Thailand and Bangladesh urge WHO to take the lead in trade – WHO 152nd Executive Board

30th Jan – 7th February 2023, WHO HQ.  Geneva

“…WHO social capital in action was demonstrated when Thailand legislated the WHO milk Code into our national law. Political interference by the industry almost derailed the legislative process. However, with a half drop off ink in the WHO DGs signature in her letter to the Head of State, totally reversed the social discourse, and the bill was finally adopted. ”  Thailand speaking WHO HQ – 6th February 2023 

Main documents HERE  Webcast HERE.    EB members  HERE

2023 is not a reporting year on Maternal Infant and Young Child Feeding, but there are always cross-cutting items on the Agenda that are of concern, including the  issue of trade that is rarely on the Agenda at WHO meetings – even though WHO is one of  the parent bodies of CODEX ALIMENTARIUS COMMISSION – the body that oversees the development of global food standards that are used as bench-marks in trade disputes.  We raised it under Agenda Item 18. Para 29b (b) suggests that WHO and Member States: strengthen needed evidence and guidance, including by supporting Member States to conduct analysis of the impacts of trade on national nutrition situations. 
Joining me (Patti Rundall) on the  IBFAN team in Geneva were: Barbara Fienieg, Senior Global Health Advocate, WEMOS, Nicoletta Dentico Global Health  Justice, Society for International Development, Dr Marta Caminiti,  People’s Health Movement, who read the emergency statement on Tuesday.

IBFAN statement on Agenda Item 18: UN Decade of Action on Nutrition (2016−2025) 152/24

“The DG’s call for a transformation of food systems and a One Health Approach is essential, but corporate-influenced initiatives such as N4G and the Voluntary Guidelines are not the right way forward.   Governments must stop inviting health-harming corporations as legitimate ‘partners’ in health programs because this increases their unregulated access to policy-making.  Governments must also stop market-led nutrition schemes that push damaging technologies and products that claim to solve all manner of problems. These are a major distraction from people’s reality. The global trade of Ultra-Processed Products exacerbates climate damage, undermining breastfeeding and healthy diets.  Weak Codex standards were cited dozens of times at the WTO in challenges to baby food legislation. This creates a regulatory chill and sabotages the adoption of effective safeguards.  WHO must ensure that global food trading standards follow WHA recommendations. Healthy food for all must take priority over trade. Thank you.”

IBFAN STATEMENT ON Agenda Item 12. Strengthening the global architecture for health emergency preparedness, response and resilience

“For 40 years IBFAN has worked with WHO to protect breastfeeding – a resilient practice that provides food, care and immune support and is often a lifeline in emergencies, while protecting against malnutrition in all its forms. However, breastfeeding continues to be under attack from manufacturers of ultra-processed foods who pretend that they care. IBFAN helped ensure safeguards in the new Codex Guidelines for Ready to Use Therapeutic Foods. These products can be important as a last resort, but have known and unknown risks. They should never be inappropriately promoted and should only be used in programmes that support skin-to-skin and re-lactation and appropriate transition to nutritious family foods [and psycho-social support]. Such short term treatment models should not undermine more culturally acceptable local food solutions, biodiversity, sustainable food production and security. The IFE Operational Guidance, Conflicts of Interest safeguards and One Health are key in pre-preparedness plans. Thank you”



“The world is passing through a trying time with the rise in extreme poverty. While we are loud and clear on human rights for all, we remain apathetic at our fellow human beings across the globe who go to bed hungry. The countries which are highly exposed to the impact of climate change and conflicts within and beyond their territorial boundaries, count on imported food to a great extent. Therefore, it would be exigent to ensure that the foods are rich in nutrients – particularly, in case of imported items. In view of the above, on the action points for WHO, we would suggest the following:

  • First, to take leadership role to ensure that global food trading standards follow WHA health recommendations;
  • Second, to strengthen Codex standards on formulas for babies;
  • Third, to promote normative measures to ensure accountability to nutrition;
  • Fourth, to promote breastfeeding to uphold the fundamental values of humanity; and
  • Fifth, to redouble efforts to make people aware of the harmful impact of ultra-processed food as well as of high sugar, fat and salt content food.

Now we would reflect upon the actions for the Member States. A fair and rule-based trade regime is essential to ensure nutrient-rich food for all. Hence, considering nutrition as a cross-cutting subject, the Member States need to engage WTO, UNICEF, FAO and WHO at the same time for a coordinated approach to implement the normative measures and course of action.”

Dr Tedros response on Nutrition (Friday, 3rd Feb).  (Page down for the response from Dr Naira)

“Thank you so much for your leadership, very appreciative of your leadership.   On this issue, there are two prayers.  One prayer, give us more food. It’s not about unhealthy food, but just food food on the table.   And the other is there is excess food but because of that, all the problems that has been outlined. So the praye’rs to God are actually different. One says more food please give us table food on the table. The other one, of course, unhealthy food because food is plentiful. So the issue now is addressing  both obesity and malnutrition,  and I think the key is to implement the action plan in its totality…The other second issue within the one minute I have to address is our partnership with the private sector or our work with the private sector. I would like to assure you that we collaborate on issues we can collaborate on. On issues we can’t and we don’t, then we continue the dialogue. But we use the regulatory function to enforce.  WHO has not been working with the food industry. Mainly it was confrontational. I don’t think that approach really helps. We can enforce regulation when needed. If it can be done through cooperation, we should do it through cooperation. I will give you an example. For instance, when during our meeting in 2019, the food industry agreed to eliminate transfers,  industrial transfats by 2023. And many of them are doing it already. So we collaborate on that. While on salt and sugar. We still have a problem. And on breastfeeding, we have a problem. Thank you so much, by the way for raising that. And on that we continue to debate and also enforce or use regulatory functions to  address.  So that’s the approach we’re using. And there is some progress.  But I think using that approach will help to achieve the SDGs.  Of course we don’t have time today. We have the Civil Society Commission now which will be established before the Assembly. We want to work more closely with the Civil Society to understand your perspective, but not only that, to also use your leverage to make progress. I think the key word in order to achieve SDGs is collaboration and partnership. But of course while saying that,  regulation should also be there. And we have to be very serious on the regulation too. So thank you so much. Maybe I’m a bit more than one minute. Thank you chair.”

Agenda Item 23.1.  Sustainable financing: feasibility of a replenishment mechanism, including options for consideration Document EB152/35 Monday 6th February. 


“Thank you chair. Thailand also offers our deepest condolences to the people of Turkey and Syria. Chair, sustainable financing is not only about the amount of budget mobilised, but also the effective budget allocation and programmatic performance. The WHO  must ensure that the fund mobilised under the replenishment mechanism is not earmarked with the highest possibly flexibility to be used for the base programmes, as well as for other urgent needs.   We reiterate the catalytic role of the WHO programme budget.   Chair by no means that WHO funding can fill the gap of country’s health needs. Thailand recommends who to maximise use of its long standing intellectual and social capital in catalysing and mobilising political and financial commitments from the Member States and other partners to fulfil national health goals and to achieve the SDGs. All this falls under the shoulders of the director general, reginal directors who are representative and the health ministers. WHO social capital in action was demonstrated when Thailand legislated the WHO milk Code into our national law. Political interference by the industry almost derailed the legislative process. However, with a half drop off ink in the WHO DGs signature in her letter to the Head of State, totally reversed the social discourse, and the bill was finally adopted.In addition, the country cooperation strategy, RCCS, is another example of using the palatial intellectual capital, as we have done in Thailand under CCS, under the leadership of the division to Thailand and the regional director of SEARO. Thank you”

Excerpt from Lancet 2023 Series on Breastfeeding

“….Responding to WHA resolutions calling on countries to strengthen implementation of the WHO International Code of Marketing of Breast-milk Substitutes in 1981 (hereafter referred to as the Code),52 Thailand began drafting a revised version of its own Milk Code in 2015. The proposed law introduced new provisions restricting educational, promotional, and marketing activities, including the use of trademarked brand names, packaging, and symbols, established criminal penalties for violators, and expanded product coverage from 0–12 months to 0–36 months.57,78 Between 2015 and 2018, the Thai Government had repeated interventions in the WTO from the USA, New Zealand, the EU, Australia, and Canada, mainly in the Technical Barriers to Trade Committee.57 In 2017, the US Trade Representative reported “seeking to ensure that Thailand’s final measure takes into account appropriate scientific and technical information”, and that it had engaged the Thai Government throughout the period “bilaterally and at the WTO and continues to monitor developments, particularly any potential regulations relating to restrictions on products for young children”.34 Evidence suggests CMF industry lobbyists met with senior government officials in the National Legislative Assembly and National Economic and Social Development Council, members of the press, and health professional associations. Lobbyists stressed the industry’s supposed economic importance, including the jobs and livelihoods of dairy farmers.78 In 2017, the Thai National Legislative Assembly passed the revised Milk Code; however, the extended product coverage for ages. 12–36 months and criminal penalties had been removed.57

Agenda 18, Nutrition. Response from. DR Maria NEIRA, Ass Deputy DG, UHA and Healthier Populations. 

“Thank you Madam Chair. Me again, I will be very brief promise I know that everybody started by now. But to begin with thank you to the member states for having made a political and financial commitments to the implementation of the decade on nutrition and thank you particularly for their recommendations on the next steps that should be taken. I should like  to celebrate the success we have heard with increasing rates of exclusive breastfeeding. You know, there’s been a 10% increase over the last 10 years and that brings us close to the global target of achieving 50% of exclusive breastfeeding for children under the age of six month. As you know, the decade of action has helped us to build alliances with member states UN system organisations and civil society groups. And we would like to continue on the TrueHD. During the    we’ve seen greater cooperation between sectors as demonstrated by the UN’s Food System Summit, and it’s also been a major change in the way we approach sustainable food production. The    transformation of the food production system is essential and it will be a very, very important step in achieving the Sustainable Development Goals. At the same time, of course, it will be a major contribution to mitigating the causes of climate change, as you know, WHO supported Egypt’s presidency at 27 in Sharm el Sheikh to launch an initiative on nutrition and climate change. We are working to ensure that strict political commitments are made and stuck to at the next GOP which as you know will be in the UAE. The decade ends in 2025. But the agenda will never and as such, we have a major cost of living and food security crisis on our hands at the moment climate change is just making the whole situation work. And that’s making it difficult for us to achieve our aims but we will not stop trying at the end of the decade together with UNICEF, India for you. We will be reviewing what has been achieved and that could be done at the next nutrition and growth summit to be held in France. The number of people suffering from food security has increased Of course as we all know. During the pandemic, each 100 million people affected and 300 million are affected by not having sufficient access to healthy food. These are not problems we can sweep under the carpet. We have to tackle the inequalities and inequities which underlie them, and in so doing guarantee the sustainability of our planet. We are working on those issues. Some member states have mentioned the importance of the gender viewpoint of the CEC some have noted that we will be particularly focusing on women and young people of reproductive age and they should continue to work to make progress on healthy diets and do that in coordination with other strategies to tackle disease such as non communicable diseases and universal health care. That I believe was suspiciously mentioned by the UK on wasting the new W H O guidelines will be ready in the course of this year. We hope in the early part of it and thanks to an appeal made by UN agencies on the problem in January this year, over 20 countries have already developed response plans turning to obesity 28 countries have taken measures in response to the W IP who plan to slow it down.  And turning to food fortification let me say this we have made progress on fortifying food but not all countries have made commitments on this the Secretariat has updated the guidance and implementation tools considering various vehicles such as rice, condiments, corn, wheat, but we are also looking at the way the policies are implemented. We are grateful for Member States support in harmonisation, quality control admissions to expand coverage. We hope we’ll be able to provide better technical assistance acting on your eyes and advice and be able to provide data on the basis of which you can take decisions. Knowing the best science available, if that can be done will approve, improve the living conditions of many, many, many people and bring down levels of malnutrition and hunger among everyone, particularly women and children…Thank you I will now give the floor to Director General but I give him only one minute.

Main concerns of IBFAN this year:

  • the need to increase  breastfeeding protection in emergency preparedness plans
  • the need for care in appeals for humanitarian products so that breastfeeding and culturally appropriate, sustainable and bio-diverse family foods are not undermined.
  • the need for  COI safeguards throughout all WHO programmes, including Universal Health Coverage (UHC) and  NCDs*, especially though ‘multi-stakeholder’  partnerships. Highly relevant to NCDs is the  Codex meeting in Germany in March where the Codex Follow on Formula standard will be discussed – and where commercial and exporting country pressures might result in a weak standard that allows promotion of sweetened flavoured milk drinks for young children.  
  • The need for the One Health approach to be integrated across all programmes,  

Dr Tedros’ speech on Day One: HERE

Agenda Item 18.  29. Possible actions by the Secretariat and Member States include the following.

Secretariat actions

(a) continue supporting Member States to develop and implement national plans to achieve the global nutrition targets;

(b) strengthen needed evidence and guidance, including by supporting Member States to conduct analysis of the impacts of trade on national nutrition situations;

(c) advance support to address nutrition challenges in the context of climate change, through advocacy, normative guidance and technical support;

(d) strengthen United Nations inter-agency coordination mechanisms, at the request of Member States, in order to be better able to support the delivery of nutrition action, including the implementation of national food system pathways; and

(e) in collaboration with FAO, prepare and convene open and inclusive dialogues towards the end of the Decade, in 2025, for reflection on global progress and challenges encountered and identification of the potential way forward.

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