Opposition to breastfeeding decision by US officials in the field of global health

Opposition to breastfeeding decision by US officials in the field of global health


A decision to promote breastfeeding was expected quickly and easily by hundreds of government delegates who met this spring in Geneva to attend the UN World Health Assembly.

Based on decades of research, the decision says breast milk is the healthiest for children and states should strive to limit the inaccurate or misleading marketing of breast milk substitutes.

The United States delegation, which had embraced the interests of the infant formula manufacturers, then adjourned the proceedings.

US officials sought to ease the decision to remove the language that called on governments to "protect, encourage and support breastfeeding," and another that called for policy makers to restrict the promotion of food products that many experts say can have harmful effects on young children.

When that failed, they turned into threats, diplomats and government officials involved in the discussions said. Ecuador, which planned to introduce the procedure, was the first to find itself in cross-hair.

The Americans are open: If Ecuador refuses to drop the resolution, Washington will punish trade measures and withdraw necessary military aid. The Ecuadorian government quickly agreed.

The standoff over the issue was reported by more than 10 participants from several countries, many of whom asked not to be identified because they feared retaliation against the United States.

Health advocates rushed to find another sponsor, but at least 12 countries, mostly poor countries in Africa and Latin America, have retreated, citing fears of retaliation, according to officials from Uruguay, Mexico and the United States.

"We were amazed, horrified and saddened," said Patty Rendall, policy director of the British Children's Milk Advocacy Group, who attended the meetings of the Assembly, the decision-making body of the World Health Organization. .

"What happened was blackmail, where the United States is holding the world hostage and trying to reverse nearly 40 years of consensus on the best way to protect the health of infants and young children," she said.

In the end, American efforts have often failed. It was the Russians who eventually intervened to present the procedure - and were not threatened by the Americans.

The State Department refused to answer questions, saying it could not discuss private diplomatic talks. The Ministry of Health and Human Services, the lead agency in trying to amend the decision, made the decision to appeal the drafting of the decision, but H.H.S. Did not participate in threatening Ecuador.

"The resolution, in its original form, created unnecessary obstacles for mothers who are seeking to provide nutrition for their children," said His Highness. The spokesman said in an email. "We do not realize that all women are not able to breastfeed for a variety of reasons," she said. "These women should have the choice and access to alternatives to their children's health and not be stigmatized in ways that enable them to do so." The spokesman asked to remain anonymous in order to speak more freely.

Although lobbyists from the food industry attended meetings in Geneva, health advocates said they saw no direct evidence that they played a role in Washington's strong tactics. The $ 70 billion industry, dominated by a handful of US and European companies, saw sales in rich countries decline in recent years, with more women embracing breastfeeding. Overall, global sales are expected to rise by 4 percent in 2018, according to Euromonitor, with most of this growth occurring in developing countries.

The administration's strong opposition to the decision to breastfeed was astonished by public health officials and foreign diplomats, who described it as a marked contrast to the Obama administration, which largely supported the long-term global health management policy of promoting breastfeeding.

During the deliberations, some US delegates suggested that the United States might reduce its contribution to W. H. Or, as many negotiators have said. Washington is the largest single contributor to the health organization, providing $ 845 million, or nearly 15 percent of its budget, last year.

The confrontation was the latest example of Trump's management alongside corporate interests in many public and environmental health issues.

In talks to renegotiate the North American Free Trade Agreement (NAFTA), Americans were pushing for a language that would limit the ability of Canada, Mexico and the United States to place warning labels on fast foods and sugary drinks, according to the New York Times revised draft.

 During the same Geneva meeting where the breastfeeding decision was discussed, the United States successfully removed data supporting soda taxes from a document recommending obese states.

The Americans also sought, unsuccessfully, to thwart the Americans' war. An attempt to help poor countries get life-saving medicines. Washington, which supports the pharmaceutical industry, has always resisted calls to amend patent laws as a way to increase the availability of drugs in the developing world, but health advocates say Trump's management has stepped up its opposition to these efforts.

The delegation's actions in Geneva are in line with the administration's tactics, which have been building alliances and established practices through a range of multilateral organizations, from the Paris Climate Agreement to Iran's nuclear agreement to NAFTA.

"There is growing fear that Trump's management will cause permanent damage to international health institutions such as the World Health Organization," said Elona Kickbos, director of the World Health Center at the Institute for Advanced Studies and International Development in Geneva. Which was vital in containing epidemics such as Ebola and the high number of deaths from diabetes and cardiovascular disease in the developing world.

"That makes everyone very nervous, because if you can not agree on multilateralism, what kind of multilateralism can you agree on?" She asked.


 A Russian delegate said the decision to make a decision on breastfeeding was a matter of principle.

"We are not trying to be a hero here, but we feel it is a mistake to try a large country to roam some very small countries, especially on a really important issue for the rest of the world," said one delegate who asked not to be identified because he was not authorized to speak to The media. .

He said the United States had not directly pressed Moscow to back down from the measure. However, the US delegation sought to weaken other participants through procedural maneuvers in a series of two-day meetings, an unexpectedly long time.

In the end, the United States was largely unsuccessful. The final decision retained most of the original wording, despite the deletion of the American negotiators from the language called WH.H.O. To provide technical support to Member States seeking to stop "inappropriate promotion of food for infants and young children".

The United States also insisted that the phrase "evidence-based" was accompanied by references to breastfeeding promotion initiatives, which critics described as a ploy that could be used to undermine programs that provide parents with advice and support on nutrition.

For four decades, Elizabeth Starkin, director of the Alliance for Infant Feeding in Canada, has emphasized the importance of breast milk, which provides essential nutrients, as well as hormones and antibodies that protect newborns against infectious diseases.

A comprehensive study conducted in 2016 in the Lancet journal found that comprehensive breastfeeding would prevent 800,000 child deaths annually worldwide and provide $ 300 billion in savings on improved health care costs and improved economic outcomes for those who breastfeed.

Scientists are reluctant to conduct double-blind studies that would provide a range of breast milk and other combinations of breast milk substitutes. "This kind of evidence-based research would be morally and morally unacceptable," Ms. Stirkin said.

Chicago-based Abbott Laboratories, one of the largest players in the $ 70 billion baby food market, has refused to comment.

Nestlé, a Swiss-based food company with large operations in the United States, has sought to eliminate threats against Ecuador and will continue to support international law to market breast milk substitutes, which calls on governments to regulate inappropriate promotion of such promotion. Products. Products and promotion of breastfeeding.

In addition to trade threats, US Ambassador to Ecuador Todd C. Chapman suggested in meetings with officials in Quito, the capital of Ecuador, that the Trump administration would also retaliate by withdrawing its military assistance in northern Ecuador, a region torn by cross-border violence. Colombia, according to the Ecuadorian government official participating in the meeting.

"We were shocked because we did not understand how such small things like breastfeeding could provoke such an exciting response," said the Ecuadorian official, who asked not to be identified because she was afraid of losing her job.


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