scholarly journals What You Don’t Know About the Codex Can Hurt You: How Trade Policy Trumps Global Health Governance in Infant and Young Child Nutrition

2021 ◽  
Author(s):  
Katheryn Russ ◽  
Phillip Baker ◽  
Michaela Byrd ◽  
Manho Kang ◽  
Rizki Nauli Siregar ◽  
...  
Keyword(s):  
Public Health ◽  
Child Nutrition ◽  
Standard Setting ◽  
World Health ◽  
International Code ◽  
Infant And Young Child ◽  
Trade Politics ◽  
Breast Milk Substitutes ◽  
Milk Substitutes ◽  
Health Organization

Background: International food standards set by the Codex Alimentarius Commission (CAC), have become more prominent in international trade politics, since being referenced by various World Trade Organization (WTO) agreements. The new standing of the CAC imposes limits on domestic public health regulation. We show this includes implementation of the World Health Organization (WHO) International Code of Marketing of Breast-milk Substitutes. Methods: Using trade in commercial milk formulas (CMF) as a case study, we collected detailed data on interventions across various WTO bodies between 1995 and 2019. We used language from these interventions to guide data collection on member state and observer positions during the CAC review of the Codex Standard for Follow-up Formula (CSFUF), and during CAC discussions on the relevance of WHO policies and guidelines. Results: Exporting member states made 245 interventions regarding CMFs at the WTO, many citing deviations from standards set by the CAC. These did not occur in formal disputes, but in WTO Committee and Accession processes, toward many countries. In Thailand, complaints are linked to weakened regulation. Exporters also sought to narrow the CSFUF at the CAC in a way that is at odds with recommendations in the International Code. Tensions are growing more broadly within the CAC regarding relevance of WHO recommendations. Countries coordinated during WTO committee processes to advocate for reapportioning core WHO funding to the CAC and in order to further influence standard-setting. Conclusion: The commercial interests of the baby food industry are magnifying inconsistencies between health guidelines set by the WHO, standard-setting at the CAC, and functions of the WTO. This poses serious concerns for countries’ abilities to regulate in the interests of public health, in this case to protect breastfeeding and its benefits for the health of infants, children and mothers.

David Clark: Defender of Human Rights and Breastfeeding

2020 ◽  
Vol 36 (2) ◽  
pp. 221-223
Author(s):  
Laurence M. Grummer-Strawn ◽  
David Lawson Clark
Keyword(s):  
Human Rights ◽  
Infant Feeding ◽  
Child Nutrition ◽  
International Code ◽  
International Trade Agreements ◽  
Training Materials ◽  
Infant And Young Child ◽  
Breast Milk Substitutes ◽  
Milk Substitutes ◽  
Human Rights Based Approach

On September 10, I had the pleasure of interviewing my friend and colleague David Lawson Clark, the legal advisor for infant and young child nutrition and expert on the International Code of Marketing of Breast-milk Substitutes at UNICEF. A native of Scotland, David began his career as an attorney with the Scottish Development Agency and subsequently worked for the United Nations Interregional Crime and Justice Research Institute in Rome, Italy. Since 1995, David has assisted more than 60 countries in drafting legislation to implement the International Code of Marketing of Breastmilk Substitutes and has been instrumental in bringing a human rights-based approach to the protection, promotion, and support of breastfeeding. He has contributed to the development of international policy guidelines in the area of HIV and infant feeding and infant feeding in emergencies, and has provided guidance on issues around international trade agreements and intellectual property rights. David has written and contributed to many articles and publications on health and nutrition policy, developed courses and training materials on the implementation of the International Code and maternity protection, and has facilitated numerous workshops on the issue. (LGS refers to Dr. Laurence Grummer-Strawn and DC are the verbatim responses of David Clark)

scholarly journals Recommendations for Adopting the International Code of Marketing of Breast-milk Substitutes Into U.S. Policy

2017 ◽  
Vol 33 (3) ◽  
pp. 582-587 ◽  
Author(s):  
Jessica Soldavini ◽  
Lindsey Smith Taillie
Keyword(s):  
United States ◽  
Breast Milk ◽  
World Health Organization ◽  
The United States ◽  
World Health ◽  
International Code ◽  
The World ◽  
Breast Milk Substitutes ◽  
Milk Substitutes ◽  
Health Organization

In 1981, the World Health Organization adopted the International Code of Marketing of Breast-milk Substitutes ( International Code), with subsequent resolutions adopted since then. The International Code contributes to the safe and adequate provision of nutrition for infants by protecting and promoting breastfeeding and ensuring that human milk substitutes, when necessary, are used properly through adequate information and appropriate marketing and distribution. Despite the World Health Organization recommendations for all member nations to implement the International Code in its entirety, the United States has yet to take action to translate it into any national measures. In 2012, only 22.3% of infants in the United States met the American Academy of Pediatrics recommendation of at least 6 months of exclusive breastfeeding. Countries adopting legislation reflecting the provisions of the International Code have seen increases in breastfeeding rates. This article discusses recommendations for translating the International Code into U.S. policy. Adopting legislation that implements, monitors, and enforces the International Code in its entirety has the potential to contribute to increased rates of breastfeeding in the United States, which can lead to improved health outcomes in both infants and breastfeeding mothers.

International Conference on Child Day-Care Health: Opening Remarks

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 987-987
Author(s):  
Hu Ching-Li
Keyword(s):  
Child Health ◽  
Child Nutrition ◽  
Well Being ◽  
Fundamental Rights ◽  
World Health ◽  
Child Day Care ◽  
Infant And Young Child ◽  
The Family ◽  
Definition Of ◽  
Health Organization

It is important to recall the definition of health embodied in the Constitution of the World Health Organization (WHO) over 45 years ago: "Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic, or social condition." Among the Organization's mandated functions is "to promote maternal and child health and welfare and to foster the ability to live harmoniously in a changing total environment." The challenge of that task is no less today than it was then. Historically, societies have evolved various patterns of family structure for social and economic functions. In preindustrial societies there evolved a great concordance between these functions, with many of the health, developmental, and socialization functions taking place first within the family and then within the immediate community. The rapid social changes of both the industrial and information revolutions have changed drastically the functions of the family, and have shifted many of the health, developmental, and social functions to nonfamily institutions, from which families are often excluded or marginally involved. Much of the international attention to child health in this last decade has been directed at simple interventions to prevent the nearly 13 million deaths each year of children under 5: universal child immunization; the control of diarrheal and acute respiratory diseases; and infant and young child nutrition, particularly breast-feeding.

Breastfeeding

2018 ◽  
Author(s):  
John Puntis
Keyword(s):  
Emotional Support ◽  
World Health ◽  
Social And Emotional ◽  
Maternity Hospitals ◽  
The World ◽  
Breast Milk Substitutes ◽  
Milk Substitutes ◽  
Health Organization ◽  
Method Of Assessment ◽  
Huge Variation

Breastfeeding has many benefits to both mother and infant and the World Health Organization (WHO) recommends exclusive breastfeeding for the first 6 months of life. Correct positioning of the baby at the breast and social and emotional support for the mother are among other factors that are important to successful breastfeeding. The ‘Baby Friendly’ initiative sets out ten steps to successful breastfeeding and encourages maternity hospitals to implement these and become accredited. The WHO ‘International Code of Marketing of Breast Milk Substitutes’ gives clear guidance on acceptable practices to formula manufacturers so that breastfeeding is not undermined. ‘Tongue tie’ has increasingly become regarded as a cause of maternal pain and difficulty latching on during breastfeeds. However, estimates of prevalence show huge variation and there is no agreed standard method of assessment. In addition, the risks of frenotomy need to be balanced against any possible benefit.

scholarly journals Evidence of Violations of the International Code of Marketing of Breast-Milk Substitutes since the Adoption by the World Health Assembly in 1981: A Systematic Scoping Review Protocol

2021 ◽  
Vol 18 (18) ◽  
pp. 9523
Author(s):  
Genevieve E. Becker ◽  
Constance Ching ◽  
Paul Zambrano ◽  
Allison Burns ◽  
Jennifer Cashin ◽  
...  
Keyword(s):  
Breast Milk ◽  
Scoping Review ◽  
Research Question ◽  
World Health ◽  
International Code ◽  
World Health Assembly ◽  
Published Evidence ◽  
The World ◽  
Breast Milk Substitutes ◽  
Milk Substitutes

This is the protocol for a scoping review that aims to systematically explore and summarise the published evidence of violations of the International Code of Marketing of Breast-milk Substitutes (the Code) and subsequent World Health Assembly Resolutions globally. The planned scoping review will seek to identify what research has been conducted on the topic, examine the geographic spread and nature of violations, and summarise knowledge gaps. The Code was adopted in 1981 by the World Health Assembly to protect infant health, in particular from aggressive and inappropriate marketing of breastmilk substitutes including formula and related products. Non-compliance with the Code or violations are described in reports, however, no existing systematic review of the global research appears to have been conducted that encompasses the varied disciplines including health, economics, and gender. The review will inform international and national decision-makers on the nature of violations and potentially highlight the need for new modalities to regulate this marketing. The proposed scoping review will use the six-step process of Arksey and O’Malley which includes defining the research question; identifying the relevant literature; selecting studies; charting the data; collating, summarising and reporting the findings; and will include a consultative group.

scholarly journals Marketing Breastfeeding Substitutes: A Discussion Document

2020 ◽  
Vol 17 (24) ◽  
pp. 9239
Author(s):  
Genevieve E Becker
Keyword(s):  
Child Nutrition ◽  
Health Workers ◽  
Long Term Effects ◽  
Policy Makers ◽  
Health And Wellbeing ◽  
Infant And Young Child ◽  
Discussion Document ◽  
Parental Confidence ◽  
Breast Milk Substitutes ◽  
Milk Substitutes

Marketing influences knowledge, attitudes, and decisions related to infant and young child nutrition, safety, development, parental confidence, and other aspects of health and wellbeing of the child. These attitudes and behaviours of parents, health workers, policy makers, and other influencers have short- and long-term effects on the child. There is an International Code of Marketing of Breast-Milk Substitutes. Is it time to have a code of marketing of breastfeeding substitutes?

scholarly journals Media audit reveals inappropriate promotion of products under the scope of the International Code of Marketing of Breast-milk Substitutes in South-East Asia

2017 ◽  
Vol 20 (8) ◽  
pp. 1333-1342 ◽  
Author(s):  
Kristine Hansen Vinje ◽  
Linh Thi Hong Phan ◽  
Tuan Thanh Nguyen ◽  
Sigrun Henjum ◽  
Lovise Omoijuanfo Ribe ◽  
...  
Keyword(s):  
Breast Milk ◽  
East Asia ◽  
Child Nutrition ◽  
Market Size ◽  
Milk Formula ◽  
South East Asia ◽  
International Code ◽  
Editorial Content ◽  
Breast Milk Substitutes ◽  
Milk Substitutes

AbstractObjectiveTo review regulations and to perform a media audit of promotion of products under the scope of the International Code of Marketing of Breast-milk Substitutes (‘the Code’) in South-East Asia.DesignWe reviewed national regulations relating to the Code and 800 clips of editorial content, 387 advertisements and 217 Facebook posts from January 2015 to January 2016. We explored the ecological association between regulations and market size, and between the number of advertisements and market size and growth of milk formula.SettingCambodia, Indonesia, Myanmar, Thailand and Vietnam.ResultsRegulations on the child’s age for inappropriate marketing of products are all below the Code’s updated recommendation of 36 months (i.e. 12 months in Thailand and Indonesia; 24 months in the other three countries) and are voluntary in Thailand. Although the advertisements complied with the national regulations on the age limit, they had content (e.g. stages of milk formula; messages about the benefit; pictures of a child) that confused audiences. Market size and growth of milk formula were positively associated with the number of newborns and the number of advertisements, and were not affected by the current level of implementation of breast-milk substitute laws and regulations.ConclusionsThe present media audit reveals inappropriate promotion and insufficient national regulation of products under the scope of the Code in South-East Asia. Strengthened implementation of regulations aligned with the Code’s updated recommendation should be part of comprehensive strategies to minimize the harmful effects of advertisements of breast-milk substitutes on maternal and child nutrition and health.

scholarly journals Old Tricks, New Opportunities: How Companies Violate the International Code of Marketing of Breast-Milk Substitutes and Undermine Maternal and Child Health during the COVID-19 Pandemic

2021 ◽  
Vol 18 (5) ◽  
pp. 2381
Author(s):  
Constance Ching ◽  
Paul Zambrano ◽  
Tuan T. Nguyen ◽  
Manisha Tharaney ◽  
Maurice Gerald Zafimanjaka ◽  
...  
Keyword(s):  
Breast Milk ◽  
Child Health ◽  
Maternal And Child Health ◽  
Public Awareness ◽  
The Philippines ◽  
World Health ◽  
International Code ◽  
Breast Milk Substitutes ◽  
Milk Substitutes ◽  
And Child Health

Breastfeeding is critical to maternal and child health and survival, and the benefits persist until later in life. Inappropriate marketing of breastmilk substitutes (BMS), feeding bottles, and teats threatens the enabling environment of breastfeeding, and exacerbates child mortality, morbidity, and malnutrition, especially in the context of COVID-19. These tactics also violate the International Code of Marketing of Breast-Milk Substitutes. This study identified marketing tactics of BMS companies since the start of the COVID-19 pandemic by reviewing promotional materials and activities from 9 companies in 14 countries, and the official Code reporting data from the Philippines. Eight qualitative themes emerged that indicate companies are capitalizing on fear related to COVID-19 by using health claims and misinformation about breastfeeding. Other promotional tactics such as donations and services were used to harness the public sentiment of hope and solidarity. Past studies show that these tactics are not new, but the pandemic has provided a new entry point, helped along by the unprecedented boom in digital marketing. There was a sharp increase of reported violations in the Philippines since the pandemic: 291 during the first months of the outbreak compared with 70 in all of 2019, corroborating the thematic findings. A lack of public awareness about the harm of donations and inadequate Code implementation and enforcement have exacerbated these problems. Proposed immediate action includes using monitoring findings to inform World Health Assembly (WHA) actions, targeted enforcement, and addressing misinformation about breastfeeding in the context of COVID-19. Longer-term action includes holding social media platforms accountable, raising public awareness on the Code, and mobilizing community monitoring.

scholarly journals Mapping child growth failure in Africa between 2000 and 2015

Nature ◽  
2018 ◽  
Vol 555 (7694) ◽  
pp. 41-47 ◽  
Author(s):  
Aaron Osgood-Zimmerman ◽  
Anoushka I. Millear ◽  
Rebecca W. Stubbs ◽  
Chloe Shields ◽  
Brandon V. Pickering ◽  
...  
Keyword(s):  
Child Nutrition ◽  
Growth Failure ◽  
Child Growth ◽  
World Health ◽  
African Countries ◽  
The Sustainable Development ◽  
Risk Of Death ◽  
Infant And Young Child ◽  
Increased Risk ◽  
Health Organization

Abstract Insufficient growth during childhood is associated with poor health outcomes and an increased risk of death. Between 2000 and 2015, nearly all African countries demonstrated improvements for children under 5 years old for stunting, wasting, and underweight, the core components of child growth failure. Here we show that striking subnational heterogeneity in levels and trends of child growth remains. If current rates of progress are sustained, many areas of Africa will meet the World Health Organization Global Targets 2025 to improve maternal, infant and young child nutrition, but high levels of growth failure will persist across the Sahel. At these rates, much, if not all of the continent will fail to meet the Sustainable Development Goal target—to end malnutrition by 2030. Geospatial estimates of child growth failure provide a baseline for measuring progress as well as a precision public health platform to target interventions to those populations with the greatest need, in order to reduce health disparities and accelerate progress.

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