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,FIAP
Regional Coordinator Iinternational Baby Food Action Network(IBFAN) Asia,
Chair Global Breastfeeding Inititaive for Child Survival, Member PM’s Council
on India’s Nutrition Challengs
Overview
• 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.
First Year is Critical!
•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 Brain development
•92 million babies under six months NOT practice exclusive breastfeeding for the first six
months
6.9 million children
die during
First by 5 yrs. and
2/3rd are
during 1st year and
related
to poor feeding.
Millions Undernourished
Years of life
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
India - Policy and programmes (Ind. 1-10 ) 2005 , 2008 ,2012
10
10
9
8 8
8
7 7
7
6
6
5
5
5
4.5
5
5
5
5
4.5
4
4 4
4
4
4
3.5
3
3
3
3
2.5
2
2
2
1
0
0
0 0 0
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 Performance
Global 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 Developments
Indian Market Constrained by Regulatory
Barriers
 The 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)
Nestle NAN Pro 1 Infant Formula
( http://www:healthcart.com/product/nestlenan-pro-infant-formula-powder )
Facilities/ Health Claims
•Easy Return Policy
• Dispatched in 24 Hrs
• Great Source of Iron
Calcium and Zinc
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
Investing in Maternity Protection
and other interventions
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
1.599
•
•
•
HW
Community support
Code implementation
Annual Cost
15.48 billion
• BFHI Implementation
2.01
• Media Promotion
0.722
• Monitoring
0.081
• Maternity Entitlement
12.6
Total
17.56 billion
18
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
Writing
group
Lancet
Series
2013
projects
Scaling
up
Nutrition
(SUN) as
a viable
global
leadership
SUN has
GAIN, and
food industry
on leadership
team
Unilever,
Britannia
GAIN is an
adviser to
Lancet
series.
GAIN
Business
Alliance,
Now moved
to SUN …has
members
Nutriset
DSM
Britannia
Pepsico
Cargill
Coca Cola
Unilever
Conflict of interests contd.
• 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.
GAIN’s core strategy
What is the Association?
Lancet
8 out of 10
Nutrition
interventions
are “products”
RUTF
Micronutrients
SUN
BF,CF
Fortification
of foods
Micronutrient
supplements
Tt. of Severe
MN
GAIN
Fortified
foods
through
market
approach
Nutrition specific interventions suggested
in Children < 5 Years
8 out of 10 interventions are based on commercial
products
Lancet
2013
Nutrition Sensitive Interventions?
Lessons from Brazil
• 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
Conclusions
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’.