Down With Formula Milk And Tobacco For A Healthy World!

During the last three decades, the World Health Assembly (WHA) agreed upon two interventions, which can have far reaching and lasting impacts on global health, if implemented (and not merely endorsed) in their true spirit and letter by the member states. The first one is The International Code of Marketing of Breastmilk Substitutes (The Code), which is an international public health recommendation to regulate the marketing of breastmilk substitutes.

The second is the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) which is the world’s first global corporate accountability and public health treaty to regulate the sale and consumption of tobacco products. While one aims to protect infant health and reduce mortality by promoting breastfeeding, the other safeguards adult health from the devastating effects of tobacco use.

The Code was adopted by the WHA in 1981 to be implemented ‘in its entirety’ as a ‘minimum requirement’ to protect infant health. It called for: all formula labels and information to state the benefits of breastfeeding and the health risks of substitutes; no promotion of breast-milk substitutes; no free samples of substitutes to be given to pregnant women, mothers or their families; and no distribution of free or subsidized substitutes to health workers or facilities. It also covers ethical regulations for the marketing of feeding bottles and teats. In 2010, the WHA added two new resolutions to this Code. The first Resolution called for member states to implement a set of Recommendations on the Marketing of foods and Non-alcoholic Beverages to Children – which aim to reduce the impact of 'junk' foods on children by restricting its marketing including in 'settings where children gather' such as schools, and to avoid conflicts of interest. The second Resolution on Infant and Young Child Nutrition highlighted the damaging impact of commercial promotion of baby foods on the health and survival of children and envisaged that there should be an 'end to all forms of inappropriate promotion of foods for infants and young children and that nutrition and health claims should not be permitted on these foods'.

Although less binding than a treaty or a convention, implementation of the International Code and Resolutions is recognised as one measure for countries to take to protect infant and child health and fulfil a country’s obligations under the Convention of the Rights of the Child. Although it has the support of every member state, yet as of December 2011, out of the 103 countries (including India where legislation requires that tins of infant formula carry a conspicuous warning about the potential harm caused by artificial feeding, placed on the central panel of the label) that had some legal regulatory measures in place, only 37 countries had made a serious enforcement of the Code’s provisions.

The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) is the world’s first global corporate accountability and public health treaty that was adopted by the  WHA in 2003 (and came into force in 2005) under article 19 of the WHO constitution. The FCTC seeks "to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke" by enacting a set of universal standards stating the dangers of tobacco and limiting its use in all forms worldwide. It calls upon the governments to: adopt tax and price measures to reduce tobacco consumption; ban tobacco advertising, promotion and sponsorship; create smoke-free work and public spaces; put prominent health warnings on tobacco packages; and combat illicit trade in tobacco products. The treaty is legally binding in 176 ratifying/accessioned countries.

However, the lucratively profitable and powerful baby food and tobacco industries continue to use dubious methods to circumvent the Code and the FCTC, and peddle their poisonous goods. While one continues to endanger the health of infants and children by promoting the use of formula and growing milk, the other finds innovative marketing tactics to hook the youths for a lifelong addiction to nicotine worldwide.

According to The Tobacco Atlas, in 2011, the global tobacco industry made an estimated profit of US $35 billion and was also responsible for 6 million deaths with nearly 80% of these deaths occurring in low- and middle-income countries. Similarly the size of the Global Baby Food Market in 2010 was US$ 36.7 billion (of which formula milk contributed US$ 25.2 billion) which is forecast to reach US$55 billion by 2015.

Two conferences were held recently in different parts of the world to discuss the obstacles and find solutions thereof in the path of enforcing the Code (the 1st World Breastfeeding Conference in India) and the FCTC (the 5th Conference of the Parties (COP 5) to WHO FCTC in South Korea), with a view to let the world’s babies and youths lead a healthy and productive life and save them from premature deaths.

At WHO FCTC COP-5 held in November 2012 in Seoul, despite continued pressure tactics from the industry, countries stood firm against Big Tobacco's obstructionist tactics and adopted measures that, when fully implemented will save 200 million lives by 2050. These included:

Adopting the world’s first public health and corporate accountability treaty-- Protocol to Eliminate Illicit Trade in Tobacco Products to rein in illicit trade in tobacco products that undermines tobacco control and costs governments billions of dollars in lost tax revenue, law enforcement and health care expenditures

Taking steps to hold the tobacco industry liable for its abuses and opening up the potential to generate revenue to treat tobacco-related disease 

Adopting a set of guiding principles/recommendations that provide a solid basis for better tobacco tax policies around the world

Strengthening action to prioritize public health over trade and protect public health policies from Big Tobacco. 

Likewise the 1st  World Breastfeeding Conference 2012 held in December 2012 in New Delhi exhorted nations to protect every feeding mother by joining the fight against the devious and misleading tactics of baby food industry  because Babies Need Mom-Made, And Not Man- Made. It called for reducing neonatal mortality by 20% by simply ensuring initiation of breastfeeding within the first hour of birth and then continuing it exclusively up to 6 months to avert at least 20% (1.5 million) of the 7 million deaths of children under five occurring globally every year. Mother’s milk gives infants all the nutrients they need for healthy development and contains antibodies that help protect infants from common childhood illnesses. Optimal breastfeeding is not only a cost effective intervention to improve child survival, it also has enormous benefits for maternal health, and reduces the mother’s risk of postpartum haemorrhage and breast and ovarian cancer.

The conference draft declaration expressed concern at the continuing inequality in health and nutrition and the subjugation of these concerns to the business objectives of corporations. It called upon all concerned to adopt human rights based set of measures (which should be entrenched in the governments’ policies and programmes) that protect, promote and support breastfeeding and optimal infant/child feeding and protect it from the commercial sector.

Let us all be a part of these mega efforts to make our babies and youths lead a healthy and artificial milk/tobacco free life. Amen!

Shobha Shukla - CNS
December 2012

(The author is the Managing Editor of Citizen News Service - CNS. She is a J2J Fellow of National Press Foundation (NPF) USA. She received her editing training in Singapore, has worked earlier with State Planning Institute, UP and taught physics at India's prestigious Loreto Convent. She also authored a book on childhood TB, co-authored a book (translated in three languages) "Voices from the field on childhood pneumonia", reports on Hepatitis C and HIV treatment access issues, and MDR-TB roll-out. Email:, website:

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