seems not to matter to our Government that Tongans and others who grow fat on these products may then clog our health system with diabetes and heart-related problems. Individual responsibility has been the mantra of successive governments challenged to limit this unsavoury trade.
There's a local market for flaps too - mainly to low-income Pacific Islanders and Maori families where obesity-related diseases are soaring.
A new book on the issue is set to reignite debate about whether regulation is needed to limit consumption of this high-fat food in addition to public health education.
New Zealand exported nearly 40,000 tonnes of flaps - high-fat trimmings from the sheep's belly - in 2007, 19 per cent going to Pacific countries where obesity rates are the highest in the world. (Until recently, the Pacific took a far higher proportion but China is now the leading market.)
"We don't make any money by not selling the whole sheep," says Ben O'Brien, Meat and Wool NZ's general manager of market access.
While cheap, these lamb and mutton cuts are "still important to maintain overall profitability of the industry".
"Our view is they are a good source of protein for people who don't have a lot of money. There's obviously demand in those countries for the product - it seems sensible to meet that demand."
O'Brien points out that flaps are available in our supermarkets.
"Certainly, myself and others I know have put them on the barbecue."
He says tests carried out by Lincoln University found the average fat content of cooked flaps was 26 per cent and the protein content 38 per cent.
"Like anything, it's not really a matter of good or bad foods but a matter of balancing the diet appropriately."
But mutton and lamb flaps have long been a target of public health officials trying to combat appalling rates of diabetes and cardiovascular disease in island nations including Tonga. They are a home-cooked meal to rival takeaways for total fat content.
Cheap Meat - Flap Food Nations in the Pacific Islands turns a spotlight on this trade and raises awkward questions about the role of New Zealand authorities in keeping exports going despite mounting pressure in the Pacific Islands.
The book is the work of American anthropologists, Deborah Gewertz and Fred Errington, who stumbled on the popularity of flaps while working in Papua New Guinea, historically a leading importer of New Zealand flaps.
The pair frame the debate about the health impacts of flap exports in a wider economic, political and social context and are careful to remain neutral.
But it's hard to avoid a verdict that exporting countries could do more to minimise the health impacts on Pacific consumers.
"[Flaps] go out to a region that includes the seven countries with the world's highest percentage of overweight adults. [It is] a first world trade that brings the epitome of fatty meat to those with the epitome of fatty bodies."
It's a trade which has long attracted fire from New Zealand health experts, some of whom have linked obesity and diabetes among Pacific Islanders to genetic factors.
Rod Jackson, professor of epidemiology at Auckland University, once termed the trade "dietary genocide" while fellow epidemiologist Robert Scragg has said mutton flaps caused more deaths in the Pacific than 30 years of nuclear tests.
While individuals do have a responsibility, health experts argue that flaps are so much cheaper than healthier alternative sources of protein that choice is constrained.
Households in Tonga now spend more on mutton flaps than any other food, ahead of chicken pieces, white bread and corned beef.
Gewertz and Errington support Jackson's belief that for there to be any real change in Tongan eating habits good food choices must be made as easy as possible - even if this means "nanny state" regulation.
While they don't expect our Government to ban flap exports to the Pacific, they are critical of New Zealand officials for discouraging island governments from limiting imports through tariffs and quotas.
According to their research, New Zealand trade officials have consistently discouraged efforts to link fatty meat imports with rising obesity rates or to restrict imports.
In 1996, when the South Pacific Commission in Fiji moved to study the role of fatty meat imports in rising obesity rates, the New Zealand Trade Commissioner put pressure on the commission to back off, a former Commission official says in the book.
Organisations such as the Meat Producers Board have also lobbied against singling out lamb and mutton flaps because of the high fat content.
Fiji is the only nation to have curbed supply - not by restricting imports but by banning their sale, in 2000. To avoid falling foul of World Trade Organisation rules on restrictive trade, the Fijians used careful wording - that flaps were "likely to cause the death ... or to adversely affect the health or well-being of a person".
Tonga was next to consider restricting flap imports, in 2002 engaging consultants including former NZ Heart Foundation director Boyd Swinburn who advocated a quota on the import of all fatty meats.
But Tonga was moving towards joining the WTO and needed the sponsorship of New Zealand and Australia.
It thought it might overcome objections by adopting the Fijian formula but the recommendation was shelved in the belief it could compromise New Zealand and Australian support for WTO assession.
In 2007, Health Minister Pete Hodgson came under pressure from his Pacific counterparts to limit exports of fatty meats.
The Ministries of Health and Foreign Affairs and Trade and NZ Aid jointly commissioned a report about the impact of flaps on obesity and chronic disease in the Pacific. Its recommendations are unknown - the report has never been released.
Also in 2007, a parliamentary health committee inquired into obesity and type 2 diabetes in New Zealand and considered ways to improve the health of Pacific Islanders.
A majority of the committee recommended that "the Government, the New Zealand meat industry and the Pacific national work cooperatively to phase out the export of fatty meats (such as mutton flaps) to Pacific nations."
The Labour-led Government rejected the recommendation, arguing that consumers would only replace flaps with another fatty meat product. It also claimed an export ban could raise issues regarding our international obligations and commitment to free trade.
The New Zealand Ministries of Health and Foreign Affairs and Trade are maintaining the previous Government's line, arguing that restricting the supply of flaps would simply see consumer demand shift to other fatty meat products.
Meat NZ says concerns about the nutritional value of flaps and other food products are best addressed through public health education "enabling consumers to make informed choices". New Zealand has provided educational materials to the Pacific Islands on appropriate preparation and cooking methods.
The authors agree it would be unreasonable to expect New Zealand to restrict the export of flaps to the Pacific Islands. "But this does not mean that it is reasonable for New Zealand to insist on blocking Tonga's attempts ... to regulate fatty meat imports.
"Tonga should be free to try whatever it can ... to deal with a set of interrelated, life-threatening and intractable problems."
Tonga's director of public health, Malakai Ake, says it's an issue which New Zealand and Australia have been "ducking and diving for a long time".
Considerable effort in Tonga (often with New Zealand funding) has gone into educating consumers about healthy eating. But Ake says regulation is needed. "Our efforts to reduce demand must be complemented by supply intervention. We can reduce demand but if supply is cheap and abundant then our health promotion activities are worthless."
Ake confirms that WTO rules have hindered Tongan efforts to limit the supply. But a new Food Bill with proposals including food standards, which address the quality of produce entering the country, is about to go before Parliament. Labelling to show fat content is another option.
In Wellington, Ministry of Pacific Islands Affairs chief executive Colin Tukuitonga says interventions at various levels are needed to address rising obesity in Pacific populations both here and in the islands.
"New Zealanders should be concerned because it does have an impact on our health system - dialysis demand at Middlemore and Auckland City hospitals is through the roof. But it goes beyond healthcare because obesity is so debilitating that people can't work."
Boyd Swinburn, these days chair in population health at Deakin University in Melbourne and involved in World Health Organisation obesity prevention projects, says New Zealand's stance is not good enough. It has a responsibility to be much more active in trying to address the rise in obesity-related illnesses "particularly when it's driven to some extent by commercial gain for meat producers in New Zealand".
"The people who carry political sway are the people who are getting economic benefit from selling mutton flaps, not the people that are having to pay for renal dialysis.
"I think they need to build some public health into their trade policies."
Associate Professor Nick Wilson of Otago University, a public health specialist, says New Zealand could take measures such as imposing a maximum fat content on sheep meat products or labelling the fat content.
"Food that's on sale has to be made healthier if we're going to lower the risk of heart disease."
A MEATY SUBJECT FOR TONGA
In Tonga, where mutton and lamb flaps are the biggest food item in household expenditure, the rate of obesity among adults is more than 60 per cent.
Twenty-nine per cent of the population dies of cardiovascular disease and 15 per cent have diabetes (the prevalence has doubled since 1973).
Cheap Meat dwells on the 1990s attempts of Tonga's King Tupou IV to take personal responsibility for his health problems and the diet and exercise regime he introduced.
The Tongan Prime Minister preferred to point the finger at the meat - describing flaps as "hardly edible".
Yet at King Tupou's funeral, vast quantities of flaps were on the menu.
In 2002, Tonga (population 106,000 at the time) imported about three million kilograms of flaps - or 540g per head of population per week. An article in the NZ Medical Journal by Otago University public health experts last year cited research that Tongans ate mutton flaps on average 2.3 times a week.
Cheap Meat's authors rightly avoid a simplistic cause and effect conclusion, just as they do not advocate simply banning flap exports or imports.
The book acknowledges that there are many causes of obesity; flaps are a cheap and clearly popular source of protein and over-consumption is linked to personal responsibility; flaps have perhaps been singled out for the wrong reasons.
The book says the King of Tonga may have stopped making bad choices "but does this mean that ordinary Tongan citizens have the same range of opportunities?"
Perhaps Tongans should not be told what to eat - "but does this mean that the Government ... should not be allowed the choice to restrict certain imports - regardless of their contribution to the NZ economy?"