WHA RESOLUTION
54.2
Infant
and young child nutrition
The
Fifty-fourth World Health Assembly,
Recalling
resolutions WHA33.32, WHA34.22,
WHA35.26, WHA37.30,
WHA39.28, WHA41.11,
WHA43.3, WHA45.34,
WHA46.7, WHA47.5 and WHA49.15
on infant and young child nutrition, appropriate feeding practices
and related questions;
Deeply
concerned to improve infant and young child nutrition and
to alleviate all forms of malnutrition in the world, because
more than one-third of under-five children are still malnourished
- whether stunted, wasted, or deficient in iodine, vitamin
A, iron or other micronutrients - and because malnutrition
still contributes to nearly half of the 10.5 million deaths
each year among preschool children worldwide;
Deeply
alarmed that malnutrition of infants and young children remains
one of the most severe global public health problems, at once
a major cause and consequence of poverty, deprivation, food
insecurity and social inequality, and that malnutrition is
a cause not only of increased vulnerability to infection and
other diseases, including growth retardation, but also of
intellectual, mental, social and developmental handicap, and
of increased risk of disease throughout childhood, adolescence
and adult life;
Recognizing
the right of everyone to have access to safe and nutritious
food, consistent with the right to adequate food and the fundamental
right of everyone to be free from hunger, and that every effort
should be made with a view to achieving progressively the
full realization of this right;
Acknowledging
the need for all sectors of society - including governments,
civil society, health professional associations, nongovernmental
organizations, commercial enterprises and international bodies
- to contribute to improved nutrition for infants and young
children by using every possible means at their disposal,
especially by fostering optimal feeding practices, incorporating
a comprehensive multisectoral, holistic and strategic approach;
Noting
the guidance of the Convention on the Rights of the Child,
in particular Article 24, which recognizes, inter alia,
the need for access to and availability of both support
and information concerning the use of basic knowledge of child
health and nutrition, and the advantages of breastfeeding
for all segments of society, in particular parents and children;
Conscious
that despite the fact that the International
Code of Marketing of Breastmilk Substitutes and relevant,
subsequent Health Assembly resolutions state that there should
be no advertising or other forms of promotion of products
within its scope, new modern communication methods, including
electronic means, are currently increasingly being used to
promote such products; and conscious of the need for the Codex
Alimentarius Commission to take the International Code and
subsequent relevant Health Assembly resolutions into consideration
in dealing with health claims in the development of food standards
and guidelines;
Mindful
that 2001 marks the twentieth anniversary of the adoption
of the International Code of Marketing of Breastmilk Substitutes,
and that the adoption of the present resolution provides an
opportunity to reinforce the International Code's fundamental
role in protecting, promoting and supporting breastfeeding;
Recognizing
that there is a sound scientific basis for policy decisions
to reinforce activities of Member States and those of WHO;
for proposing new and innovative approaches to monitoring
growth and improving nutrition; for promoting improved breastfeeding
and complementary feeding practices, and sound culture-specific
counselling; for improving the nutritional status of women
of reproductive age, especially during and after pregnancy;
for alleviating all forms of malnutrition; and for providing
guidance on feeding practices for infants of mothers who are
HIV-positive;
Noting
the need for effective systems for assessing the magnitude
and geographical distribution of all forms of malnutrition,
together with their consequences and contributing factors,
and of foodborne diseases; and for monitoring food security;
Welcoming
the efforts made by WHO, in close collaboration with UNICEF
and other international partners, to develop a comprehensive
global strategy for infant and young child feeding, and to
use the ACC Sub-Committee on Nutrition as an interagency forum
for coordination and exchange of information in this connection;
-
THANKS
the Director-General for the progress report on the development
of a new global strategy for infant and young child feeding;
-
URGES
Member States:
(1)
to recognize the right of everyone to have access to safe
and nutritious food, consistent with the right to adequate
food and the fundamental right of everyone to be free from
hunger, and that every effort should be made with a view
to achieving progressively the full realization of this
right and to call on all sectors of society to cooperate
in efforts to improve the nutrition of infants and young
children;
(2)
to take necessary measures as States Parties effectively
to implement the Convention on the Rights of the Child,
in order to ensure every child's right to the highest attainable
standard of health and health care;
(3)
to set up or strengthen interinstitutional and intersectoral
discussion forums with all stakeholders in order to reach
national consensus on strategies and policies including
reinforcing, in collaboration with ILO, policies that support
breastfeeding by working women, in order substantially to
improve infant and young child feeding and to develop participatory
mechanisms for establishing and implementing specific nutrition
programmes and projects aimed at new initiatives and innovative
approaches;
(4)
to strengthen activities and develop new approaches to protect,
promote and support exclusive breastfeeding for six months
as a global public health recommendation, taking into account
the findings of the WHO expert consultation on optimal duration
of exclusive breastfeeding, (note 1)
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;
(5)
to support the Baby-friendly Hospital Initiative and to
create mechanisms, including regulations, legislation or
other measures, designed, directly and indirectly, to support
periodic reassessment of hospitals, and to ensure maintenance
of standards and the Initiative's long-term sustainability
and credibility;
(6)
to improve complementary foods and feeding practices by
ensuring sound and culture-specific nutrition counselling
to mothers of young children, recommending the widest possible
use of indigenous nutrient-rich foodstuffs; and to give
priority to the development and dissemination of guidelines
on nutrition of children under two years of age, to the
training of health workers and community leaders on this
subject, and to the integration of these messages into strategies
for health and nutrition information, education and communication;
(7)
to strengthen monitoring of growth and improvement of nutrition,
focusing on community-based strategies, and to strive to
ensure that all malnourished children, whether in a community
or hospital setting, are correctly diagnosed and treated;
(8)
to develop, implement or strengthen sustainable measures
including, where appropriate, legislative measures, aimed
at reducing all forms of malnutrition in young children
and women of reproductive age, especially iron, vitamin
A and iodine deficiencies, through a combination of strategies
that include supplementation, food fortification and diet
diversification, through recommended feeding practices that
are culture-specific and based on local foods, as well as
through other community-based approaches;
(9)
to strengthen national mechanisms to ensure global compliance
with the International Code of Marketing of Breastmilk Substitutes
and subsequent relevant Health Assembly resolutions, with
regard to labelling as well as all forms of advertising,
and commercial promotion in all types of media, to encourage
the Codex Alimentarius Commission to take the International
Code and relevant subsequent Health Assembly resolutions
into consideration in developing its standards and guidelines;
and to inform the general public on progress in implementing
the Code and subsequent relevant Health Assembly resolutions;
(10)
to recognize and assess the available scientific evidence
on the balance of risk of HIV transmission through breastfeeding
compared with the risk of not breastfeeding, and the need
for independent research in this connection; to strive to
ensure adequate nutrition of infants of HIV-positive mothers;
to increase accessibility to voluntary and confidential
counselling and testing so as to facilitate the provision
of information and informed decision-making; and to recognize
that when replacement feeding is acceptable, feasible, affordable,
sustainable and safe, avoidance of all breastfeeding by
HIV-positive women is recommended; otherwise, exclusive
breastfeeding is recommended during the first months of
life; and that those who choose other options should be
encouraged to use them free from commercial influences;
(11)
to take all necessary measures to protect all women from
the risk of HIV infection, especially during pregnancy and
lactation;
(12)
to strengthen their information systems, together with their
epidemiological surveillance systems, in order to assess
the magnitude and geographical distribution of malnutrition,
in all its forms, and foodborne disease;
-
REQUESTS
the Director-General:
(1)
to give, greater emphasis to infant and young child nutrition,
in view of WHO's leadership in public health, consistent
with and guided by the Convention on the Rights of the
Child and other relevant human rights instruments, in
partnership with ILO, FAO, UNICEF, UNFPA and other competent
organizations both within and outside the United Nations
system;
(2)
to foster, with all relevant sectors of society, a constructive
and transparent dialogue in order to monitor progress
towards implementation of the International Code of Marketing
of Breastmilk Substitutes and subsequent relevant Health
Assembly resolutions, in an independent manner and free
from commercial influence, and to provide support to Member
States in their efforts to monitor implementation of the
Code;
(3)
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 six months as a global public
health recommendation, taking into account the findings
of the WHO expert consultation on optimal duration of
exclusive breastfeeding (note 1),
the provision of safe and appropriate complementary foods,
with continued breastfeeding up to two years of age or
beyond, and community-based and cross-sector activities;
(4)
to continue the step-by-step country- and region-based
approach to developing the new global strategy on infant
and young child feeding, and to involve the international
health and development community, in particular UNICEF,
and other stakeholders as appropriate;
(5)
to encourage and support further independent research
on HIV transmission through breastfeeding and other measures
to improve the nutritional status of mothers and children
already affected by HIV/AIDS;
(6)
to submit the global strategy for consideration to the
Executive Board at its 109th session in January 2002 and
to the Fifty-fifth World Health Assembly (May 2002).
Note
1: As formulated in the conclusions and recommendations of
the expert consultation (Geneva, 28 to 30 March 2001) that
completed the systematic review of the optimal duration of
exclusive breastfeeding (see document A54/INF.DOC./4).
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