IBFAN statements at the 140th WHO Executive Board Meeting (23rd January-1st February 2017) Geneva
Two days were spent in closed meetings for the selection of the short-list of three for the post of the new Director General of WHO. CLICK HERE
Prevention and control of noncommunicable diseases
A69/10 – Agenda Item 12.4
Thank you for the opportunity to speak on this important subject, and in particular the Global Coordinating Mechanism (GCM). IBFAN has consistently expressed its reservations about the GCM’s status, governance and poor terms of reference. NGO concerns have been downplayed by GCM chairs, even described by some as paranoid.
Instead of following WHO’s existing rules on conflicts of interest, GCM has set harmful precedents that threaten WHO’s credibility, integrity and effectiveness. Apart from tobacco, GCM seems open to just about any business – including members of the World Economic Forum – but access is denied to some critical NGOs.
The GCM model is loosely based on the EU Platform on Diet, Physical Activity and Health – an initiatve that after 9 years has failed to make any significant progress in curbing harmful marketing practices, wasting precious time and resources.
GCM proposes to invite corporations to voluntarily submit evidence of action with no independent scrutiny or assessment of its quality. The report warns that contributions should not be used to “serve their interests or promote their brand, products, views or activity with limited or no benefits for the prevention and control of NCDs” but its proposed solution is merely to “clearly define the parameters of what constitutes a contribution and what does not.” Is it wise to trust the corporations most responsible for NCDs to monitor themselves and not exploit WHO’s name?
Even though there is no evidence of their effectiveness in nutrition, GCM promotes partnerships with corporations that are not only promoting unhealthy foods, but land-grabbing, mono-cropping and undermining access to bio-diverse wholesome foods – strategies that all contribute to climate change.
We remain especially concerned about corporate funding of education and advocacy since this can distort education and political agendas.
Bad diet is acknowledged to be the biggest cause of death and disability. Instead of wasting time on ill-conceived diversionary schemes, we urge WHO and Member States to focus on effective legislation to control harmful marketing. Thank you
WHO Engagement with non-State actors. Agenda Item 14.3
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). The first five applications for Official Relations are a test of its thoroughness. 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.
Preparation for the third High-level Meeting of the United Nations General Assembly on the Prevention and Control of Non-communicable Diseases in 2018 (delivered Saturday, 28th January. CLICK HERE for webcast. move slider to 1.37.38 – the last of 10 NGO statements) IBFAN Statement on Agenda Item 10.1
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, is just one 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 and of course, breastfeeding. Over-emphasis on single nutrients 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 in these products.
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
IBFAN statement on 10.4 Commission on Ending Childhood Obesity (ECHO): Implementation Plan
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.
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 whom 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
IBFAN Statement Agenda item 7.1.2 (Emergences)
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.
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.