Who answers, for what, and to whom: the obesity community sets out what real accountability looks like
On 26 October 2026, the World Obesity Federation brought together more than 130 people from civil society, including youth and lived experience, academia, governments, and UN agencies, in Madrid, Spain, for the Global Obesity Forum.
The Global Obesity Forum is World Obesity’s annual flagship event. This year, it opened a week of global discussions in Madrid, happening alongside the Madrid Global Obesity Summit co-hosted by the Government of Spain and WHO, in collaboration with UNICEF and the World Bank, the first global stocktake of the WHO Acceleration Plan to Stop Obesity. The focus was on shared accountability: when everyone has a role to play in addressing obesity, how can we make sure it doesn't end up being nobody's responsibility?
Key takeaways
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Looking ahead to the 2027 UN High-Level Meeting on Universal Health Coverage, the next round of commitments must be measurable, with specific people accountable for delivering them
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Accountability means reporting back to the people the commitments are for, so they can see what has and hasn't been delivered
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Civil society, people with lived experience, and youth need a consistent place in tracking and accelerating progress, with real power to shape decisions, not just consultation
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Speakers came from ten countries across five regions, including Zambia, South Africa, India, Malaysia, Spain, Switzerland, Slovenia, Brazil, Trinidad and Tobago and the United Arab Emirates. They included people living with obesity, young advocates, clinicians, researchers, city and national government officials, and leaders from WHO and UNICEF.
The Forum came at a pivotal moment for obesity policy. Obesity is now understood to be a disease that affects all parts of the world, with low- and middle-income countries (LMICs) facing the most rapid rises in obesity in recent years. UNICEF’s 2025 Child Nutrition Report found that, for the first time, more children and adolescents aged 5-19 live with obesity than with underweight. And just weeks before the Forum, the Lancet Commission on 21st century global threats to health found that obesity carries the largest avoidable burden of all 17 threats it assessed.
The good news is that we already know what works. WHO’s ACT framework sets out a package of evidence-based policies, from front-of-pack labelling, taxes on sugary drinks and limits on marketing to children, to healthy school food and integrating obesity care in primary health care. These policies have not only been shown to be successful, but also cost-effective. Commitments only matter when they lead to sustained action. The Forum gave the people closest to the work the chance to share what is working, where things are stalling, and what's needed to accelerate progress. These insights will be carried forward through World Obesity's work with governments, and with WHO and UNICEF in the Global Obesity Coalition.
Obesity in a changing world: Connecting the dots
Opening the forum in conversation with health journalist Jacqui Thornton, Dr Bruno Halpern, President of the World Obesity Federation, said political discussions on obesity must not keep coming back to personal responsibility.
He also pointed to a double standard on cost. For other diseases, we accept that people deserve treatment whether or not it saves money, but for obesity, we have to prove that it’s cost-saving first, and governments tend to weigh its price against doing nothing at all. But while inaction may look cheaper in the short term, it costs far more in the long term.
When asked what governments should be held accountable for in a year from now, he said that the most important thing is real commitment, and someone to check that it is being delivered. This is where civil society comes in, monitoring government work, and placing pressure when needed: “It's not possible to do a 10-year plan and just wait for 10 years to see what happens afterward. You need, year after year, an accountability on that… it's part of the civil society to look at what governments are doing."
Changing the environments that shape health
The environments where people live, learn, and play shape their health, and we already know which policies make them healthier. The challenge is making sure those policies are implemented, with specific people accountable for specific results. Our first panel asked how we can make the healthy choice the easy choice, and who is responsible for that change. Dr Santiago Gómez Santos of the Gasol Foundation explained how Spain has introduced a National Strategic Plan for the Reduction of Childhood Obesity, including 200 measures across 18 ministries. The plan provides a strong starting point, but the task now, he said, is to accelerate implementation at the national, regional and local level, and civil society is central to that. Programmes are being scaled up thanks to community organisations and the network of people around children, including teachers, coaches, early childhood educators and families. Every level of government, and every sector of society has a part to play.
"The problem is fully systemic and the solution should be also systemic." Dr Santiago Gómez Santos, Gasol Foundation
Much of that implementation happens locally. Javier Calatrava Sánchez of Madrid Salud said that cities are where policy becomes part of daily life, and where the drivers of obesity, from urban design to access to healthy food, are most visible.
From Zambia, Brenda Chitindi of the Zambia Heart and Stroke Foundation, an advocate with lived experience of obesity, described how processed snacks are heavily targeted at children in the country. Zambia’s school feeding programme now serves almost five million children every day, but she raised concerns about what food is actually served, and who is held accountable.
Professor Kent Buse of Monash University Malaysia, Chair of the World Obesity Federation’s Policy and Prevention Committee, outlined what is needed for plans to achieve results. Countries are not on track to meet global obesity targets, he noted, citing this year’s World Obesity Atlas. To be successful, he argued, accountability must be specific: who answers, for what, against which standards, judged by whom, and at what cost if they fail. He called for strict public standards with independent monitoring of obesity commitments, an independent panel reporting annually to the World Health Assembly, and specific text on accountability in the 2027 Political Declaration on Universal Health Coverage.
The decade has been good at producing plans… but it hasn't been good at delivering accountability."
Professor Kent Buse, Monash University Malaysia, World Obesity Federation Policy and Prevention Committee Chair