Who gains from saving nature
Ledger 1 : 33 — For each dollar financing nature-based solutions in 2023, about $33 financed activities harmful to nature. (UNEP)
Cases / Lobbying, PR and greenwashing · China / India · 1978–2026

Coca-Cola and ILSI: influence on obesity policy in China and India

Nature's voice · report
No measurement of the harm done to me here is on record.
Did nature suffer? Not measured.
What the record lacks: 6 none on record · 6 insufficient · 1 not measured · 2 disputed See the gaps

The International Life Sciences Institute (ILSI), founded in 1978 by a Coca-Cola executive, has branches in China and India. A 2019 BMJ study and later reporting describe ILSI's links to health regulators in both countries; ILSI and Coca-Cola dispute the reading that it shaped policy.

one third → two thirdsShare of ILSI-China obesity events on physical activity: 2004–2009 vs 2010–2015
Greenhalgh, The BMJ, January 2019. The author states that the effect on policy cannot be measured precisely.

Status As of 11 October 2026: FSSAI proposed a warning label on 28 September 2026; a court deferred its decision; no penalty found.

What?
An industry-funded scientific body founded by a Coca-Cola executive operated alongside health regulators in China and India while obesity policy was formed; China adopted no sugary-drink tax and India's warning-label draft was suspended.
Where?
China (ILSI-China, inside the Chinese CDC building) and India (FSSAI panels, New Delhi).
When?
From 1978; China analysis covers 2004–2015; India draft April 2018, new proposal 28 September 2026.
Who?
Gained
  • Coca-Cola and other ILSI member companies — No sugary-drink tax in China and no warning label in force in India; any commercial effect is not quantified in the sources reviewed.
Lost
None on record
Harmed
  • Populations in China and India — The sources reviewed give national obesity and diabetes estimates for India (reported, unverified) but do not attribute any share to sugary drinks.
Why?
Not established. Greenhalgh states the effect on policy cannot be measured precisely; ILSI rejects the claim that it advances company interests.
How?
Through shared premises with a state health agency in China, and overlapping roles and panel seats in India.
6 of 6 questions answered from the record

What happened

The record, in order.

ILSI was founded in 1978 by Alex Malaspina, then a senior vice president of Coca-Cola. It is funded by food and agricultural-chemical companies and has branches in 17 countries. ILSI describes itself as a bridge between government, academia and industry and rejects the claim that it advances company interests. Corporate donations to ILSI totalled $2.4 million in 2012; Coca-Cola gave $163,500 in 2012 and $337,000 in 2013.

In China, a study by Susan Greenhalgh of Harvard published in The BMJ in January 2019 found that ILSI-China operates inside the building of the Chinese Center for Disease Control and Prevention. Between 2004–2009 and 2010–2015, the share of ILSI-China's obesity events devoted to physical activity rose from about one third to about two thirds, while the share devoted to diet fell to about one fifth. A sugary-drink tax and restrictions on food advertising to children did not enter China's policy. Greenhalgh states that the effect on policy cannot be measured precisely. Coca-Cola co-founded the programme Exercise is Medicine China (2012), which promotes physical activity.

In India, the treasurer of ILSI India was also the director of regulatory affairs of Coca-Cola India, and ILSI members sat on panels of the Food Safety and Standards Authority of India (FSSAI) covering pesticides, additives and functional foods. In 2019 the India Resource Center wrote to FSSAI that this was unlawful. In April 2018 FSSAI published a draft requiring a red mark on products high in sugar, salt or fat and banning advertising to children. In August 2018 its chief executive, Pawan Agarwal, suspended the draft, citing industry concerns.

On 28 September 2026 FSSAI proposed a red hexagonal warning mark with a 365-day voluntary compliance period after notification. A court asked what had been done since 2022 and deferred its decision.

Coca-Cola ended its ILSI membership at all levels in January 2021 and gave only a routine review as the reason. The sources reviewed record that PepsiCo, Kellogg and McDonald's remained members. Coca-Cola says excess sugar is good for no one, that it supports the recommendation that added sugar not exceed 10% of energy, and that since 2017 it has required that at least half of the research it supports be funded by other bodies. No fine or penalty against Coca-Cola or ILSI is on record.

  1. 1978ILSI founded by Alex Malaspina, a senior vice president of Coca-Cola
  2. 2012Exercise is Medicine China launched, co-founded by Coca-Cola; ILSI corporate donations $2.4m
  3. 2015Global Energy Balance Network, backed by Coca-Cola, dissolves in November; Rhona Applebaum retires
  4. 2018FSSAI publishes front-of-pack warning draft (April); suspended by its chief executive (August)
  5. 2019Greenhalgh study in The BMJ (January); ILSI-China publishes a response; India Resource Center writes to FSSAI
  6. 2021Coca-Cola ends ILSI membership (January)
  7. 2026FSSAI proposes red hexagon warning with 365-day voluntary period (28 September); court defers decision

What was said

Claims, in the words of those who made them.

Where accounts differ

Each party's account, side by side, with its source. The record does not settle these points; it shows them.

Did ILSI-China steer China's obesity policy toward physical activity?
Researchers
Susan Greenhalgh, Harvard (The BMJ, January 2019)

ILSI-China works inside the Chinese CDC building; its share of events on physical activity rose from one third to two thirds between 2004–2009 and 2010–2015; a sugary-drink tax and limits on child-directed food advertising did not enter policy. She states the effect on policy cannot be measured precisely.

Company or project
ILSI Focal Point in China

Published a response to the BMJ study rejecting its findings.

ILSI
Company or project
Coca-Cola

Said it supports limiting added sugar to 10% of energy and that exercise programmes such as Exercise is Medicine China promote physical activity.

Were ILSI-linked people on FSSAI panels contrary to law?
Communities and civil society
India Resource Center

Wrote to FSSAI in 2019 that ILSI members sitting on its pesticide, additive and functional-food panels was unlawful.

Government and regulators
FSSAI

No reply to the 2019 letter appears in the sources reviewed.

How it looked

What was shown, beside what was recorded.

Shown

  • ILSI described itself as a bridge between government, academia and industry.
    ILSI
  • Coca-Cola said it supports a limit on added sugar of 10% of energy and, since 2017, requires that at least half of the research it funds be financed by other bodies.
    Coca-Cola

Recorded

  • ILSI-China operates inside the building of the Chinese Center for Disease Control and Prevention (Greenhalgh, The BMJ, January 2019).
  • Share of ILSI-China obesity events on physical activity rose from one third (2004–2009) to two thirds (2010–2015); share on diet fell to one fifth.
  • The treasurer of ILSI India was also director of regulatory affairs at Coca-Cola India.
  • FSSAI's April 2018 warning-label draft was suspended in August 2018; a new proposal was made on 28 September 2026.

Who gained

Money that reached nature, beside money that stayed elsewhere.

Reached nature or the ground

Not published
No figure published.

Gained elsewhere

Not totalled
Currency: USD · Window: . All figures cover the same period. * Estimate built from cited figures.

Responses on record

  • Coca-Cola (2017–2019): Said excess sugar is good for no one, that it supports the recommendation that added sugar not exceed 10% of energy, and that since 2017 it requires at least half of the research it funds to be financed by other bodies.
  • Coca-Cola (January 2021): Ended its ILSI membership at all levels, giving a routine review as the only reason.
  • ILSI Focal Point in China (February 2019): Published a response to the BMJ study and a related article, headed “Setting the record straight”. · ILSI
  • FSSAI (chief executive Pawan Agarwal) (August 2018): Suspended the April 2018 warning-label draft, citing industry concerns.

In court and with insurers

Every proceeding and every insurer decision on record.

Lawsuits and rulings

No court case on record. No court has ruled on this case.

Insurers

No insurer decision on record.

What nature saw

Outcomes measured on the ground, and nature's note.

Nature's report opens this page. Below: further outcomes measured on the ground.

Front-of-pack warning label, India
Not in force
Draft April 2018, suspended August 2018; new proposal 28 September 2026, court decision deferred
Sugary-drink tax, China
None
Not part of China's policy, per Greenhalgh (2019)
Penalty against Coca-Cola or ILSI
None on record
No fine or penalty found in the sources reviewed

What we don't know

Undisclosed, unproven, untried: recorded as data.
Case pending / contested

Nature

  • Not measured Harm to nature: The record holds no measurement of harm to nature.

Accounts

  • Disputed Did ILSI-China steer China's obesity policy toward physical activity?
  • Disputed Were ILSI-linked people on FSSAI panels contrary to law?
  • None on record FSSAI: No reply to the 2019 letter appears in the sources reviewed.

Record

  • None on record How much of India's diabetes and obesity burden can be attributed to sugary drinks: no source reviewed says.
  • None on record The sources reviewed record no fine, penalty or court ruling against Coca-Cola or ILSI.
  • None on record Greenhalgh states that the effect of ILSI-China on Chinese policy cannot be measured precisely.
  • None on record The court that deferred its decision on 28 September 2026, and the parties before it, are not named in the sources reviewed.
  • Insufficient Reported but not independently verified: that B. Sesikeran, a member of the board of ILSI India, was elected chair of FSSAI's warning-label panel.
  • Insufficient Reported but not independently verified: that The New York Times reported in 2019 that ILSI's influence in India coincided with rising obesity and diabetes.
  • Insufficient Reported but not independently verified: the 2022 proposal of a star-rating system in place of warnings, a Supreme Court deadline of 9 April 2025 that was exceeded, and the rejection of the star system in October 2025 after more than 14,000 comments.
  • Insufficient Reported but not independently verified: that the sugar mills' association argued there was no evidence of harm from sugar.
  • Insufficient Reported but not independently verified: an ICMR-INDIAB study (2023) estimating about 101 million adults with diabetes, 136 million with prediabetes and 254 million with obesity in India.
  • Insufficient Reported but not independently verified: that The Wire counted 239 cases against health policies in six countries in 2010–2025, more than a third of identified company cases brought by nine groups led by Coca-Cola, PepsiCo and Mondelez.
  • None on record The content of ILSI-China's published response to the BMJ study is known only; the page itself was not read in full.

Did the harm stop?

Coca-Cola ended its ILSI membership in January 2021 and cited a routine review. The India warning label remained undecided as of September 2026.

Who paid?

No fine or penalty is on record; the sources reviewed do not say who bore the health cost.

Sources

Voices on record: ✓ Company or project— Government and regulators— Courts— Press and investigations— Communities and civil society— Researchers

Company or project

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Related matters, and cases linked to this one through the same organisations, with the role each played in both.
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