IBFAN comment on EFSA Public Consultation on the draft scientific opinion on appropriate age for introduction of baby foods.

93rd NDA Plenary Meeting in Parma. – 3rd July 2019

Panel on Nutrition, Novel Foods and Food Allergens (NDA)

After attending the EFSA open meeting I submitted the comments below.   My poor rating did not relate to the EFSA staff who were always polite and helpful.

I appreciate the decision to allow me to attend as an on-site observer, however I do not understand why this decision was described as ‘exceptional.  I cannot find any EFSA message explaining that attendance in person would be possible. The message I received on the 19th June (addressed to those who had made submissions) said that there would be a plenary meeting on the 3rd July and that I could register to watch online. I didn’t take a screenshot, but I think the link implied that the room was full. In response to my query I received an email saying that exceptionally I could attend in person.  In fact, when I arrived in Parma I found that there were several/many free places in the room.  Perhaps there are particular rules about the number of observers (and from which constituencies – private sector, NGO etc) who can attend in person that I am not aware of.  If so could you send them to me

At the start of the meeting I mentioned my particular concern to attend the meeting. Alongside concerns about food crises in the late 1990s, IBFAN’s exposure of the lack of transparency and failure to address Conflicts of Interest in the Scientific Committee for Food, was a key factor in the setting up of EFSA.  In order to protect public health the EU needed a publicly-funded agency that would operate independently of the European legislative and executive institutions (Commission, Council, Parliament) and EU Member States.  My understanding has been that EFSA decisions should not be influenced in any way by the political or commercial desire to expand the EU market for baby foods. I expressed my appreciation of EFSA’s role over the years, and its past determination to stick to the evidence, especially in relation to the setting of Codex standards on controversial issues related to formulas and foods targeting children 0-36 months.

Interpretation of the Question: A key problem that was never properly addressed or acknowledged was NDA Panel’s unnecessarily restricted and narrow interpretation of the original and quite loose question from the Commission to revise its 2009 opinion. The NDA’s interpretation was – in itself ­– a highly political decision that clearly favoured the baby food industry. NDA members must be well aware that science and politics are not separate and that social, economic and commercial consequences MUST be taken into account when a scientific opinion is formed that will be translated into a legislation that will have such an enormous impact globally.  The framing of questions is critically important.  By choosing to ignore the context of the question (the forthcoming legislation) the NDA Panel chose to eliminate the most important and urgent risks to child health. In my view this showed that there was a commercial influence within the Panel (if not from current COI – but from COI in the near past) that could threaten EFSAs global reputation for scientific independence and its commitment to its public health mandate.    Of course there is a difference between risk assessment and risk management.  But the NDA Panel must know that its opinion is highly likely to be used by industry to lobby governments both within and outside the EU to weaken regulation and worsen the current appalling situation. See latest report from Public Health England highlighting the confusion caused by the  baby food industry’s failure to follow global health recommendations. Whatever decision regarding EU legislation is taken, the opinion will be interpreted by all those who read it (EFSA’s role is communication after all) – including paediatricians, health professionals and possibly families – that it is fine to start complementary feeding at 3-4 months.  It was shocking therefore to see the important and highly relevant comments and evidence from observers dealt with in such a cursory and dismissive way:  described as invalid, not focused on science, risk management rather than risk assessment, outside EFSA’s remit, too political etc. In only a few non-essential places was the Opinion changed.

Format of the meeting: The description of the structure/format of the meeting was made very hastily at the beginning. Aside from giving my name and a brief introduction (see above), as an observer I was not allowed to ask questions about this or comment on anything that was said until AFTER the NDA Panel finished speaking and AFTER the very speedy adoption of the opinion and report. It was never made clear that this would happen. As I expressed at the meeting, it rendered the expensive effort of attending the meeting a waste of time. Although I was given time to speak (I believe I was the only observer who spoke on this subject) it was clear that nothing I said would alter the decision – clearly pre-determined – to adopt the opinion more or less as it was.   I was told that I was not allowed to photograph the screens (which I found difficult to see at first) but was eventually allowed to move forward to the round table.  Although we were told that the written comments from observers would be published, I did not see any analysis of how many were critical or in favour of the opinion. However, it seemed to me that the large majority (including those from WHO and UNICEF) were highly critical and raised a large range of serious and fundamental concerns about the flaws and omissions. Most importantly the opinion failed to address the possible risk /impact of marketing, labelling of industrially produced and highly processed commercial foods on child health and the length of ANY exclusive breastfeeding (a wholly legitimate risk). Instead we were frequently told that it was not within EFSA’s remit to look at the ‘optimal age for exclusive breastfeeding’ – something that all observers know is done and dusted and not a question put to EFSA. What is relevant is whether a label (alongside other promotional claims, packaging, promotion, sponsorship etc ) that suggests that a food is suitable (and by implication necessary) from 3, 4 or 5 months, will harm child health and child development in any way and/or lead to a reduction of breastfeeding – even by one day.  These are the questions that policy makers have to tackle in the future delegated Act foreseen in Regulation 609/2013 – questions that were continually dismissed as being outside the scope of the research.

Age rangeThe decision at the end to change the title from ‘Age of introduction’ to ‘range’ was taken very quickly with no acknowledgement that the panel had limited its research to the lower age range – 3-6 months and had ignored risks and developmental readiness post 6 months.  This is a further important reason why the opinion will not provide policy makers with the evidence they need to arrive at a sound health protective decision on labelling.  It will unfairly favour an age range for labelling of 3-6 months rather than say 5-7 months.

Composition of foods ignored In relation to developmental readiness – we were told that the composition of foods was not looked at all – just its consistency. Are we to assume that the pureed and pulverised products fed to children in single use plastic pouches through nozzles are fine?

Impact of Exports: As I mentioned in the meeting, the Panel failed to explain why it did not address the risks of the export of products labelled as suitable from 3,4 or 5 months. Given the importance of EU export market and the EU’s influence on Codex global standards, this is a legitimate question that falls well within the Commission’s question.  With the increase in liberalized economic policies and the advent of digital technology, online shopping portals in India are selling complementary foods manufactured by UK-based companies with labels from “4 months+” all of which violate the Indian law (The IMS Act). Why did the NDA panel not address the risks of exports that would add to the commercial pressure to reduce weaken legislation in Third countries, including stated wishing to join the EU and developing countries where these are matters of child survival.

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