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Holding to account | E4 and NGOs fought to curb these harmful marketing practices in the 1970s and 1980s, and the International Code of Marketing of Breastmilk Substitutes was adopted by the World Health Assembly in 1981 (WHO 1981), and strengthened and clarified in a subsequent series of assembly resolutions. The code was particularly important in establishing a precedent for regulating the harmful practices of transnational corporations. Although adherence to the code has been patchy, it has helped to improve breastfeeding rates, and thereby reduce child mortality Two important civil society networks are encouraging compliance: the International Baby Food Action Network (IBFAN) and the World Alliance for Breastfeeding Action (WABA). Both play a crucial role in upholding its principles and the regulatory function of governments, identifying non-adherence and pressing for action. Nevertheless baby milk companies continue to use health facilities to influence mothers and staff with their promotional material, especially in countries that have not implemented or fully applied the code and subsequent resolutions. Free supplies and samples of formula remain a major problem, with companies competing to receive equal and sometimes exclusive treatment by hospitals. Distribution and display of company materials is widespread, and more prevalent in countries where consumer purchasing power is high, such as Hong Kong, Singapore and the United Arab Emirates (IBFAN 2004). Companies also exploit weaknesses in the code. For example, since direct marketing to mothers is restricted, companies mark promotional material as ‘information for health professionals’ and supply it in bulk to health facilities where mothers are the intended audience. Nestlé even states that material for health professionals is intended for distribution to mothers. Advertising is designed to give the impression that infant formula gives babies an added advantage, even suggesting that formula supplemented with fatty acids provides ‘intelligence in a bottle’. Not only is there no proof that such supplementation has a beneficial effect, the fact that it is not superior to breastmilk is not mentioned. Companies also suggest that other added ingredients bring a product ‘closer to breastmilk’, boosting immunity to disease and promoting healthy growth – misleading claims that are promotional in nature and prohibited by the code. Many companies wrongly claim that the code applies only to infant formula, not to ‘other products marketed or represented as breastmilk substitutes’. The promotion of breastmilk substitutes by health services may act as an endorsement of the product and undermine public health messages that promote exclusive breastfeeding. An increasing number of health professionals are becoming addicted to company donations and sponsorship. The impact 314
24 A pack of Cerelac cereal food purchased in Bulgaria on 2 June 2003, labelled for use from 4 months. Campaigners found that nearly ten years after it was required to stop labelling complementary foods for use from before 6 months of age, Nestlé was still doing so. Big business 315
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About this book Today’s global he
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Global Health Watch 2005-2006 An al
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Contents Boxes, figures and tables
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C2.1 The facts about disability 180
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Illustrations 1 Medicine cannot dea
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Acknowledgements The following indi
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London School of Hygiene and Tropic
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Victoria, Canada; Centre for Health
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Foreword New reports on different a
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Introduction Origins The Global Hea
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Child malnutrition, death and disab
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Human rights and responsibilities A
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impacting on health. The Watch hope
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part a | Health and globalization T
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Health and globalization | A1 and h
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Health and globalization | A1 in 20
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Health and globalization | A1 is gl
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Health and globalization | A1 peopl
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Health and globalization | A1 numbe
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Health and globalization | A1 and p
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Health and globalization | A1 econo
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Health and globalization | A1 Box A
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Health and globalization | A1 half
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Health and globalization | A1 appro
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table a1 Key health concerns with W
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Health and globalization | A1 Healt
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Health and globalization | A1 merci
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Health and globalization | A1 thems
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Health and globalization | A1 Even
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Health and globalization | A1 • A
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Health and globalization | A1 non-v
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Health and globalization | A1 27-28
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Health and globalization | A1 Jenki
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Health and globalization | A1 Satte
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Health and globalization | A1 WHO (
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and regulatory authorities mandated
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Health care systems | B1 4) selecti
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Health care systems | B1 • And si
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Health care systems | B1 • declin
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Health care systems | B1 user charg
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Health care systems | B1 focus on t
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Health care systems | B1 for health
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Health care systems | B1 their cont
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Health care systems | B1 health car
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Health care systems | B1 ing servic
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Health care systems | B1 Box B1.7 G
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Health care systems | B1 many of th
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Health care systems | B1 the lack o
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Macro-economic factors Impoverished
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Health care systems | B1 HALE 2000
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Health care systems | B1 But improv
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Health care systems | B1 high-incom
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Health care systems | B1 Structural
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Health care systems | B1 the high t
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Health care systems | B1 and histor
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Health care systems | B1 norms (Loe
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Health care systems | B1 Foster M,
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Health care systems | B1 Toole M et
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B2 | Medicines Introduction Essenti
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Health care systems | B2 of new med
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Health care systems | B2 chapter re
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Health care systems | B2 the fourth
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Health care systems | B2 agenda thr
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Health care systems | B2 nonetheles
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Health care systems | B2 decision o
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Health care systems | B2 for the an
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Health care systems | B2 expenditur
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Health care systems | B2 Medawar C
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Health care systems | B3 between he
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Severe shortage Low density Moderat
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Health care systems | B3 sector and
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Health care systems | B3 to the US,
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Health care systems | B3 500 400 30
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Health care systems | B3 have been
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Health care systems | B3 to underta
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B4 | Sexual and reproductive health
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Health care systems | B4 10 Policy-
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Health care systems | B4 women and
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Health care systems | B4 of funding
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Health care systems | B4 debate on
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Health care systems | B4 the sexual
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Health care systems | B4 perspectiv
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Health care systems | B5 genome res
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Health care systems | B5 drugs base
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Health care systems | B5 Complete f
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Health care systems | B5 when a tes
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Health care systems | B5 are allowi
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Health care systems | B5 of life sc
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part c | Health of vulnerable group
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Health of vulnerable groups | C1 me
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Health of vulnerable groups | C1 pr
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Health of vulnerable groups | C1 Th
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Health of vulnerable groups | C1 Ca
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Health of vulnerable groups | C1 Bo
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Health of vulnerable groups | C1 Pa
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Health of vulnerable groups | C2 DP
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Health of vulnerable groups | C2 di
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part d | The wider health context T
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D1 | Climate change Introduction En
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increasing quantities are now causi
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development, local availability foo
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14 Droughts threaten the food secur
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Protocol can meet their targets by
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15 Transport and travel are major d
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• Redesign trade rules. Governmen
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D2 | Water Access to enough clean w
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water consumption worldwide. Each p
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table d2.1 Top corporate players in
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16 Protesting against the privatiza
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Box D2.3 Regulating private water c
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The private sector overestimates th
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Box D2.7 US citizens told to boil t
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to water. Worse still, it does this
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References Barlow M, Clarke T (2002
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D3 | Food Undernutrition is by far
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Functional and Productive Capacity
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table d3.1 Corporate control of US
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keting and processing means that sm
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average Indian family of four reduc
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Bank’s US$ 93.5 million loan to C
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Avery N, Drake M, Lang T (1993). Cr
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D4 | Education Some 135 million chi
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ledge about health-care practices a
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2005, and on present trends about 4
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Box D4.3 Programmes that aim to emp
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• per capita public spending fall
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unable to recruit 9000 badly needed
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Gordon D et al. (2003). The distrib
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D5 | War War has an enormous and tr
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19 Chechnya destroyed. War has wide
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initiated a ‘war on terrorism’.
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an explosive force equivalent to ab
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the risk of their misuse and divers
Page 281 and 282: Box D5.3 An agenda for peace The Ha
Page 283 and 284: Machel G (1996). Impact of Armed Co
Page 285 and 286: part e | Holding to account: global
Page 287 and 288: E1 | World Health Organization The
Page 289 and 290: The sources consulted worldwide in
Page 291 and 292: Box E1.1 Milestones in WHO history
Page 293 and 294: aised by his attempts to revitalize
Page 295 and 296: • stronger internal focus on perf
Page 297 and 298: 21 WHO - up in the clouds? Reaction
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Page 301 and 302: to speak openly, while bullying and
Page 303 and 304: velop a unified, purposeful health
Page 305 and 306: to medicines, and the mobilizing ro
Page 307 and 308: Recommendations WHO’s core purpos
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Page 311 and 312: E2 | UNICEF In 2005, Carol Bellamy,
Page 313 and 314: In sum, for almost a decade, childr
Page 315 and 316: prompted a global debate on how to
Page 317 and 318: E3 | The World Bank and the Interna
Page 319 and 320: 22 World Bank: the centre of world
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Page 323 and 324: tal policies should explicitly refe
Page 325 and 326: E4 | Big business This chapter deal
Page 327 and 328: 23 The Marlboro Man was described b
Page 329 and 330: dedicated funding [Articles 5.6 and
Page 331: grass roots in building government
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Page 339 and 340: These trends in taxation are underp
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Page 343 and 344: Global aid trends - allocation Wher
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Page 347 and 348: table e5.1 Value (in £) of new DFI
Page 349 and 350: OECD (2005). Development Co-operati
Page 351 and 352: 25 Breaking the chains of debt: pro
Page 353 and 354: Box E6.1 Zambia: inflation or death
Page 355 and 356: have met the Fund’s conditions, a
Page 357 and 358: E7 | Essential health research Rese
Page 359 and 360: Developing national health research
Page 361 and 362: for African Medical Editors (Certai
Page 363 and 364: Neither the consultations leading u
Page 365 and 366: Box E7.4 Asking the social-politica
Page 367 and 368: • global architecture for health
Page 369 and 370: part f | Conclusions Global Health
Page 371 and 372: current debt relief mechanism - the
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Page 375 and 376: ity of the now-developed countries
Page 377 and 378: tion and water are experiencing sim
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