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.
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