In conversation with Cristian Cofré: evidence use in the Ministry of Health in Chile

By  Hub LAC
11 January 2024
SERIES Voices of evidence users

Welcome to the ‘Voices of evidence users’ interview series, offering first-hand insights from the people who use evidence in decision-making.

In this conversation, Hub LAC talks to Cristian Cofré about the role and regulatory mechanisms for food in Chile, related to the scientific evidence.

Cristian Cofré Sasso is a technical advisor at the Ministry of Health in Chile. He is an expert in public health and nutrition policies/a consultant in public policies and regulation in food and nutrition. 

He is also part of the ministerial advisory committees on food taxes, and on regulation in labelling and alcohol advertising, among others. 

Additionally, he is a member of the Advisory Commission of the Food Sanitary Regulation and the co-coordinator of the National Codex Alimentarius Committee on Food Labelling and the Coordinator of the National Codex Committee on Nutrition and Foods for Special Dietary Uses.

1. What are the priority issues or problems in your organisation?

There are many questions to be asked because there are so many policies being developed. Specifically, in my food and nutrition department, one of the topics that we currently spend the most time on (although not the only one) are those related to regulatory policies. 

Everything associated with the evidence available on what kind of policies exist in relation to food and nutrition regulation, specifically in aspects related to food labelling and advertising in order to provide information to the consumer.

2. What role has scientific evidence played in addressing these priority problems or issues, and what partnerships or synergies have supported or enabled this process?

There is a work in progress on the regulation of nutritional information in fast food restaurants. Its objective is to know the best location where this nutritional information or labelling should be. The work has been done with a unit of the Ministry of Health: the Evidence Informed Health Policy Unit (UPSIE).

This unit has, in turn, linked with other actors, such as the Catholic University of Chile, to develop systematic literature reviews and citizen dialogues.

Precisely in the latter, the literature review and regulatory proposals are socialised in order to have the opinion of citizens and key actors for the implementation of future actions in this regard. This information is processed to generate a report that will support decision-making to design the regulatory policy for fast food. 

In Chile, there is a pioneering initiative in the world: the front-of-package labelling. And the objective is to replicate this initiative with fast foods. 

Similarly, we have the National Food and Nutrition Policy, whose lines of action are also based on evidence – these are experiences of evidence-informed policies.

Regarding the frequency of evidence requests, this is not previously defined but depends on the priorities established by the health authority regarding an issue of interest. 

In the area of nutrition, for example, there is a very relevant issue: the increase of obesity in the child population and in general. This means that the request for evidence for the construction and design of policies to address this health problem has increased in recent years.

3. What are the main challenges and opportunities you identify for institutionalising and systematically incorporating evidence into the decision-making process?

The main challenges we face are the lack of specialised human resources: those who dedicate the time available for evidence-based decision-making. 

There is a high demand for questions, which implies prioritising many of them due to the absence of human resources. This process takes time and can lead to delays in the generation of evidence. 

On the other hand, the chances of finding evidence on innovative public policies are low due to the scarcity of supported information. If it comes to public policy formulation, not only technicians should be involved with the use of evidence, but also decision-makers should be aware that policies need to be informed by evidence. 

On the opportunity side, international organisations encourage the state to produce evidence-informed policies. This is done through organisations such as the UN, WHO/PAHO, FAO and academia, among others.

4. What advice would you give to researchers and decision-makers who want to improve the impact and use of scientific evidence in policy decisions?

The advice to researchers is to show patience for their work to be reflected in public policy. This will depend on many factors and priorities, but if you are patient it will be achieved anyway. The impact will not be from one-month-to-the-next or from-one-year-to-the-next – the disposition of a policy will take longer than that. 

Researchers must take advantage of contextual opportunities for evidence-informed policy development. There needs to be a close linkage between research and public policy.

The advice to decision-makers is that their actions will impact on those people who have placed their trust in them; these may be their peers or senior decision-makers, but more important are those people who live in the territory. 

Decision-makers must follow the principles of effectiveness and efficiency in following evidence-informed policies. These policies should be for the benefit of society and solve the problems that occur. 

Evidence-informed policies are important for any area, especially in sensitive areas such as health care.

Contact: [email protected]