America’s Baffling Opposition to the WHO’s Breastfeeding Resolution

It seems that any institution that is global or multilateral in nature or name elicits visceral opposition by huge swathes of the American public. While there has long been an undercurrent of insularity and outright hostility in America towards the rest of the world, it goes without saying that under the present administration — which came to power on a platform of nationalism, protectionism, and revanchism against foreigners — the sentiment has been worsened to the point of absurdity.

The most salient recent example is our strange response to a sensible resolution at the World Health Organization (WHO) that no one would have imagined was controversial. As The New York Times reports:

Based on decades of research, the resolution says that mother’s milk is healthiest for children and countries should strive to limit the inaccurate or misleading marketing of breast milk substitutes.

Then the United States delegation, embracing the interests of infant formula manufacturers, upended the deliberations.

American officials sought to water down the resolution by removing language that called on governments to “protect, promote and support breast-feeding” and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children.

When that failed, they turned to threats, according to diplomats and government officials who took part in the discussions. Ecuador, which had planned to introduce the measure, was the first to find itself in the cross hairs.

The Americans were blunt: If Ecuador refused to drop the resolution, Washington would unleash punishing trade measures and withdraw crucial military aid. The Ecuadorean government quickly acquiesced.

On top of the economic threats, the U.S. ambassador to the Ecuador suggested that the U.S. government might retaliate by withdrawing well needed military assistance in the north of the country, which is wracked by violence; one Ecuadorean official recounted how shocked everyone was “because we didn’t understand how such a small matter like breast-feeding could provoke such a dramatic response.”

Moreover, according to official from the U.S., Uruguay, and Mexico, advocates quickly sought out another sponsor, only to find that at least a dozen countries — most of them poorer nations in Africa and Latin America — backed down explicitly out of fear of retaliation. As one British advocate observed, “what happened was tantamount to blackmail, with the U.S. holding the world hostage and trying to overturn nearly 40 years of consensus on the best way to protect infant and young child health.”

Ultimately, the bizarre effort failed, only thanks to unlikely savior.

It was the Russians who ultimately stepped in to introduce the measure — and the Americans did not threaten them.


A Russian delegate said the decision to introduce the breast-feeding resolution was a matter of principle.

“We’re not trying to be a hero here, but we feel that it is wrong when a big country tries to push around some very small countries, especially on an issue that is really important for the rest of the world,” said the delegate, who asked not to be identified because he was not authorized to speak to the media.

He said the United States did not directly pressure Moscow to back away from the measure. Nevertheless, the American delegation sought to wear down the other participants through procedural maneuvers in a series of meetings that stretched on for two days, an unexpectedly long period.

While we cannot know the motivation for certain, it is safe to say that Russia was more than keen on once again filling the void in leadership that we continue to leave behind.

As for why we were intensely opposed to such a measure, it allegedly had to do with the wording of the resolution “placing unnecessary hurdles for mothers seeking to provide nutrition to their children,” namely “access to alternatives for the health of their babies.”

Yet there was nothing in the resolution precluding a mother’s choice to go with baby formulas; it simply supported what the overwhelming medical consensus has long confirmed: breast-feeding, whenever possible, is crucial to the health of infants:

Elisabeth Sterken, director of the Infant Feeding Action Coalition in Canada, said four decades of research have established the importance of breast milk, which provides essential nutrients as well as hormones and antibodies that protect newborns against infectious disease.

2016 study in The Lancet found that universal breast-feeding would prevent 800,000 child deaths a year across the globe and yield $300 billion in savings from reduced health care costs and improved economic outcomes for those reared on breast milk.

Scientists are loath to carry out double-blind studies that would provide one group with breast milk and another with breast milk substitutes. “This kind of ‘evidence-based’ research would be ethically and morally unacceptable,” Ms. Sterken said.

Though there is no direct evidence that the baby food industry, which is worth $70 billion, played any role in such unusually strong-armed tactics, it certainly doesn’t help that, amid stagnant sales in rich countries — due to increased breast-feeding no less — they’re expecting rising sales in the developing world — which the resolution was heavily focused on (and which would gain the most from breast-feeding).

This also fits a recurring pattern of animus towards “globalists” in favor of narrow nativist interests:

The intensity of the administration’s opposition to the breast-feeding resolution stunned public health officials and foreign diplomats, who described it as a marked contrast to the Obama administration, which largely supported W.H.O.’s longstanding policy of encouraging breast-feeding.

During the deliberations, some American delegates even suggested the United States might cut its contribution to the W.H.O., several negotiators said. Washington is the single largest contributor to the health organization, providing $845 million, or roughly 15 percent of its budget, last year.

The confrontation was the latest example of the Trump administration siding with corporate interests on numerous public health and environmental issues.

In talks to renegotiate the North American Free Trade Agreement, the Americans have been pushing for language that would limit the ability of Canada, Mexico and the United States to put warning labels on junk food and sugary beverages, according to a draft of the proposal reviewed by The New York Times.

During the same Geneva meeting where the breast-feeding resolution was debated, the United States succeeded in removing statements supporting soda taxes from a document that advises countries grappling with soaring rates of obesity.

The Americans also sought, unsuccessfully, to thwart a W.H.O. effort aimed at helping poor countries obtain access to lifesaving medicines. Washington, supporting the pharmaceutical industry, has long resisted calls to modify patent laws as a way of increasing drug availability in the developing world, but health advocates say the Trump administration has ratcheted up its opposition to such efforts.

From the Paris climate accord to the Iran nuclear deal to NAFTA, the U.S. seems more than keen to undermine if not dismantle any and every multilateral alliance or norm no matter how reasonable or innocuous. The consequences go well beyond breast-feeding, as important a public health issue as it is:

Ilona Kickbusch, director of the Global Health Centre at the Graduate Institute of International and Development Studies in Geneva, said there was a growing fear that the Trump administration could cause lasting damage to international health institutions like the W.H.O. that have been vital in containing epidemics like Ebola and the rising death toll from diabetes and cardiovascular disease in the developing world.

“It’s making everyone very nervous, because if you can’t agree on health multilateralism, what kind of multilateralism can you agree on?” Ms. Kickbusch asked.

It is utterly senseless to oppose something just because it is foreign or multinational. Like it or not, our increasingly globalized world must work together to tackle numerous problems that transcend borders and jurisdictions, from climate change to terrorism. This sets a bad precedent in a world that cannot afford any more division and conflict given the common challenges we face.

What are your thoughts?

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