Abstract
Breastfeeding is important for the health and development of the child, and for maternal health, in all country contexts. However, global sales of breast-milk substitutes (BMS), including infant, follow-up and toddler formulas, have 'boomed' in recent decades. This raises the importance of international food standards established by the Codex Alimentarius Commission (Codex) on the safety, composition and labelling of BMS. Such standards appear to be strongly contested by governments, industry and civil society groups, yet few studies have investigated the politics of Codex standard-setting processes. The aim of this paper is to understand who participates in decision-making, and how actors frame and contest proposals to revise the Codex Standard on Follow-up Formula (FUF). We adopted a case study design involving two steps. First, we enumerated government, industry, civil society, and international organization stakeholders participating in standard-setting processes of the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU). Second, we conducted a framing analysis of stakeholder inputs during the FUF standard revision in CCNFSDU meetings. Publicly available online meeting reports (2015-2019) were retrieved, analyzed using a theoretical framework, and organized thematically. High-income country (HIC) delegates greatly outnumbered those from other country income categories. Industry representation was higher compared with other observer categories. Member state delegations included more industry representation than civil society representation, and were occasionally the only member state delegates. Industry stakeholders framed arguments in terms of trade implications, science, and flexible standards. Civil society groups used public health, science, and pro-breastfeeding frames. Codex BMS standard-setting procedures are dominated by HICs and industry groups. Limited representation of civil society, and of low- and middle-income countries (LMICs), suggest actions are needed to substantially increase support for their involvement at Codex. Such representation may help to counteract power asymmetries and commercial influences on food standards for infants and young children.
Highlights
We categorized observers by the type of organization they represented; Government[29]; industry[29]; NGOs59; and ntergovernmental organization (IGO).[59,60]
A mean percentage comparison between member state participation at Codex Alimentarius Commission (Codex) and the CCNFSDU by country income level is shown in Figure S2
The results show that the revision procedures were dominated by High-income country (HIC) and industry groups, compared to limited middleand low-income country, and civil society representation
Summary
The World Health Organization (WHO) recommends infants begin breastfeeding within the first hour of life, are exclusively breastfed for six months, followed by the introduction of safe and nutritionally adequate complementary foods while breastfeeding continues for up to 2 years of age and beyond.[1,2] The WHO’s 2003 Global Strategy on Infant and Young Child Feeding encourages governments to promote, protect and support breastfeeding,[3] including incorporating the International Code of Marketing of Breastmilk Substitutes (The Code) and subsequent relevant World Health Assembly (WHA) resolutions into national legislation.[3]Breastfeeding reduces the child’s risk of diarrhoea, pneumonia and dental malocclusions, with growing evidence suggesting it may lower the risk of obesity and type-2 diabetes, and help children realise their full cognitive potential.[4]. The world exclusive breastfeeding rate
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International Journal of Health Policy and Management
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
