Updated: Alan Court: the Lancet: Is it Right that Producers of Breastmilk substitutes Sponsor Pediatric Conferences?

Janet Nelson Arazi

Hello, Tom,

I contacted GIFA - the Geneva association which is a member of IBFAN and WABA - received back this message with links to some very informative reports about events at the WHA as well as CODEX.

"All the analysis that IBFAN does on country positions is mainly posted on the policy blog of my colleague Patti Rundall, from Baby Milk Action/IBFAN UK. You probably know her personally..? I would therefore forward you some articles on the BMA website for any information from IBFAN that is of public domain: http://www.babymilkaction.org/archives/17379 ; http://www.babymilkaction.org/archives/17531 ; http://www.babymilkaction.org/archives/17748 . Patti, please complete if I missed any relevant articles.”

I have clicked on a number of the blogs, which specifically cite the countries that played a leading role on both sides of the debate.

Here is a very interesting paragraph on what IBFAN sees as the main issue:

"President Trump does seem to have a real dislike of breastfeeding, however the controversy is NOT really about breastfeeding – or about infant formula, which is a legitimate and necessary product for babies who are not breastfed. The debate at this time is about the trade of  ‘follow-on’ or ‘toddler’ formulas,  unnecessary products that target babies 6 -36 months and are aggressively and misleadingly promoted. These products are fuelling global formula sales (set to rise to $70bn by 2019) and exacerbating the obesity epidemic – while undermining breastfeeding  –  a lifeline for so many children and undermining the health safeguards that exist in many countries.

Unless there is a radical change of policy, the US has no intention of bringing in laws to control baby food marketing at home –  it never has.  This tactic of threatening less powerful countries has much more to do the corporate need to trade highly processed products globally with minimal restrictions  – forcing developing countries to welcome these products as somehow better than their own, and to abandon their traditional food cultures.”

In the exchange below about the potential role of pediatric associations, do we know whether UNICEF is actively engaged with the IPA?  I remember the close relationship that Grant had with Ihsan Dogramaci, the Turkish Pediatrician who as President of the IPA, helped him to energetically promote breastfeeding with national pediatric associations.

Best,

Janet

Tom McDermott

Thanks Janet - this is very helpful.   I believe the rest of us will need a little time to pursue the BMA site.  

Thanks for pointing out the importance of the 'follow-on' toddler foods which I suppose are not addressed in the Code.  Joan French had pointed to this issue during last year's discussion.  Any ideas on what role retirees could play?   I suppose one is to raise public awareness of the issue in countries where we have members (letters to the editors, partnering with interested nutrition lobby groups).   

Alan has written to Ted Chaiban and Stefan Peterson asking who in UNICEF has the relationship with IPA .  Let's see their response.  

Dear Ted, Stefan and Luwei,

Greetings and Happy New Year!

This week’s Lancet has a very good comment on the issue of breastmilk substitutes which I have attached. It is by Tony Waterston and Charlotte Wright and focuses on companies' sponsorship of pediatric associations. Ted, you will recall that you and I had a call with Tom McDermott about the US government position about 9 months ago. The increase in use of breastmilk substitutes worldwide is worrying, particularly the steep rise in Asia. It would be good to mainstream the pro-breastfeeding alliance through pediatric associations and others who wield much more influence on governments than IBFAN or WABA. Do any of you know who in UNICEF or outside has a relationship with the leaders of the International Pediatrics Association, the organization through which the authors suggest action is taken?  Stefan, aren’t you very much involved with a pediatric association? Or do you know who from among UNICEF retirees has   a connection to the IPA’s current leadership?

Beatrix Bazin Rushton	Fri, Feb 15, 5:29 PM (3 days ago)
to Patrick, Bjorn, Janet, Nicholas, Padmini, Vijay, Leila, jfrenchf, Karin-Stanley, Fuderich, me, Alan

Thanks Alan, understand why french young women are not encouraged to breastfeed but there is also a feeling i have heard expressed by more and more of those dr is that the food we eat is full of pesticides so why should we breastfeed our children !!

Still a long fight to go!

Bea

Alan Court	Fri, Feb 15, 9:41 AM (3 days ago)
to me, Patrick, Bjorn, Janet, Nicholas, Padmini, Vijay, Leila, Beatrix, jfrenchf, Karin-Stanley, Fuderich

Thanks Tom,

as you can imagine, no let up from the Administration in the US. However, in this week's Lancet (out tomorrow) there is a very good comment on the issue which I have attached. It is by Tony Waterston and Charlotte Wright and focuses on companies' sponsorship of pediatric associations. The increase in use of breastmilk substitutes worldwide is worrying, particularly the steep rise in Asia. It would be good to mainstream the pro-breastfeeding alliance through pediatric associations and others who wield much more influence on governments than IBFAN or WABA. Do we know who in UNICEF or outside has a relationship with the leaders of the International Pediatrics Association?  Perhaps one or more retirees with a connection to current leadership could be particularly helpful.

I will also share this with Ted and others in UNICEF who may not get the journal.

https://drive.google.com/file/d/0B8Ki9j3yqNFNUkVyZzJVazB6bnVSZ0VVSDJRNElDV0xiLUow/view?usp=sharing

Dear Patrick, Bjorn, and Janet

Thanks for your replies.  I know that in all your cases you are continuing to work and of course understand that you do not have the time to take on leadership of a discussion group.  I am myself tied up with the newsletter, blog and so forth, plus occasional (but these days less frequent) paid work.

While this issue is important, it seems to be too narrowly focused for much action by retirees. Also we have very little new info to act on - at least for the moment.  

 Last year Alan Court and I discussed the issue Ted Chaiban along with the issue of marketing of generic drugs marketed in developing countries (another commercial issue opposed by the US Admin).  He promised at the time to push for a stronger UNICEF position.  We ought to follow up to see where things stand.  I am copying Alan in case he has more recent information.

I think that we should drop the question of a separate discussion group on this topic, at least until we know more about what is happening.  Once we do know more, the discussion perhaps needs to be with the wider XUNICEF group.

Janet - yes, it would be great if IBFAN could give us an update, but would be good if they could say something beyond what the US is or isn't doing.  Are attitudes of other governments shifting, etc.?  Interesting point about the irony in Trump's call for maternity leave.  

Bjorn - you make important points about Triple A being forgotten in UNICEF offices.  I think this is worth a direct talk with Ted Chaiban or others in the programme / policy positions.  If and when you find time, it would be good to make a summary of the issues you are seeing on the UNICEF nutrition side - something for NY, but also perhaps one we can circulate in XUNICEF.

Patrick - your earlier message on the breastmilk substitute issue in Thailand, as well as this both point to the need for a wider discussion into many areas beyond the US position at last year's WHA, including the recent measles outbreaks in so many countries.  All touch on the rumor and false info story along with the story of unscrupulous or lazy leadership.  The question for us always comes back to whether we see a potential role for UNICEF retirees.  Advocacy with our respective governments and in our communities is one possibility.  But if advocacy with UNICEF - what do we want done?

Thanks again.  Let's keep an eye for any opportunities where we can help.

Tom

Patrick Hennessy	Feb 8, 2019, 8:35 PM (15 hours ago)
to me, Bjorn, Fuderich, Janet, Karin-Stanley, Leila, Nicholas, Padmini, Stephen, Vijay, jfrenchf

Thanks Tom

I am not qualified to lead a discussion on breast milk despite some wags in my local bar who look at me and think me over qualified.

But this issue is tied up with all others, including the vaccination debacle you referred to in another email. It is tied up to young girls who are rounded up in India and elsewhere and burned because of a tweet, online message, rumour .....

Sadly we live in a world where marketing trumps truth. We live in a world where what is legal trumps what is right or moral. We live in a world where one anonymous online message can get you hounded up and burnt alive.

That money could force the US delegation at the WHA to vote against everything they know to be true, and do it shamelessly, is the issue of our times.

Whether climate change, vaccination, breast  milk, diet, etc. etc the fundamental breakdown in this century is not just dishonesty and lying but the normalisation of it ADDED to the facility which social media lends to the distribution of lies, without little or no consequence for the liar.

I don’t hear the SG or the Head of any UN Agency put their neck on the line to call out world leaders for blantant lying and using social media to promote such lying. I don’t see a  coherent UN campaign against the abuse of social media across all strata of news exchange.

When our species loses its moral compass it’s time to get off the ship.

If anybody can send me a speech from the SG or any UN Agency Head on the normalisation in this century of lying and dishonesty at the the level of world leaders I would like to read it. If you can believe nobody who comes to vaccinate your child or ask you to breast feed why listen? That is the tragedy of our time. The messenger has no credibility. The UN are messengers on public health, on human rights, in climate change. But with no credibility why take the plane. And who/where in the sphere of international ‘governance’ is addressing the vicarious celebration of the death of the truth by world leaders.

So yes to a discussion on breastfeeding but who is going to help the messenger have credibility?

Patrick

Bjorn Ljungqvist	2:06 AM (9 hours ago)
to Fuderich, Janet, Karin-Stanley, Leila, Nicholas, Stephen, Vijay, jfrenchf, Patrick, me, Padmini

Dear Tom and all, I signed up to this working group from my vantage point of continuing to do work at country level supporting UNICEF and other UN partners on nutrition programming. I can see very clearly that promotion of proper breast-feeding is taking on lower priority despite negative trends and unacceptably low levels in most countries visited. While CMAM and (usually but not always) VAC supplementation is taking all attention of the UNICEF teams. The participatory, essential Triple A part of the UNICEF strategy is forgotten. 

However, I am not very close to the policy process in the US so that is why I hesitate to assume a leading role in this group but I reconfirm my interest to contribute. 

Best/bjorn/camp/khartoum