The incursion of ‘Big Food’ in middle-income countries: a qualitative documentary case study analysis of the soft drinks industry in China and India

Public health research is only just beginning to explore the myriad ways in which the food and beverage industry, or ‘Big Food’, has sought to influence policy and increase consumption of energy-dense products high in sugar, salt, and fat in middle-income countries. In particular, very little research has focused on Asia-Pacific markets, including China and India. This article uses the soft drink sector as a case study, and focuses on The Coca-Cola Company – the largest soft drinks company in both China and India. Documentary data from company reports, news articles, industry analyst reports, and industry magazines are analyzed to explore how the company successfully re-entered these markets following liberalization of their economies, and how it subsequently sought to influence government and key organizations in order to increase consumption and challenge public health policy. Applying a framework previously used in an analysis of Big Food in high income countries like the United States, I find that Coca-Cola has used the same strategies in China and India. Findings reveal that Coca-Cola lobbied US Government officials (in order to influence international issues); made political contributions; participated in a ‘revolving door’ between government and industry; funded professional organizations; and generally lobbied to resist regulation or urge weak regulation. The findings of this study could help to inform public health debates about Big Food in other emerging markets, including the Middle East and Africa.