Science
defeats baby food industry vested interests at the World Health
Assembly
A landmark
Resolution recommending that infants be exclusively breastfed
for 6 months was passed at the 54th World Health Assembly (WHA)
today.
The
Resolution settles a 7-year controversy over at least two aspects
of the baby food issue - the optimal duration for exclusive
breastfeeding and the marketing of complementary foods for infants.
Clarity on
these issues will support policies aiming to improve infant
health and decrease rates of mortality and morbidity globally.
The
new Resolution also contains important protective clauses regarding
baby food industry promotional practices such as health claims
and internet advertising and addresses other issues such as
human rights.
The
Resolution was agreed at the Committee stage of WHA on Wednesday
16 May after a 2.5 hour debate chaired Dr. Prof. S. Ongeri of
Kenya. There were interventions by 50 member states and 7 international
NGOs. Speaker after speaker stressed the need to do more to
protect breastfeeding, especially during the first 6 months
of life. The
debate followed 15 hours of discussion at the WHO
Executive Board meeting in January 2001.
After
appeals by the Chair consensus was reached with no dissenting
voices. The Resolution was approved by the full Assembly today
in time for the 20th Anniversary of the adoption of the International
Code of Marketing of Breastmilk Substitutes on Monday 21st
May.
Members
of the International Baby Food Action Network (IBFAN)
were present during the Assembly, launching the latest report
on violations of the International Code, Breaking
the Rules 2001. Monitoring conducted in 14 countries has
again revealed the systematic and sometimes blatant ways that
companies continue to undermine health in pursuit of profits.
IBFAN
and Save the Children also urged WHO to show caution in its
relations with the private sector - and to ensure that its health
policies reflect the best available science, rather than the
pressures exerted by those with who put economic interests before
health.
The
new Resolution (ref: Agenda Item 13.1, Infant and Young child
nutrition, A54/45) in para. 2 (4) urges Member States to:
"...support
exclusive breastfeeding for six months as a global public
health recommendation taking into account the findings of
the WHO Expert Technical Consultation on optimal duration
of exclusive breastfeeding and to provide safe and appropriate
complementary foods, with continued breastfeeding for up to
two years or beyond...."
The
new Resolution was first put forward by Brazil in May 2000,
one of the 62 countries which already have "6 months"
as a national policy and a country which has led the research
into breastfeeding.
The
decision illustrates the importance of independent science in
the public interest, something IBFAN has been calling for.
Denise
Coitinho, Head of Food and Nutrition Policy Unit at Ministry
of Health, Brazil, said:
"I am extremely
happy that we reached a global agreement on this issue. The
most important thing is to act globally in consensus - and
the expert committee conclusions were very important in facilitating
this consensus."
Cesar
Victora, Prof of Epidemiology at the University Pelotas, and
visiting professor at the London School of Hygiene and Tropical
Medicine, has never accepted funding from the baby food industry
and was a member of WHO Expert Committee. He was present at
the debate and said:
"I'm really
pleased to see that scientific evidence can result in changes
in a global policy - for 15 years we have been accumulating
evidence on the benefits of exclusive breastfeeding and it's
a great pleasure that this has at last led to a change in
global policy. The scientists greatest frustration is when
our studies do not result in changes in the real world."
The
United States joined the consensus, laying aside its earlier
objections to aspects of the Resolution.
Thomas
Novotny, MD, MPH, Deputy Assistant Secretary for International
and Refugee Health, US Department of Health & Human Services,
said:
"We are
pleased to have consensus on this issue. It does a lot to
move forward on an effective recommendation for exclusive
breastfeeding for 6 months, while at the same time allowing
all the considerations that need to be taken into account."
Dr Hans
Troedsson, Team Coordinator, Health Services Delivery, Department
of Child and Adolescent Health and Development, WHO, said:
"We are
pleased that the World Health assembly has adopted this important
public health resolution. The implementation of this public
health resolution is associated with two important challenges.
The first is the need to increase exclusive breastfeeding
rate for 6 months at the population level. The second, to
promote nutritionally adequate, safe and appropriate complementary
feeding."
Dr Tomris
Turmen, speaking for WHO Secretariat, stressed the importance
of the Resolution, and referred to 3 studies in Brazil, Mexico
and Bangladesh which demonstrated that simple interventions
that support mothers could rapidly and effectively increase
rates of exclusive breastfeeding, which all acknowledged were
extremely low world wide.
The
aim of the Resolution is not intended to force mothers to breastfeed
against their will, and recognises that some mothers may not
experience conditions that facilitate exclusive breastfeeding
for the first 6 months, and then continued breastfeeding with
adequate complementary foods. However it should empower those
women who want to do this, and ensure that all women are supported
in their decision to do what is best for their children's health.
It is
hoped that the clear statement of the recommended period of
exclusive breastfeeding contained in the Resolution will stop
the baby food industry from marketing complementary foods for
use from 4 months of age or even ealier as is too often the
case (see the evidence in Breaking
the Rules 2001). This remains to be seen as the industry
presently disregards a 1994 Resolution (WHA
47.5) which states that complementary feeding should be
fostered from "about 6 months" of age. The extra sales of complementary
foods resulting from labelling products for use from 4 months
of age rather than 6 months are estimated to be worth US$1 billion
annually.
Before
the Assembly the International
Association of Infant Food Manufacturers (IFM) wrote to
member states in an attempt to weaken support for the Resolution.
IFM is made up of some of the worst violaters of the International
Code and subsequent, relevant Resolutions, including Nestlé,
Wyeth, Numico (parent company of Nutricia, Milupa, Cow&Gate)
and Hipp. Industralised countries especially came under pressure
from the baby food industry.
Last
year IFM attempted to stop the Resolution from even being discussed
at this Assembly (see British
Medical Journal report 9 September 2000).
During
the Committee discussion Prof. Dr. Abdul Malik Kasi, Minister
for Health of Pakistan, stated that while Pakistan was among
the frontline member states to support the Code, promotion of
breastmilk substitutes has misled mothers. He explained that
the Pakistan government is working to introduce legislation,
but the industry has been attempting to stop this for the past
decade. He called on WHO to launch a campaign to halt industry
pressure against the Code.
For
further information contact:
Patti
Rundall, (UK) +44 1223 464420 Mobile +44 7990 501337
Email:
info@babymilkaction.org
For
updates from the World Health Assembly see the IBFAN website
at:
http://www.ibfan.org/english/news/press/presswhamay01.html
Notes:
The
Resolution URGES Member States para 2.(4): "to strengthen
activities and develop new approaches to protect, promote and
support exclusive breastfeeding for 6 months as a public health
recommendation, taking into account the findings of the WHO
expert consultation on optimal duration of exclusive breastfeeding,
and to provide safe and appropriate complementary foods, with
continued breastfeeding for up to two years of age or beyond,
emphasizing channels of social dissemination of these concepts
in order to lead communities to adhere to these practices."
The
Resolution REQUESTS the Director General: "to provide support
to Member States in the identification, implementation and evaluation
of innovative approaches to improving infant and young child
feeding, emphasizing exclusive breastfeeding for 6 months as
a public health recommendation, taking into account the findings
of the WHO expert consultation on optimal duration of exclusive
breastfeeding, and to provide safe and appropriate complementary
foods, with continued breastfeeding for up to two years of age
or beyond, and community-based and cross-sector activities."
The
conclusions and recommendations of the WHO expert consultation
on optimal duration of exclusive breastfeeding are available
as a pdf file from
http://www.who.int/gb/EB_WHA/PDF/WHA54/ea54id4.pdf
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