The International Code of Marketing of Breastmilk Substitutes 30 Years of protecting babies against commercial pressures

Highlights of Code Celebration, Geneva, 13th May 2011

IBFAN-GIFA, the Geneva-based member of the International Baby Food Action Network, organized this 30 year International Code celebration. We wanted to pay tribute to all the people around the world who have been working to ensure Code compliance and its national implementation. The International Code is a unique instrument that aims to protect, promote and support breastfeeding and optimal infant and young child feeding practices. Thus we wished to highlight the importance of a tool that has made an inestimable contribution to saving lives and improving health of the world's children. About 60 persons participated in this event, from IBFAN national and regional offices around the world, from UN agencies such as UNICEF, the World Health Organization and the UN High Commission for Refugees, from the Committee for the Rights of the Child, and from Swiss authorities, universities and Non Governmental Organizations. We were also happy to have with us many friends and supporters of our work.

In the introduction, Robert Peck, IBFAN-GIFA's president, highlighted the importance of the collaboration with the Swiss government. The City of Geneva was thanked for making this celebration possible and for participating in this landmark event.

A silver plate was presented to the Geneva government representatives, Mr. André Klopmann, NGO Liaison Officer, and Ms. Elisabeth Debenay, Head of the Health Prevention and Promotion Department (DARES). The Swiss press club was also acknowledged and thanked for hosting the IBFAN press conference on May 12th on the 30 years of the International Code.

Lida Lhotska, Regional coordinator of IBFAN Europe, from IBFAN-GIFA, presented the history of the International Code and highlighted the fact that it was a long and hard battle to get the Code adopted at WHA in 1981. 14 subsequent relevant WHA Resolutions have been adopted since then to clarify and strengthen the Code in response to new marketing strategies of the baby food industry. She pointed out that the Code is not working in isolation, but in a larger political and economic environment. When the Code was adopted back in the 80s, the situation was very different. The neoliberal economic order of today has as one key feature a strong opposition to any legally binding measures.

Annelies Allain, Director, IBFAN’s International Code Documentation Center (ICDC), presented the 2010 IBFAN ‘Breaking the rules’ report, which summarizes Code violations from around the world from the 11 largest baby food manufacturers and 11 makers of feeding bottles and pacifiers. The BTR report shows that Code violations are not diminishing, but companies are finding more subtle ways to market their products, in particular through the use of health claims. Nestlé is still leading with 134 allegations of the breaches of the Code. Annelies Allain also highlighted the biggest current problem and a clever marketing strategy: use of health and nutrition claims. She used examples from Ukraine to demonstrate lack of Code compliance in Europe. She also launched the latest version of the ‘State of the Code’ by country report which shows how individual countries score in terms of child protection through legal means based on the Code. Ms. Allain also quoted Dr. Halfdan Mahler, former WHO Director General: "Without the NGOs, there would never have been a Code".

Following on from the presentations on the history of the Code and the ‘Breaking the rules’ report, representatives of IBFAN regional offices presented briefly on the situations in their regions of the world. Arun Gupta, Regional coordinator for IBFAN Asia, explained that there were major challenges in the Asia region as the market for baby food products was one of the fastest growing in the world. Floryana Vasquez, representative of the IBFAN Latin America and Caribbean region, explained the importance of Code training for IBFAN, Code implementation and monitoring being the centerpiece of IBFAN's work. Edouard Zerbo, representative of IBFAN Afrique and Joyce Chanesta, Regional coordinator of IBFAN Africa presented on the situation in the African region, highlighting the importance of Code monitoring and its positive impact at national level, including removals of Code violating publicity. Nahed Ismail, Regional coordinator of IBFAN Arab World, presented the case of repeated Code violations in Egypt, where a new IBFAN-ICDC report ‘Look what they are doing in Egypt’ had just been released to motivate government action. Elisabeth Sterken, Regional coordinator of IBFAN North America, highlighted how IBFAN’s work on Codex Alimentarius standards was closely linked to the national implementation of the Code and central to IBFAN's activities.

Overall, from the various presentations from across the world, the same conclusions applied: much progress has been achieved, thanks to the watchdog function of IBFAN and support from allies. However, a lot remains to be done to achieve full Code implementation and compliance. The Global Initiative for Child Survival project (gBICS), a joint IBFAN and WABA (World Alliance for Breastfeeding Action) project, presented by its chair, Arun Gupta, aims to galvanize action on the protection, promotion and support of breastfeeding at national and international level. The World Breastfeeding Trends Initiative (WBTi), a participatory tool to track infant and young child feeding policies and programmes on a country-by-country basis, is a key component of gBICS, and the first WBTi ‘State of breastfeeding in 33 countries’ report launched in 2010 documents progress, including on Code implementation.

David Clark, UNICEF’s infant and young child feeding legal officer, stressed that breastfeeding was "a natural safety net against the worst effects of poverty" and the International Code is vital to protect breastfeeding from unethical marketing and manipulation. He emphasized that companies were complaining about Code regulation, therefore, "we must be doing something right". UNICEF remains committed to work with governments on Code implementation and encourages adoption of legally enforceable measures with systems to ensure effective monitoring and sanctions for enforcement.

Francesco Branca, head of the WHO Department Nutrition for Health and Development in Geneva, emphasized that without strong action on implementation of the Code there would be little progress in nutrition. He stressed that the Code was second in line, after the Framework Convention on Tobacco Control (FCTC), in terms of comprehensive frameworks on protection against marketing. He highlighted WHO's commitment to better tracking Code implementation, underscoring the need for sanctions and overall scale up of implementation. He also emphasized the importance of linking breastfeeding with other health agendas, in particular non communicable diseases (NCDs).

Caroline Wilkinson, nutrition officer for UNHCR, highlighted the importance of protection, promotion and support of breastfeeding and the International Code and relevant subsequent WHA resolutions, in emergencies, where mothers and babies are even more vulnerable and generous donations can do more harm than good. There has been a huge positive evolution in the protection and support of breastfeeding in emergency situations over the last decade. The 2007 key policy guidance ‘Operational Guidance on Infant and Young Child Feeding in Emergencies’ contains a clear statement on the importance of preventing and avoiding donations of breastmilk substitutes, bottles teats and other milk products, and on how to minimize the risks of artificial feeding. The International Code and relevant subsequent resolutions is embedded throughout this guidance, with the 2010 WHA resolution 63.23 on infant and young child nutrition urging Member States to follow this policy.

Yanghee Lee, chairperson, Committee on the Rights of the Child, explained in her speech, read out by Ina Verzivolli of IBFAN-GIFA, how the Convention on the Rights of the Child, adopted in 1989, directly addresses the issue of breastfeeding in its article 24. Breastfeeding is a legal right of the child and the promotion of breastfeeding is an obligation of the State. Many countries, both industrialized and developing, are alarmingly quite lax in applying the evidence-based research supporting the benefits of breastfeeding to their policies and health practices. She also noted an absence of political will to implement the International Code, with the resulting non implementation of article 24 of the CRC. Welcoming the launch of the ‘Breaking the rules’ 2010 IBFAN Code monitoring report, she said that it was quite alarming to note how substitutes to breastmilk were being “pushed” through various clever means. She stressed that adopting the Code was only a start. To ensure protection of breastfeeding, continuous monitoring of Code implementation is essential, and in this regard, she wished IBFAN all the success and said the CRC Committee counted on continued support and collaboration with the network.

Sarah Amin, Director of the World Alliance of Breastfeeding Action, WABA, emphasized that for WABA the International Code is one of eight core issues of work. She stressed that any organization or individual wishing to be a member of the WABA network had to be Code compliant and not accept any sponsorship from baby food and related companies. Congratulating IBFAN and ICDC, she underscored the importance of the ‘Breaking the rules’ report as it enables naming and shaming of companies to hold them accountable. She also paid tribute to the late Prof. Michael Latham, and to the current Chairperson Emeritus of WABA, Anwar Fazal, both key players in "making the Code happen". She conveyed the strong message of Anwar Fazal to continue protecting women and children worldwide and be incorrigible in holding corporations and governments accountable.

Finally, after presentations from UN agencies and WABA, participants were given a brief overview of the situation in Switzerland, the Code’s birthplace and home to the very first IBFAN office, IBFAN-GIFA. Daphné Lachavanne, programme officer responsible for IBFAN-GIFA's Swiss project, briefly described the new edition (2010) of the Swiss agreement on the promotion of breastmilk substitutes. This agreement has been somewhat strengthened, to include formulas up to six months. However, overall, it is inferior to the minimum standard of the Code and the WHA resolutions. She welcomed the presence of the Swiss authorities and in particular of the Department of Health in Geneva, as well as the representative of the Swiss Foundation for the Promotion of Breastfeeding, highlighting the importance of their presence to improve collaboration on the protection, promotion and support of breastfeeding in Switzerland.

© IBFAN-GIFA, 2011

MORE INFORMATION: 

The International Code of Marketing of Breastmilk Substitutes - 30 Years of protecting babies against commercial pressures - French

"Celebrating 30th Anniversary of the International Code Of Marketing of Breastmilk Substitutes" Statement by the Chairperson of CRC Yanghee Lee