Codex, Trade, Policy coherence and the protection of IYC health Elisabeth Sterken, IBFAN North America World Breastfeeding Conference 2 Johannesburg, 2016
What is the Codex Alimentarius? Joint UN body of WHO and FAO Codex sets standards for food commodities and food products Includes safety/risk analysis of food additives Sets levels of contaminants for foods Sets microbial criteria for foods Sets labelling requirements Sets guidelines for nuiritionand health claims
WHAT is the Codex Alimentarius? Joint UN body of WHO and FAO Codex sets standards for food commodities and food products Includes safety/risk analysis of food additives Sets levels of contaminants for foods Sets microbial criteria for foods Sets labelling requirements Sets guidelines for nutrition and health claims
What is the mandate? 1. its purpose is two-fold: * to protect consumer s health and * to ensure fair practices in the trade of food commodities and food products. Secondary to this the Codex Commission also acts in an advisory capacity through codes of practice, guidelines and other recommended measures. In effect, Codex harmonizes food products for international trade
Who participates? Member states UN agencies NGO Observers Industry based NGOs Independent NGOs
WHY is IBFAN involved? To ensure the protection of breastfeeding and optimal family food based complementary feedingin the international trade of foods for infants and young children Codex standards are the benchmarks for the WTO Inclusion of the International Code and WHA resolutions into the scope of the standards for infant formulas, complementary and supplementary food products
WHY is IBFAN involved? To ensure that infants who have a medically indicated need for artificial feeding also receive adequate consumer protection Additives Contaminants Safe upper levels of nutrients Appropriate ingredients sugar levels
WHY is IBFAN involved? To ensure that the WTO trade dispute mechanisms will not over-rule national legislation or regulation regarding the International Code of Marketing of Breastmilk Substitutes and subsequent resolutions of the WHA Protects the ability of national governments to regulate the marketing and labellingof these products
WHY is IBFAN involved? To ensure that consumer protection for parents, pregnant and lactating women through full and informative labellingof commercial food products for infants and young children. Claims only if permitted if national legislation permits them No comparison s should be made to breastmilk
How? IBFAN has NGO Observer status with Codex Submit written comments on relevant agenda items During the physical sessions IBFAN comments on every aspect of the development of the standard Participate in electronic/physical working groups Briefings for member state delegates
How is IBFAN involved?
Policy coherence with Code and WHA resolutions Standard for follow-up formula and formulas for young children WHA 39.28 FUFs are not necessary WHA 69.9 Guidance to end the inappropriate marketing of foods for infants and young children
FUFs for young children are breastmilk substitutes WHA 69.9 A breast-milk substitute should be understood to include any milks (or products that could be usedtoreplace milk, such as fortified soy milk), in either liquid or powdered form, that are specifically marketed for feeding infants and children up to the age of 3 years (including follow-up formula and growing-up milks). It should be clear that the implementation of the International Code and subsequent relevant WHA resolutions covers all these products.
Industry influence at Codex At the recent CCFSDU -revision of FUF standard Total number of delegates 300 of which 132 were industry Government delegations 197 of which 56 were industry Observer delegations 95 total of which 76 were industry
Industry influence When determining safety of ingredients, additives etc. Codex often refers to ill defined terms such as generally accepted History of safe use science--based scientifically demonstrated rather than the terms recommended by WHO: Relevant convincing / generally accepted scientific evidence or thecomparable level of evidence under the GRADE classification
Industry influence at Codex Redefine FUFs as cow s milk replacements Reposition use as supplementary milks Reposition use as part of the progressively diversified complementary foods diet of young children
Cross-branding Cross-branding or brand stretching is a form of marketing promotion where customers of one product or service are targeted with promotion of a related product. This can include packaging, branding and labellingof a product to closely resemble that of another. WHA69/7 Add.1
Press release by Abbott Ross Oct, 2016 A new infant formula infused with prebiotics protects a baby s immune system like breast milk, according to a new study. The study, published Wednesday in the Journal of Nutrition, studied 200 babies over six weeks, divided into three feeding groups: breastfed, formula-fed and formula fed with specific prebiotics. Multiple immune markers of breast-fed babies and babies using the prebiotic formula were nearly identical, the study showed. Prebiotics are fibers that support good bacteria in the body. This is the biggest breakthrough in the last decade for Abbott formula, the ownersimilac, said Dr. Rachael Buck, one of the study's researchers who works for the company. The new formula contains2 -fucosyllactosehuman milk oligosaccharide, prebiotics found naturally in breast milk. The HMOs used in the new formula aren t from human breast milk, but are created like vitamin supplements to have similar properties. They are absorbed into the baby's circulation to boost health, Buck said. The formula, Similac Pro-AdvanceTMand SimilacPro-SensitiveTM,is shipping to national retailers this month. It has a suggested retail price of $28.99, about two dollars more than Similac Advance. While the new formula is advertised as the company's closest product to breast milk, Buck said it's not identical. "Nothing can replace breast milk," Buck said. "But for those moms who need or choose to use formula, we are committed to providing the most scientifically advanced nutrition."
Codex as a key instrument to deregulation and loss of national independence to protect health Trade agreements Codex standards for foods for infants and young children Regulations and loss of government policy capacity Health impacts increased mortality, obesity, cancers, CVC, Diabetes altering the local availability, nutritional quality, price and desirability of foods
Important changes to food systems facilitated by Codex opening of domestic markets towards international food trade and foreign direct investment (liberalisation); subsequent increased entry of transnational food companies and their global market (integration), and global food advertising (cultural hybridization).
Impact of trade Currently, the regulation of marketing in developed countries and a trend to return to breastfeeding, is giving formula companies an incentive to shift their attention to developing countries in the Asia Pacific region where regulatory and health care systems are embryonic or weak, and maternity protection minimal. Women are being harnessed into formal employment by G20 policy priorities to address the gender gap in labourforce participation. Smith JP, GaltryJ, Salmon L. Confronting the formula feeding epidemic in a new era of trade and investment liberalisation. J Aust Pol Econ. 2014;73:132 71.
Impact of trade Global sales of baby foods -mainly bovine milk-based formulas -rose from US$18 billion in 1999 to US$58 billion in 2013, and are forecast to rise to US$89 billion by 2017 (EuromonitorInternational). Yet it is wrong to assume that the current international trade and investment framework will improve food security for infants and young children, as it fails to prioritiseoptimal breastfeeding, public health, and the human rights of mothers and children. Smith JP, GaltryJ, Salmon L. Confronting the formula feeding epidemic in a new era of trade and investment liberalisation. J Aust Pol Econ. 2014;73:132 71.
Impact of trade The TPP will be more like an investment treaty, designed to increase economic integration and arguably shifting the balance of policy-making power firmly in favourof corporate interests These behind-the-border regulatory controls on government increasingly limits policy space and national sovereignty to regulate investors or introduce public health policies that investors consider in contravention to the trade agreement. Frielet al, (2013) 21st century trade: radical change and real concern for public health, Globalization and Health.
Impact of trade Netherlands has performed consistently well and has a stranglehold on the number 1 spot boastinga 34% share of the current market and has shown a 22.4% year on year increase in total export volume. Coming in at number 2 are my home nation with 16.3% market share and a commendable 25% year on year increase in total export volume. New Zealand showed ahefty 54.5% increase in year on year total exports. Germany weighed in with a whopping 11.4% market share and an astonishing 84.8% increase in market share.
Impact of trade Content claims and functional claims are contingent on a products formulation. Higher quality products with addition of optional ingredients have an inherently greater potential to make eye catching labellingclaims. With competition fierce product differentiationis vital to succeeding in China's markets. Paul O Brien, (2014) China Dairy:Infant Formula Labelling Claims as Key Differentiators
Impact of trade From Jan to April of 2016, 60,100 tonnesof infant formulawere exported to China representing a 26% increase in import volume compared to the same period last year. From Jan -April 2016 the total value of imported infant formula was 833 million USDwhich represents a 27.3 % increase compared to the same period last year. Average price per ton also increased by 1.1% comparedto the same period the year before (13,500$).
China imports of IF -Jan April 2016
Protection of breastfeeding and Codex Critical for national governments to implement the International Code and WHA resolutions Essential for national governments to have strict regulations on the labellingof products and prohibit nutrition and health claims Important for governments to have informed delegates to Codex
Impact on consumer health? Marketing to compete with breastfeeding Compromises exclusive breastfeeding rates Compromises sustained breastfeeding to 2 years and beyond Compromises family food based complementary feeding Increased use of single approach product driven treatment of SAM and MAM Obesity, cardiovascular disease, diabetes, cancers, infectious disease, auto-immune disease and IYC mortality
Thank you! This is our struggle and we will not rest until the barriers to enable mothers and their children to breastfeed are gone and the sabotage of breastfeeding ends.