have you ever wondered what the relationship is between the American Academy of Pediatrics and formula companies?
"Outside of advertisements and exhibits at its annual meeting, the AAP receives a total of $3.3 million each year from 4 formula companies, accounting for less than 3% of its annual budget. The funding supports the annual meeting and dissemination of initiatives developed by the AAP, including the Institute for Healthy Childhood Weight, Pediatric Care Online, and the Neonatal Resuscitation Program."
This is NOT new US policy, even if the language -- buried as it is in a huge report -- is now more aggressive. Updated annually, this document has kept much of the same language from year to year and contained similarly concerning remarks regarding countries that are protecting breastfeeding by restricting the marketing of food products for infants and young children before Mr.Trump took office. (see below)
The problem is not presidential; rather, it is twofold: 1. Primarily, the United States' lack of acceptance of and adherence to the WHO International Code of Marketing of Breastmilk Substitutes “The aim of this Code is to contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breastfeeding, and by ensuring the proper use of breastmilk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution.” — Article 1 of the Code 2. And secondarily, in order to protect their commercial interests, formula companies employ powerful lobbyists who have significant influence and are very successful at what they do.
Below are the paragraphs in question from the 2016 (under Mr. Obama) and 2017 (under Mr. Trump) documents.
Hong Kong 2016: The Hong Kong government published a draft Code of Marketing and Quality of Formula Milk and Related Products and Food Products for Infants & Young Children (Code) in October 2012. If implemented as currently drafted, stakeholders are concerned that the Code, together with related legislative proposals, would pose significant trade barriers to manufacturers and distributors of imported infant and follow-up formula. The United States is continuing to engage with the Hong Kong government on this measure, including with respect to whether it is more restrictive than relevant international standards. 2017: The Hong Kong government published a draft Code of Marketing and Quality of Formula Milk and Related Products and Food Products for Infants and Young Children (draft Code) in October 2012, and is in the process of finalizing the draft Code. If the draft Code is implemented as originally drafted, U.S. stakeholders maintain that, together with related legislative proposals, it will have significant negative impacts on sales of food products for infants and young children, and is more restrictive than relevant international standards. The United States is continuing to engage with the Hong Kong government on this draft measure.
Indonesia: 2017 (new section not present in 2016 version): Indonesia Food Law Implementing Regulation Indonesia’s food and drug regulatory agency, the National Agency of Drug and Food Control (BPOM), has issued a draft regulation, the “Government Regulation Concerning the Label and Advertisement of Food,” to implement provisions of the Law 18 on Food of 2012. Among other things, the regulation would prohibit advertising or promotion of milk products for children up to two years of age, as well as any functional claims to children under three years of age. The regulation also would severely restrict interactions with health care providers, and the draft contains additional restrictions, including a ban on advertising for alcohol and stringent requirements for nutrition labeling. It is unclear when Indonesia intends to finalize this regulation. The United States has asked Indonesia to notify the measure to the WTO TBT Committee before finalizing the regulation.
Malaysia: 2016: Infant and Follow-up Formula Products Malaysia’s Ministry of Health has proposed revisions to its existing Code of Ethics for the Marketing of Infant Foods and Related Products, which includes restrictions on the use of trademarked brand names and symbols on product labels or packaging, as well as restrictions on educational, promotional, and marketing activities for infant formula products and products for toddlers and young children. The United States continues to follow the issue, and has raised questions about the evidence Malaysia used in developing the proposed measure. 2017: Infant and Follow-up Formula Products In 2014, Malaysia’s Ministry of Health launched an effort to revise and expand its existing Code of Ethics for the Marketing of Infant Foods and Related Products (“Code of Ethics”). The proposed revisions include restrictions on the use of trademarked brand names and symbols on product labels or packaging, as well as restrictions on educational, promotional, and marketing activities for infant formula products and products for toddlers and young children. The United States has raised questions about the evidence Malaysia used in developing the proposed measure. The draft Code of Ethics is not likely to be finalized until after the first quarter of 2017.
Thailand: 2016: The United States has raised concerns with Thailand about a draft measure related to infant and follow-up formula products. Thailand’s Draft Marketing Control of Food for Infant and Young Child and Related Products includes additional restrictions on the use of trademarked brand names, packaging, symbols, and educational, promotional, and marketing activities for modified milk for infants, follow up formula for infants and young children, and supplemental foods for infants. The United States has asked for the rationale and scientific evidence that support the proposed measure, as well as the extent to which the measure is based on international standards, as the current draft is more restrictive than relevant international standards, specifically the Codex Alimentarius Commission and the World Health Organization Code of Marketing of Breast-Milk Substitutes. Where other countries in the region regulate marketing of breast-milk substitutes, the marketing restrictions generally do not apply to follow-up formula for young children over one year. After numerous requests, Thailand notified the measure to the WTO. The United States has submitted formal comments on Thailand’s draft and continues to communicate to raise the issue with the Government of Thailand. 2017: Labeling Restrictions on Foods for Infants and Young Children (0-36 months of age) In December 2015, following repeated requests from the United States, Thailand notified to the WTO its Draft Marketing Control of Food for Infant and Young Child and Related Products (“Milk Code”). This measure imposes restrictions on the use of trademarked brand names, packaging, symbols, and educational, promotional, and marketing activities for modified milk for infants, follow-up formula for infants and young children, and supplemental foods for infants. The restrictions cover infants and children up to 36 months of age and establish considerable penalties for violations of the Milk Code. In November 2016, Thailand notified to the WTO a revised draft measure that includes a penalty of jail time for advertising violations. Thailand forwarded the revised draft measure to the National Legislative Assembly for its consideration in the fall of 2016. The Assembly is still reviewing the revised measure, including the labeling and health claim prohibitions. The United States is seeking to ensure that Thailand’s final measure is developed transparently and takes into account appropriate scientific and technical information in order to avoid any unnecessary restrictions on trade.
Full text of the NTE Reports below: 2016: https://ustr.gov/sites/default/files/2016-NTE-Report-FINAL.pdf 2017: https://ustr.gov/s ites/default/files/files/reports/2017/NTE/2017%20NTE.pdf
Techdirt has not posted any stories submitted by Becki Neely, RN BSN IBCLC.
and furthermore...
"Outside of advertisements and exhibits at its annual meeting, the AAP receives a total of $3.3 million each year from 4 formula companies, accounting for less than 3% of its annual budget. The funding supports the annual meeting and dissemination of initiatives developed by the AAP, including the Institute for Healthy Childhood Weight, Pediatric Care Online, and the Neonatal Resuscitation Program."
See http://jamanetwork.com/journals/jamapediatrics/fullarticle/2624070 for the full article.
Not a presidential issue... (as Rebecca Neely, RN BSN IBCLC)
report -- is now more aggressive. Updated annually, this document has kept much of the same language from year to year and contained similarly concerning remarks regarding countries that are protecting breastfeeding by restricting the marketing of food products for infants and young children before Mr.Trump took office. (see below)
The problem is not presidential; rather, it is twofold:
1. Primarily, the United States' lack of acceptance of and adherence to the WHO International Code of Marketing of Breastmilk Substitutes “The aim of this Code is to contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breastfeeding, and by ensuring the proper use of breastmilk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution.” — Article 1 of the Code
2. And secondarily, in order to protect their commercial interests, formula companies employ powerful lobbyists who have significant influence and are very successful at what they do.
Below are the paragraphs in question from the 2016 (under Mr. Obama) and 2017 (under Mr. Trump) documents.
Hong Kong
2016:
The Hong Kong government published a draft Code of Marketing and Quality of Formula Milk and Related Products and Food Products for Infants & Young Children (Code) in October 2012. If implemented as currently drafted, stakeholders are concerned that the Code, together with related legislative proposals, would pose significant trade barriers to manufacturers and distributors of imported infant and follow-up formula. The United States is continuing to engage with the Hong Kong government on this measure, including with respect to whether it is more restrictive than relevant international standards.
2017:
The Hong Kong government published a draft Code of Marketing and Quality of Formula Milk and Related Products and Food Products for Infants and Young Children (draft Code) in October 2012, and is in the process of finalizing the draft Code. If the draft Code is implemented as originally drafted, U.S. stakeholders maintain that, together with related legislative proposals, it will have significant negative impacts on sales of food products for infants and young children, and is more restrictive than relevant international standards. The United States is continuing to engage with the Hong Kong government on this draft measure.
Indonesia:
2017 (new section not present in 2016 version):
Indonesia Food Law Implementing Regulation
Indonesia’s food and drug regulatory agency, the National Agency of Drug and Food Control (BPOM), has issued a draft regulation, the “Government Regulation Concerning the Label and Advertisement of Food,” to implement provisions of the Law 18 on Food of 2012. Among other things, the regulation would prohibit advertising or promotion of milk products for children up to two years of age, as well as any functional claims to children under three years of age. The regulation also would severely restrict interactions with health care providers, and the draft contains additional restrictions, including a ban on advertising for alcohol and stringent requirements for nutrition labeling. It is unclear when Indonesia intends to finalize this regulation. The United States has asked Indonesia to notify the measure to the WTO TBT Committee before finalizing the regulation.
Malaysia:
2016:
Infant and Follow-up Formula Products
Malaysia’s Ministry of Health has proposed revisions to its existing Code of Ethics for the Marketing of Infant Foods and Related Products, which includes restrictions on the use of trademarked brand names and symbols on product labels or packaging, as well as restrictions on educational, promotional, and marketing activities for infant formula products and products for toddlers and young children. The United States continues to follow the issue, and has raised questions about the evidence Malaysia used in developing the proposed measure.
2017:
Infant and Follow-up Formula Products
In 2014, Malaysia’s Ministry of Health launched an effort to revise and expand its existing Code of Ethics for the Marketing of Infant Foods and Related Products (“Code of Ethics”). The proposed revisions
include restrictions on the use of trademarked brand names and symbols on product labels or packaging, as well as restrictions on educational, promotional, and marketing activities for infant formula products and products for toddlers and young children. The United States has raised questions about the evidence Malaysia used in developing the proposed measure. The draft Code of Ethics is not likely to be finalized until after the first quarter of 2017.
Thailand:
2016:
The United States has raised concerns with Thailand about a draft measure related to infant and follow-up formula products. Thailand’s Draft Marketing Control of Food for Infant and Young Child and Related Products includes additional restrictions on the use of trademarked brand names, packaging, symbols, and educational, promotional, and marketing activities for modified milk for infants, follow up formula for infants and young children, and supplemental foods for infants. The United States has asked for the rationale and scientific evidence that support the proposed measure, as well as the extent to which the measure is based on international standards, as the current draft is more restrictive than relevant international standards, specifically the Codex Alimentarius Commission and the World Health Organization Code of Marketing of Breast-Milk Substitutes. Where other countries in the region regulate marketing of breast-milk substitutes, the marketing restrictions generally do not apply to follow-up formula for young children over one year. After numerous requests, Thailand notified the measure to the WTO. The United States has submitted formal comments on Thailand’s draft and continues to communicate to raise the issue with the Government of Thailand.
2017:
Labeling Restrictions on Foods for Infants and Young Children (0-36 months of age)
In December 2015, following repeated requests from the United States, Thailand notified to the WTO its Draft Marketing Control of Food for Infant and Young Child and Related Products (“Milk Code”). This measure imposes restrictions on the use of trademarked brand names, packaging, symbols, and educational, promotional, and marketing activities for modified milk for infants, follow-up formula for infants and young children, and supplemental foods for infants. The restrictions cover infants and children up to 36 months of age and establish considerable penalties for violations of the Milk Code. In November 2016, Thailand notified to the WTO a revised draft measure that includes a penalty of jail time for advertising violations. Thailand forwarded the revised draft measure to the National Legislative Assembly for its consideration in the fall of 2016. The Assembly is still reviewing the revised measure, including the labeling and health claim prohibitions. The United States is seeking to ensure that Thailand’s final measure is developed transparently and takes into account appropriate scientific and technical information in order to avoid any unnecessary restrictions on trade.
Full text of the NTE Reports below:
2016: https://ustr.gov/sites/default/files/2016-NTE-Report-FINAL.pdf
2017: https://ustr.gov/s ites/default/files/files/reports/2017/NTE/2017%20NTE.pdf
Techdirt has not posted any stories submitted by Becki Neely, RN BSN IBCLC.
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