Mandate from the World Health Assembly
In May 2010, in resolution WHA63.23, the Sixty-third World Health Assembly recognized that the promotion of breast-milk substitutes and some commercial foods for infants and young children undermines progress in optimal infant and young child feeding and urged all Member States “to end inappropriate promotion of food for infants and young children”. Two years later, in May 2012, in resolution WHA65.6, the Sixty-fifth World Health Assembly requested the Director-General “to provide clarification and guidance on the inappropriate promotion of foods for infants and young children cited in resolution WHA63.23, taking into consideration the ongoing work of the Codex Alimentarius Commission”.
In response, WHO presented a report to the 67th Assembly in 2014 with clarification of criteria to define inappropriate promotion. The report to the 69th Assembly provides guidance on the inappropriate promotion of foods for infants and young children, as requested.
Goals
The goals of the Guidance on Ending the Inappropriate Promotion of Foods for Infants and Young Children are to protect breastfeeding, prevent obesity and chronic diseases, and to promote a healthy diet. In addition, the Guidance aims to ensure that caregivers receive clear and accurate information on feeding.
World Health Assembly Resolution
WHA69.9 Ending inappropriate promotion of foods for infants and young children
Agenda item 12.1, 28 May 2016
A69/7 Add. 1 Maternal, infant and young child nutrition - Report by the Secretariat
Guidance on ending the inappropriate promotion of foods for infants and young children
Provisional agenda item 12.1, 13 May 2016
Process for developing the guidance
The Secretariat established a Scientific and Technical Advisory Group (STAG) on Inappropriate Promotion of Foods for Infants and Young Children in 2013. STAG members were selected to have geographic, gender, and disciplinary diversity. They represented a wide spectrum of expertise in complementary feeding programmes, policy, and science. Members were Azza Abul-fadl (Egypt), Louise Baur (Australia), Helen Crawley (United Kingdom), Kathryn Dewey (United States), Laurence Grummer-Strawn (2013 only) (United States), Rukhsana Haider (Bangladesh), Corinna Hawkes (2015 only) (United Kingdom), and Alessandro Iellamo (Philippines).
All members completed declarations of interest that were reviewed by the Department of Nutrition for Health and Development and the Office of the Legal Counsel. The only member with a potential conflict of interest was Kathryn Dewey because of funded research projects on lipid-based nutrient supplements. Based on the review, Dr Dewey was asked to recuse herself on any discussions of these products.
The STAG met in person in June 2013 and June 2015 and edited documents extensively via email. They reviewed definitions of terms, current guidance on complementary feeding (both globally and for individual countries), current marketing practices, current laws and regulations on marketing of complementary foods (both globally and for individual countries), evidence on the health effects of commercially-available complementary foods, and evidence on the effects of marketing commercial complementary foods on infant and young child feeding.
The STAG produced two reports to the Secretariat. The first, developed in 2013, provided a definition of the term “inappropriate promotion”2 and the second, developed in 2015, contained draft guidance to help achieve the goal of ending the inappropriate promotion of foods for infants and young children.3 The STAG reports were developed jointly and all issues of disagreement were resolved by consensus. No votes were taken.
Using the reports from the STAG, the Secretariat developed a discussion paper containing a set of recommendations on ending the inappropriate promotion of foods for infants and young children. The document was made available for public comments from 20 July to 10 August 2015. A total of 299 distinct comments were received. Comments were received from 47 organizations or individuals, including 23 civil society organizations, 11 academic members (including nutrition, maternal and child health, non-communicable diseases, and law), 5 industry groups (including dairy, special dietary foods, and pharmaceuticals), 6 government representatives (Colombia, Jamaica, Solomon Islands, Sri Lanka, Turkey), and 2 UN organizations (UNICEF & WFP).
In addition, in order to develop the text further, the Secretariat convened informal dialogues with nongovernmental organizations in official relations with WHO and private sector entities on 17 August 2015 and informal consultation with Member States and other United Nations organizations on 18 August 2015.
The draft report was edited based on the comments received to create a guidance document, containing recommendations on ending the inappropriate promotion of foods for infants and young children. This report was presented to the 138th Executive Board meeting of the WHA in January 2016 along with a draft resolution for implementation of the guidance. The Executive Board requested a period of four weeks to make additional comments and ask for clarification on the document. Further changes were made and the final document has been submitted for consideration by the 69th World Health Assembly in May 2016.