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Mr
Chairman, Director General, honourable Members of the
Board, friends, good afternoon. I welcome the opportunity
to speak on behalf of Consumers International. On the
issue of infant feeding, Consumers International is a
partner with the International Baby Food Action - IBFAN
- a coalition of over 150 citizens groups who have been
working to protect infant health in more than 90 countries
for the last two decades.
Consumers
International and IBFAN in this, the twentieth anniversary
of the landmark adoption of the International
Code, wish to continue working with WHO in our efforts
to ensure that all the Resolutions of the World Health
assembly are upheld. We welcome the report of the Secretariat.
To quote from it: "the aim of the of the strategy should
be to help fulfil the right of every child to the highest
attainable standard of health by protecting, promoting
and supporting optimal feeding practices"
It
is undeniable that the highest attainable standard of
health for the majority of the world's infants is attained
through breastfeeding. There are a number of issues related
to the report which fail to reflect this which we would
like to mention. Firstly , the issue of period of exclusive
breastfeeding - 'about 6 months', versus '4 to 6 months'
. We already have a World Health Assembly Resolution (WHA
47.5) which addresses and resolves this problem and
urges members states to foster complementary feeding from
'about 6 months.'
Although
research continues to support the appropriateness of this
policy; and although the policy is, as of today, in place
in 61 countries, the status of this Resolution is continually
ignored and undermined.
We
hear Dr Brundtland's call for science-based evidence.
On this question we understand that WHO already carried
out a review of studies in developing countries in 1998
which clearly recommended 'about 6 months.' On the other
hand, there seems to be no scientific basis for a policy
of '4-6 months.' In this current review, given that few,
perhaps only 25 of the 2,900 references being examined,
meet the required criteria, we have to question the delay.
The economic interests are evident. A conservative estimate
of the value of sales of infant foods in those two short
months is at least one billion dollars. But
should financial gain influence health policy?
If,
as the report states, the review will be ready in March,
we assume it will available to assist in the adoption
of a Resolution settling the marketing question in May
2001 and that matters will not be delayed till 2002. Such
a Resolution in 2001 would greatly facilitate the adoption
of a strong Codex standard on complementary foods which
would benefit the majority of the worlds infants. If decisions
are delayed again who will take responsibility for the
infant lives that might be lost as a result?
As
you know, IBFAN has been monitoring the International
Code and Resolutions for 20 years. We are now confronted
with two new problems, namely health claims and internet
advertising.
Our
second concern is Health Claims. Increasingly companies
are bringing out new versions of products, medicalising
normal infant feeding behaviour, and making claims which
are in direct contravention of the spirit of the Code
and which can be very confusing for mothers. To give just
two quick examples. This company claims that its product
'significantly improves symptoms in 94% of babies' This
one claims to 'stop diet related colic in 48 hours.' -
with only a passing reference to breastfeeding.
Thirdly,
Internet advertising. This is becoming increasingly prevalent
and respects no national boundaries or national laws.
If you are in any doubt about the blatant nature of such
advertising can I urge you to see for yourself on your
own computers. A resolution clearly showing that such
promotion is contrary to WHO Policy and the provisions
of the International Code would be invaluable and
would underscore that the Code and the Resolutions are
universal.
This
leads us to our 4th concern, the important question of
the Independence of monitoring.
WHO, as the highest health policy setting body in the
world, should be crystal clear in its guidelines and recommendations.
Yet in the Resolution currently under discussion, there
is an important contradiction in Operative Paragraph 2.5..
How can a monitoring body be both transparent, independent
and free from commercial influence, while at the same
asked to work 'especially with' the private sector?
Would
we expect the public to be confident about research into
the safety of, for example beef, or tobacco, if all the
research was done in conjunction 'with' or funded by the
meat or tobacco industry?
This
question of independent research leads to our fifth concern,
the controversial issue of vertical transmission of HIV.
This issue was brought into sharp focus when the US and
Swiss media made an attack on UNICEF, simply for refusing
to accept corporate donations of formula for their pilot
projects on HIV. This shows how industry involvement can
distort health policies and public perceptions of them.
In this case donated formula was presented as the 'simple'
solution to the problem. The British
Medical Journal and other media, have now thankfully
highlighted the falsity of this simplistic view, which
ignored the risks of artificial feeding. We appreciate
Dr Nabarro's comments on this.
Its
important to keep such things in perspective: while 1.7
million babies might have contracted HIV through breastmilk
in the last 20 years, almost certainly, over 15 million
babies will have died from lack of breastfeeding in only
10 years.
We
still do not have the answer to this terrible dilemma.
Only research will help. We feel that in addition to any
research done by and with commercial enterprises - research
that it is completely independent from any wealth generating
objectives must be done. Only then will the important
questions be properly addressed. For example primary prevention
of HIV infection of the mother and the impact of patterns
of breastfeeding, in particular exclusive breastfeeding,
which seems to confer a much reduced risk of HIV transmission
than mixed feeding. This would be much more feasible and
culturally appropriate for the disadvantaged, those most
at risk
Thank
you, Mr Chairman, for giving us the opportunity to speak
today. We would be happy to share our other concerns about
the draft Resolution and other parts of the report with
members of the Board.
Statement
presented by Madame Blanche Bationo, IBFAN Afrique, on
behalf of Consumers International and IBFAN
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