The realization that there are different moral grounds for responsibility (promotion and protection) of health and that different actors may have different moral reasons to contribute to health can also highlight the standardization of the prevention agreement in the Netherlands or similar public-private health partnerships. The package of measures for the prevention of obesity includes: more pipes in public spaces, a ban on the sale of sugary soft drinks in schools, a “schijf van vijf” campaign, Dutch dietary guidelines, further reduction in sugar content in soft drinks, healthier foods in canteens and restaurants , the intensification of the “Young Healthy Weights” program and the support provided by health organizations to lifestyle. The goal is to reduce the expected increase in obesity from more than 60% in 2040 to a decrease of less than 40%. This is a great ambition because it means returning to overweight levels in the early 1990s. RIVM estimates that the package will result in a limited reduction in the increase in obesity. Further action is needed to achieve this goal. While we recognize that governments and public and private organizations all have compelling ethical reasons for promoting and protecting health, it means that it is not so much a “national agreement” or a public-private partnership that determines the extent of their responsibilities. A social agreement such as the one signed in the Netherlands should be seen as an expression and not as a basis or definition of their responsibilities. A relevant conclusion is that liability can go beyond what has been agreed.
Another consequence is that these “joint responsibilities” are not subject to the two conditions. If one party withdraws at some point in the agreement, it will not affect its responsibility or that of the other parties. Their responsibility for health is justified regardless of the agreement they have reached. An interpretation of the agreement would be that it is the basis of each party`s responsibility and that the government and public and private partners have agreed on who should do what (hence a division of tasks) to meet the overall ambitions of the agreement.