World Health Assembly May 2000

Infant and Young Child Nutrition WHA Agenda Item 12.4

Consumers International

Mr Chairperson, Director General, distinguished delegates of the Assembly, I welcome the opportunity to speak on behalf of Consumers International, on the issue of infant and young child nutrition. Consumers International is a partner with the International Baby Food Action Network (IBFAN), a network of over 150 citizens' groups who have been working for the last two decades to protect infant health in more than 90 countries. In 1998 IBFAN received the Alternative Nobel Prize for its efforts.

IBFAN works in partnership with UNICEF and WHO. It also works directly with governments and the health care system. Through training, monitoring and the development of important resource tools it has been instrumental in the implementation of the International Code and relevant resolutions in many countries. We continue to see, however, that interference by the infant food industry and false statements about compliance has delayed legislation in several countries. We would like to congratulate Ghana on the enactment of the Breastfeeding Promotion Regulations, passed into Law just last week after a nine-year struggle.

There was no WHA resolution in the last reporting year of 1998. Another reporting year without resolution would send the message that infant and young child nutrition is not an area of concern. This is certainly not true as we heard during the long debate yesterday. The World Health Assembly should continue to give guidance to Member States. A Resolution this year would not inhibit progress in the global strategy and plan of action; in fact it would accelerate the progress.

IBFAN and Consumers International note that the Technical Consultation on Infant and Young Child Feeding which took place in March 2000 came up with a concluding statement signed by nearly all participating experts on the Duration of Exclusive Breastfeeding. This helps to resolve the controversy surrounding the appropriate age of introduction of complementary foods. The technical consultants stated and I quote, "there is now sufficient scientific, including epidemiologic evidence for changing the recommended duration of exclusive breastfeeding to about 6 monthsÉ" Unquote. Delegates may also wish to see the article in today's British Medical Journal on this issue.

There is indeed sufficient science to make policy on this question of age. WHO has already published a review of the research on this subject . It appeared as Technical Report: WHO/NUT/98; Complementary Feeding of Young Children in Developing Countries: a review of current scientific knowledge. That report states that the optimal length of exclusive breastfeeding is about 6 months. What must also be taken into account is that major respected national and international agencies such as the International Lactation Consultants Association, La Leche League International, the USAID funded Linkages, the American Academy of Pediatrics and last but not least UNICEF have already adopted the six months' recommendation rather than the old "4 to 6 months". As the delegate from C™te d'Ivoire said yesterday: "if we say four, it means cereals can be promoted from that age on".

We therefore appreciate the call by Brazil for a 6 month exlusive breastfeeding recommendation. We were heartened to see that more than 26 countries supported that call yesterday. We would like to remind Member States that two Resolutions were already adopted which mention 6 months. Resolutions are policy of the Organisation. Could there be other reasons for WHO not to follow its own policy guidelines?

Also in the Brazilian draft was a call to strengthen the implementation of the International Code of Marketing of Breastmilk Substitutes and all subsequent relevant WHA Resolutions which enjoy the same status as the International Code. IBFAN views this as a major tool in the realisation of steps needed to prevent the premature interruption of exclusive breastfeeding and to reverse the decline in the prevalence and duration of breastfeeding. In this connection we ask that WHO take effective measures to ensure compliance with the International Code in new methods of electronic communications, especially the Internet where we see parent-targeting websites which promote artificial feeding as equivalent to breastfeeding and offer free product samples.

We also request WHO and Member States to address the increasing use of health claims by manufacturers of processed infant foods by ensuring that such claims are prohibited in standards set at the Codex Alimentarius and national legislation.

IBFAN and Consumers International are pleased that WHO is considering the adoption of Guidelines on Interaction with Commercial Enterprises. In a world where health care systems and services are increasingly being privatized, there is an urgent need for WHO to protect its status as a truly independent advocate for human rights and health for all. As the highest policy setting body on health, WHO has a duty to ensure that its policies, research priorities (including its research on HIV) and its direction are not inadvertently subverted in its drive to attract funds and resources. It is essential that companies with a vested interest in the HIV and the infant feeding market are not taken on as partners by WHO. We hope that the final draft will garantee WHO's independence in policy and action. And in order to minimize the need for funds from the private sector we urge all Member States to fulfil their financial obligations to the organization.

IBFAN and Consumers International will continue to offer WHO and Member States its cooperation in technical and policy development in infant and young child nutrition and looks forward to the time where mothers will be supported in their infant feeding decisions without commercial interference so that infants and young children can enjoy the highest attainable level of health.

We thank you for your attention.