RTSL is aiming to save 94 million lives over 25 years by advocating for countries to implement policies to reduce non-communicable diseases. We believe the industrially-produced trans fat elimination program is the most cost-effective of their initiatives. RTSL has worked with the WHO to develop guidance on best practices around implementing trans fat limits around the world. They have already successfully helped India, Brazil, Bangladesh and a number of other countries implement these limits through advocacy and technical assistance. We estimate that additional funding would enable them to accelerate the process of eliminating artificial trans fats among the majority of countries which have not yet done so by three years, saving over ten thousand additional lives. Even after very conservative discounts to RTLS’s impact projections we estimate this program to be more cost effective than most of our top global health and development recommendations.
What is the problem?
In recent decades a scientific consensus has emerged that consuming trans fats leads to hundreds of thousands of deaths per year. As a result a number of high-income countries passed laws to limit the amount of trans fat in their food supply. These early experiences demonstrated that producers could replace trans fats with healthier alternatives without significant costs, and that they did not resist the passage of these laws. The strongest evidence for the impact of trans fat elimination campaigns comes from quasi experimental studies looking at previously implemented bans, demonstrating decreases of 4.5% in coronary heart disease deaths in New York State and 6.5% in Denmark. There is additional evidence from short-term randomized controlled trials, and observational studies showing that trans fats have a higher association with coronary heart disease per calorie than any macronutrient.
Why do we recommend them?
The CEO of RTSL, Tom Frieden, likely prevented tens of millions of deaths by creating an international tobacco control initiative in a prior role that may have been much more cost effective than most of our top recommended charities. Before that he successfully guided the Indian Tuberculosis Control program through his work on a World Bank-supported project, and was responsible for multiple innovations through his work as the Health Commissioner of New York City and director of the CDC in the US. We believe that by leveraging his influence with governments, and the relatively low cost of advocating for regulations to improve health, Tom Frieden has the potential to again save a vast number of lives at a low cost. RTSL succeeded in getting trans-fat regulations enacted to cover over a quarter of the world’s population since 2018, and we believe recent funding cuts are slowing their progress.