Microsoft Word - D23-3704092 HSR - Monitoring Framework

OFFICIAL

Health Star Rating system

Post Five-Year Review

Monitoring Framework

July 2023

Health Star Rating system program logic model – updated 2023

Funding

 Commonwealth

 State and Territory

Governments

Governance

 HSRAC*

 FRSC**

 IWG

 The FMM

*Replaced previous

WGs: FOPL

Technical Design

Working Group &

Implementation

Working Group

** replaced FoPL

Steering Committee

Expertise

 Government

(public health

policy, nutrition,

FSANZ)

 Food industry

 Public health &

consumer

organisations

 Consumer

research

 Social marketing

 Monitoring &

Evaluation

1. Implementation of

the updated HSR

System

 HSR algorithm &

calculator

 Guide for Industry

 Anomaly

considerations

 Complaint handling

 Implementation Plan

2. HSR Public Relations

Strategy

 Consumers (adult

grocery buyers and

priority groups) (1°)

 Industry (2°)

 Stakeholders &

Professionals (3°)



Media (3°)

AoE1: Uptake

Essential: HSR system is voluntarily adopted by food industry to meet

agreed uptake targets:

 50% of intended products by 14 November 2023

 60% of intended products by 14 November 2024, and

 70% of intended products by 14 November 2025.

Indicators within this AoE that may be monitored:

 Uptake by food category

 Uptake by HSR/ rating distribution

Inputs

Activity Streams Outputs

Outcomes

Short (Jun 22 – Jun 23) Medium (Jul 2023 – June 2026) Long (post July 2026)

3. HSR Social Marketing

Campaign (includes

website)

Targets

1. Consumers (including

low SES, low literacy/

numeracy, Indigenous and

CALD groups)

2. Food industry

HSR is understood, trusted

and used correctly across

socio-economic groups, CALD

and low literacy/numeracy

groups.

AoE 2: Consumer use and understanding

Essential: Main grocery buyers in priority groups are aware of HSR,

understand and can correctly use the HSR, have confidence in HSR

and incorporate consideration of HSR when making purchase

decisions, leading to healthier choices.

Other indicators within this AoE that may be monitored:



Understanding and use in the general population

Monitoring areas of enquiry (AoE 1-2) will describe the impact of the

HSR for activities, outputs and outcomes in the blue boxes above.

External Factors

*Food industry, retailers, key stakeholders and opinion leaders (such as academics, health

professionals, public health groups and consumer advocates) may positively or negatively

influence support for HSR, and the general public’s perception of, and trust in HSR.

HSR is well supported by food

manufacturers and retailers,

appearing accurately on the

vast majority of products on

shelf, in particular on food

products of food categories

that make greatest contribution

to intake of energy and key

nutrients and have greatest

market share.

HSR promotion

continued;

consumers notice

communications

and HSR on food

products

HSR drives a decrease in risk

nutrients and/or an increase in

positive nutrients (e.g. fibre) in

particular on food products of

categories that make greatest

contribution to intake of

energy and key nutrients and

have the greatest market

share.

Food manufacturers, retailers, other key stakeholders and opinion

leaders* continue to support and promote the HSR to their target

audiences via relevant communication modes (e.g. resources,

education, media).

Key issues raised by

stakeholders from all

sectors (food industry,

public health groups,

consumer advocates,

academics and

others) are

considered by the

RAC or the IWG.

HSRS endorsed by

the FMM.

Commonwealth,

State & Territory

agencies.

Governments support

and promote the HSR

system.

Consumers make healthier

purchases when choosing

packaged foods (i.e. choosing

higher star nutritious core

foods and less discretionary

foods).

HSR Objective: Assist consumers to make informed food purchases and healthier eating choices by providing convenient, relevant and readily understood nutrition

information and/or guidance on food packs

AoE3: Nutrient status and application of the system

Desirable: HSR system encourages a decrease in risk nutrients and/or

an increase in positive nutrients by manufacturers

A range of indicators may be monitored:

 Reformulation and nutrient status of HSR products

 Compliance and accuracy of ratings

Voluntary uptake

and promotion of

HSR by food

manufacturers and

retailers

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1 Program logic

The program logic first developed in 2016 and updated in 2023 outlines the intended

objective and proposed outcomes for the system. This sets the context for the monitoring

framework.

2 The Framework

2.1 Purpose and scope

The purpose of this monitoring framework is to guide the initial monitoring of the updated

Health Star Rating (HSR) system with further discussion and initial monitoring outcomes

required to inform an evaluation strategy for the HSR and the outcomes of other public

health initiatives.

In 2020, Food Ministers agreed to the system continuing on a voluntary basis for a further

five years (until 2025), with a view to consider mandating at the end of this period should

uptake not meet set targets. They also agreed to improvements to the monitoring of the

system.

Monitoring of the HSR system aims to:

 enable systematic and objective assessment of the implementation and outcomes of

the system

 collect information and evidence about what is working well and what is not, for the

purposes of continuous improvement, accountability and decision making.

An evaluation of the HSR system’s impact on public health has not been included in this

Framework. The importance of a thorough evaluation of the changes made to the HSR

system to assess whether it is achieving its long term outcomes following the Review is

acknowledged. These long term outcomes include positive reformulation of products and

alignment of ratings with dietary guidelines. These requirements will be considered in the

future.

The period of monitoring will run from November 2023 to early 2026 inclusive. In Australia

the monitoring will be overseen by the Australian Government Department of Health and

Aged Care and in New Zealand by the Ministry for Primary Industries. The framework aims

to improve consistency between New Zealand and Australian monitoring.

Other aspects of monitoring may be undertaken through other avenues.

2.2 Monitoring principles

The Framework aims to:

 act as an initial guide on the priority areas of enquiry for the HSR system over the

coming monitoring period.

 provide a rationale for inclusion (or not) of indicators within the Framework,

transparent and available to all stakeholders.

 be adaptable and not exhaustive, noting a commitment to monitor both essential

monitoring requirements stated in the below table.

 provide sufficient time and guidance for the industry to be informed of what measures

will be monitored.

To develop the framework and the areas of enquiry for the monitoring period the following

principles were considered:

 aspects that Food Ministers requested in the Review Response to be monitored.

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 indicators that the system is achieving its aims, necessary to inform an evaluation on

whether the HSR should continue as a voluntary system or be mandated.

 Alignment with the World Health Organization (WHO) Guiding Principles and

Framework for Front-of-Pack Labelling for Promoting Healthy Diets (Appendix 2).

 Consistency between Australian and New Zealand monitoring.

 Consideration of the impact on priority populations.

 The need for areas of enquiry and measures must be material and objective.

2.3 Focus areas for monitoring

Improved population health

Contribution to improved population health and public health outcomes in Australia and

New Zealand is the overarching goal of the HSR system. Food Ministers indicated that the

performance and results of the HSR system on a population health level should be

considered in future monitoring

. Measurement of the public health impact of the HSR is

challenging noting that the HSR is one tool to improve population health. Data on dietary

intakes against the dietary guidelines and rates of chronic disease need to be available to

enable any analysis. Thus measurements on this scale are out of scope for the HSR

monitoring framework. This aspect may be explored as data becomes available or as part of

a broader population health outcome evaluation.

The following focus areas are proposed to be included as they can provide important data to

consider the public health impact of the HSR system.

Voluntary uptake

The HSR is voluntary and relies on the cooperation of food manufacturers and retailers to

implement the system in their labelling. As noted, in the Review Report, low and inconsistent

uptake on products reduces the actual effectiveness of the HSR system by allowing fewer

opportunities for meaningful comparison and negatively affects consumer trust in the HSR

system. To address this, the Review Report recommended uptake targets be set for the

system going forward.

The only monitoring Food Ministers have currently committed to is a measurement of uptake

against the targets, therefore this is a major focus of the monitoring.

Consumer understanding and ability to use the system correctly

To be effective, the HSR system must be understood and able to be used correctly by

consumers, to guide them towards healthier food choices. Therefore, an important

measurement of success is whether the system is understood and used correctly.

An aspect of this measurement is the need to investigate whether priority groups are aware

of, understand and use the HSR correctly. “Priority groups” refers to populations of low

socio-economic status (SES), Aboriginal, Torres Strait Islander people and culturally and

linguistically diverse (CALD) populations in Australia, Pasifika and Māori people in New

Zealand.

Food Ministers response to the 5-Year Review recommendations

http://www.healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/D1562AA78A574853CA2581B

D00828751/$File/V1-Forum-

Health%20Star%20Rating%20System%20five%20year%20review%20response%202019-12.pdf

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In Australia, the burden of disease for Aboriginal and Torres Strait Islander people is 2.3

times that of non-Indigenous Australians, including rates of chronic disease

, with growing

overweight and obesity ratings in children, along with low intake of fruit and high intake of

sugar-sweetened beverages in people aged 15 years and over in rural and remote

communities

In New Zealand, people less likely to eat the recommended amounts of vegetables are men,

Pacific and Asian adults and adults living in the most socioeconomically deprived areas.

Māori were 1.8 times as likely to be obese than non-Māori, and Pacific adults were 2.5 times

as likely to be obese as non-Pacific adults. Adults living in the most socioeconomically

deprived neighbourhoods were 1.6 times more likely to be obese than adults living in the

least deprived areas

These groups are a high priority for monitoring activities to measure understanding,

acceptance and use of any public health nutrition intervention, with an aim to improve the

above statistics.

Reformulation

A secondary (desirable but not direct) goal of the system is for manufacturers to reformulate

foods and recipes to reduce risk nutrients and/or increase positive components to achieve a

higher HSR, thereby improving the nutritional quality of the food supply.

Analysis in 2018 showed that in Australia, food products displaying the HSR had statistically

significant reductions in energy and saturated fat content over the four years since the HSR

system was introduced, compared to those not displaying the HSR (which showed no

significant reductions in these components).

Analysis of 929 products displaying the HSR in New Zealand found that 79% had been

reformulated over the first four years of the HSR to change at least one key nutrient by a

minimum of 5%

. A 2022 study found that the introduction of the HSR was associated with

lower sodium, lower protein and higher fibre purchases in New Zealand when purchased

products carrying an HSR were compared with the same products before the introduction of

the program

2.4 Areas of enquiry: essential, potential and not to be pursued

A number of potential areas of enquiry were identified and have been discussed as being of

value by the HSR Advisory Committee and IWG. However, given resource constraints, these

have been prioritised as per the colour coding shown below:

Essential monitoring

requirements - the minimum

monitoring requirements for the

system. These AoEs should be

monitored as a first priority with

available funding.

Potential areas of enquiry -

additional monitoring areas

that could be investigated if

resources permit.

Areas of enquiry that

are not proposed to be

pursued in this

monitoring period.

National Health and Medical Research Council (NHMRC), 2013. Australian Dietary Guidelines. Canberra:

NHMRC.

Australian Bureau of Statistics. (2018-19). National Aboriginal and Torres Strait Islander Health Survey. ABS

Ministry of Health. 2020. Eating and Activity Guidelines for New Zealand Adults: Updated 2020. Wellington:

Ministry of Health.

Mantilla Herrera, et al, Cost-effectiveness of product reformulation in response to the Health Star Rating food

labelling system in Australia, 2018, Nutrients, vol. 10, no. 614, pp. 2-16.

Bablani L, et al, Effect of voluntary Health Star Rating labels on healthier food purchasing in New Zealand:

longitudinal evidence using representative household purchase data. BMJ Nutrition, Prevention &

Health 2022. doi: 10.1136/bmjnph-2022-000459.

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For the purposes of the Program Logic the essential monitoring requirements have been

sorted into area of enquiry (AoE) headings:

AoE 1: Uptake

 Progress against uptake targets

 Uptake by food category

 Uptake by HSR/ rating distribution

AoE 2: Consumer use and understanding

 In priority groups

 In general population

AoE 3: Nutrient status and application of the system

 Reformulation and nutrient status of HSR products

 Compliance and accuracy of ratings

The table below outlines the proposed AoEs and their rationale, potential data sources and

timing for the monitoring and reporting. Following agreement to this draft framework, further

consideration will be given to how and when data will be collected, analysed and reported.

The AoE will be measured based on priority and the funds available.

“Priority groups” refers to populations of low socio-economic status (SES), Aboriginal, Torres Strait Islander

people and culturally and linguistically diverse (CALD) populations in Australia, Pasifika and Māori people in New

Zealand.

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Area of enquiry

Rationale

Timing

Data type

Potential data sources

Uptake

Progress against

uptake targets

Ministers agreed to establish uptake targets as part of the review. Measuring uptake

against these targets is essential to assess if industry is meeting these established uptake

expectations.

Commence following each target. An

uptake report to be delivered ASAP

following each target date.

Quantitative

 Branded food product databases

(e.g. GS1, Nutritrack, FSANZ BFD,

George Institute, Heart Foundation

Food Track)

 In-store data collection

 Online shopping data collection – via

collaboration with retailers

Uptake by food

category

Help identify whether there is preferential application of the system and support targeted

industry engagement to increase uptake. The food categories would be determined later.

At interim target 1, and again if interim

target 2 is not met.

Uptake b

y HSR/

rating distribution

Can be used in conjunction with Nutrient status to indicate whether application is being

favoured for higher rated products. These measures indicate similar information. This in

turn would assist to inform the value of mandating.

Sales weighted

uptake

Obtaining sales data is costly. In their response to the

ear review Ministers agreed to

not establish sales weighted uptake targets.

Consumer use and understanding

In priority groups

Key to inform decision on whether to mandate the system. Helps assess whether the

system is meetings its objective: to provide convenient, relevant, and readily understood

nutrition information and/or guidance on food packs to assist consumers to make informed

food purchases and healthier eating choices

Ideally align with uptake targets monitoring,

but at a minimum at beginning and end of

monitoring period.

Following the Australian Campaign.

Quantitative

and qualitative

 Surveys

 Focus groups

 Targeted stakeholder forums

 Public forums

 The HSR Australian Campaign

evaluation will may provide some

information

In general

population

Only monitor if second interim uptake target

not met. If monitored, report delivered with

or before final uptake report.

Nutrient status

and application of the system

Reformulation Has there been reformulation of products whose HSR has been impacted by the review, to

achieve a higher rating (i.e. good result)?

Collected by final report Quantitative

and qualitative

 Branded food product databases

(e.g. GS1, Nutritrack, FSANZ BFD,

George Institute, Heart Foundation

Food Track)

Nutrient status of

products

displaying the

HSR

Healthfulness of the food supply is being looked at under P2 and is of a broader scope

than the HSR system.

Alignment of ratings with dietary guidelines?

Is the higher penalisation for high in sugar and sodium reflected in ratings?

Rating accuracy will be difficult to measure during and immediately following the Review

implementation period due to a high number of ratings, label and potentially recipe

changes

Collected by final report- if necessary to

inform mandating

Accuracy of

calculations

This is relevant after implementation of a changed system, possibly not as an ongoing

need, depending on findings. Can be utilised to inform a margin of error re: uptake, rating

distribution.

Collected by final report

Quantitative

and qualitative

 Branded food product databases

(e.g. GS1, Nutritrack, FSANZ BFD,

George Institute, Heart Foundation

Food Track)

Consistency with

the style guide

Not considered required for ongoing monitoring.

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Appendix A

Background of the HSR system

The HSR system was conceptualised as a response to Labelling Logic: Review of Food

Labelling Law and Policy (the Blewett Review), published in 2011, which recommended an

interpretive front of pack labelling system in Australia and New Zealand, as one of several

preventative health initiatives designed to improve dietary intakes in line with a

comprehensive nutrition policy. The intent was to help people to make better informed,

healthier choices quickly and easily when comparing similar types of packaged foods.

According to the statement made by Food Ministers at the time

, the stated aim of the FoPL

scheme was to guide consumer choice towards healthier food options by:

 enabling direct comparison between individual foods that, within the overall diet, may

contribute to the risk factors of various diet-related chronic diseases

 being readily understandable and meaningful across socio-economic groups, culturally

and linguistically diverse groups and low literacy/numeracy groups

 increasing awareness of foods that, within the overall diet, may contribute positively or

negatively to the risk factors of diet-related chronic diseases.

On 27 June 2014, Food Ministers endorsed the HSR system to be voluntarily implemented

in Australia and New Zealand for an initial five years, with a formal review to occur at five

years.

The five-year review

In April 2016, the HSR Advisory Committee (HSRAC) commenced planning for the Review.

Between 2017 and 2019, an independent consultant, mpconsulting, reviewed the system,

undertaking numerous stakeholder consultations and commissioning several technical

papers and pieces of research.

The final Review Report found that overall, the system works well and should be continued,

but recommended a package of 10 changes to improve the system, regarding the operation

of the HSR Calculator, driving further uptake, and improving the management and

monitoring of the HSR System.

Food Ministers responded to the Review’s recommendations, supporting the majority, with

some caveats and adaptations. Recommendations 7 and 8 relate specifically to the

approach to monitoring, and Recommendation 9 is relevant to monitoring as it outlines

targets for uptake, which must be monitored.

Previous monitoring activities and background

Previous Areas of Enquiry

Monitoring of the HSR system is completed and funded separately for Australia and

New Zealand. However, monitoring activities are aligned between the two countries

wherever possible.

The monitoring of the HSR has historically been overseen by the Health Star Rating

Advisory Committee (HSRAC), who determined the three original Areas of Enquiry (AoEs).

Department of Health and Aged Care. Front of pack labelling Project Committee, Objectives and principles for

the development of a front-of-pack labelling (FoPL) system.

https://foodregulation.gov.au/internet/fr/publishing.nsf/Content/frontofpackobjectives.

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AoE1: Label implementation and consistency with the HSR system Style Guide.

Over the first 6 years this included (inconsistently) assessment of overall uptake of the HSR

system (absolute and sales weighted), uptake by manufacturer and retailer, and uptake by

food category and by rating.

Consistency with the HSR Style Guide, consistency with the HSR calculator (accuracy of

ratings) and the proportions of the different HSR display options were also assessed.

AoE2: Consumer awareness and ability to use the HSR system correctly. This involved

assessment of consumer awareness, recognition, understanding, correct use and trust,

credibility, and confidence of the HSR system across the general population and for priority

groups.

AoE3: Nutrient status of products carrying a HSR system label. Changes to the nutrient

content of HSR products were monitored to determine whether the overall average nutrient

profile had changed, i.e. products had been reformulated, compared with non-HSR products.

In New Zealand the nutrient content of products displaying the HSR pre and post

implementation of the system were compared. This also included looking at the distribution

of HSRs and considering whether they were being applied more to higher rating products.

Australian monitoring activities

In Australia, the Australian Government Department of Health engaged the National Heart

Foundation of Australia (Heart Foundation) to undertake data collection and analysis for the

three key AoEs.

The Heart Foundation developed the first framework to guide monitoring and reporting

against these three AoEs, in both Australia and New Zealand. The Heart Foundation

published a series of reports covering each of the first five years of implementation of the

HSR system in Australia.

New Zealand monitoring activities

In New Zealand, the New Zealand Ministry for Primary Industries (MPI) contracted the

National Institute for Health Innovation at the University of Auckland to monitor uptake of the

system and changes to nutrient status of the food supply (including reformulation).

The New Zealand Ministry of Health funded the Health Promotion Agency (HPA) to develop,

implement and monitor the consumer marketing and education campaign to help consumers

understand the HSR System. HPA commissioned Colmar Brunton to conduct surveys to

monitor AoE2. Surveys were conducted in 2015, 2016 and 2018.

MPI internally considered consistency with the HSR Style Guide.

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Five year review recommendations of relevance

Ministers’ response to monitoring under Recommendation 7 was as follows:

Supports, subject to funding.

…Monitoring deliverables and methodology will need to be adjusted in response to

recommendation 9 (uptake targets). This is a good opportunity to make monitoring

requirements more overarching as well as more specific – looking at the performance and

results of the HSR system on a population health level as well as more specific criteria. It

also presents an opportunity to improve consistency between New Zealand and Australian

monitoring moving forward.

Minister’s response to Recommendation 8 was as follows:

Supports, subject to funding.

Overall the concept of enhancing and expanding existing infrastructure is supported. There

are planned activities irrespective of, and separate to, this recommendation. The

recommended activities come with several additional logistical considerations, particularly

regarding funding. In particular, the costs associated with regular national health and

nutrition surveys is known to be high and the financial viability of such a proposal will need to

be assessed. Further work and substantial planning will be required to implement many of

the initiatives recommended.

Pleasingly, FSANZ has already commenced scoping work on options for a comprehensive

branded food database – which will enable better monitoring of the food supply.

Recommendation 8: Enhance the critical infrastructure to support implementation and

evaluation of food and nutrition-related public health initiatives, including the HSR System,

through: regular updates to Dietary Guidelines; regular national health and nutrition

surveys; establishment of a comprehensive, dataset of branded food products; and

improved monitoring of the System.

Expansion of FSANZ’s existing data management system to enable the automated upload,

validation and public reporting of branded food data (including the HSR) will: support public and

industry confidence in the HSR System; enable automated validation of the HSR displayed on a

product; track longitudinal reformulation of products; and support development of food and

nutrition policy, surveys and regulation.

Recommendation 7: Minor changes be made to the governance of the HSR System to:

 support greater consumer confidence in the System by transferring management of

the HSR Calculator and (Technical Advisory Group) TAG database to FSANZ

 clarify the role of governance committees

 increase the transparency of the System

 improve monitoring, enabling the System to be more responsive.

As the HSR System moves into the next stage of implementation, adjustments to the

governance arrangements are recommended to support greater consumer confidence; enable

more effective monitoring; provide greater transparency; and improve responsiveness.

Recommended changes include adjustments to the composition and role of the HSRAC and

independent custodianship (by FSANZ) of the HSR Calculator and TAG database (including

resourcing for this work).

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Identification of a preferred option will include consideration of future financial obligations

required to appropriately develop and maintain the database.

Minister’s response to Recommendation 9 was as follows:

Supports in principle, subject to agreeing interim and final target metrics and discussions

with the Office of Best Practice Regulation.

The Forum is aware that the voluntary basis on which the HSR system currently operates

has been a point of contention for many stakeholders since its inception. The resulting

inconsistent uptake on products negatively affects consumer trust in the HSR system, as

well as reducing the actual effectiveness of the HSR system by allowing fewer opportunities

for meaningful comparison. A commitment to high interim and final uptake targets with the

potential of mandating should those targets not be met demonstrates a commitment to

improved public health nutrition outcomes. It would also render the HSR system more useful

for consumers if it were applied to a greater number of products. The Forum notes the

original intention that the HSR system be applied to processed and packaged foods, and not

to single ingredient foods and unpackaged, minimally processed fruits and vegetables.

Taking this rationale into account, the Forum requests that FRSC consider the target metrics

to be used to measure successful uptake. The details of the agreed metrics and

implementation timeframes will be included in an implementation plan to be developed

following release of this response, and considered at the first Forum meeting of 2020. In

addition to the metrics and timeframes, the implementation plan will also detail a process

that further explores the implication of a voluntary versus mandatory approach.

Following further committee consideration of Minister’s response, the HSR System is to

remain voluntary for the time being, but clear uptake targets have been set for a percentage

of intended products (that is, products that are both eligible to and are intended to have the

HSR system applied), with a view to mandating should they not be met by their set date.

These are:

50% of intended products to have applied the system by 14 November 2023,

60% of intended products to have applied the system by 14 November 2024, and

70% of intended products to have applied the system by 14 November 2025.

Details on which products are eligible and intended to apply the HSR are in the HSR system

Calculator and Style Guide.

Recommendation 9: The HSR System remain voluntary but with clear uptake targets set

and all stakeholders working together to drive uptake. If the HSR System continues to

perform well but the HSR is not displayed on 70% of target products within five years of a

government decision on these recommendations, the HSR System should be mandated.

Consistent and widespread adoption of the HSR is required for the System to have a significant

public health impact. The Review closely considered whether improved uptake should be achieved

through mandating the System. On balance, the Review considers that attention should first be

focused on improving the System, setting clear uptake targets and continuing to incentivise

uptake.

This approach continues to build on the significant investment and goodwill of industry and others;

is consistent with the principles of best practice regulation; and reflects international experience

(where the majority of interpretive front-of-pack labelling schemes have been implemented on a

voluntary basis).

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Changes to the way HSR system is implemented resulting from the Review that are

relevant to future monitoring:

 HSR graphic Option 5, the energy icon only, has been removed from the HSR system as

a display option.

 A package of changes has been made to the way the HSR is calculated for foods,

including stronger penalties for sugars and sodium, rescaled dairy categories to allow a

greater spread of ratings, an automatic 5 star rating to fresh and minimally processed

fruit and vegetable products, and changes made to the way the HSR is calculated for

non-dairy beverages to better discern water (and drinks similar in nutritional profile) from

high energy drinks.

o Note: Food Ministers suggested that it would not be appropriate to include the

application of the HSR system to unpackaged and minimally processed fruit and

vegetables in uptake numbers.

Full details on the Review recommendations, Ministers response to the recommendations,

and the changes resulting from the Review, can be found at the following web page:

http://healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/formal-review-

of-the-system-after-five-years.

Funding and governance

Funding

To date, the HSR system has been jointly funded by the Australian Government, state and

territory governments and the New Zealand Government, as per the previous Australian

Health Ministers’ Advisory Committee (AHMAC) cost share formula. The New Zealand

Government has contributed for base funding only, on the basis that New Zealand consumer

education and monitoring activities are undertaken separately.

Monitoring governance

Until the Review, monitoring was the remit of the HSRAC. As a result of the Review’s

recommendation to “improve monitoring, enabling the system to be more responsive”,

monitoring is now overseen by the FRSC, and this will be the case for the monitoring period

to which this Framework applies.

Stakeholders

Government

The HSR system is jointly funded between the Australian Government, State and Territory,

and New Zealand Governments. The system is overseen by the Australian Government

Department of Health and Aged Care in all aspects – inception, development, secretariat,

administration, communications, marketing and implementation. The New Zealand MPI

oversees a range of these aspects on behalf of New Zealand. Australian, New Zealand and

State and Territory representatives are (currently) involved with the ongoing implementation

and management of the system via the HSR IWG, and Campaign Working Group (Australia

only).

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Public Health

Public health representatives, such as health and medical research organisations and peak

health bodies, have been involved with the HSR system since its development. A public

health representative from each of Australia and New Zealand is a standing position on the

HSRAC. Public health stakeholders provide valuable input on the main objective of the HSR

system, which is improved public health outcomes.

Academics and health professionals have contributed significantly to the HSR both directly

through involvement in committees/groups, and via a large body of independent research.

Food Industry

The HSR is implemented on a voluntary basis and relies on the cooperation and good will of

food retailers and manufacturers to apply it to their labelling. Large food industry

associations such as the Australian and the New Zealand Food and Grocery Councils, as

well as representatives of individual companies have been involved in the HSR since its

development, representing the interests of the food industry. Retailers in both countries have

also been strong supporters of the system. A food industry representative to represent the

broad sector from each of Australia and New Zealand is a standing position on the HSRAC.

Consumer Groups

Consumer groups are also represented with a standing position on the HSRAC and have

been involved with the HSR since its development. Consumer groups represent and advise

consumers and families on a variety of products, programs, services and price

recommendations.

OFFICIAL

Appendix B

World Health Organization’s Guiding Principles and Framework Manual

for Front-of-Pack Labelling for Promoting Healthy Diets

WHO’s Guiding Principles and Framework Manual for Front-of-Pack Labelling for Promoting

Healthy Diets was consulted during the development of this Framework. Indicators under

these Guidelines that should be monitored are:

• The extent and fidelity of implementation of the FoPL system

• The effect of the FoPL system on changes to consumer understanding

• The effect of the FoPL system on changes to product purchases

• The effect of the FoPL system on changes to population dietary intakes

• The effect of the FoPL system on changes to nutrient compositions of food products

(reformulation). Is uptake meeting the set targets?

These principles were all included in proposed areas of enquiry considered by the HSR IWG

prior to development of this framework.