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French and US Trade delegations put child health at risk

39th Codex Alimentarius Nutrition Committee (CCNFSDU), Berlin, Germany

4th – 8th December 2017

The nutrition committee of the WHO/FAO Codex Alimentarius Commission – the UN body that sets standards for the global trade of foods and commodities – met in Berlin last week [1].  The mandate of Codex is ostensibly to protect consumer health and facilitate fair trade, however, these aims were threatened once again by the commercial and political interests of producer countries, and the Conflict of Interest rules that do not safeguard these aims effectively.   This year the United States (US) and France were the most problematic countries. Only through the strong representation from other governments, including many from developing countries, alongside WHO, UNICEF, the International Baby Food Action Network (IBFAN) and other civil society organisations, were consumer protective safeguards retained.

Of the 350 delegates listed in the report, 40% (143) were from industries and their front groups that represent the agro-chemical industry and manufacturers of highly-processed foods, drinks, additives and supplements.   The priorities of these corporations is to extend the shelf life of products, protect and promote their global trade, and, if possible, portray all this as being in the best interests of the poor [2].   Their impact on the environment and involvement  in  deforestation, mono-cropping, land and sea grabbing and risky technologies is rarely mentioned. [3]

Not content with sitting at the back of the room with other Observer organisations,  over 60 industry representatives managed to persuade  governments to include them on their delegations, so gaining easy and privileged opportunities to push their deregulatory trade agendas. [4]  Such inappropriate commercial involvement at Codex is largely ignored even though it includes a range of tactics, for example the funding of “technical” side events, dinners and receptions for participants, the promotion of industry-funded research. All have the aim of weakening standards so that the food industry’s capacity for trade is not compromised. [5]

IBFAN has participated in Codex meetings since 1995 for the very different purpose of protecting infant and young child health. IBFAN is now renewing its call that Codex and governments end the Conflicts of Interest that affect all aspects of the Codex standard-setting process. [6] One straightforward step would be to ensure that no industry participants sit on government delegations and that all are clearly listed in the Official Report. Dozens, including the Policy and Intelligence Manager of Danone (second to Nestlé in the global baby food market) are not listed at all because they attend wearing  public badges. Some 40 countries seem to have responded to this call and many have now reduced industry presence or are industry free – a step in the right direction to protect the independence of policy making.

Some examples: This year China had just one industry person on its 15-member delegation.  In 2006, when it had nine from industry and just two from the Government, it repeatedly supported industry positions and opposed health safeguards. Similarly, India stopped including industry representatives in its delegation in 2011 and consistently advocates safeguards to protect breastfeeding and child health.

This year the European Union (EU) led the calls to lower sugar levels in formulas for babies 12-36 months.  However,  in 2006, when it was represented by an industry-friendly delegate (who has since retired)  it joined the US in successfully opposing a call from Thailand  to reduce sugar levels in baby foods. [7]

In 2016 the US, unusually, had just one person from industry on its 13-person-delegation and did not oppose the consensus view that a key World Health Assembly Resolution (WHA 69/9) , passed in 2016, should be included in the text under discussion. [8]  This year with five industry people on its 15-person-delegation, the US and France (with three of it 4-person delegation from industry) cast doubt on the global consensus achieved for that Resolution and went on to call for the removal of references to recommendations of the World Health Organisation generally (as cited in the Report of the meeting: “It was not the role of Codex to include references to WHO policies and some WHA resolutions that may go beyond the scope of the standard and the mandate of Codex, and such inclusion could set a risky precedent and could undermine the credibility of Codex standards”.

At the same time as the Codex meeting, Salmonella contamination was discovered in French-made formulas. [French recall due to Salmonella contamination of formula].Unlike the UK, France does not legally require that powdered formulas carry the preparation instructions recommended by WHO –that water must be boiled and left to cool to no less than 70 degrees before reconstitution, a safeguard that would reduce the risk of babies becoming ill. Prof M Guelaye Sall, speaking for Senegal, emphasised the importance of breastfeeding and the difficulty of preparing formula safely in his country.

WHO, one of the parent organisations of Codex, gave a strong response that was supported by many other Member States and civil society organisations.[4]  WHO noted that no Member State had disassociated itself from WHA69.9 at the Assembly, that the approval of Resolutions is expressed by many different phrases such as ‘adopts, approves, endorses, welcomes, noted with appreciation and notes’ that all lie ‘on a spectrum expressing approval’.  WHO stressed that  ‘there is one thing which is common to all these resolutions and decisions and that is they are the resolutions and decisions of the WHA which is the highest Governing Body of WHO’.   Many WHA Resolutions and Codex Commission decisions have called for Codex to take proper account of WHA decisions [10]. IACFO commented that the Resolution and Guidance had in fact been weakened to ensure consensus, and that conflict of interest safeguards are embedded in all WHO policies and recommendations, and are highly relevant for the standard-setting procedures of Codex.  Since WHO safeguards have been embedded in Codex texts for decades, the change proposed by the US would necessitate a complete overhaul of all the standards on baby foods and many other products and would be a major setback for global consumer protection and child survival.

The only reason that producer countries are pushing weak rules at Codex is to put pressure on countries to accept products that they may not want or need, in this case the countries where the risk to child health is greatest. IBFAN will be working to stop such a U-turn being taken by the Committee. The consensus position from last year’s meeting was that references to WHA Resolutions,  including WHA 69.9, should be included so that the  marketing and labelling of formulas for babies 6-36 months can be controlled.


IBFAN members attended the Berlin meeting on the observer delegations of the International Association of Consumer Food Organisations (IACFO) and the International Lactation Consultants Association (ILCA).  For more information:

Elizabeth Sterken – IBFAN (Canada) esterken@infactcanada.ca

Patti Rundall – IACFO (UK)  prundall@babymilkaction.org (+44 7786 523493   )

Dr J.P Dadhich – IBFAN (India) jpdadhich@bpni.org

Dr Marina Rea (invited to join the Brazilian delegation) marifrea@usp.br

Maryse Arendt – ILCA  (Luxembourg): maryse.arendt@pt.lu

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Some of the main issues on the agenda in Berlin

Revision of the Follow-up Formula Standard (milks for babies 6-36 months) [11] : WHO, UNICEF, IBFAN,  and several other Civil Society organisations [5] made strong interventions in support of the many Member States (including Philippines, Nepal, Indonesia, India, Kenya, Sudan, Nigeria, South Africa, Brazil, Chile, Senegal, Togo, Egypt, Mali,  Sri Lanka, Burkina Faso and Equador) to retain key safeguards from WHA resolutions in the revised standard, stressing that the product is not necessary. IACFO reminded the Committee that developing countries – where the market growth of these products is strongest and where the risks of improper use are the greatest – should be listened to most. These countries need to assess the risks, safety and appropriateness of these products in the local context before allowing their import and not rely on the assurances of the exporters.

The US resisted the strong calls from WHO, the EU, IBFAN, IACFO  and many countries for much lower levels of sugar. There is global consensus and concern amongst the world health community that these expensive, sweetened and flavored milks are not only unnecessary,  but that they contribute to childhood obesity; affect the development of a child’s taste palate and undermine breastfeeding. Nevertheless they now account for 50% of absolute growth in a formula market that is set to rise by 55% from US$45 billion to US$70 billion by 2019. [12]   An attempt to reach consensus on these difficult issues will resume next year.

The global trade of Ready to Use Therapeutic Foods (RUTF) [13] for malnourished babies is also a highly contentious issue. Many developing countries, supported by IBFAN and others, called for: the current high sugar levels of 25% (used by manufacturers to maintain palatability and long shelf life) to be lowered, for safeguards to restrict use to emergency use, a prohibition on misleading labelling (promotional claims), marketing and retail sale. IACFO supported India’s call that governments who do not use RUTF and do not want imports should not come under pressure to do so. The majority of countries called for a preamble that would outline the appropriate  context for any use of these products as well as the need to protect breastfeeding and the use of more sustainable biodiverse and culturally appropriate foods. ILCA asked for clarification and got a clear reassurance from the secretariat that these products are not for sale. A point that was anchored in the report.

Transparency: the Nutrition Meetings when held in Germany are notorious for their lack of transparency. The Chair has used German privacy and phone tapping laws to forbid recording of the  proceedings,  so the report is written entirely from recall, which is often disputed. This year IACFO asked that the meeting be webcast as many other Codex meetings are. The Secretariat promised to explore this possibility but refused to include the request in the Report of the meeting.

Biofortification: This term is being promoted by International Food Policy Research Institute (IFPRI). The EU insisted that could not be supported because within the EU there were legally binding regulations on the term “bio” where it is understood to be associated with organic production. IBFAN and IACFO opposed the term because it is promotional and deceptive; opens the door to Genetic Modification and other risky technologies and to corporate takeovers of agriculture;  promotes the single nutrient approach and undermines biodiverse and more sustainable systems of agriculture and nutrition.  

Scientific substantiation: WHO explained its efforts to evaluate the quality of evidence in a more systematic manner and why it would no longer use the term ‘convincing.’  The quality of evidence is now required to be done through Grading of Recommendations Assessment, Development and Evaluation (GRADE). IBFAN and IACFO have long questioned the scientific basis of Codex Standards and called for consistency and the replacement of meaningless terms such as ‘science-based’  ‘generally accepted’ or ‘ history of safe use.’

Transfats: IACFO called for warnings and prohibitions on the use transfats rather than health and nutrition claims that can mask other harmful ingredients.  

Independence: IACFO and many countries supported the EU, who called for warnings on labels that formula products should only be used on the advice of  ‘independent health professionals.’  One Delegation (Thailand) supported by the Chair (and with applause from the industry observers) said that the word was unnecessary because he claimed  all health professionals are independent.

 

Notes:

[1]  Since 1995 when the World Trade Organisation determined that Codex Standards should be the bench marks in Trade Disputes, IBFAN has attended Codex with the aim of integrating WHO recommendations.  While governments  have the sovereign right and duty to protect health –  the prospect of a legal challenge that its laws are a barrier to trade because they are more trade restrictive than those specified  in Codex is a clear disincentive.  Despite its importance of global health,  trade, sustainable development and farming, Codex is largely overlooked by the media and civil society.

[2] 2011 The Business of malnutrition: breaking down trade rules to profit from the poor,  Bad Soden, Frankfurt, IBFAN Press Release, November 2011.

[3] Carbon Footprint due to milk formula.  A study from selected countries in the Asia Pacific region.  IBFAN BPNI report. 2015,  Click Here

[4]  REPORT OF THE THIRTY-NINTH SESSION OF THE CODEX COMMITTEE ON NUTRITION AND FOODS FOR SPECIAL DIETARY USES Berlin, Germany 4 – 8 December 2017.  Participants on Government, Observer or UN delegations are listed in Appendix 1 on pages 19-48. A further 60 or so people (including Danone’s Policy and Intelligence Manager from its Global Affairs Unit) wore public badges and do not appear on the list.

Governments listed with industry representatives:  Australia: 3 of 6 (Aspen Pharmacare, Fonterra, Nestlé plus a consultant from the Lipid Research Centre); Brazil: 1 of 6 (Brazilian Association of Food Industries); Chile: 1 of 2 (DSM Nutritional Products); China: 2 of 15 (Synlait, China Nutrion and Health Food Association); Colombia: 1 of 2 (Food and Nutrition Industry Mead Johnson); Denmark: 1 of 3 (Danish Agriculture and Food Council); Egypt:  2 or 3 of 4 (Hero, Wyeth/Nestle plus a consultant); France: 3 of 4 (SFNS and two from Nutriset) Germany: 8 or 9 of 13 (Diaetverband, Specialised Nutrition Europe, Federation of German Dietetic Foods, Dupont; Indonesia:  3 of 4 APPNIA (Asia Pacific Young Child Feeding Products); GAPMMI, the Indonesian Food and Beverages Association); Japan: 1 of 6 (Japan Health & Nutrition Food Association); Kenya: 1 of 3 (Nestlé); Malaysia: 2 of 4 (Federation of Malaysian Manufacturers/Mead Johnson, Malaysia Palm Oil Board); Mexico: 6 of 7 (ANIPRON, Abbott, CANILEC); Morocco: 4 of 7 (l’AMNI, Nestlé, Society of Mineral Water); New Zealand: 2 of 4 (Fonterra, Dairy Goat Cooperative); Philippines: 1 of 2 (Infant Nutrition Association of the Philippines Infant Nutrition Association) ; Poland: 1 of 3 (Polish Federation of Food Industry Union of Employers); Switzerland: 4 of 5 (DSM, SANI, Nestle, Nutricia/Danone, ); Thailand: 1 of 5 (Thai Industries/MeadJohnson); Uganda: 1 of 2 (Reco Industries); US: 5 of 17  (Abbott, International Dairy Foods Association, Mead Johnson, Gage, International Formula Council); Vietnam: 8 of 9 (Vinamilk x2, Eneright Vietnam Corporation, Abbott, Mead Johnson, Vietnam Food Administration, Vietnam Dairy Association x2).

[5] Interference in public health policy: examples of how the baby food industry uses tobacco industry tactics, World Nutrition, [S.l.], v. 8, n. 2, p. 288-310, dec. 2017. ISSN 2041-9775. Available at: https://worldnutritionjournal.org/index.php/wn/article/view/155 

[6]  IBFAN and Helen Keller International (HKI)  held briefings for participants.

[7] CLICK HERE 2006 EU and US block Thailand’s proposal to reduce sugar in baby foods,  Codex meeting in Chiang Mai, Thailand, IBFAN Press Release, Nov 2006.   [Click Here]

[8] Global standard-setting committee puts child health before trade, IBFAN Press Release, December 2016.

 WHO Guidance on ending the inappropriate promotion of foods  for infants and young children A69/7 Add. 1 May 2016. “The purpose of this document is to provide guidance on ending the inappropriate promotion of foods for infants and young children, with the aim to promote, protect and support breastfeeding, prevent obesity and noncommunicable diseases, promote healthy diets , and ensure that caregivers receive clear and accurate information on feeding.”    WHA 39.28 is also important because its states that these products are not necessary.

Chart showing the number of countries calling for the inclusion of the Guidance. Baby Milk Action April 2017

[9]  CLICK HERE  for the report of the  French Government recall of Lactalis formula due to Salmonella contamination.

[10] Para 14 of the CX/CAC 16/39/11 report states:  “Given that the membership of Codex is almost identical to the membership of FAO and WHO, the Commission is invited to note the importance of ensuring that all relevant policies, strategies and guidelines of FAO/WHO receive appropriate consideration in the work of Codex.”    

[11] IBFAN Policy Brief on the Revision of the Codex Follow-up Formula standard. (Codex Stan 156-1987)
CLICK HERE

[12]  IBFAN/ ICDC’s global monitoring report, Breaking the Rules, Stretching the Rules 2017,  CLICK here 

[13] IBFAN Policy Brief on Ready to Use Therapeutic Foods (RUTF)  CLICK HERE

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