|Is Gro Harlem Bruntlandt, the WHO Director
General, neglecting her obligations under the International Code?
|Although a number of IBFAN delegates from Latin
America, Europe, North America, Asia and Africa were able to attend the May
2000 World Health Assembly (WHA) meetings, results did not live up to
Every even year the Director General is required to report to the WHA on the status of infant and young child nutrition and implementation of the International Code. Many issues regarding implementation remain outstanding and 2000 could have been a productive year to settle a number of key areas which continue to hamper full implementation of breastfeeding protection measures.
First, WHO's lack of adopting as its policy recommendations, previous Resolutions (1992 in the preamble, and 1994 in the operative paragraphs) on the appropriate age of introduction of complementary foods being at about six months. This neglect has led to much confusion among both individual health workers and national policy makers.
Not only has WHO not incorporated the member state decisions, but it has discouraged and continues to actively discourage member states from adopting "at about six months" as their position at the Codex Alimentarius revisions of the standards for infant formula and cereal-based complementary foods.
Secondly, the number of outstanding concerns is escalating -- the proliferation of internet advertising, the growing use of misleading and unsubstantiated health claims for artificial infant feeding products, conflict of interest issues as partnerships and sponsorships with industry are receiving institutional support, the need to make unequivocal recommendations regarding industry exploitation of HIV and infant feeding.
Already prior to the Assembly, the WHO Executive Board (EB) which met in January was reluctant to draft a resolution on infant and young child feeding, because all the board members were awaiting the outcome of a global technical consultation on infant feeding. However, despite the EB's lack of interest, Brazil presented a proposed draft resolution at the WHA. As much as Brazil's draft had many positive elements, it needed editing to focus the text. The lateness of the proposed draft presented some difficulties in making the needed changes and the WHO secretariat rather aggressively informed the Brazilian delegation to drop any references to "at about six months", which to their credit, the Brazilians refused to do. Thus the proposal was tabled mostly in its original form.
The WHA debate was intense, with 53 countries and six NGO's (including industry) taking the floor. About half, mostly from the developing world supported the proposed resolution while the industrialized countries wanted it deferred to the Executive Board meeting in January 2001. As there was no consensus, the chair set up a working group for the next day to make a final decision. In the end, the working group, dominated by members from the EU, supported sending the draft resolution to the Executive Board for further work including the incorporation of the amendments proposed during the debate.
Thus, for those expecting a WHO to show commitment to a new and strong resolution, addressing many outstanding marketing issues, there was disappointment. However, supporters of the draft resolution and amendments now have an opportunity to strengthen and focus the text. The draft will go before the Executive Board in January for redrafting and the Director General will be asked to put infant and young child nutrition on the agenda for the WHA meeting May 2001.
We hope that the WHO secretariat will not impede progress in providing governments with effective public health policy which truly protects infant health.