World Health Assembly Resolution tackles conflicts of interest

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Press release 26 May 2012


Health campaigners including the International Baby Food Action Network are welcoming a new resolution (WHA 65.6) passed at the 65th World Health Assembly which calls on governments to strengthen controls on the marketing of breastmilk substitutes and to establish 'adequate mechanisms' to deal with conflicts of interest.


The Resolution will be especially important in relation to the new partnerships and "multi-stakeholder" arrangements that are springing up to tackle poor nutrition - many of which are pushing fortified processed baby foods and fuelling the multi-billion 'business of malnutrition.'  


Proposed by Canada, UK, Swaziland and Mexico, the Resolution ushered in WHO's Comprehensive Implementation Plan on Maternal, infant and young child nutrition, which emphasises the importance of breastfeeding and sound infant and young child nutrition in child survival.


An initial strong Resolution proposed by Swaziland and Uganda to protect infant health, prompted several days of behind the scenes wrangling, where Canada and the US called for the deletion of everything except a single line adopting the Implementation Plan. One particular sticking point was Paragraph 3.3. which requests the Director General of WHO  " to develop risk assessment, disclosure and management tools to safeguard against possible conflicts of interest in policy development and implementation of nutrition programmes consistent with WHO’s overall policy and practice."    The US wanted this tied down to the 'country level.'  However, after Norway stepped in, with support from Swaziland and other countries, saying that Conflicts of Interest need to be addressed at all levels, the reference to 'country Level'  was removed.  


During the Assembly debates several Member States expressed concerns about the emphasis on fortified processed foods and supplements, which may not be necessary and can also undermine support for and attention to breastfeeding and nutritious, affordable, culturally appropriate and sustainable local foods.  Indeed, instead of improving child health, many feared that the market-led approaches to "prevent" malnutrition championed by public-private-partnerships, could actually worsen the situation and increase further the double burden of malnutrition -  both under and over nutrition. In response to the particular concerns of Finland regarding the overemphasis on fortified supplements and other issues, the tables contained in the Action Plan were removed.   


The Global Alliance for Improved Nutrition (GAIN), which works with over 600 companies,  including Danone (the world's second largest baby food company and violator of the World Health Assembly baby food marketing requirements), PepsiCo, Mars and Kraft,  is one such body that has been lobbying to use health and nutrition claims to promote baby foods. Another initiative called, Scaling Up Nutrition (SUN) was wholeheartedly supported in the speech by the International Special Dietary Industries (ISDI). SUN has been encouraging developing countries to partner with companies to address malnutrition. However, it has yet to formulate its own conflict of interest safeguards. 

In calling  for Conflict of Interest safeguards at all levels and mandating WHO "to provide clarification and guidance on the inappropriate promotion of foods for infants and young children"  the Resolution could do much to clean up these initiatives and ensure that they work truly in the interests of child health.

Welcoming the Resolution,  Dr Francesco Branca, Director of WHO Nutrition, stressed the importance of having an agreement on a common vision on targets which can be measured, and where an accountability framework can be developed.


Maternal, infant and young child nutrition (WHA 65.6)

Resolution proposed by the delegations of Canada, Mexico,Swaziland and the United Kingdom of Great Britain and Northern Ireland


The Sixty-fifth World Health Assembly,

PP1  Having considered the report on maternal, infant and young child nutrition: draft comprehensive implementation plan,1

1.    ENDORSES    the comprehensive implementation on maternal, infant and young child nutrition;

2.    URGES  Member states 2 to put into practice, as appropriate, the comprehensive implementation plan on maternal, infant and young child nutrition, including:

  1. developing or, where necessary, strengthening nutrition policies so that they comprehensively address the double burden of malnutrition and include nutrition actions in overall country health and development policy, and establishing effective intersectoral governance mechanisms in order to expand the implementation of nutrition actions with particular emphasis on the framework of the global strategy on infant and young child feeding;
  2. developing or where necessary strengthening legislative, regulatory and/or other effective measures to control the marketing of breast-milk substitutes;
  3. establishing a dialogue with relevant national and international parties and forming alliances and partnerships to expand nutrition actions with the establishment of adequate mechanisms to safeguard against potential conflicts of interest;
  4. implementing a comprehensive approach to capacity building, including workforce development.


3.    REQUESTS the Director-General:

  1. to provide clarification and guidance on the inappropriate promotion of foods for infants and young children as mentioned in resolution WHA63.23, taking into consideration ongoing work of the Codex Alimentarius;
  2. to support Member States to monitor and evaluate policies and programmes, including those of the global strategy for infant and young child feeding, with the latest evidence on nutrition;
  3. to develop risk assessment, disclosure and management tools to safeguard against possible conflicts of interest in policy development and implementation of nutrition programmes consistent with WHO’s overall policy and practice;
  4. to report to the 67th World Health Assembly through the Executive Board on progress in the implementation of the code of marketing breastmilk substitutes and related WHA resolutions.

 

  • IBFAN/Consumers International  Statement on WHO Reform read by Ina Verzivolli 

    IBFAN Comments on WHO Reform 

    IBFAN/Consumers International Statement  on Infant and Young Child Nutrition read by Dr Arun Gupta 

     

    by Judith Richter Social Medicine (www.socialmedicine.info) 147, Volume 6, Number 3, March 2012  (attached)  CLICK HERE
    http://info.babymilkaction.org/sites/info.babymilkaction.org/files/14.12.WHO reform Richter.pdf

     

  • Thank you, chairperson.

    As Consumers International, the global federation of consumer organisations worldwide and an IBFAN founding member, we welcome the opportunity to address the Implementation Plan on Maternal, Infant and Young Child Nutrition.

    Poor infant and young child feeding practices are central to the problem of child malnutrition and survival and yet resources to protect, support and promote breastfeeding are far from commensurate with its importance and UNICEF warns that breastfeeding rates are stagnant or declining in many areas.

    We are concerned that the overemphasis on micronutrient interventions in the current plan, neglects the underlying causes of childhood malnutrition, many of which are in the 2002 Global Strategy for Infant and Young Child Feeding.

    We wish to raise the following points:

    Firstly the implementation plan should include indicators for the periodic evaluation of policies and programmes, as well as the identification of gaps and action plans to bridge them.

    Secondly we would like WHO to assist countries to end the inappropriate promotion of commercial complementary foods for infants and young children (WHA 63.23). In order to halt any further reappearance of promotional strategies that contravene the International Code on Marketing, the implementation plan should also include independent monitoring and reporting of such Code violations. This would be in line with Para 44 of the Global Strategy, which specifically obligates the infant feeding industry to provide safe products according to Codex Alimentarius and follow the Code and all its resolutions.

    Third, the proposal in para 31 to establish adequate mechanisms to safeguard against potential conflicts of interest should also be addressed by WHO and international partners, and not limited to member states. These mechanisms should be established before initiatives such as SUN are promoted to member states.

    We endorse the Resolution proposed by Swaziland and Uganda in Conference document 6.

    Finally we invite Member States to join us for the World Breastfeeding Conference in New Delhi on 6-9th December, in partnership with Government of India, which focuses on the Global Strategy and with the oblective of “Lets Protect Every Feeding Mother”, and campaign line, “Babies Need Mom-made Not Man-made”.

    Thank you Chair.



 


 

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CI Final WHO Reform 2012.pdf138.16 KB
IYCN statement CI final.pdf142.36 KB
IBFAN WHO reform May 2012.pdf139.44 KB
14.12.WHO reform Richter.pdf297.73 KB