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Case Study

Protecting Heart Health in Brazil

Brazil approved strict limits on trans fat in food following strategic advocacy led by local civil society organizations supported by the Global Health Advocacy Incubator (GHAI).

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The Challenge

Trans fat consumption has been linked to more than 11,000 cardiovascular disease deaths per year in Brazil. After the Pan American Health Organization’s (PAHO’s) Trans Fat Free Americas declaration in 2008, the Brazilian Association of Food Industries voluntarily committed to reducing trans fat in processed foods. Brazil’s regulatory agency, the National Agency of Sanitary Surveillance (ANVISA), announced plans to explore regulatory options to reduce the country’s still growing trans fat burden in 2018, but limited public awareness and strong industry interference in political matters meant that the elimination of industrially produced trans fat was far from certain.

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GHAI’s Response

GHAI met with Brazilian decision-makers in 2018 to explore opportunities for civil society advocacy to support trans fat elimination. We partnered with the Brazilian Association of Nutrition (Asbran) and Federal Council of Nutritionists (CFN), an organization with more than 170,000 members and chapters across the country, on a broad-scale campaign to support ANVISA’s regulatory efforts.

Asbran and CFN worked closely with ANVISA to assess regulatory options and determine the most effective one from a public health perspective and according to guidelines issued by the World Health Organization (WHO) and PAHO. GHAI shared scientific evidence and international best practices and, together with partners, promoted the submission of expert testimony to guide regulators.

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Stopping Industry-Backed Legislation

The Brazilian National Congress took steps to limit the content of trans fat – but while initial efforts aimed to reach best practices, food industry interests were able to amend a legislative proposal after it had been approved by the Senate and referred to the House of Deputies. Asbran and CFN worked to defeat the proposal, which sought to limit ANVISA’s authority to reduce trans fat in food to limits recommended by WHO and PAHO.

The campaign monitored legislative activity, tracked industry actions, and fed information to lawmakers, media and other allies. It developed informational materials, briefed lawmakers, and participated in public hearings to make the case for strict trans fat limits. In June 2019, a public hearing on trans fat organized by influential legislators with support from Asbran and local partners drew considerable media attention and won media allies who continued to report accurately and favorably on trans fat elimination. The event convinced members of the National Congress to put trans fat legislation on hold, deferring instead to ANVISA to regulate trans fat levels in food.

Consensus Building

The campaign continued to create momentum for regulatory change. Asbran and CFN built consensus among leading public health and consumer protection organizations on a proposal that aligned with WHO and PAHO recommendations. A well-functioning coalition of advocates directly engaged political decision-makers and leveraged media to create a sense of urgency. Every step of the way, coalition partners tracked and neutralized opposition messages and tactics.

GHAI supported coalition partners’ active participation in public hearings and other events and activities. We helped partners develop and implement joint communications plans that built public awareness and support for trans fat policies using the slogan “Pela Saúde do Coração, Gordura Trans Não” (“For heart health, no trans fat”). A campaign website and social media channels served to educate the public and demonstrate support for trans fat elimination.

Mobilizing Public Support

On August 7, 2019, ANVISA launched a public consultation on trans fats, and campaign partners embarked on a nationwide tour to mobilize nutritionists, advocates, and concerned citizens to action. The goal: to increase participation in ANVISA’s public consultation. Asbran and CFN organized more than a dozen meetings with nutritionists and advocates throughout Brazil. With support from GHAI, they launched a massive email and social media campaign that reached tens of thousands of people.

All told, ANVISA received 1,220 public comments, 97 percent in favor of the agency’s trans fat proposal. GHAI was among the international institutions that submitted comments.


On December 17, 2019, ANVISA’s board of directors approved regulations capping trans fat at 2 percent of total fat in all foods by July 1, 2021, and banning partially hydrogenated oils starting January 1, 2023, marking the beginning of the end of industrially produced trans fat in Brazil.

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Lessons Learned

  • Government engagement and ownership is key to successful policy change campaigns.
  • Policy change often needs to be supported by capacity strengthening for implementation.
  • Health and nutrition experts can be powerful voices for trans fat elimination.
  • Events and media can mobilize people to act in support of trans fat elimination and other health priorities.
  • Industry groups may oppose public health campaigns that threaten their revenues.
  • Strategic and technical assistance can help civil society advocates to conduct effective campaigns that build on international experiences and best practices.