Providing Food Security, Tackling Undernutrition

International Symposium. Human Development in Global South: Emerging Perspectives in the Era of Post-Millennium Development Goals

April 28 – 29, 2014, in New Delhi

Dr Arun Gupta MD,FIAPRegional Coordinator Iinternational Baby Food Action Network(IBFAN) Asia, Chair Global Breastfeeding Inititaive for Child Survival, Member PM’s Council

on India’s Nutrition Challengs

• Why first year is critical, importance of infant and young child feeding practices (IYCF)

• Unfinished agenda of gaps in policy and programmes behind breastfeeding and IYCF

• Policy actions• International Baby Food Action

Network(IBFAN)’s Other major concerns: Conflict of interest in policy development of nutrition.

Overview

•The criticality of infant feeding practices is not just children are vulnerable, this time their brain develops very fast. •22% of all newborn deaths can be avoided if all mothers are able to begin breastfeeding within one hour, this number is estimated to be about 830,000.•Exclusive Breastfeeding is the best possible intervention for diarrhea and pneumonia control•1.4 million deaths attributed to sub-optimal breastfeeding in 2008 •92 million babies under six months NOT practice exclusive breastfeeding for the first six months

Years of life

Brain development

Millions Undernourished

6.9 million children

die during

First by 5 yrs. and

2/3rd are

during 1st year and

related

to poor feeding.

First Year is Critical!

World Breastfeeding Trends Initiative( WBTi), 82 Countries

WBTi National Assessment Completed WBTi Training done & National process on

Report of analysis of policy from 51 countries

Glaring Gaps in 10 Areas

IYCF Practice Indicator Rates of WBTi India Assessment 2012 (Source: DLHS 3 (2007-08)

WHAT DOES THAT MEAN? MAJOR POLICY ACTIONS

WHO’s Code Implementation Report 2013

• 37/165(22%) countries have passed a law based on all provisions of the International Code adopted in 1981

• 45/165(23%) countries have ‘some’ monitoring system in place

• 69/199(35%) ban advertising of formula

• 64/199(32%) ban gifts to health workers

•

Global PerformanceGlobal Baby Food Market Continues to Grow Baby food global retail value sales will surpass US$31 billion in 2008, a current value increase

of 10.5% from the previous year at fixed US$ exchange rates.

Source: Euromonitor International

Key Trends and DevelopmentsIndian Market Constrained by Regulatory BarriersThe huge disparity in the retail value of milk formula sales between China and India is

mainly due to the significant differences between their official regulatory regimes.

Source: Euromonitor International

Scientific Symposium on “Role of Nutrition during Pregnancy and Feeding of the LBW Infants , Organised by Nestle Nutrition Institute , 16th March , 2013 , Ludhiana

Posters in A pediatric Clinic in Varanasi Feb’2013

INTERNET VIOLATION Heinz Baby Break Fast Creamy Oat Porridge for 4+ months Infant(http://www.firstcry.com/heinz/heinz-baby - breakfast -creamy -oat-porridge)

Facilities/ Health Claims •Easy Return Policy • Dispatched in 24 Hrs• Great Source of Iron Calcium and Zinc

Facilities/ Health Claims •Easy Return Policy • Dispatched in 24 Hrs• Great Source of Iron Calcium and Zinc

Nestle NAN Pro 1 Infant Formula( http://www:healthcart.com/product/nestle-nan-pro-infant-formula-powder )

World Breastfeeding Costing Initiative

• Development of policies and plans AND coordination

• BFHI• Training of public health

worker• Community services and

mother support• Media promotion• Maternity Protection• Implementing the Code• Monitoring and Research

Action Area IBFAN estimates USD in billions (214 countries)

One Time Cost 2.08 billion

• IYCF policy devp & review 0.004

• International Code drafting and legislative process 0.479

• Trainings• HW• Community support• Code implementation

1.599

Annual Cost 15.48 billion

• BFHI Implementation 2.01

• Media Promotion 0.722

• Monitoring 0.081

• Maternity Entitlement 12.6

Total 17.56 billion18

Investing in Maternity Protection and other interventions

CONCERNS ON CONFLICTS OF INTERESTS IN NUTRITION

SUN-the Scaling Up Nutrition…..movement creating new “power of five”

Not approved by member States, pushes PPPs, and business networks, no rules on conflict of interests

Scaling Up Nutrition, or SUN, is a unique movement founded on the principle that all people have a right to food and good nutrition. It unites people – including governments, civil society, the United Nations, donors, businesses and researchers – in a collective effort to improve nutrition.

Manipulation by Association

• Organizers of the Lancet Launch in India, Coalition for Nutrition Security, ‘Save the children’ hosts it. Pepsi and others are donors. PHFI again Pepsico and several other companies are partners

• GAIN recommends/even threatened to Kenya not to go for a strong law, Kenya kept their nerves

• “Foundations” in food and drink industry interfere a lot.• Former Government of India officer joins adviser to

Britannia foundation, recommends de-regulation on complementary foods advertising in BMJ “personal view”

• Former NIN director is on board of Nestles committee and writes their report of nutrition.

• Nestle has confirmed that it pays ch25000 annually to its CSV members.

Conflict of interests contd.

GAIN’s core strategy

What is the Association?

Nutrition specific interventions suggested in Children < 5 Years

Lancet 2013

8 out of 10 interventions are based on commercial products

Nutrition Sensitive Interventions?

• Brazil: Recent Comment from CONSEA Brazil in the document on ICN 2:– 50% reduction in malnutrition past 2 decades– inter-sector public policies – health, education, nutrition,

and real increase in minimum wage– No Private sector– All Public interventions with civil society participation

Lessons from Brazil

For Undernutrition •Address the Unfinished agenda of breasfeeding and infant and young child feeding in the post 2015 discussions on priority.•Address conflict of interest issues both at global and national level, institutionally, and in policy development before getting into any ‘partnerships’.

Conclusions