Noah Flora
Intervening between babies and their mother’s nipples may seem like a curious way to do global politics. But the administration of President Donald Trump, a man long known for putting his hands where they don’t belong, recently made a shocking backroom lurch to block a World Health Organization resolution promoting nature’s ideal source of newborn nutrition, according to an investigation by The New York Times.
The resolution brought to the World Health Assembly in Geneva, suggested by Ecuador, was expected to slip through non-controversially. But soon the tiny Latin American country found itself in the Trump Administration’s sites, as officials warned that if they didn’t drop the initiative, “Washington would unleash punishing trade measures and withdraw crucial military aid.” Ecuador gave into Trump’s pressure, but ultimately the Russian delegation stepped in to push the proposal through.
The dust-up exposes the kind of backchannel trade politics that often shape global health and food policies, usually in the interests of corporate profits and at the expense of families’ welfare.
The Department of Health and Human Services defended its stance, insisting it was simply trying to tweak a few words and telling the Times that the resolution’s broad language threatened to pose “unnecessary hurdles for mothers seeking to provide nutrition to their children.” The department said women “should have the choice and access to alternatives for the health of their babies, and not be stigmatized for the ways in which they are able to do so.”
The language that mothers need “choice” and “alternatives” in childhood nutrition is cover for corporate efforts to commercialize infant healthcare.
But this argument flies in the face of a growing global consensus that, whenever possible, breastfeeding is the best form of infant nourishment. A recent study published in the journal Lancet projects that universal breastfeeding could yield massive benefits worldwide, saving more than 800,000 babies’ lives and $300 billion in public health costs, with major additional social benefits for parental bonding and neurological development.
Certainly, there are instances in which nutritional or logistical barriers make infant formula a necessity, but these are often the byproduct of over commercialization of infant healthcare, not a lack of it.
The U.S. baby formula industry, however, is invested heavily in mass produced, and often nutritionally inferior, breastmilk wannabes. So even a modest hint of regulation drove Washington to wield its financial clout as the WHO’s largest donor country with a chest-thumping defense of Big Breastmilk’s global monopoly.
Last year, the U.S. office of the Trade Representative publicly denounced common-sense rules on the marketing of infant and maternal nutrition products, including Malaysia’s Code of Ethics for the Marketing of Infant Foods and Related Products, which aimed to regulate infant formula marketing to protect infant health.
Similar resistance was seen in the pushback against Hong Kong’s voluntary infant formula marketing guidelines. And in a swipe at Thailand’s health authorities, the United States chided a supposedly “unfair” policy to curb the unethical marketing and promotion of “modified” breastmilk substitutes, follow-up formulas for infants and young children, and “supplemental” baby food products.
Nipplegate has a long history in the Global South.
Nipplegate has a long history in the Global South, in fact, dating back to the late 1970s and early 1980s when the exposure of Nestle’s deceptive formula marketing blitz in poor countries triggered global public outrage, a worldwide boycott, and eventually, the WHO’s adoption of voluntary rules on the marketing of infant nutritional products. Since then, health authorities have established a broader global regulatory framework focused on “ending the inappropriate promotion of foods for infants and young children.”
But in recent years, baby food giants like Nestle and Gerber have courted vulnerable consumers, particularly in relatively poor countries with endemic risks of malnutrition or susceptibility to deceptive advertising claims, such as “inspired by human milk.” Nestle’s hard sell on fake milk recently prompted the watchdog organization Changing Markets Foundation to conclude that in many countries, from Hong Kong to South Africa, the corporation’s manipulative marketing ploys were “not driven by nutritional science but instead by a sharp and prioritised focus on profit and growth at the expense of infants and their parents.”
And long before Trump took office, the United States was quietly fostering the industry's expansion by intimidating countries that sought to shield new moms from misinformation. According to Lori Wallach of Public Citizen, “There has been a consistent, bipartisan, disgusting attack on breastfeeding promotion policies, often using trade agreements.”
Back in the early 1990s, for example, the Clinton Administration pressured Guatemala for trying to block Gerber’s mass marketing campaigns, accusing it of violating World Trade Organization rules.
The breastfeeding kerfuffle is just one prong of Washington’s global war on public-interest regulations. In recent years, Trump, avowed foe of NAFTA, has leveraged the renegotiation of the North American trade pact to help food and drug manufacturers leach off of poor consumers around the Global South—for instance, by pressuring the Mexican government to back off enacting stronger labeling requirements for junk food as an anti-obesity measure, which threaten to shrink children's appetite for the flood of U.S. snack exports.
But public health protections have had even more lethal consequences. The Trump Administration has, like many predecessors, sought to embed intellectual property strictures in trade policies for medicines in order to block other countries’ health agencies from registering cheaper generic versions of brand-name drugs. Historically, the Clinton Administration paved the way for coercive trade regimes for life-saving medicines—for instance, by trying to bar South Africa from expanding access to cheap generic HIV/AIDS medications for patients in the Global South.
Trump’s breastmilk wars in fact fold into a worldwide frontal assault on women’s health: upon entering office, he has gratuitously wielded his executive pen to restrict foreign aid for any humanitarian organization that informs women about abortion as a method of family planning, for example, under the so-called Global Gag Rule, a resurrected holdover from the Reagan Administration.
Andrea Flynn of the Roosevelt Institute argues that, facing the expanding weaponization of trade and aid policies globally, “countries that are reliant on international funding to address public needs are especially vulnerable to the ideological whims of donor countries.” In an email Flynn elaborated, “such funding restrictions put governments of developing countries in impossible positions: reject funding and not have enough resources to support health infrastructure people desperately need . . . or accept the funding and create programs that contradict science and best practice and ignore the needs of the population.”
In past years, global solidarity in the public health community has managed to combat efforts by the United States to cajole and subjugate its “trade partners.” Trump has so far brazenly disrupted global markets with his brand of “America First” economic nationalism. But on the breastmilk battlefront, there should be no question over who should speak louder on the global stage for public health: the threats of Washington’s corporate patriarch, or the voice of mothers worldwide who know what’s best for their families?