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. 2000 Oct 14;321(7266):960.
Unicef and baby food manufacturers
Unicef continues to base its actions and programmes on the best interests of the child
Editor—I write with reference to Yamey's article about the alliances Unicef is seeking to form with manufacturers of infant formula that do not comply with the international code of marketing of breast milk substitutes.1 Unicef does not accept donations from manufacturers of infant formula whose marketing practices violate this code and subsequent World Health Assembly resolutions. Unicef stands firmly behind the code and will continue its longstanding support for breastfeeding programmes worldwide.
Over the past few months there has been considerable discussion within Unicef about our relationships with the corporate community, including manufacturers of infant formula milk. This internal discussion emerged mainly because Unicef is one of the cosponsoring agencies of UNAIDS and has, at the request of the United Nations secretary general, participated in discussions with five large pharmaceutical companies on the possibility of obtaining various drugs to fight HIV/AIDS at discounted prices on behalf of developing countries. One of these companies is widely viewed as violating the code.
Some people inside and outside Unicef have misinterpreted our participation in these discussions as a sign that we are weakening our support for breast feeding and the code. Nothing could be further from the truth. Unicef believes that in the face of AIDS our support for breastfeeding must be strengthened, not diminished.
Nonetheless, when we think that a company—any company—may offer a compelling solution to a crucial child health problem such as HIV/AIDS, we will explore how to get that company working on behalf of children and women. At the same time, Unicef will uphold its support of the code and will continue to call violators of the code to account publicly.
Are the issues complex? Yes. Is the growing calamity of HIV/AIDS forcing us all to consider new approaches to our work? Absolutely. That's why the debate in Unicef is spirited. But regardless of our soul searching on how best to navigate through the sometimes conflicting policy issues raised in part by AIDS, Unicef remains resolutely committed to breast feeding and the many benefits it provides to both mother and child. At the same time, Unicef recognises that mothers infected with HIV face an agonising dilemma on how best to feed their infants and strongly supports the efforts of researchers better to understand this crucial area of transmission.
Finally, as has been the case throughout the 10 years since the ratification of the convention on the rights of the child, Unicef will strive to base its actions and programmes on the best interests of the child.
References
1.Yamey G. Unicef accused of forming alliance with baby food industry. BMJ. 2000;321:132. . (14 July.) [Google Scholar]
Editor—Yamey's article raises important issues about the partnerships between the United Nations, non-governmental organisations, and industry.1-1
We appreciate the courage that Unicef, more than any other UN agency, has shown over the past two decades in speaking out about corporate practices that undermine infant health. A key factor has been Unicef's understanding of the influence that inappropriate sponsorship and partnerships can have. Carol Bellamy, the executive director of Unicef, has confirmed that Unicef will continue to refuse donations from manufacturers of infant formula that violate the international code of marketing of breast milk substitutes and subsequent World Health Assembly resolutions, but we do have other concerns—for example, the following.
What about manufacturers of other breast milk substitutes, bottles, teats, or the new “medical” foods—all products that are promoted in ways that undermine breast feeding?
Are partnerships with corporations really the best way to find appropriate solutions to HIV/AIDS? Surely the world health community can research this problem without having to beg from companies who will inevitably look for wealth generating answers? There will never be a commercial incentive to research exclusive breast feeding, yet recent research has shown that it may prove to be a more appropriate way to combat HIV transmission
How will Unicef judge compliance of a partner or other company to the code? Even in the face of the most compelling evidence, companies will argue their innocence.1-2 Rightly or wrongly, the public expects the UN to provide an independent and authoritative view
How will Unicef protect its right to speak out? In January this year at the executive board meeting of the World Health Organization the intervention of the International Baby Food Action Networks included a comment exposing a report by a baby food company which claimed that it followed the code. Unicef and other agencies had been outspoken in their criticism of the report, and Unicef had given permission for its critique to be made public. The WHO, which is actively pursuing partnerships with industry, pressured us to remove this section completely.1-3 We refused and said that, rather than edit it, we would hand it to members of the executive board and the media. In the event the entire speech was delivered as drafted. But the critical piece about the company was deleted from the provisional summary record.
If we are to have informed debates about issues that affect public health so profoundly, surely all of us working in the interests of public health should be encouraged to express our concerns frankly.
References
1-1.Yamey G. Unicef accused of forming alliance with baby food industry. BMJ. 2000;321:132. . (14 July.) [Google Scholar]
1-2.Yamey G. Nestlé violates international marketing code, says audit. BMJ. 2000;321:8. . (1 July.) [PubMed] [Google Scholar]
1-3.Ferriman A. WHO accused of stifling debate about infant feeding. BMJ. 2000;320:1362. . (20 May.) [PMC free article] [PubMed] [Google Scholar]
