The Battle of the Bottle: In Geneva it was the U.S. against the world

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In Geneva it was the U.S. against the world

The outcome of last week's World Health Organization vote was never in doubt. Delegates to the WHO meeting in Geneva were considering an international code of conduct to restrict the advertising and marketing of baby formula, a processed, usually powdered substitute for mother's milk. The formula can lead to infant malnutrition and death when used improperly, so the WHO code had the support of doctors and government health officials all over the planet. The final tally was 118 to 1, a near miracle of consensus in any international forum. Which nation was it that cast the only no vote, thus appearing to align itself in opposition to good health for babies? The U.S.

That dissent, ordered by the White House and based on concern that the code would restrict free speech and free trade, touched off a wave of outrage, much of it in the U.S. Dr. Stephen Joseph, the top health official at the U.S. Agency for International Development, and Eugene Babb, the agency's top nutrition expert, resigned their jobs in protest. Joseph called the vote "contrary to the best interests of my country, inexplicable to my professional colleagues . . . and damaging to the health and growth of the world's children." Senator Edward M. Kennedy of Massachusetts convened an unofficial hearing on the U.S. dissent, which he denounced as "shameful." Republican Senator Mark Hatfield of Oregon warned that the vote could send "a message of indifference to the sanctity of human life." Outside the U.S., the reaction was more puzzlement than anger, though even London's conservative Financial Times declared, "It is special pleading of the worst kind to invoke the right to free expression and free competition if a potential danger to life and health has been identified."

The infant-formula controversy began about ten years ago, when Dr. Derrick Jelliffer, a public health specialist, declared that infant malnutrition could be linked to the use of baby formula. That substance, usually made from a milk base with vegetable fat, milk sugar, vitamins and minerals added, is nutritious if correctly used. In poor areas of the world, however, that is sometimes impossible. Mothers may unknowingly mix powdered formula with contaminated water or, to save money, dilute it too much. Moreover, breast feeding is healthier and more economical, assuming a baby's mother is healthy and able to produce adequate nourishment for her child.

Critics have also complained that the infant-formula industry, which has world-wide sales of $2 billion, compounded those hazards by stepping up marketing efforts in Third World countries. Some of the sales tactics were questionable. Employees of some formula companies, dressed as medical personnel, would go from village to village promoting the products. New mothers were routinely given advertising brochures and free samples while still in the hospital.

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