Partnerships with Industry

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Partnerships with Industry to Improve Beverage Choices of Young Children June 22, 2017 Anne Ferree Chief Strategy and Partnership Officer

Today Overview of Partnerships with Industry Elements of Successful Partnerships Measuring Partnership Results

Our Strategies Healthier Marketplace Healthier Community Environments

There is Not One Cause & Not One Solution

One Early Voluntary Agreement In 2004 & 2005, SSBs widely available in K-12 schools In 2006, voluntary Alliance School Beverage Guidelines created, pre-dating the Healthy, Hunger- Free Kids Act of 2010 In 2006, companies agreed to phase out sales of fullcalorie carbonated soft drinks (CSDs), shift product mix toward low- and no-calorie beverages, reduce portion sizes Agreement included provision to track compliance by an independent 3 rd party evaluator

Results between 2004 and the 2009-2010 school year 90% reduction in all beverage calories shipped to schools 77% reduction in volume of beverages shipped to schools 97% reduction in shipment volume of full-calorie CSDs 94% reduction in shipment volume of all restricted beverage calories (including juice drinks, flavored waters, teas) Industry self-regulation, with the assistance of a transparent and independent monitoring process, can be a valuable tool in improving public health outcomes. Wescott et al. Industry Self-Regulation to Improve Student Health: Quantifying Changes in Beverage Shipments to Schools Am J Public Health. 2012.

Our Business Sector Engagement History Snack Food Manufacturers Health Insurers/ Employers & Natl Associations Beverage Manufacturers Dairy Industry Food Service Providers: Sodexo 2005 2006 2007 2008 2009 2010 School Food Manufacturers, Interflex, GPOs McDonald s Beverage Manufacturers Amazon Large School Districts 2011 2012 2013 2014 2015 2016

Continued Call to Action We cannot allow our nation s children to continue to consume this ridiculous amount of calories and sugar from their drinks. We made significant progress in the past and we can do it again. It is going to take everyone families, communities, schools, business and government to make children s health a priority. The next generation is counting on us. Howell Wechsler, EdD, MPH Chief Executive Officer Alliance for a Healthier Generation

What Are We Learning?

Analyze the Systems

Bring Entire Sectors to the Table Multiple large companies or large market share Shared information and values + competitive pressure Complexities to collaboration, yet greater impact and more fairness Sensitive competitive information requires attention to issues of confidentiality, accountability, and impartiality

Create a Domino Effect

Get Top-Down Support and Work towards Long-Term Partnerships

2nd Agreement with the Beverage Industry 2014 Calorie counts and promotion of calorie awareness on all company-controlled point-of-sale equipment in convenience stories, restaurants and other locations: Vending machines Retail coolers Self-serve fountain dispensers Complete business practice change: Innovation, reformulation, distribution and marketing to change and sustain consumer interest in no- and low-calorie beverages Consumer education and outreach: taste tests, sampling programs, coupons and other incentives, in-store displays, community engagement

Speak Their Language and Challenge Their Thinking They came in with an open mind and invested a lot of time and resources in getting to know our business. It s important to have the skill set to understand the business aspect and connect the dots. McDonald s Representative

Reduce beverage calories consumed per person per day by 20% by 2025 2-Part Goal Test and Learn Communities Selected to Date Little Rock & Los Angeles September 2014 New York City May 2015 Counties in MS & AL April 2016

Be Transparent NGO role from the beginning Maintain integrity through independence we do not accept funds from those with whom we negotiate Third party evaluation (replicable with public data sources, even if proprietary sources are used for measurement as well)

.and Data-Driven Selected through a competitive RFP process Track progress and interim benchmarks NATIONAL BEVERAGE GOAL Baseline Report for the National Initiative March 2016 2015 Progress on the National Initiative November 2016 COMMUNITIES BEVERAGE GOAL Communities Initiative Baseline Report & 2015 Update Pending distribution

National 2014 Baseline & 2025 Target Average Daily Per Capita Beverage Calories DrinkTell, 2015 250 200 20% 150 100 50 199 159 0 2014 Baseline* 2025 Target* * Revisions to the underlying data from DrinkTell may result in revisions to the baseline and target estimates. Source: Beverage Marketing Corporation: DrinkTell Database; U.S. Census Bureau, 2015

Measuring Progress Towards the National Calorie Goal Average LRB Calories Per Person Per Day: DrinkTell* 200 150 199.0 198.7 20% DECLINE 159.2 100 50 0 2014 Baseline 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Target * Revisions to the underlying data from DrinkTell resulted in revisions to the baseline and target estimates originally published in 2014. Source: Beverage Marketing Corporation: DrinkTell Database, 2015; U.S. Census Bureau, 2015

Corroborating Data: Beverage Digest Average LRB Calories Per Person Per Day: Beverage Digest* 200 150 177 177 20% DECLINE 142 100 50 0 2014 Baseline 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Target * Beverage Digest data does not include significant portions of LRB volume, including many juices and RTD Teas. Source: Beverage Marketing Corporation: DrinkTell Database, 2015; U.S. Census Bureau, 2015

Corroborating Data: Nielsen Scantrack Average LRB Calories Per Person Per Day: Nielsen Scantrack* 200 150 100 119.8 117.9 20% DECLINE 95.8 50 0 2014 Baseline 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Target *Nielsen Scantrack data does not include several important sales channels, such as fountain. Source: Beverage Marketing Corporation: DrinkTell Database, 2015; U.S. Census Bureau, 2015

Long-Term Shifts and Potential Headwinds Sales Volume Trends, 2000-2014 No- & Low-Calorie CSDs and Bottled Waters, Millions of 8 oz. Servings 100,000 Single-Serve Bottled Water 80,000 60,000 40,000 No- & Low- Calorie CSDs 20,000 0 2000 2002 2004 2006 2008 2010 2012 2014 Source: Beverage Digest Fact Book, 2015

Slowdown of Calorie Reduction Trend Average Calories per Person per Day, 2000-2014 Calories from Beverages Included in Beverage Digest (Excludes some Non-Carbs) 200 200 198 196 195 193 191 189 187 185 184 182 180 178 175 177 177 150 100 50 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Sources: Beverage Digest Fact Book, 2013-2016

Key Conclusions from the 2015 Progress Report 1 Calorie declines must accelerate to meet the 2025 goal 2 Calorie reduction momentum has stalled and must be regenerated 3 Growth of bottled water was notable, but had limited caloric effects 4 Falling no- and low-calorie CSD consumption represents a headwind 5 Companies laid groundwork in 2015 for future calorie reductions

McDonald s Year 1 Progress in U.S.

Local Results?

Top Data Challenges: Community Level Analysis 1 No existing data sources for measuring consumption in small geographies. 2 Company shipment data does not include sales for (1) brands of non- Agreement companies; (2) some Agreement company warehouse brands; and (3) sales by third-party distributors. 3 Nielsen Scantrack is (1) based on data from a small, unrepresentative samples of stores, and (2) does not include small independent stores, restaurants/fountain, and vending/other channels.

Baseline Estimate: Calorie Consumption LRB Calories Per Person Per Day Baseline for Communities & National Average 2014 BASELINE 2015 BASELINE 300 300 246 2014 National: 199.0 265 244 2015 National: 198.7 200 200 167 100 100 111 0 Little Rock Community Eastern L.A. Community 0 Montgomery- Lowndes Community Mississippi Delta Community Bronx-Brooklyn Community* * Bronx-Brooklyn Community is likely biased downward due to data limitations Sources: Company-Reported Volumes and Nielsen Scantrack

Baseline Estimate: Volume Consumption LRB Volumes, in Ounces, Per Person Per Day Baseline for Communities & National Average 2014 BASELINE 2015 BASELINE 50 50 40 2014 National: 34 40 2015 National: 35 30 31 30 38 35 20 24 20 10 10 0 Little Rock Community Eastern L.A. Community 0 Montgomery- Lowndes Community Mississippi Delta Community Bronx-Brooklyn Community excluded due to data limitations Sources: Company-Reported Volumes and Nielsen Scantrack

Baseline Estimate: Calories Per Serving LRB Calories Per 8-Ounce Serving Baseline for Communities & National Average 2014 BASELINE 2015 BASELINE 100 100 75 50 63 2014 National: 47 55 75 50 55 56 2015 National: 46 25 25 0 Little Rock Community Eastern L.A. Community 0 Montgomery- Lowndes Community Mississippi Delta Community Bronx-Brooklyn Community excluded due to data limitations Sources: Company-Reported Volumes and Nielsen Scantrack

Changes from 2014 Baseline: LRB Calorie Consumption Percent Change in LRB Calories Per Person Per Day Change from 2014 Baseline 3% 2% 0.4% 0% -0.2% -2% -3% National Little Rock Community -2.6% Eastern L.A. Community Sources: Company-Reported Volumes and Nielsen Scantrack, 2014 and 2015

Learnings 1. Analyze the Systems to Find and Fill the Gaps 2. Bring Entire Sectors to the Table or Create a Domino Effect 3. Get Top Down Support and Work Towards Long-Term Partnerships 4. Speak Their Language and Challenge Their Thinking 5. Be Transparent and Data-Driven

Business Sector Engagement VOLUNTARY AGREEMENTS & PARTNERSHIPS RESEARCH/ EVALUATION COMPANY/ COMMUNITY RESOURCES CONSUMER MARKETING/ ACTIVISM SHAREHOLDER RESOLUTION/ LITIGATION LEGISLATION/ REGULATION Range of Approaches* to Engage Companies to Support a Culture of Health * Approach categories established based on self-reported results to an online survey conducted June 2016 by Alliance for a Healthier Generation and Partnership for a Healthier America, funded by Robert Wood Johnson Foundation. 11 U.S. based non-profit organizations and 1 for-profit business known for national level engagement with companies or industries related to creating healthier conditions

Consumer Behavior Change Research and Development Test and Learn Marketing Sustainability