WHO's global strategy is tool to protect breast feeding and
child health
EDITORWaterson and Tumwine assert that governments
should accept promotion and protection of breast feeding as critical forimproving child health.1 In May 2002 the
World Health Assemblyproduced its strategy for infant and young
child feeding.2The World Health
Organization's international code of marketingof breast milk
substitutes3 and subsequent relevant assemblyresolutions are integral to this strategy, which is intended as
a model for all governments to adapt and adopt as nationalpolicy.
In the United Kingdom there is no indication that the government is
considering this strategy or intends to commit to a comprehensive
national policy, including the implied collection and evaluationof
information.2 Currently only some provisions of the
WHOcode and World Health Assembly resolutions are enacted in UK
legislation;no formal monitoring has been undertaken; legal
mechanisms forenforcement have proved cumbersome. Since the United
Kingdom performspoorly in terms of breastfeeding rates in comparison
with otherEuropean countries there is no room for complacency (R
Saadev,Department of Health conference on barriers to breast
feeding,London,2002).
If the United Kingdom were to commit to a national policy on feeding infants
and young children it would help protect childhealth in the United
Kingdom. In addition, if full collaborationof all concerned
government agencies were implemented effectively,aid to low income
countries could include capacity building sothat countries such as
Togo and Burkina Faso would have the meansto monitor the protection
of their children's health. Currentlymonitoring is all too often
left to small non-governmental groupsoperating on shoestring
budgets. Let us take heed of the warningfrom west Africa and act now
in the United Kingdom to contributenationally to global child
health.4
World Health Organization. Infant and young child
nutrition: global strategy on infant and young child feeding. In:
Geneva: WHO, 2002.
www.who.int/gb/EB_WHA/PDF/WHA55/ea5515.pdf
Aguayo VM, Ross JS, Kanon S, Ouedraogo AN.
Monitoring compliance with the International Code of Marketing of
Breastmilk Substitutes in west Africa: multisite cross sectional
survey in Togo and Burkina Faso. BMJ 2003; 326: 113-114[Free Full Text].
(18 January.)
Manufacturers encourage transparent and official monitoring
of WHO code
EDITORWaterston and Tumwine's editorial and the study
it describes are an example of why the International Association of
Infant Food Manufacturers supports a better way to monitor and
enforce the code in many countries. 12 Our member companiesare committed
to the health and wellbeing of infants and youngchildren. We support
the aims and principles of the WHO code.For the code to succeed,
however, national governments must overseemonitoring and enforcement
in keeping with their own legislativeand regulatory framework. The
code itself recommends this, andindeed it is key to its
success.
The reported study was led by a representative of the International Baby
Feeding Action Network, which has devised its ownsystem of
monitoring. Under the WHO code, monitoring groups arerequired to
inform companies of alleged non-compliance immediatelyso that they
can respond and take corrective actions, if necessary.Yet in the
three years since this monitoring took place, noneof the researchers
contacted the companiesmentioned.
Data collection for the study was based on inaccurate interpretations of the
WHO code. Most of the alleged violations referto products that are
complementary foods (such as baby cerealsor fruit juices) and not
breastmilk substitutes. The code explicitlyexcludes complementary
foods from the marketing restrictions.Accusations came to light only
in thisarticle.
We are interested in cooperation and partnership with WHO, other institutions
dedicated to the welfare of children, non-governmentalorganisations,
and our member companies. To protect the healthand promote nutrition
of infants and young children, governmentsneed to be encouraged to
enforce the WHO code; monitoring mustbe based on research methods
that fulfil basic reliability criteria,be transparent, and be
carried out according to national legislationand standards. Only
when we are focused on this shared goal willthe code
succeed.
Andrée Bronner, secretary general.
International Association of Infant Food Manufacturers, 194 rue de Rivoli,
F75001 Paris, France
andree.bronner@wanadoo.fr
Aguayo VM, Ross JS, Kanon S, Ouedraogo AN.
Monitoring compliance with the International Code of Marketing of
Breastmilk Substitutes in west Africa: multisite cross sectional
survey in Togo and Burkina Faso. BMJ 2003; 326: 113-114[Free Full Text].
(18 January.)
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PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
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LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"