140th WHO Executive Board Meeting 23rd January – 1st February 2017

There has been an IBFAN team in Geneva for the WHO Executive Board Meeting.  Two days have been spent in closed meetings for the shortlisting of three candidates for the post Director General of WHO.   (CLICK HERE)

IBFAN’s statements on three of the Agenda items  (Emergencies and NCDs) are on the WHO website   and pasted below.

The proceedings are live webcast  HERE

Agenda Item 14.3 Engagement with non-State actors.

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IBFAN is one of WHO’s longest-standing partners. Our work since Halfden Mahler’s time – has centred on WHA Resolutions that have saved countless infant lives.

IBFAN is anxious that WHO emerges from the FENSA process as the lead agency in public health, able to fulfill its constitutional mandate and not be relegated a limited role in a ‘multi-stake-holderised’ global health architecture. Through ill-defined terms such as ‘partnership’ ‘stake-holder’ and ‘trust’ corporations claim the right to participate in public health decision-making processes, sidelining governments, the UN and peoples’ human rights.

Despite this, FENSA was adopted – with promises of due diligence and increased transparency, and that WHO would “exercise particular caution…when engaging with private sector entities …whose policies or activities are negatively affecting human health..”  The DG report further promotes this notion.

The report was presented to Member States too late for us to comment before the meeting of WHO’s Programme Budget and Administration Committee meeting (as Dr Chan called for many times).   It includes recommendations on  five new applications for Official Relations status, and  is a test of  the thoroughness of the FENSA process. The Gates Foundation application is an example that has prompted a new letter to the EB from 35 organisations.

That the Foundation has made substantial contributions to WHO and many health initiatives is matter of public record. That it might have an influence on WHO’s nutrition policy setting– for good or for bad – we make no judgement here – is also no secret.

Less well known are its substantial investments in food and beverage industries – investments that are merely noted in the report as: “engagements with select members of the pharmaceutical… food and beverage…health care… industries in pursuit of our public health goals.”

The FENSA process could have provided clarity on the relationship between WHO and the Foundation.  This opportunity has been lost, and public trust that the process will tackle the task ahead properly has been severely damaged.

We ask that the Gates decision be delayed, ‘stakeholder’ defined and FENSA reviewed and evaluated as soon as possible and that WHO is provided with adequate, untied funding to carry on its essential work.

Agenda item 10.1: Preparation for the third High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases, to be held in 2018            

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IBFAN has long followed WHO’s efforts to tackle NCDs. We have watched with growing alarm as the Global Coordinating Mechanism – before and after the adoption of FENSA – has given disproportionate access and promotion to a wide range of corporations and public private partnerships. The GCM shows no sign of heeding WHO’s FENSA requirement to “exercise particular caution…when engaging with private sector entities …whose policies or activities are negatively affecting human health..”

Now the GCM proposes an annual self-reporting mechanism for NSAs that we believe will mislead the public and policy makers alike. Although it is welcome that NSAs are ‘encouraged’ to submit only actions within their core area of business, spurious marketing strategies masquerading as health initiatives could be registered and so gain credibility from the image transfer from WHO. The baby food industry hi-jacking of World Breastfeeding Week, for example. The promotion of voluntary – here today, gone tomorrow – initiatives, can also undermine government resolve to bring in effective legislation.

Since WHO states that it does not have the capacity to ‘quality assure’ all activities and guarantee that they are in conformity with WHO policy, this idea should be abandoned. It is far too risky.

Last, we call on WHO to be consistent in its messaging. On the one hand WHO emphasises micronutrients – on the other, it encourages consumption of fresh fruit, vegetables and minimally processed, bio-diverse foods. Over-emphasis on single micronutrients opens the door to idealising health and nutrition claims on less healthy processed products. The public meanwhile is unaware that high heat processing and storage can destroy essential nutrients.

You could stare at a banana all day and not see the nutrients it contains. Whereas a glance at a package laden with nutrition claims immediately inspires confidence.

We are keen to continue working with WHO to address this challenge

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 IBFAN statement on the Report of the Echo Commission: Implementation Plan (Agenda Item 10.4)

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Thank you for the opportunity to speak on this important subject.

IBFAN participated in the development of the ECHO Report and is pleased that many of our comments were taken on board, in particular the recognition of the importance of breastfeeding and appropriate complementary feeding in obesity prevention and in diabetes prevention.

As you know, States obligations with regard to breastfeeding are defined in the 3-pillar framework ‘Protect, Promote and Support’ adopted in 2002 by the WHA. Recently, a group of UN experts, among which the Special Rapporteur on the Right to Health and the Committee on the Rights of the Child, have reiterated that these obligations, including protection against misleading marketing, constitute an integral part of States’ human rights obligations.

Mothers themselves have no obligation to breastfeed their child. Indeed, they always remain fully sovereign over their own body. It is rather the role of States to ensure that mothers do not face obstacles to breastfeeding.

States have the obligation to provide mothers with accurate and unbiased information and counseling from the start of their pregnancy, including on the continuation of breastfeeding up to 2 years or beyond. We regret that key factor, is not mentioned in Action 4. The Baby Friendly Hospital Initiative should also be mentioned as the external audit that guarantees implementation of the Ten Steps.

To be consistent with the recommendation to exclusively breastfeed up to 6 months, States should grant working mothers with a minimum of 6 months of maternity leave.

Finally in relation to education, we are pleased that Action 5 warns of the risks of corporate sponsorship and the need for conflict of interest safeguards – corporate sponsorship of education blurs the lines between marketing and education. As highlighted by the Special Rapporteur on the Right to Education the rapid increase in the commercialization of education is a major concern.

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Emergencies:  breastfeeding –  a lifeline in emergencies.

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IBFAN is the global network that protects breastfeeding and works for policy coherence with WHO’s Resolutions.

Our work is especially important in emergencies, where responses are often characterized by influxes of unsolicited donations of all manner of baby feeding products – donations that can often do more harm than good.

Breastfeeding is a lifeline for infants and young children in emergencies, has zero environmental impact, and States have a human rights obligation to ensure that mothers are enabled to make an informed decision on infant feeding, free of conflicts of interests. Yet, breastfeeding is often forgotten or badly managed.

Meanwhile, media reports show starving babies and rarely question why they are not breastfed. IBFAN’s World Breastfeeding Trends Initiative assessment of policies and programmes on Infant feeding during emergencies show that implementation of UN recommendations on this is dismal.[1]

WHO – as a norm-setting, rather than implementing agency – can play a key role in reversing this situation by promoting emergency preparedness protocols that aim to improve food security in the long term. Such actions could even be opportunities for public health generally. 

We know emergencies prompt philanthropy, but they are also opportunities for commercial exploitation and the Business of Malnutrition. While the speedy delivery of products can be essential in certain circumstances, emergency relief protocols must prevent over-emphasis on product-based, quick-fix approaches to the treatment of malnutrition, approaches that can undermine confidence in breastfeeding and sustainable, local, bio-diverse foods. If breastmilk substitutes are required they must be purchased, distributed and used according to the UN’s agreed strict criteria. Training is essential – to support breastfeeding, of course, but also to minimize the risks of artificial feeding for non breastfed children, whilst ensuring that breastfeeding is not undermined.

We look forward to continuing work with WHO on this important issue.

Thank you

[1]  http://worldbreastfeedingtrends.org/84-country

http://worldbreastfeedingtrends.org/WBTi-84Country/84-country-report-Indicator9.pdf

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