Infant formula marketing code has failed, says expert
By Lorraine Heller, 28-Jul-2010
Related topics: Industry, Maternal & infant health
Measures designed to ensure optimal infant nutrition are being hampered by disputes over the implementation of an international code of marketing for infant formula products, according to a child nutrition expert.
Writing in the Archives of Disease in Childhood, Professor Stewart Forsyth says the 30 year-old International Code of Marketing of Breast-Milk Substitutes is mired by a series of alleged violations and boycotts, which are counter productive to the code’s goal.
He calls for international governance to step in and replace the voluntary marketing code.
Collaboration across the board
Developed via a collaboration between UNICEF, the World Health Organisation (WHO), industry and international organisations, the code was adopted by the World Health Assembly in 1981. It aimed to promote appropriate marketing and distribution of infant formula products in order to encourage safe and adequate nutrition.
However, according to Professor Forsyth, an honorary consultant paediatrician formerly of the UK’s NHS Tayside, there has been an “unrelenting series of disputes, predominantly relating to alleged violations of the code, which have provoked high profile acrimonious exchanges, boycotts and legal proceedings”. This, he said, has “led to an atmosphere of mistrust that has now become embedded between key agencies”.
He particularly highlights the disputes between the non-governmental group Baby Milk Action and infant formula manufacturer Nestle.
Good intentions
The marketing code intended to provide a framework for cooperation between governments, organisations of the United Nations system, non-governmental organisations, experts in various related disciplines, consumer groups and industry in efforts to improve maternal, infant and young child health and nutrition.
Its 11 articles set out the nutrition goals, as well as recommendations on quality and standards for milk substitutes. It also provides guidance as to the responsibilities of governments, industry and health groups in attaining these goals. All involved parties, it says, should co-operate to ensure appropriate measures are being taken at all levels.
Calls for governance
However, over thirty years after its creation, the code’s failure is hindering improvements in maternal, infant and child nutrition, says Professor Forsyth.
“Unfortunately, the evidence indicates that this rather complex multi-agency monitoring framework has failed to deliver effective corporate governance. It is probably not surprising that each of the components of this self-regulatory structure continue to manifest aspects of self-interest, and this is likely to continue in the absence of an ‘ombudsman’ or independent body with the authority to arbitrate and ensure that actions taken by respective parties are in keeping with the spirit of the code.”
He argues that the only foreseeable way of maintaining the original spirit and goals of the code is strengthen governance both at national and international levels.
“It is proposed that measures are taken to replace current hostilities with effective national and international governance,” he concludes.
Source: International code of marketing of breast-milk substitutes—three decades later time for hostilities to be replaced by effective national and international governance
Arch Dis Child (2010). doi:10.1136/adc.2010.187294
Author: James Stewart Forsyth
BUT, an article on www.physorg.com says he has collaborated with formula companies for research in the past. A study published in the BMJ is one example.
International formula milk marketing code mired in 3 decades of dispute
July 26, 2010
An international marketing code for formula milk, intended to foster global cooperation among governments, industry, and aid agencies, has instead been mired in three decades of often bitter dispute, claims a child nutrition expert in the Archives of Disease in Childhood.
As long as hostilities continue, improvements in maternal, infant, and child nutrition will be less likely, says Professor Stewart Forsyth, formerly of NHS Tayside.
Professor Forsyth has published widely on the benefits of breast feeding and collaborated with formula milk companies on research.
The Thirty Fourth World Health Assembly adopted the fourth draft of the International Code of Marketing of Breast Milk Substitutes in May 1981 as a minimum requirement to protect and promote appropriate feeding for infants and young children.
Although voluntary, the implementation of the 11 articles of the code, which range from marketing and distribution, through quality standards, to national government responsibilities, is closely monitored by the World Health Organization.
At the time of its inception, it was envisaged that the code would provide a framework for governments, UN bodies, aid agencies, specialists, consumer groups and industry to cooperate fully, says Professor Forsyth.
But instead, he writes: "There has been an unrelenting series of disputes, predominantly relating to alleged violations of the code, which have provoked high profile acrimonious exchanges, boycotts, and legal proceedings."
Crucially, there is a lack of official independent information on the validity or otherwise, of these claims and their outcomes, he adds.
The self regulatory national governance arrangements for the code have lacked transparency and clearly defined responsibilities, he contends.
"It is probably not surprising that each of the components of this self regulatory structure continue to manifest aspects of self interest, and this is likely to continue in the absence of an 'ombudsman' or independent body with the authority to arbitrate," he writes.
Self appointed monitoring groups, which have stepped into the breach, have been hampered by insufficient access to all the relevant information and an approach that is unlikely to inspire the confidence of all the players involved, he suggests.
International accountability also potentially lacks transparency and consistency, he contends, especially for issues that cross national and continental boundaries.
"The controversy that has bedevilled the code for 30 years is almost entirely limited to matters of interpretation and compliance," he writes. "However, because these issues have been so protracted it has led to an atmosphere of mistrust that has now become embedded between key agencies."
It is time to "replace current hostilities with effective national and international governance," he says.
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