World
Health Assembly Resolution removes commercial influences from
infant feeding programmes
After
a thorough debate and a 3-hour drafting session, a new strengthened
Resolution on Infant and Young Child Nutrition (WHA
55.25) was adopted at the World Health Assembly in Geneva
on Saturday 18th May.
38 countries
spoke in the debate, the large majority of speakers from the
developing world calling for the draft text to be strengthened
to ensure that the critical importance of exclusive breastfeeding
for the first six months was mentioned and that infant feeding
programmes do not involve the baby feeding industry (beyond
the requirement to respect the International
Code and subsequent relevant WHA Resolutions).
The
Resolution endorses a new Global Strategy for Infant and
Young Child Feeding, the outcome of a four-year consultative
process involving all member states.
One
issue that raised consciousness of the need to do more to protect
breastfeeding in all countries, not just in developing countries,
was the case of the 5 day old Belgian baby, who died of meningitis
in March after being fed Nestlé Beba 1 dried infant
formula from a batch which was contaminated with Enterobacter
Sakazakii. As a 'precautionary measure' on April 22,
Nestlé blocked sales of the affected batches of Beba
1 in Belgium and Luxembourg. It has not done so in Switzerland
where the product is also sold. Nestlé maintains that
current manufacturing processes are not sufficient to remove
the contamination, indicating that the problem may be widespread.
A search in Medline reveals many more cases of enterobacter
sakazakii infections due to contamination of infant formula
in the past years. IBFAN is calling for more to be done to warn
the public about the risks of artificial feeding. (see IBFAN
Press Release 10 May 2002)
Two
new monitoring reports from the USA and Canada launched in Geneva
at the time of the World Health Assembly also highlighted the
flagrant violations of the International Code in industrialised
countries and the failure to protect mothers' rights to make
fully informed decisions about infant feeding. (Click
here for IBFAN's intervention on infant and young child feeding).
During
the Assembly debate on the draft resolution notable interventions
were made by several countries: The Indian delegation called
for the removal of the term 'commercial' saying:
"Commercial
enterprises by definition are profit driven entities. It is
neither appropriate nor realistic for the WHO to expect that
commercial groups will work along with governments and other
groups to protect, promote and support breastfeeding."
India
also drew attention to WHA
Resolution 49.15 which in 1996 urged member states to ensure
that monitoring is carried out in a transparent independent
manner, free from commercial influence and that financial support
for professionals working in infant and young child health does
not create conflict of interest.
These
concerns were reinforced by a number of countries including
Palau which appealed to WHO to "protect Member States
from undue and unwanted influence by industries and manipulation
by them".
In addition
to the intervention on the infant feeding debate, IBFAN and
Consumers International made an intervention on the report on
Diet, Nutrition and Physical Activity (click
here for text). IBFAN supported the opening address by the
Director General Dr Gro Harlem Brundtland, in which she laid
down a clear challenge to the trillion dollar food industry,
referring to WHO's intention to "reinvigorate WHO's
work on diet, food safety and human nutrition," and
the problem of "excessive consumption of fatty, sugary
and salty foods". Dr Brundtland said that:
"Getting
loyalty to brand names is the key to influencing consumer
behaviour - from the time children start to walk. Children
currently influence 45% of household purchases in the US,
and 65% in urban China.....Brand name promotions - whether
for tobacco, alcohol or fast foods - are designed to take
advantage of peoples subconscious....... There is certainly
a need for guidance: in some cases, like tobacco advertising
and alcohol advertising aimed at the young, what we need is
control. WHO will play its part."
IBFAN
warmly welcomed this new initiative but also expressed caution
about the increasing trend towards Public Private Partnerships.
These concerns were shared by the People's Health Movement and
many NGOs such as, Infact and Health Action International. IBFAN
called for an urgent review and change in WHO’s checking
procedures and guidelines on conflict of interest . Earlier
in the infant feeding debate, several Member States had expressed
concern about the new UN/Bill Gates backed Global Alliance for
Improved Nutrition (GAIN) launched on 9th May. GAIN - ironically
the name of an infant formula - involves companies known for
pushing unhealthy brands of foods. The companies include Procter
and Gamble, Kraft, (a subsidiary of Philip Morris, the tobacco
giant) and Heinz a company well known for its violations of
the baby food Code. WHO has in the past clearly indicated that
it does not want to be involved in any 'partnership' or 'interaction'
with the tobacco industry or any of its subsidiaries, but its
guidelines on conflicts of interest are only in draft stage
and are unclear. UNICEF by joining this initiative is also violating
its own guidelines on the interaction with the private sector
which exclude the tobacco as well as violators of International
Code.
An article
in the Wall St Journal on 9th of May, stated that the companies
involved in GAIN expect the UN system to intervene on their
behalf to lobby for favourable tariffs and tax rates and a speedier
regulatory review of new products in targeted countries. WHO
staff denied that such promises had been made, but failed to
give assurances about whether they would be involved in this
venture.
In his
answer on the Nutrition debate Dr Derek Yach, Executive Director,
of WHO's Non-communicable Diseases and Mental Health Cluster,
said that this issue needs to be addressed from a life course
perspective, including infant and young child nutrition. He
went on to note: "the concern of Consumers International
with regard to the possible adverse commercial influences on
WHO's policy. And we certainly can assure you that as Dr Brundtland
emphasised in her opening address, that we have a commitment
to strengthen our protection of conflict and perceived conflict
of interest. "
WHO
was also asked for an affirmation that initiatives such as GAIN
would not be used to undermine breastfeeding or the progress
made on banning health claims on foods for infants and young
children. At the Codex Alimentarius labelling meeting in Halifax,
Nova Scotia, the week before the Assembly, this moved one step
further. IBFAN stressed that fortified junk foods would not
be the answer to malnutrition and called for WHO to conduct
independent research into the impact of marketing on the very
poor.
Resolution
WHA 55.19 (click
here for a pdf file) was also adopted, calling for more
action to implement the development goals set out in the Millenium
Declaration. Breastfeeding is included as an important strategy
in achieving the development goals of the United Nations Millennium
Declaration adopted by the UN in September 2000. The Millennium
Declaration sets out to reduce maternal mortality by three-quarters
and under-five mortality by two-thirds by the year 2015. In
order to facilitate the achievement of these goals Member States
are urged to "continue to advocate as public health
prioritites for safe pregnancy and childbirth, breastfeeding
and neonate, child and adolescent health and development".
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