Strong lobby behind breastfeeding alternatives in some countries


U.S. delegates to the World Health Organization in Geneva three months ago stand accused of greedy motives for seeking to expand information about breastfeeding alternatives. They were accused of not caring about women and children. They were accused of threatening a poor country’s national security to funnel billions of dollars to U.S. corporations.

What really happened is that a U.S. delegation, including women who were experienced breastfeeding advocates and savvy negotiators, bested the entrenched interests of a powerful activist lobby in a fair fight and for good reasons. As the New York Times accurately reported, this “stunned” global health officials who had gotten all too accustomed to the status quo, including the previous U.S. administration’s reluctant acquiescence to the 2016 version of the resolution.

The trouble began when a small country made a negotiating faux pas. Ecuador decided to sponsor the biennial breastfeeding resolution that long had been informed by a cadre of breastfeeding activists seeking to ban baby formula.

A U.S. negotiator from the Department of Health and Human Services, said her colleagues reached out to their Ecuadorian counterparts months before the negotiation but they did not return any of the phone calls or emails. As the talks drew near, Washington asked its ambassador in Quito to deliver its concerns.

Complicating the Ecuadorian strategy was the fact that Vice President Mike Pence would be on his way to Quito in just a few weeks to sign an important deal that included military aid. Ecuador decided to drop sponsorship of the resolution.

Alma Golden, a pediatrician at the talks who spent years teaching and advocating on behalf of nursing infants, told me that Ecuador’s original draft was just too extreme. The USAID deputy assistant administrator spent years attending to indigent mothers. When mothers can’t breastfeed and don’t have formula, they turn to dangerous options such as rice water. One mother came to her with 7-month-old twins who were severely dehydrated, developmentally delayed, and had a horrifying skin condition. “Mothers have the right to know there are safe, healthy alternatives when they need them,” she said.

She called the resolution’s final text “balanced” — strongly endorsing breastfeeding and allowing countries to give mothers information about alternatives.

The United States also targeted a WHO/UNICEF guide that says “any promotion of complementary foods for infants less than 6 months of age is prohibited by the code.” That is the same complementary formula that kept the U.S. negotiator’s son alive, and that could have helped Dr. Golden’s patients.

Many assume that activists always have good intentions and governments never do. The reporter who broke the story likely thought the baby formula story fitted into his series of stories on corporate interests regarding obesity, trans fats, and sugary breakfast cereals; that may be why he missed the substantive debate. He is not alone, and his story hews to that of the United Kingdom-based Baby Milk Action version of events. The group’s leader, Patti Rundall, shares an anti-corporate worldview and is the only source named in the story.

Not a single Western country has fully implemented the code, including the United Kingdom. After 40 years, only 35 countries have done so, and all of them are poor countries where women need information and access to nursing alternatives the most. Even with low compliance and lack of consensus for the code, nations have increased exclusive breastfeeding and rates doubled across 20 priority countries between 1990 and 2014.

Completing the triad of complaints was the disgruntled Ecuadorian negotiator, a colleague of the one who had refused to return American phone calls last spring. She told two American negotiators I interviewed that baby formula should be available only by a doctor’s prescription.

In the end, Russia took over sponsorship of the resolution and closed the deal. Five minutes into the final WHO ceremony, the final version was hailed with much applause as a great success. There is no indication it was a disappointment.

Moving forward, we can hope that this controversy will open up some space for more informed debate and less point-scoring in future deliberations. It is incumbent on people in the field to tell the story in all its complexity. Women and children deserve such attention because their issues, and their lives, are vitally important. And sometimes the guys in white hats are women from the U.S. government.

(Views expressed are personal)

Courtesy: Global governance watch


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