CALL TO WHO AND UNICEF:

STOP industry inspired ‘Call to Action’ that gives companies a 10-year-licence to harm children.

July 2020

The International Baby Food Action Network (IBFAN)[i] has denounced a new Breastmilk Substitutes Call to Action (BMS Call) that has been issued by WHO and UNICEF and 6 non-governmental-organisations (many substantially funded by food corporations and the Bill and Melinda Gates Foundation (BMGF). The BMS Call asks 24 baby food companies to make voluntary public commitments to partially implement the International Code of Marketing of Breast-milk Substitutes and the 19 subsequent Resolutions of the World Health Assembly (WHA)  (the Code) for a decade and to provide a ‘roadmap’ for how they will achieve full Code compliance by 2030.

The Code was adopted by the WHA in 1981 with the key purpose of ending the unethical marketing of baby foods. It is a critically important safeguard for infant survival that protects parents‘ rights to make free and informed decisions about infant and young child feeding. The obligation of States parties to implement the Code and the companies‘ obligations to comply with it has been since clarified under the international human rights law as human rights. Furthermore, the Independent Review Panel of the UN Seretary-General’s Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030) recommends developing a global human rights framework to address harmful marketing of foods for and to children.

The BMS Call is the end result of a BMGF-backed-proposal, started in 2016 to involve baby food companies as “stakeholders” in a new “Global Monitoring Mechanism.  IBFAN opposed the GMM from its inception – highlighting that it violated the basic principle that “no one should be the judge in his own cause.”[ii]

This 2020 BMS Call, is presented as a “fresh” and “industry savvy” strategy to achieve full Code compliance. IBFAN believes this to be a false assertion.  The BMS Call is a sharp departure from the Code that could derail and delay such compliance, undermining 40 years of work by WHO and UNICEF’s member states, public interest NGOs, health professionals and parents.

While IBFAN greatly values its collaboration with UNICEF and WHO in the protection of breastfeeding over so many years we call on these two agencies to STOP the BMS Call and publicly disassociate from it.

 

IBFAN’s main concerns about the BMS Call

  1. It conflicts with WHA Resolutions and gives companies a 10 year license to harm children and undermines the human rights approach to health, adequate food and nutrition: The BMS Call asks companies to publicly commit to full compliance with the Code and subsequent relevant WHA Resolutions in all countries. This could be a welcome move.  Despite claiming to be Code compliant already, for the last 40 years Nestlé and many other companies have deliberately ignored the resolutions and, unless forbidden by law, limit their actions to a few products in ‘high risk’ countries. The BMS Call allows companies 10 years to achieve full compliance so there will be nothing meaningful to be monitored for many years. In the meantime companies will have a 10-year license to violate children’s rights and continue putting lives of infants and young children at risk of commerciogenic ill-health and deaths.  The notion that companies should be allowed to phase compliance as they wish conflicts with decisions taken by Member States at the WHA – the world’s highest health policy setting body. The WHA has never authorised delays on ending harmful marketing that threatens infant and young children survival.
  2. It promotes weak voluntary commitments: The BMS Call will give credibility to voluntary commitments that, unlike legislation, can be ‘here today and gone tomorrow.’  For the first year the ‘roadmaps’ will  focus only on milks for infants 0-12 months. The fast-growing market of sweetened, additive-laden milk products (toddler and so-called ‘growing-up’ milks) that target babies 12-36 months must wait until 2030 – conveniently for the companies – long after the  Codex global standard on these products is finalised.  Formulas for older babies that look like infant formula have been fueling the obesity epidemic, adding to the environmental burden and are condemned as unnecessary by the WHA and public health community. Bottles, teats and baby foods are not mentioned.  Cleverly written industry commitments will confuse matters and hand companies a commercially valuable public relations opportunity. If challenged about violations, a company could claim that it is ‘on the road’ to full compliance – with the blessing of WHO – so must be considered a worthy partner in public health planning and possibly deserving of a reprieve from fines or other legal penalties under national law.
  3. It disregards safeguards to protect public health policy spaces from conflicts of interest, promoting instead commercial lobbying, inappropriate partnerships and commercial ‘education’: The BMS Call asks companies to support the adoption of Code-aligned legislation, with no definition of what this term means. ‘Code-aligned’ can mean ‘formatted vertically to improve readability‘ whereas ‘Code-compliant’ means ‘meeting or in accordance with rules or standard. Terminology matters, especially when it comes to the drafting of laws. Corporate lobbying is invariably behind the scenes – hidden and powerful – and for over 40 years, the baby food industry has subverted, undermined and interfered with policy making. [iii] It is not credible that companies will now, voluntarily,  urge governments to fetter a highly profitable aspect of their business – unless there is a pay-off. The potential for partnerships with governments could be enough to prompt a cleverly written 10-year promise.  The BMS Call ignores the WHA’s repeated call that the funding and involvement of the baby food industry in infant feeding policy development and programme delivery is an unacceptable conflict of interest – whether or not they are considered to violate the Code. Background materials and the Q&A imply that companies that reply positively could gain ‘trust’ and be eligible for partnerships, nutrition initiatives and consumer education.[iv]
  4. The COVID-19 pandemic presents added risks. Not surprisingly, baby food companies have been exploiting the pandemic, donating formulas, setting up ‘advice’ forums and offering themselves as trusted partners. Governments are now under acute financial pressure and more vulnerable than ever to offers of ‘assistance’ from the baby food industry.
  5. It promotes commercially influenced monitoring.  Companies are asked to report to the Access to Nutrition Foundation (ATNF) – an initiative that was designed from the outset to whitewash company promotional activities and encourage investments. ATNF’s monitoring has revealed violations over the years, but it is not ongoing like IBFAN’s which is continual and able to, for example, quickly expose and curb the exploitation of Covid-19. Although ATNF claims to be independent it works closely with the world’s largest food companies, including on the presentation of its results. This is in direct conflict with WHA Resolution 49.15 that calls for monitoring to be “…carried out in a transparent, independent manner, free from commercial influence.” While all the companies score poorly, Nestlé and Danone use ATNI’s flattering analyses repeatedly in their claims of Code compliance. [v] [vi]
  6. Company claims that the Code is only directed at governments are not true. Since 1981 Article 11.3 of the Code has called on manufacturers and distributors to ensure that ‘independently of any other measures taken for implementation’ they should monitor their marketing practices according to the principles and aims of the Code and  ‘ensure that their conduct at every level conforms to them.’ Similar direct calls are made in Para 2 of WHA 63.23 in 2010 and in Para 3 of WHA 69.9 in 2016.

As said before, IBFAN greatly values its collaboration with UNICEF and WHO in the protection of breastfeeding. Both agencies are needed now, more than ever, to guide country responses on the protection of breastfeeding and the host of global threats that children face – not least climate change, new viruses, anti-microbial resistance and non-communicable diseases.  IBFAN believes that the best tried-and-tested way to protect children from harmful marketing is to help governments with legislation and monitoring.[vii],[viii],[ix]

As IBFAN makes this call to WHO and UNICEF to stop the BMS Call and publicly disassociate from it, the public health community and WHO member states also have good reason to be concerned that this BMS Call departs so sharply from decisions taken at the WHA– the world’s highest health policy setting body.

As Dr JP Dadhich, Co-Chair of IBFAN’s Global Council says:“Harmful marketing will not stop until every country has strong laws that are independently monitored and enforced. We fear that this Call to Action will give corporations the PR cover they need to gain access to policy setting.  40 years is more than enough time to comply with the Code. It is naive to believe that they will suddenly change voluntarily now.”

IBFAN appeals to UNICEF and WHO, in words of Peter Utting,  former key researcher on corporate social responsibility at the UN Research Institute for Social Development (UNRISD): “You have a choice. You can either be a party to corporate strategies of reputation management or an ally of the global corporate accountability movement and insist, in stronger terms than it has been to date, that business improve its human right, social and environmental record”.[x]

This Call is endorsed by

IBFAN Global Council (G5)

IBFAN Regional Coordinators: IBFAN Africa: IBFAN Afrique:IBFAN Europe: IBFAN Latin America: IBFAN North America: IBFAN South Asia: IBFAN Southeast Asia: IBFAN East Asia:  IBFAN Arab World:IBFAN GIFA

IBFAN Technical Offices:  World Breastfeeding Trends Initiative (WBTi):  Baby Milk Action/International Campaigns Office: International Code Documentation Centre: Codex Working Group.

 

Footnotes:

[i] IBFAN is a  global network  of over 270 groups 160 countries that has been working with the WHO, UNICEF and governments for over 40 years to help governments bring in national legislation on the Code.  IBFAN has monitored and reported on violations of the International Code and Resolutions and  assists governments in drafting or strengthening national legislation

[ii] The  secretariat of the ‘Call to Action’ is the Meridian Institute,  funded by the  Bill and Melinda Gates Foundation (BMGF),  who in 2017 proposed a public-private monitoring mechanism (Global Coordinating Mechanism (GCM). The GCM was abandoned after being strongly opposed by IBFAN and over 60 civil society organisations and losing the support of WHO and UNICEF. The BMS CTA uses the same criteria and end date as that used by the  Nutrition 4 Growth Summit. The Government of Japan is seeking financial and policy commitments to focus the world’s attention on SDG 2: Zero Hunger – to end all forms of malnutrition by 2030 and ensure that all people have access to safe and nutritious diets all year round.

[iii] The WHO/UNICEF/IBFAN national implementation of the Code Status Report (2020). 70% of countries have implemented the Code to some extent.

[iv]. BMS Call to Action Powerpoint makes no mention of the Code’s ban on sponsorship and conflicts of Interest.   Slide 7 refers to the need to allow corporations to be involved in partnerships, sponsorship and education: “The controversy over BMS marketing is holding back private sector from making a more positive contribution to global nutrition challenges. Formula companies are prohibited from joining many global initiatives and partnerships.. the issue contributes to general distrust of private sector among global nutrition stakeholders. To further progress, the Call to Action takes an approach to directly appeal to companies to take action, supplementing advocacy, social behavior change, and consumer education.” Slide 17 gives the rationale for the 10-year delay: “The timeline aligns with the timeframe of the Sustainable Development Goals (SDGs) and allows time for companies to make the necessary adjustments in business models and meet training and monitoring needs….Proposing a shorter time frame that does not factor in the complexity of internal business systems poses a greater risk that companies will walk away from the Call to Action and not take any steps at all toward full Code compliance.”

Q&A BMS CTA: In answer to the Question: How will companies who reply positively to the CTA be acknowledged? “Better Code compliance will result in better corporate reputation, potentially stronger customer trust and loyalty, and generate additional dividends such as better ATNI scores. Code-compliant companies may also become eligible to participate in programs with NGOs and other agencies that they have to date been excluded from because of their poor policies and record on this issue.”

[v] Nestle’s Breastmilk substitute marketing: Compliance record refers to the ATNF India Index, 2016.With respect to BMS marketing, Nestlé India demonstrated a high level of compliance with the Indian IMS Act and the Code.” India ranked Joint 1st Nestlé USA  Nestle FB page   Nestle using ATNF reports as ‘Transparency and Accountability’ documents  Danone -highlighting its top BMS company status  Danone using it as an example of external evaluation   Danone UK engaging HSG to launch a consumer care line and referring to ATNI as a positive thing for Danone  

[vi] Nestlé welcomes the Call to Action by WHO, UNICEF and civil society organizations “We comply with the Code and relevant resolutions of World Health Assembly (WHA) as implemented by national governments everywhere in the world, as a minimum….The Call to Action recognizes that a level playing field for all companies is essential. In the absence of legislation, achieving such a level playing field will require everyone to work together, including us. Nestlé is committed to leading the way and encourages all stakeholders to work together to achieve this important goal”

[vii] The Impact of Marketing of Breast-Milk Substitutes on WHO-Recommended Breastfeeding Practices Piwoz et al

[viii] India’s Infant Milk Substitutes Act, Monitoring, and Enforcement. May 30, 2018. https://medicine.yale.edu/ysm/news-article/17463

[ix] IMS Act Monitoring and Implementation Articles relating successes in implementing  to India’s legislation

[x]Peter Utting: UN-Business Partnerships: Whose Agenda Counts? Paper presented at seminar on Partnerships for Development or Privatization of the Multilateral System?, organised by the North-South Coalition, Oslo, Norway, 8 December, 2000  http://www.unrisd.org/80256B3C005BCCF9%2F(httpAuxPages)%2FA687857BD5E36114C1256C3600434B5F%2F%24file%2Futting.pdf

 

Further reading:

Interference in public health policy: examples of how the baby food industry uses tobacco industry tactics World Nutrition, 2017.

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