The Code Requires Global and Local Action and going beyond… Dr. Arun Gupta MD FIAP Chair, global breastfeeding initiative for child survival (gBICS) A Joint IBFAN WABA initiative 13 May, Years of Code

Promises to Keep ! ILO World Health Assembly Resolutions Innocenti Declarations, World Fit for Children, MDGs, WHO Growth Standards call for fully implementing the Global Strategy for Infant and Young Child Feeding (WHO 2002) UN Secretary General’s Global Strategy for Women’s and Children’s Health. World leaders’ commitments for children Keep to your word !

World Health Assembly Resolution To develop and/or strengthen legislative, regulatory and/or other effective measures to control the marketing of breast-milk substitutes in order to give effect to the International Code of Marketing of Breast-milk Substitutes and relevant resolution adopted by the World Health Assembly; Recognised 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 member states ‘to end inappropriate promotion of food for infants and young children and to ensure that nutrition and health claims shall not be permitted for foods for infants and young children, except where specifically provided for, in relevant Codex Alimentarius standards or national legislation.’ to scale up interventions to improve infant and young child nutrition in an integrated manner with the protection, promotion and support of breastfeeding and timely, safe and appropriate complementary feeding as core interventions; the implementation of interventions for the prevention and management of severe malnutrition; and the targeted control of vitamin and mineral deficiencies;

UN Secretary General’s Global Strategy for Women’s and Children’s Health Returns on investment In 2015 alone: 1.43 million new users would have access to family planning 2.19 million more women would give birth supported by a skilled birth attendant million additional neonatal infections would be treated million more infants would be exclusively breastfed for the first six months of life million more children under one year of age would be fully immunized million more children under five would receive vitamin A supplements 7.40 million more children would be protected from pneumonia

What it takes to enhance exclusive breastfeeding for the first six months and timely and appropriate complementary feeding after six months along with continued breastfeeding At least seven strategies to work simultaneously: Protection, Promotion and Support; coordination, Research, Info management, and Education/training

World Breastfeeding Trends Initiative (WBTi) 40 country analysis reveals GAPS in all key areas demonstrating the need to BRIDGE them in all Ten Indicators Code National policy programmes BFHI Maternity protection

IYCF Policies and Programmes ( all 10 indicators)

Implementation of the International Code

Maternity Protection

Baby Friendly Hospital Initiative (Ten Steps to Successful Breastfeeding)

National Policy, Programme and Coordination

2012 The World Breastfeeding Conference 2012 comes up to see Where We Stand and Where do We go?

Challenges Conflicts of interests in decision making. More emphasis on RUSFs for Nutrition, vaccines for child survival Lack of understanding of how to enhance the rate of Exclusive breastfeeding for the first six months and timely and appropriate complementary feeding after six months along with continued breastfeeding, therefore are ignored ! Lack of coordinated response and budgets to implement the Global Strategy for Infant and Young Child Feeding. Continued interference of baby food corporations, Code is neglected. Will current thrust on NCDs address the issues of infant nutrition ?

Some food for thought…way forward ! NCD : Should include time bound plan to implement fully the Global Strategy for Infant and Young Child Feeding (WHO 2002) with assured resources. Go beyond the Code of 1981 to end promotion of baby foods of Code as a priority, followed by maternity protection and skilled counselling in health systems. Proactive UN to ask national governments what they should be doing avoiding conflicts of interests Avoid all conflicts of interests

P: WE offer gBICS capacity in the ICDC in helping nations creating legislation but WE need a pro active UN S: WE offer gBICS capacity to guide nations HOW to develop maternity protection and on other issues P: WE offer gBICS capacity in all regions to help nations create capacity for skilled counselling and all relevant issues