World health officials were shocked earlier this year when the United States came out strongly against a resolution to encourage breastfeeding during a meeting of the World Health Assembly in Geneva.
Based on decades of research, the resolution says that mother’s milk is healthiest for children and countries should strive to limit the inaccurate or misleading marketing of breast milk substitutes.
American officials sought to water down the resolution by removing language that called on governments to “protect, promote and support breast-feeding” and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children.
Facing opposition to their efforts, U.S. officials resorted to bullying tactics:
Ecuador, which had planned to introduce the measure, was the first to find itself in the cross hairs.
The Americans were blunt: If Ecuador refused to drop the resolution, Washington would unleash punishing trade measures and withdraw crucial military aid. The Ecuadorean government quickly acquiesced.
The showdown over the issue was recounted by more than a dozen participants from several countries, many of whom requested anonymity because they feared retaliation from the United States.
After Ecuador backed away from the resolution, health advocates struggled to find another sponsor, with several countries fearing retaliation from the U.S. should they choose to take up the measure.
“We were astonished, appalled and also saddened,” said Patti Rundall, the policy director of the British advocacy group Baby Milk Action, who has attended meetings of the assembly, the decision-making body of the World Health Organization, since the late 1980s.
“What happened was tantamount to blackmail, with the U.S. holding the world hostage and trying to overturn nearly 40 years of consensus on best way to protect infant and young child health,” she said.
The American attempt to kill the resolution was ultimately unsuccessful, however, as Russia stepped in as its sponsor, and the U.S. made no threats against it.
A Russian delegate said the decision to introduce the breast-feeding resolution was a matter of principle.
“We’re not trying to be a hero here, but we feel that it is wrong when a big country tries to push around some very small countries, especially on an issue that is really important for the rest of the world,” said the delegate, who asked not to be identified because he was not authorized to speak to the media.
When asked for an explanation for U.S. opposition to the uncontroversial resolution, the Health and Human Services Department – which led efforts to change wording but claimed nothing to do with threats – said it was to protect women who are unable to breastfeed.
“The resolution as originally drafted placed unnecessary hurdles for mothers seeking to provide nutrition to their children,” an H.H.S. spokesman said in an email. “We recognize not all women are able to breast-feed for a variety of reasons. These women should have the choice and access to alternatives for the health of their babies, and not be stigmatized for the ways in which they are able to do so.” The spokesman asked to remain anonymous in order to speak more freely.
The baby food industry, controlled largely by American and British companies, is a $70 billion industry but has witnessed sales stall in wealthier nations as greater numbers of women gravitate toward breastfeeding.
Overall, global sales are expected to rise by 4 percent in 2018, according to Euromonitor, with most of that growth occurring in developing nations.
The Times notes that Trump administration officials have opposed public health issues – siding with corporate interests instead – on a number of occasions:
In talks to renegotiate the North American Free Trade Agreement, the Americans have been pushing for language that would limit the ability of Canada, Mexico and the United States to put warning labels on junk food and sugary beverages, according to a draft of the proposal reviewed by The New York Times.
During the same Geneva meeting where the breast-feeding resolution was debated, the United States succeeded in removing statements supporting soda taxes from a document that advises countries grappling with soaring rates of obesity.
The Americans also sought, unsuccessfully, to thwart a W.H.O. effortaimed at helping poor countries obtain access to lifesaving medicines. Washington, supporting the pharmaceutical industry, has long resisted calls to modify patent laws as a way of increasing drug availability in the developing world, but health advocates say the Trump administration has ratcheted up its opposition to such efforts.
World health advocates are left anxious by the Trump administration’s apparent hostility toward cooperation on global health issues – a sharp reversal from the general position of the Obama administration.
Ilona Kickbusch, director of the Global Health Centre at the Graduate Institute of International and Development Studies in Geneva, said there was a growing fear that the Trump administration could cause lasting damage to international health institutions like the W.H.O. that have been vital in containing epidemics like Ebola and the rising death toll from diabetes and cardiovascular disease in the developing world.
“It’s making everyone very nervous, because if you can’t agree on health multilateralism, what kind of multilateralism can you agree on?” Ms. Kickbusch asked.