Tuesday 23rd May. The public health NGOs – annoyingly called Non State Actors (NSAs) – who stayed on till 11pm to speak on the Emergency Debate. Standing: Baba Aye. Public Services International, Seated Left Jaume Vidal, HAI, Patti Rundall on the right.
76th World Health Assembly 21–30 May 2023
STOP PRESS: WHO has confirmed that aspects related to marketing will be included in the operational guidance on food fortification and that WHO is working on a definition of Ultra Processed products.
Agenda Item 16.5 United Nations Decade of Action on Nutrition (2016–2025 Draft decision EB 152/213: Accelerating efforts for preventing micronutrient deficiencies and their consequences, including spina bifida and other neural tube defects, through safe and effective food fortification.
IBFAN is especially worried this Resolution. The market for fortified products is enormous and expected to grow from 127 billion (in 2021) to $240 Billion by 2030.
Thank you Chair. IBFAN welcomes WHO’s attention to nutrition. However, the resolution on fortification is concerning for many reasons. Although the primary role of diverse diets is acknowledged, the Resolution implies that it is almost inevitable that fortification and supplements will be needed. There is no mention of cultural acceptability or that reliance on fortified supplements can undermine confidence in bio-diverse, minimally processed REAL foods. We call once again for WHO to urgently develop a global definition for the Ultra Processed products that are doing so much harm to human health and the environment. The Resolution should not go forward without a new operative Paragraph 9, urging Member Sates to “adopt legally binding safeguards to protect policy setting and implementation from commercial influence and exploitation”.
Statement from Slovakia:
Slovakia aligns itself with the EU statement on the items. In support of Maldives and other colleagues allow us to have several comments on the safe and effective fortification under the item 16.15 UN Decade of action on Nutrition :
1. Thanks for WHO work and for leadership of its MS for presenting micronutient defficiences solutions
2. On the other hand in some cases we can see examples of misuse, and unnecessary fortification or false claim of benefits
3. We highlight the importance of national context and national legal control frameworks to prevent /safeguard against such misuse, and the need for any interventions to be based on independent and convincing evidence of their efficacy.
4. We would like to recommend that it is necessary to pay attention in implementation process of the proposed decision also to disorders other than the neurological system and its disorders, as this area goes beyond only the narrowly defined neurological group of disorders and conditions mentioned in the title of this resolution.
As the last point, we would like to call on Secretariat, Ms and all actors addressing the needs of the communities affected by humanitarian disasters, where we should pay particular attention to the challenge of the affected population and ensure that fortified supplements and products are culturally appropriate and do not undermine confidence in bio-diverse, minimally processed foods.
We are all in the same boat to improve the nutrition and health of a particularly vulnerable population. In conclusion, SK calls for methodological collection of the evidence and science based implementation approaches with incorporation of the national legal control frameworks for the appropriate implementation of the important proposed decision.
Statement from Bangladesh: 4. Now we would like to shed light on the resolution on food fortification in 16.5.
Other IBFAN Statements
Agenda Items 14/15 – Emergencies
Thankyou chair. For 40 years IBFAN has worked with WHO to protect breastfeeding – a resilient practice that provides food, nurturing care and immune support. Breastfeeding is a lifeline in emergencies and prevents violence and malnutrition in all its forms.
IBFAN helped ensure safeguards in the Codex Guidelines for Ready to Use Therapeutic Foods – products that may be important as a last resort, but should only be used in programmes that support breastfeeding, skin-to-skin contact, wet-nursing, re-lactation and appropriate transition to nutritious family foods.
In the absence of regulations to stop commercial exploitation, such approaches mislead the public, undermine parents’ confidence in real food and put children’s lives at risk. UN and humanitarian agencies should be using their considerable diplomatic influence to challenge the corporate-led food system that has done so much harm to health and the environment. Governments need courage to address power imbalances and safeguard breastfeeding, the ecosystem and bio-diverse sustainable foods.
The IFE Operational Guidance, sound Conflicts of Interest policies and a One Health approach are essential safeguards for disaster training of health workers and citizens in normal times, alongside Baby Friendly implementation. Thank you
Agenda item 12. Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030). See paras 5,6,10,12, 22,23,
IBFAN and ILCA welcome the DG report, especially its highlighting of predatory marketing of baby feeding products – many unnecessary and ultra-processed – that undermine breastfeeding and harm families, health care systems, the economy and the environment. While 144 countries have at least some legislation based on the International code, only 32 have resisted the commercial lobbying that always, always weakens essential safeguards. To transform food systems, policy setting must be protected commercial influence. Codex has at last agreed a new global standard for follow-on formulas, so now is the perfect time to strengthen laws without fear of costly challenges. There must be accountability for unethical exports into poorly resourced countries. WHO’s Congress on Code implementation in June could help Member States ensure that healthy food takes priority over trade. Please attend this important event.
Agenda item 13.2 Political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases, and mental health: • Draft updated menu of policy options and cost-effective interventions for the prevention and control of noncommunicable diseases
IBFAN has supported WHO’s work on NCDs since the start, highlighting the need for Conflicts of Interest safeguards, clear terminology and the protection breastfeeding and sound child feeding – essential in preventing NCDs. FENSA has led to much confusion about identities and responsibilities. Corporations have no democratic accountability and in our experience ‘multi-stakeholder’ partnerships with health-harming corporations delay effective legislation, especially on labels and marketing. WHO must develop a global definition for Ultra Processed products. They are so often covered in claims about added micro-nutrients, yet do so much harm. Deaths from unhealthy food now exceed those of tobacco. We can say this because IBFAN is not a ‘stakeholder’ does not take corporate funding and has no financial ‘stake’ in this issue.
Please encourage your government representatives to attend WHO’s Global Congress on Implementation of the International Code of Marketing of Breastmilk Substitutes. This will take place
New and Important publications:
“The shift towards market fundamentalism and increasingly powerful transnational corporations has created a pathological system in which commercial actors are increasingly enabled to cause harm and externalise the costs of doing so.” Lancet CDOH 2023
Following on from the 2023 Lancet Breastfeeding series (launched in February) a new Lancet series on the Commercial Determinants of Health outlined the impact of all transnational corporations on the escalating rates of avoidable ill health, planetary damage, and social and health inequity.
UNICEF’s 24 country survey,Barriers to Food and Beverage Marketing Regulation illustrates the lack of legislation in countries: “Almost all respondents (90 per cent) reported insufficient financial resources to develop a comprehensive legal response to address food marketing….Despite most respondents reporting that unhealthy food marketing was a problem in their country, only 34 per cent reported that they had sufficient available data to describe the extent and nature of unhealthy food marketing in their country…. More than two-thirds of respondents (70 per cent) considered that the industry-led codes for regulating unhealthy food marketing in their country were insufficient..”
For more on IBFAN’s concern about fortified Supplements see: Is “small quantity lipid nutrition supplement” (SQ-LNS) a sustainable and pragmatic strategy to prevent malnutrition?
WHO’s 75th Birthday
On 7 April 2023, the World Health Organization (WHO) marked its 75th anniversary, along with its 194 Member States and other partners, by calling for a renewed drive for health equity: “Over the last 75 years, WHO has been working to protect people fromkey risks that lead to chronic diseases, such as tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets – that lead to diseases and conditions such as diabetes, cancer, stroke, and associated trauma and suffering, accounting for 74% of all deaths worldwide.”
IBFAN has been present at the WHA for many of its key moments. Most notably for us was the adoption in 1981 of the International Code of Marketing of Breastmilk Substitutes and the adoption of the Global Strategy of Infant and Young Child Feeding in 2003. Also important but problematic was the Global Strategy for the Prevention and Control of Noncommunicable Diseases in 2004. We contributed to the development and adoption of the Political Declaration on NCDs at the United Nations in 2011, launching the Conflict of Interest Coalition at the same time.