Sir, the use of vending machines is becoming popular in developing countries such as India and China.1 Their use is increasingly found in school premises, where the income from them can be used to supplement limited budgets.2 The problem is accessibility; students can walk from their classroom and use one coin to obtain a whole range of sugary snacks and carbonated drinks. Young children enjoy this freedom, yet the machines offer them some of the most unhealthy food options and increase snacking frequency during school hours. Indeed, most studies show that the use of school vending machines is positively correlated with confectionery consumption and negatively correlated with fruit consumption.3 Evidence from developed countries shows significant differences in the caries level of children from schools with and without vending machines.4

While some schools in some countries are trying to implement rules and programmes that eliminate these unhealthy options, it is often difficult and expensive to offer fresh fruits and vegetables as an alternative.5 However, according to the Centre for Science in the Public Interest (CSPI), schools that have switched to selling healthier foods in vending machines have not experienced a reduction in vending machine revenue.6

Developed countries have learnt this lesson and adopted a public health approach by developing guidelines and/or legislation about the appointment of bodies responsible for the management of vending machines in school (eg US Department of Agriculture) and what should be loaded in the machines.6 Developing countries should not delay in adopting these positive lessons.