Contibutions for 10 Year Anniversary of the Right to Food Guidelines

02.05.2014

I'd like to contribute to this debate concentrating with Brazilian's experience.

Brazil has advanced in many aspects of the implementation of the right to adequate food, but at the same time there are many challenges to be achieved.

Theme 1: Right to Adequate Food - Past and Present

What have been some of the most important achievements and some of the major shortcomings in the struggle for the right to adequate food during the past decades on the global, regional and local level?

Brazil has translated the international instruments to domestic laws and policies.

  • Child and Adolescent Statute, 1990
  • National Food and Nutrition Policy, 1999.
  • Food and Nutrition Security Law, 2006
  • School Feeding Program Law, 2009
  • Food and Nutrition Security Policy, 2010
  • Federal Constitution Amend, 2010.

Brazil also translated the Voluntary Guideline to Portuguese, in an accessible language to public services, prosecutors, social movements, and so on.

Theme 2: The Right to Food Guidelines

How have the Right to Food Guidelines contributed to the promotion and protection of the right to adequate food over the last ten years? What are some of the key achievements and the main limitations of the Guidelines and their implementation? 

The Voluntary Guidelines contribute with information to implement the right to adequate food in the countries.

The key achievements are cited above, in case of Brazil.

Limitations: the language and the format are not accessible to population.

There are no examples to facilitate the meaning of the document.

There is no explanation about administrative and judicial remedies.

Theme 3: The Future

What are the major challenges and ways ahead for the full realization of the right to adequate food at the local, national, regional and global levels?

Challenges:

  • To monitor the right to food at local level and Municipal level.
  • To analyze the food and nutrition security status by race or ethnical group and to have a plan or action to achieve the most food and nutrition insecure groups based on disaggregated data.
  • To create, administrative, quasi-legal, legal and judicial instruments to redress violations. To make them available and effective, especially at the municipal level.
  • To provide and support physically and economically, include with human resource, the recourse instruments to redress violations.
  • To provide information about the right to food to all people, children, adolescents, adults and elderly in an appropriate language.
  • To empower people to claim their rights or demand policies and actions to realize the right to adequate food.
José María Medina Rey PROSALUS, Spain
30.04.2014

PROSALUS  es una de las organizaciones de sociedad civil que participó en el Grupo de Trabajo Intergubernamental que elaboró las Directrices Voluntarias, y en los últimos 12 años hemos trabajado intensamente en este tema, asumiendo la coordinación de la campaña española por el derecho a la alimentación: www.derechoalimentacion.org

Aportamos en documento adjunto y a continuación nuestros comentarios sobre los tres temas planteados por los moderadores del Foro.

Un cordial saludo

Tema 1: Derecho a una Alimentación Adecuada:  pasado y presente

¿Cuáles han sido algunos de los logros más importantes y algunas de las principales carencias en la lucha  por el derecho  a una  alimentación  adecuada durante las últimas  décadas  a nivel mundial, regional y local?

En los últimos 20 años el reconocimiento formal del derecho a la alimentación se ha ido abriendo camino de forma notable. Una serie de hechos se fueron encadenando para que esto fuera así: la propuesta de Código de Conducta sobre el derecho a la alimentación que surgió desde organizaciones de la sociedad civil después de la I Cumbre Mundial de la Alimentación de 1996, actuando como detonante o como inspiración para la Observación General 12 del Comité DESC en 1999; la creación de la relatoría especial sobre el derecho a la alimentación en 2000; el mandato dado a la FAO por la II Cumbre Mundial de la Alimentación en 2002 para poner en marcha un grupo de trabajo intergubernamental que elaborara las directrices voluntarias para la realización progresiva del derecho a la alimentación (finalmente aprobadas en noviembre de 2004); la posterior creación de un equipo específico sobre el derecho a la alimentación en la FAO; y todo ello trufado con multitud de campañas e iniciativas de diversa índole, surgidas fundamentalmente de organizaciones de la sociedad civil, que han hecho sensibilización e incidencia sobre este tema.

Cuando miramos hacia atrás, nos damos cuenta de que el posicionamiento del DHAA en la agenda no ha sido regalado; ha habido muchísimo trabajo de muchísima gente en muchísimos lugares para empujar este enfoque, de manera que ahora ya es impensable hablar de erradicación del hambre o de impulsar la seguridad alimentaria y nutricional sin incorporar la referencia al enfoque de derechos humanos, al derecho humano a la alimentación adecuada.

Todo el movimiento que se ha producido a nivel internacional en torno a la crisis alimentaria que se abrió en 2007-2008 así lo acredita. Tanto en el trabajo hecho por Naciones Unidas, con la creación del High Level Task Force on Food Crisis y el desarrollo del Comprehensive Framework  for Action, como en otras iniciativas multilaterales (L’Aquila, GAFSP) o desde las agencias estatales de cooperación, y desde las ONG y movimientos sociales, la referencia a la realización del derecho a la alimentación aparece por todas partes. En muchos países – especialmente en América Latina- se han desarrollado procesos legislativos que, de una u otra forma, incorporan el reconocimiento explícito de este derecho.

Sin embargo, este posicionamiento del enfoque del derecho a la alimentación sigue siendo todavía más formal que real. En esos mismos 20 años de referencia, desde la I CMA en que se firmó la Declaración de Roma de la Seguridad Alimentaria Mundial con el compromiso de reducir a la mitad el número de personas hambrientas antes de 2015, el número de personas que ven violado su derecho a la alimentación no ha disminuido en términos absolutos. Probablemente, la realidad del hambre en el mundo es la más masiva violación de derechos humanos que se da en nuestro tiempo, pero parece que esta violación es “tolerable”.

Los esfuerzos por llevar el derecho a la alimentación de los papeles a la vida, desde el reconocimiento formal a la realización efectiva, no han sido tan exitosos como en el plano de las declaraciones. Se ha conseguido poner en marcha respuestas frente a las causas inmediatas y subyacentes del hambre, pero no frente a las causas estructurales. Muchas de estas causas profundas responden a lógicas globales, frente a las cuales la gobernanza es muy débil: las causas estructurales del hambre están identificadas pero no hay respuestas adecuadas, no se toman las decisiones necesarias, por falta de capacidad o por falta de voluntad.

Cabe señalar que aún existe una fuerte resistencia y trabas políticas en muchos países para la aprobación de leyes de derecho a la alimentación debido, entre otras cosas, al choque de intereses con las políticas y acuerdos comerciales que tienen suscritos. Por otro lado, aún son amplísima mayoría los países que no han ratificado el Protocolo facultativo PIDESC y que, por tanto, no han asumido un compromiso de refuerzo de la exigibilidad de los DESC, y entre ellos, del derecho a la alimentación.

Tema 2: Las Directrices sobre el Derecho a la Alimentación

¿Cómo  han  contribuido las  Directrices  sobre el Derecho  a  la  Alimentación  a  la  promoción  y protección del derecho a una alimentación  adecuada en los últimos diez años? ¿Cuáles son algunos de los logros fundamentales y las principales limitaciones de las Directrices y su implementación?

Si bien, desde las organizaciones de la sociedad civil, el carácter voluntario de las directrices y los términos en general poco exigentes en que están formuladas fueron desde el primer momento un hándicap muy importante, no por ello dejamos de reconocer que, en estos 10 años de vida, han supuesto una aportación importante a diversos niveles.

Probablemente el primer y quizás más importante logro de las directrices ha sido el impulso que han dado a una nueva forma de ver las cosas en la propia FAO. Quienes participamos en el grupo de trabajo intergubernamental y luego hemos seguido de cerca la aplicación de la directrices, la creación del equipo del derecho a la alimentación y sus vicisitudes, sabemos que no ha sido un camino fácil; pero sin duda, aunque quede todavía mucho por hacer en este sentido, el enfoque del derecho a la alimentación está muchísimo más incrustado en el conjunto de la FAO de lo que estaba hace 10 años. No ha sido nada fácil, pero el avance en este sentido ha sido importante y tiene repercusiones muy significativas: la FAO tiene una presencia territorial inmensa y desarrolla una enorme cantidad de acciones de todo tipo (asistencias técnicas, apoyo a proyectos, asesoría a los Estados, etc.); si toda esta acción capilar se impregna y transmite el enfoque del derecho a la alimentación, este irá empapando la acción de los Estados.

De hecho, es significativo que en estos diez años se hayan impulsado multitud de procesos de elaboración de piezas legislativas y de estrategias de seguridad alimentaria en muchos países (destacando en este sentido América Latina, sin duda, gracias al trabajo de la IALCSH) que incorporan el enfoque del derecho a la alimentación.

Probablemente, como ya hemos señalado en el punto 1, el paso de las declaraciones formales a la práctica sigue teniendo muchas limitaciones. Los términos genéricos en que están redactadas las directrices quizás no han ayudado en este sentido. Pero el trabajo desplegado por el Equipo del Derecho a la Alimentación, elaborando muy diferentes materiales de apoyo (guías, cuadernos, checklist, manuales, etc.) y facilitando formación a los Estados interesados, ha ido supliendo esta carencia y ha ayudado a que las directrices vayan tomando cuerpo en acciones concretas.

Sin embargo, desde nuestro punto de vista, hay una importante limitación que es difícil de abordar: las directrices están pensadas para apoyar a cada Estado en el cumplimiento de sus obligaciones relacionadas con la realización progresiva del derecho a la alimentación; sin embargo, como se ha comentado, algunas de las causas estructurales del hambre responden a lógicas supraestatales, en las cuales la eficacia de las directrices es muy limitada.

Tema 3: El futuro

¿Cuáles son los principales desafíos y caminos a seguir para la plena realización del derecho a una alimentación  adecuada a nivel local, nacional, regional y mundial?

Nuestra impresión, a través de nuestro trabajo en diferentes países y a través del diálogo con otras organizaciones con las que trabajamos, es que se va abriendo paso la toma de conciencia de los Gobiernos (en el nivel estatal) sobre sus obligaciones relativas al derecho a la alimentación. Pero queda mucho trabajo por hacer en dos direcciones, hacia arriba y hacia abajo:

•    Hacia abajo, para que las normas, las políticas, las estrategias  y los programas vayan permeando a los niveles locales. Es importante que la aplicación de las directrices no se quede en las capitales de los Estados, sino que las autoridades departamentales, provinciales y municipales entiendan que les toca una parte importante en la realización del derecho a la alimentación, que deben poner en marcha iniciativas en su nivel y destinar presupuestos, y que las acciones a todos estos niveles tienen que estar debidamente coordinadas y articuladas. Y para ello, hace falta potenciar una participación activa y bien informada de la sociedad civil.

•    Hacia arriba, para poder abordar esas causas estructurales que comentábamos en los apartados anteriores y para avanzar en la coherencia de esas otras políticas que tanto impacto tienen en el derecho a la alimentación (energía, comercio, flujos financieros, etc.). La gobernanza internacional aparece fragmentada (G-8, G-20, BRICS, UE) y débil. En este ámbito, debemos reconocer que esperábamos más del Comité de Seguridad Alimentaria Mundial reformado.

Será importante trabajar para que el derecho humano a la alimentación sea una de las prioridades destacadas en la Agenda para el desarrollo Post-2015 y en los Objetivos de Desarrollo Sostenible. Nos parece igualmente que un camino sobre el que interesa profundizar (aunque quizás excede del ámbito de las directrices y de las competencias de la propia FAO) es la forma en que el Protocolo Facultativo PIDESC podrá contribuir a fortalecer la exigibilidad del derecho a la alimentación.

See the attachment: 
APORTACION PROSALUS.pdf
Claudio Schuftan Viet Nam
28.04.2014

For us in nutrition, the normative clarifications achieved with General Comment 12 are now, better late than never, actually to be operationalized --not voluntarily!

The People's Health Movement has, from early on, been critical of any voluntary guidelines, including the report on Voluntary  Guidelines to Support the Progressive Realization of the Right to Food, issued by the UN Food and Agriculture Organization. For PHM and others, voluntary guidelines do not work. We are all aware of the situation with the marketing of breastmilk substitutes and its sorry record over the last two decades.  

Let me here look at the many shortcomings of voluntary guidelines, be they for governments and/or for industry: 

As relates to the control the food and drink industry, the word here must be statutory regulation. (We just have to convince ourselves that this is a reasonable possibility). Voluntary guidelines here make no sense. Take an example: Industry has ‘volunteered’ to reformulate junk food to make it les harmful.  The case against product reformulation, particularly when used as a main strategy to curb NCDs, has recently been summarised in The Lancet. Reformulation is not of healthy foods. It is of inherently unhealthy products. These are usually identified in dietary guidelines as products to be consumed only occasionally. They are made merely somewhat less unhealthy by manipulation of their ingredients. Reformulation of the type volunteered by manufacturers or suggested by government officials, usually results in relatively small and sometimes even trivial adjustments in nutrient profiles of products that remain basically unhealthy. Therefore, voluntary product reformulation is a distraction from public health actions that will certainly have much more significant benefits. As with tobacco and alcohol products, such actions include statutory regulations. These need to include pricing and other statutory measures designed to promote healthy food, such as those that remove price support for unhealthy commodities, tax unhealthy products and restrict their advertising and availability especially to children, and thus protect the public interest and promote well-being. Such policies, analogous with those that control the use of toys, cars, guns and drugs --and use of tobacco and alcohol-- are now being considered by a number of governments and have been actually enacted by others. 

As things are now, voluntary guidelines on reformulation of inherently unhealthy ultra-processed food products are agreed or confirmed by ‘public-private partnerships’. In these, the public ‘partners’ include officials from UN and other international organizations, and politicians and officials from national governments, with just a notional presence of public interest organizations. The private ‘partners’ are predominately marketing and publicity executives of transnational corporations whose sales and profits derive mainly from unhealthy products, together with their hired, representative, associated, and supportive organizations. Use of the term ‘partnerships’ implies that the corporations are sharing in responsibility for the public interest, notwithstanding their duty to maximize their bottom lines, share price, sales volume, and market presence.

Let me give another two examples: The reliance on voluntary agreements on labeling instead of statutory prohibition, is a long-running public health scandal in the US, one of the worst in our history. Also in the USA, the bottle feeding culture continues to resist strenuous breastfeeding promotion efforts by voluntary and professional groups, probably because of continued provision of free samples, still allowed in most states, and the continued offering of free supplies of infant formula to babies born in the country participating in WIC.

I think the point is that, when industry is involved, if everything relies only on voluntary guidelines, it simply is not working. Thus there always needs to be a push for legally binding guidelines. 

Similarly, for governments, we need strong movements to lobby for legally binding obligations. Unless public interest civil society and movements can exercise adequate pressure for their implementation, not much will happen. So, nutritionists and their allies must push for legally binding regulations. 

For an example here, fiscal policies can be used to control NCD risk factors by reducing tobacco consumption and fat, alcohol and salt intake, preventing obesity, and promoting physical activity.  But this has to be on a mandatory rather than on a voluntary basis.

Over the last 40 years, efforts at building consensus on binding international systems of responsibility and accountability for what ultimately amounts to human rights violations by transnational actors and in particular transnational corporations, as well as other business enterprises have been undermined by strategies of corporations and complicit and/or corrupt States. The result has been non-binding, voluntary approaches that provide “guidance” and recommend good corporate practice, but avoid sanctions and thus allow corporate abuses to continue.

With voluntary guidelines, more often than not, there is a lowering of the bar and emphasis is put on small incremental changes that fulfill industry (and government) criteria and needs.

Voluntary guidelines do not offer an important opportunity to revitalize the development of food and nutrition policy frameworks and do not help to structure nutritional governance from an entitlements perspective. This is why many NGOs were and are skeptical about the voluntary nature of the FAO document.

Take the Codex Alimentarius recommendations; they are not endorsed by either WHO and/or FAO, as they are best practice guidelines. Whether they are followed is on a voluntary basis; is this good enough?

Bottom line, we need to forcefully renew our calls to ensure that the commitments required by General Comment 12 to achieve desired nutritional goals supersede the voluntary guidelines. 

Claudio Schuftan, Ho Chi Minh City

26.04.2014

From an infant point of view, this issue needs to be looked at with keen attention to the policies that address Infant feeding as they are vulnerable and their rights to feeding are either not well enshrined in national legislations for better understanding by parties concerned.

Making popular the Universal declaration of Human Rights will conspicously situate the rights of children with regards to nutrition. In Cameroon many of the International injunctions, policies and declarations merely exist in papers with the academia that has been crippled by bereaucratic bottlenecks,

Advocacy is a long political process while Infant feeding support innovations never survive party allergance. A pilot study conducted by Prime Lactation Center Cameroon demonstrated a huge unawareness of the following by a majoriy of workers in these fields:

The convention on the rights of the child

The International Code of Marketing of Breast Muilk substitutes

The ILO's Maternity Protection Convention Number 103

The Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding

Much has been mentioned in the international scene through policies and declarations what needs to be done at national levels is ratification and enforcements, ungoing capacity builiidiing that includes every memebr in the health care continuum, parents inclusive. One way is workiing directly with NGOs/CSO, interpreting the documents and translating to local languages with non-technical parlance.

Our deepest concern as a center (Prime Lactation Center Cameroon) is Infant Feeding in HIV, the child's right to adequate. appropriate and quality feeding.

“THE PUBLIC HEALTH CHALLENGES OF PMTCT INTERVENTION: EVALUATION OF A FAMILY FOCUSED INFANT FEEDING CARE”.

 

Breastfeeding is a pillar of child survival; it reduces morbidity and mortality in children worldwide. HIV pandemic has threatened to “knock breastfeeding off its pedestal as a pillar of child survival”. For infants, breastfeeding is unequalled in its role in reducing morbidities and improving child growth, development, and survival in developing and industrialized countries. Because lactation is a metabolically expensive process, the initial concern that breastfeeding could be deleterious to HIV-infected mothers’ health has not been demonstrated. However, in general, the major risk of breastfeeding is vertical transmission of HIV and not adverse health effects for the mother. Vertical transmission can take place during pregnancy, labor, and delivery, as well as postpartum, through breastfeeding. The risk of transmission depends on many factors, including the timing of maternal infection, maternal viral load, immune function, nutritional status of the woman and baby, antiretroviral (ARV) use, breast health type of breastfeeding duration of any breastfeeding, and presence of oral lesions in the infant. With currently implemented prenatal and perinatal interventions, one-third to one-half of all MTCT is estimated to occur in the postpartum period, i.e. through breastfeeding.

In general pediatric populations,  replacement of breastfeeding with formula milks, animal milks, and other foods is attended by increased mortality, morbidity, poor growth, and development in both developing and industrialized countries.

PMTCT interventions, postnatal and otherwise, will be better understood and therefore more effective if they are evaluated more holistically, i.e. in terms of their psychosocial and economic consequences as well as their biological ones. Much of the research on postnatal PMTCT to date has focused solely on the biomedical consequences of infant feeding modalities, primarily disease transmission and survival. Yet the spectrum of strategies for reducing MTCT has frequently come with a range of unintended and often unmeasured psychosocial ramifications, from unintended disclosure to physical abuse, rejection by partners, ostracization by families, and abandonment of infants. It is one of my course goals to understand community and family centered strategies and tools to evaluate these interventions and gauge their psychosocial consequences.

On the other hand the magnitude and timing of private costs (individual and household-level expenses), public sector costs and civil society costs of interventions to HIV-affected persons is another component of PMTCT interventions that has frequently been overlooked. Individual costs include opportunity costs, such as income foregone while traveling far distances to clinics or waiting in long lines for care, as well as expenditures required to adhere to recommendations, e.g. to buy medicines, to pay for transportation to facilities, and to buy replacement milks for infants. The economic consequences of participating in PMTCT programs and adhering to prescribed recommendations have also received little attention. Families may sell assets to pay for care, HIV-positive women may engage in transactional sex to pay for formula for their infants, and governments may re-appropriate funds from other programs to fund the purchase of formula and medicine or the training of health care workers. These consequences are not sufficiently documented in most analyses. These costs will influence not only the willingness and ability of women to participate in PMTCT programs but also the amount of time they spend in programs and the degree to which they adhere to program recommendations. This program will expose me and give me the opportunity to understand household-level focus strategies that can be adopted for economic analyses.

Lastly, the enormous consequences need to be considered not just for the mother or the health care system but in the context of the household and community in which the HIV-exposed infant is raised. For example, are community members supportive of EBF? And if not, why? How can mothers strategically navigate barriers to EBF? Is it culturally acceptable to give newborns nevirapine syrup for a prolonged period of time? Does the mother need to conceal this behavior? Can she enlist family member support, e.g. others reminding her to administer it or acquiring more from the clinic?

Our center’s strategic goals for the next 5 years amongst others include enhancing local community health promotion and in-depth research in major health problems affecting Infant and Young Child feeding in our local communities. Most emphatically we are looking at exclusive breastfeeding, newborn feeding and infant nutrition in the context of HIV in a resource poor setting, challenges, local sustainable innovative interventions and public health concerns.

25.04.2014

What have been some of the most important achievements and some of the major shortcomings in the struggle for the right to adequate food during the past decades on the global, regional and local level?

To jump from global and regional levels, let me comment on the local (Kenya) shortcomings in the struggle for the right to adequate food: Malnutrition – both over and under-nutrition are now becoming a public health concern in Kenya. Children have persistently remained under-nourished in many parts of the country, while the adults are becoming overweight particularly in the urban areas. My main concern is that the right to adequate food is far from being achieved in areas where we have hunger due to famine as a result of drought and those from poor households. There is a regional disparity in terms of food availability and accessibility, whereby the fertile regions of the country may produce surplus foods but due to lack of or poor food processing and preservation methods the perishable products do not reach the dry and semi-arid areas. This is also hampered by poor infrastructure- the roads to these regions are inaccessible or accessed with difficulty. In addition, the gap between the poor and the rich is very wide such that the poor even the food producing zones of the country still suffer due to inability to purchase of produce food. Therefore, in such situations these women and children (the vulnerable group) whose rights to adequate food are violated really have no one to step in and fight for their rights. The government is answerable; however, there is no voice to advocate for this right to food, which is also a human right. A child or a pregnant women does not need to go hungry in a world where there surplus food!

When talking about over-nutrition, we can no longer ignore it. The right to adequate and QUALITY food need to be emphasized and nutrition education need to be core in implementing any nutrition program to educate people on the dangers of consuming too much food especially those high in saturate fats and high in refined  sugars  and refined grains. It is a right for this group that is food secure to be taught in ways of making the right food choices and to incorporate physical activity in their day-to-day life. Also who is answerable to this: someone will be quick to say that one has a choice on how much to consume, however do they have informed choice? Are they educated on the dangers of being overweight and the consequences that follow i.e. hypertension, diabetes etc.?  What about children and adolescents who are becoming overweight and obese? We are lagging behind also in this and we need to do something quickly. The double burden of malnutrition is very costly considering the health and economic cost especially for a developing country.  

See the attachment: 
comment on adequate to food.docx
George Kent University of Hawaii (Emeritus), United States of America
23.04.2014

RIGHT TO FOOD FOR INFANTS AND YOUNG CHILDREN

In this discussion, Theme 3, on The Future, asks, “What are the major challenges and ways ahead for the full realization of the right to adequate food at the local, national, regional and global levels?” I suggest that the right to food of infants and young children should be recognized as an important part of the agenda, especially because of new challenges resulting from the globalization of the baby food industry.

The nutrition risks faced by children are very high. A recent report in The Lancet said that in 2011, undernutrition caused more than 3 million child deaths annually. The risks are highest in low-income countries, but they are serious in all countries. One study estimated that if most US infants were breastfed optimally, more than 900 early deaths would be prevented. The evidence indicates that there is significant mortality and morbidity of children associated with malnutrition in all countries.

The malnutrition that shows up as overweight has been increasing at an alarming rate in many populations, usually linked to increased consumption of processed foods. The tendency toward being overweight often begins in childhood. As many people’s first processed food, infant formula may be a significant factor leading to overweight in childhood and throughout the lifespan.

Many countries categorized as poor are now described as “emerging economies”, with a substantial middle class. These people have money to spend, and therefore attract sellers of many different kinds of goods, from both inside and outside the country. Baby food is high on the list of goods promoted to this segment of the population. In much of the world, the production of processed baby food is being taken over by outside interests. The manufacture and marketing of baby food is globalizing rapidly.

Some countries give a great deal of attention to the safety of infant formula, but do little to ensure its nutritional adequacy. To illustrate, until now, in the United States,  manufacturers have not been required to demonstrate that formula supports normal physical growth in the infant. They are not required to show that infant formula is nutritionally adequate in the sense of ensuring intellectual development, vision, and immune system development comparable to that obtained with breastfeeding.

For new infant formulas that are marketed, the standards in the U.S. are allowed to be different for formulas that are intended for export, rather than for domestic consumption. It is not clear why manufacturers should be permitted to use different standards for formulas that are exported. There is a need to clarify the responsibilities of national governments and food manufacturers with regard to consumers beyond their national jurisdictions.

Many countries have little capacity to ensure the safety and nutritional adequacy of formula used by their infants and young children. With the increasing globalization of the formula market through trade and joint ventures, there is a need for attention from the global level.

In many countries there are serious commitments to support breastfeeding. However, there is intense international promotion of baby foods pushing in the opposite direction. According to one report, US$41 billion was spent on milk formula globally in 2013. That figure is expected to grow as a result of vigorous promotion by the manufactuerers..

Some people might have thought that with the adoption of the International Code of Marketing of Breast-milk Substitutes in 1981, the need for regulation at the global level was met. However, regulation needs to be strengthened in several ways:

  • It needs to be made clear that the Code applies to all countries, not just low-income countries.
  • The Code needs to be updated to recognize that not only manufacturers but also some governments promote the use of infant formula in a way that is contrary to the principles set out in the Code.
  • There is a need to clarify and strengthen the application of the Code in international trade and other international relations.
  • The Code is sometimes viewed as applying only to infant formula, so its applicability to other breast-milk substitutes needs to be clarified.
  • The Code should be adapted and placed into the international human rights framework.

Many exaggerated claims are made about baby foods. There is a need to ensure that new parents and health workers are provided fair, evidence-based, user-friendly information that would help them make well-informed choices about how their children should be fed.

The baby food industry is being globalized at an unprecedented pace. There is a need for global monitoring and regulation of the baby food industry. The food rights of infants and children should be clearly articulated.  This could be done through a new Optional Protocol to the Convention on the Rights of the Child that focuses on children’s nutrition, a new General Comment on the topic, or new right to food guidelines that focus specifically on infants and young children. While other elements of food systems might be controlled locally, the baby food industry needs global governance to ensure the food security of infants and young children everywhere.

Claudio Schuftan Viet Nam
23.04.2014

I think it is very fitting to this discussion to quote from a recent letter by Urban Jonsson in the April 2014 issue of World Nutrition:

Misconceptions

While most agencies operating in the area of nutrition have adopted the conceptual framework of the causes of malnutrition, not all have used it correctly. There are a number of misconceptions, of which the three most common and serious are the following:

-The fact that household food security (‘food’), access to basic health services (‘health’), and adequate maternal and child care (‘care’) are necessary conditions of good nutrition, but that each of them or any two together are not sufficient conditions for good nutrition, is often not understood and appreciated in planning. Sufficiency requires that each of the food, health and care conditions are satisfied at the same time.

-Some agencies tend to leave out any recognition of the basic causes. The most common reason is a deliberate avoidance of the political aspects of malnutrition. The World Bank, for example, often avoids any strong recognition of the basic causes. The Scaling Up Nutrition (SUN) initiative has gone even further by simply defining two type of causes, ‘nutrition effective causes’ for the immediate causes and ‘nutrition sensitive’ for the underlying causes, avoiding any serious discussion of the basic (structural) or ‘root causes’.

-There is confusion in the understanding of the difference between causality and correlation. Many seem to believe that for example, risk-factor epidemiology identifies ‘causes’. This is not correct. Determinants, often mixed up with causes, derived from such statistical methods, may or may not represent a cause. This mix-up had some serious consequences in the analysis of the causes of HIV infection, for example. A similar confusion has plagued the UN Food and Agriculture Organization for the last 30 years, in its insistence on using the term ‘food and nutrition planning’. This is not a correct term. The proper term should be a phrase such as ‘nutrition planning, with a particular focus on food’.

The World Nutrition Editorial’s recommendation to broaden the meaning of ‘nutrition’, to include issues like ‘clinical nutrition’, ‘public health nutrition’, and so on, is a most welcome proposal. This clearly reflects the structure and content of the conceptual framework.

In developing and then working with the conceptual framework now approaching 40 years, I have found many advantages with its use. The most important one is that in practical work, there cannot be any agreement on priority actions for solving a problem until there is a reasonable agreement on the causes of the problem. The conceptual framework helps to ‘ask the right question’. Albert _Einstein once stated: ‘In science, the most important thing is to ask the right question. The answers can be left to amateurs’.

Panagiótis Paraskevás Venezuela (Bolivarian Republic of)
18.04.2014

>> ENGLISH TRANSLATION BELOW <<

El derecho a la alimentación, como derecho humano, debe estar orientado principalmente a quienes sufren vulneraciones en cuanto a la calidad y cantidad de alimentos que consumen diariamente, por eso propongo, a título personal, que en primer lugar, los Estados disminuyan la demagogia de esta índole y se avoquen definitivamente a que los obliguen a dar cuenta internacionalmente de las acciones llevadas a cabo para con su Nación en cuanto a las contribuciones realizadas, bajo la confirmación de las ONG's del país y de los observadores internacionales y delegados de la FAO, pues otra cosa es la cifra oficial que emite un Estado, pues le conviene publicar cifras descabelladas a su favor, y otra totalmente distinta la real que existe entre la población, por eso haría falta no quedar satisfechos con las cifras oficiales sino en materializar este derecho de manera eficaz y eficiente.

Además, soy partidario que se promulgue la Declaración de los Derechos Humanos de los Campesinos bajo la premisa de formación de una institución distinta y separada de la FAO pero adjunta a la ONU, donde se conozcan materias de Reforma Agraria y de Políticas Públicas de Desarrollo Rural para todos los paises miembros, porque alimentación sin campesinos, no me suena; pero, tierras para generar capital y desplazar a los campesinos, sería mas digno suministrarles un revolver y que ellos desidan qué final puedan tener sus vidas y la de sus familias. Disculpen la crudeza.

The right to food, as a human right, should primarily target those whose daily food intake quality and quantity are undermined. Therefore, I personally suggest that countries reduce the related demagogy and definitely accept their international accountability regarding the contributions made, under the confirmation of NGOs in the country and international observers and FAO representatives. Official statistics published by a country and conveniently biased in their own interest are one thing, but real figures are something completely different. Not being satisfied with official statistics and effectively and efficiently realizing this right, is therefore necessary. 
 
In addition, I support the Declaration of Farmers Human Rights on the premise of the establishment of an institution different to and separated from FAO, but belonging to the United Nations, where Agrarian Reform and Rural Development Public Policies are commanded for all member countries. Food without farmers is not feasible, but using land to generate capital and displacement of farmers is unfortunately common. Handing them a gun, so they can choose to put an end to their lives and the lives of their families would be more dignified. My apologies for the harshness.