Label warnings needed to save babies’ lives, World Health Assembly delegates decide
Representatives to the World Health Assembly lobbied
by Andrée Bronner, representative of the infant formula industries.
World Health Assembly delegates representing the world’s health ministries met in Geneva from May 16 to 25 to pass a resolution requiring warnings on formula tins as a measure to improve safeguards for infants who need to be artificially fed.
The warnings are intended to inform both health professionals, parents and other caregivers of infants that powdered infant formulas are not sterile products and may contain harmful bacterial contaminants. The resolution followed a contentious debate pitting some industrialized countries such as the US, Canada, Switzerland, Japan and Germany against developing countries where rates of illness and death related to formula feeding are already high.
The debate was necessitated by the reports from a number of countries, more recently France and New Zealand, of deaths caused by the bacterium, Enterobacter sakazakii, known to contaminate powdered formulas during manufacturing of the product. This "intrinsic" contamination has resulted in reports of infant fatalities or serious illness such as nectorizing enterocolitis, meningitis and sepsis, in a number of industrialized countries. The full scale of the problem remains unknown and could be extensive for developing nations. Developing countries expressed their support for the need to label products.
"Powerful commercial forces are opposing. We are saving the lives of infants and children and these cannot be held to ransom for the sake of commercial interests."
South Africa noted that, "these products are imported" and stated that because of insufficient testing … "one cannot establish a link to the product and the reason that babies die is not known."
Burkino Faso’s Minister of Health expressed his worries about importing the same products that caused the E.sakasakii outbreak in France. Yemen’s representative too urged for the need to label products, "Why should our children receive infected products?" he asked.
Madagascar, speaking on behalf of the African countries supported full and effective labeling in the face of the high prevalence of HIV infections. "Replacement feeding can have a higher risk of mortality than HIV transmission. Therefore exclusive breastfeeding would be the preferred choice for infant feeding. On the other hand the need for infant formula remains because of the need to feed orphaned children and these need to be protected."
Using the WHO slogan of ‘every mother and every child counts,’ Nepal, one of the original sponsors of a strong WHA resolution for warnings on formula labels, questioned how on the one hand WHO can talk about saving lives and on the other hand delay passing the resolution that can save lives? Amendments by child-friendly countries need to be approved.
On the other hand, several industrialized countries were considerably less child-protective. Canada was one of them. Supporting a weaker resolution than that requested by developing countries, Canada supported the US in noting that the issue of contamination should be addressed through the Codex process. However the Codex process is very slow and laborious. Other countries such as Argentina stated that there should be clear warnings on formula labels, "because if we leave this problem up to Codex …this could take up to seven years."
South African’s delegate expressed her frustration with the resistance to adopting a strong resolution, "Powerful commercial forces are opposing. We are saving the lives of infants and children and these cannot be held to ransom for the sake of commercial interests."
The full text of Resolution 58.32 can be found at: www.who.int/gb/ebwha/pdf .les/WHA 58 32-en.pdf