The U.S. has become a bully on the world stage over, of all things, breast-feeding. In a development that shocked many, the U.S. delegation to the World Health Assembly attempted to shut down what should have been a relatively benign resolution to “protect, promote and support” the practice of breast-feeding.
Why would the U.S. do such a thing? Unfortunately, the apparent answer is as simple as it is crass. Instead of standing up for the health of babies and children around the world, this country’s delegation stood up for the interests of corporate manufacturers of infant formula. Another passage in the resolution would have urged restrictions on the promotion of food products that can be used as substitutes for breast milk.
A U.S. Health and Human Services spokesperson later said the resolution “placed unnecessary hurdles for mothers seeking to provide nutrition for their children.” That is a specious argument that ignores the very real fact that in many low-income countries, the lack of clean water can make infant formula a dangerous choice. The National Bureau of Economic Research earlier this year found that the availability of formula in low- and middle-income countries over 40 years raised infant mortality, “suggesting that unclean water acted as a vector for the transmission of waterborne pathogens to infants.”
For this reason and others, the World Health Organization has long recommended that infants be breast-fed for up to two years. In this country, the American Academy of Pediatrics recommends up to one year, so established are the benefits.
That is not to say infant formula should not be available to women who struggle with breast-feeding. No organization has proposed that. But overly aggressive marketing can persuade women without access to clean water and relatively sterile conditions, who may lack the resources to afford formula, to pass on breast-feeding. A number of countries have responded with restrictions on the promotion of alternatives to breast milk. That is a concern to the multibillion-dollar infant formula industry, which wants to expand its market, both for infant formula and for what it sees as the potentially lucrative market for “follow-up” formula for children older than 6 months.
The U.S. government, however, has — or should have — broader concerns that factor in its responsibility to uphold its role as a leader in global health. The New York Times reported that when Ecuador attempted to introduce the resolution, the U.S. threatened to punish this tiny nation, 1/35th its size, where a third of the people live in poverty, with harsh trade measures and a loss of military aid. Ecuador capitulated quickly.
That is a disgraceful use of this country’s might on the international stage. In an embarrassing coda to this episode, it was Russia that stepped up to save the U.N. resolution, proposing it after Ecuador was forced to back down. Interestingly, the U.S. withdrew its opposition at that point.
The world’s multilateral organizations are under continued assault by this administration, and each blow struck diminishes this nation’s claim to world leadership a little more.