The large, windowless and wood-panelled room has long since lost its lustre. But this week this unremarkable location in the heart of Geneva will play host to 32 officials and diplomats who will gather to make a decision which could reverberate across the globe.
They will decide whether or not the world should have a plan for tackling its greatest health hazard - obesity.
All eyes will be on William Steiger, a youthful Yale graduate who is also the godson of George Bush senior. Steiger is special assistant to the US Health Secretary Tommy Thompson and a rising star of the Bush administration. At the executive board meeting of the World Health Organisation on Tuesday, he will attempt to pull apart the world's only realistic attempt so far to help poorer nations avert the looming public health disaster threatened by the growing burden of heart disease and diabetes.
The target of Steiger's attack will be the WHO's road-map for action, known as the Global Strategy on Diet, Nutrition and Physical Activity. In a fiercely controversial 30-page document which came to light last week, Steiger, on behalf of the Bush administration, argues that there is little robust scientific data on which to base its broad range of suggestions on how to prevent obesity. And if America has its way, then the goals of the past 18 months, involving an effort by many hundreds of public health experts and doctors worldwide to come up with workable initiatives, will slip further out of reach.
Britain, in the form of its chief medical officer Sir Liam Donaldson, is fighting to keep the policy alive along with other countries, but the Americans - and more particularly, their food lobbyists - have used different tactics to undermine anything that would affect their lucrative food industry. The sugar barons who pour so much into the presidential coffers before elections have hired lobbyists and used senators to threaten to pull funding away from the WHO.
Many compare it with the battles which were fought in the early nineties over the tobacco industry. This time round, the fight is over what goes on our plates.
In April last year the WHO, along with the Food and Agriculture Organisation, published a report spelling out the dangers of sugar, fat and salt. The combination of sedentary lifestyles and processed food, experts warned, meant that countries such as Brazil and India were soaring up the obesity league.
The developing regions, even more than the western world, are at risk from junk food because their populations carry more of the 'thrifty genes', the DNA which predisposes people to putting on weight quickly after centuries of living through periods of starvation and then periods of plenty. The scientific report, which was put together by 36 of the world's leading nutrition and activity experts, warned that by 2025, India would have one of the highest rates of Type 2 diabetes.
The report, which became known by its technical number, 916, looked at the strength of evidence on how to prevent and control the major diet-related diseases, including diabetes, obesity, some cancers, cardiovascular and dental disease. But the clause that created most angst was the one suggesting that only 10 per cent of average energy intake for an adult should come from added sugar. Currently, 13 per cent of calories in the British diet come from added sugar, which would be around 60 to 70 grams a day per adult. In America, the public health guidelines are more lax, and state that added sugar can provide as much as 25 per cent of your intake.
As Ellen Ruppel Shell points out in her groundbreaking book Fat Wars, the average American consumes 34 teaspoons of sugar a day in their diet, a 30 per cent increase from just 15 years ago. The annual consumption of sweeteners - not just the sugar but the high-fructose corn syrup, dextrose and glucose - has leapt by 32lbs since 1970, mostly because of soft drinks. In a 12oz can of a fizzy drink there will be about ten teaspoons of sweetener.
President Bush, under pressure at home to do something about the fact that two-thirds of Americans are now overweight or obese, has announced initiatives to encourage fitness, but argues that it is an individual's responsibility to keep their weight down. The President himself, a former jogger, likes to use exercise machines and claims that he has no problem fitting workouts into his life.
However, that is not Bush's only reason for arguing against any kind of social policy or public measure to prevent weight gain. There are enormous financial interests tied up in 'Big Sugar'. The sugar industry has strong connections to the highest levels of the US government through its lobbying firms, which have aggressively targeted politicians and government officials. One of the strongest factors in its favour is that much of US sugar production is based in Florida, a state that was vital in 2000 presidential election and is likely to be key this year too.
One of the sugar magnates close to President Bush is Jose 'Pepe' Fanjul, president of giant Florida sugar firm Florida Crystals Corp. He is one of Bush's top fundraisers, and enjoys access to senior officials close to the president. His brother Alfy Fanjul deals, meanwhile, with the Democrats. Their access is seen as unmatchable - Bill Clinton famously took a phone call from Alfy Fanjul while entertaining intern Monica Lewinsky.
Experts say that anyone hoping to raise political money in Florida will have to pay attention to its sugar industry. This is particularly true of the current administration as Florida's governor is Jeb Bush, the brother ofthe President. There have been other sugar contributions too. In 2000 J. Nelson Fairbanks, chief executive of US Sugar Corp, became a 'Pioneer', a special status among fundraisers, for raising at least $100,000 for Bush's campaign. Warren Staley, chief executive of Cargill, which has a large sugar trading operation, is a Pioneer in 2004. Sometimes the money has come directly from the lobbyists themselves. Alan Feld pledged to raise $100,000 for Bush in 2000. He is employed by a lobbying firm which works for the Grocery Manufacturers of America. The industry has also created its own lobbying instruments. In 1978 the International Life Sciences Institute (ILSI) was founded in Washington by the Heinz Foundation, Coca- Cola, Pepsi-Cola, General Foods, Kraft and Procter and Gamble. Despite once being headed by Alex Malaspina, vice-president of Coca-Cola, the body has gained accreditation to the WHO and the UN Food and Agriculture Organisation.
The food corporations also appear to have been vigorously lobbying the sugar exporting countries such as Mauritius, Brazil and French Guyana. All of them have already expressed reservations about the WHO strategy, fearing that a curb on consumption may mean a decline in their sugar exports. A letter sent by French Guyana is remarkably similar to one mailed early last year by the Sugar Association.
One of those who saw the intensive lobbying efforts at first hand is Dr Pekka Puska, who was head of non-communicable diseases at the WHO until he left to run Finland's leading public health institute.
'After we produced the 916 report, the lobbying was quite extraordinary, particularly when they threatened to withdraw US financial support to WHO,' recalled Puska.
'We had done everything possible to be transparent, to be fair and rigorous, and we held meetings around the world on it. Ours was a balanced road-map to help individual nations decide how they could combat this trend. Every third person in the world has cardiovascular disease - how can we stand by and not try to do something?'
The decision by the US government to fight the global strategy has come as a major shock to many experts in the field. Bruce Silverglade, of the US health campaign group Centre for Science in the Public Interest, said that the influence of 'Big Sugar' in the about-turn was obvious.
Steiger himself comes from a family with long-standing connections to the Bush family. His father, also called Bill Steiger, was a senator and close friend of Bush senior and also of vice-president Dick Cheney. Steiger's mother, Janet, was appointed by Bush senior to chair the Federal Trade Commission.
As the WHO prepares to meet this week to thrash out a possible solution to the global obesity crisis, many believe they face a formidable opposition.Or as Silverglade puts it: 'The sugar industry has its hands wrapped around the political system.'
· Additional reporting by Alison Langley in Zurich.
Help the children - join our debate
The Observer is to hold an evening debate on Tuesday, January 20, about obesity and what can be done to combat it. 'Growing Pains: Can Britain's Kids Escape a Fat Future?' will be held at RIBA, 66 Portland Place, London W1 at 7pm. The panellists include the Health and Sports Ministers, Melanie Johnson and Richard Caborn, as well as experts from the fields of fitness and diet. Tickets are priced at £6 each, including a booking fee. To book a seat, please telephone 0870 890 6002.
