Call to end sponsorship from commercial milk formula companies
Authors: Iona Macnab, Daniela Drandić, Ann Kellams, Iqbal Ahmad Memon, Alex Stevenson, Karen Walker
Journal: The Lancet (2024)

We, the undersigned representatives of health-care professional associations (HCPAs), call upon all HCPAs to bring an end to sponsorship relationships with companies that market breastmilk substitutes. Since 1981, WHO has repeatedly called for restrictions on the marketing of breastmilk substitutes.1WHO International code of marketing of breast-milk substitutes. World Health.https://www.who.int/publications/i/item/9241541601Date: Organization, 1981Date accessed: November 7, 2023Google Scholar In 2016, the World Health Assembly called on member states to end the inappropriate promotion of foods for infants and young children, including breastmilk substitutes, to health-care professionals.2World Health Assembly Ending inappropriate promotion of foods for infants and young children. World Health.https://apps.who.int/gb/ebwha/pdf_files/wha69/a69_r9-en.pdfDate: Organization, 2016Date accessed: November 7, 2023Google Scholar The WHO Guidance on Ending the Inappropriate Promotion of Foods for Infants and Young Children recommends that HCPAs should not allow "such companies to sponsor meetings of health professionals and scientific meetings". There is compelling evidence that aggressive marketing by manufacturers and distributors of breastmilk substitutes adversely affects feeding practices for infants and young children.3WHO How the marketing of formula milk influences our decisions on infant feeding. World Health.https://www.who.int/publications/i/item/9789240044609Date: Organization, 2022Date accessed: November 7, 2023Google Scholar Such marketing undermines breastfeeding and contributes to poor health outcomes in children. It also contributes to the burden of non-communicable disease, particularly among women.4Nanishi K Hongo H Breastfeeding and the role of the commercial milk formula industry.Lancet. 2023; 402: 448Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar Sponsorship of HCPA educational events is a marketing activity that creates conflicts of interest among health-care professionals. Conflicts of interest have been defined as "[S]ituations where an individual has an obligation to serve a party or perform a role and the individual has either: 1) incentives or 2) conflicting loyalties, which encourage the individual to act in ways that breach his or her obligations."5Rodwin MA Attempts to redefine conflicts of interest.SSRN. 2017; (published online Dec 8. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3084307 (preprint).)Google Scholar Sponsorship of educational events influences many activities, including research and prescribing behaviour, even when health-care professionals do not recognise this influence.6Baker P Smith JP Garde A et al.The political economy of infant and young child feeding: confronting corporate power, overcoming structural barriers, and accelerating progress.Lancet. 2023; 401: 503-524Summary Full Text Full Text PDF PubMed Scopus (50) Google Scholar The WHO Guidance on Ending the Inappropriate Promotion of Foods for Infants and Young Children cautions health-care professionals and HCPAs to be aware that our credibility will be damaged if we continue to accept funding from companies that promote breastmilk substitutes and other foods for infants and young children. As HCPAs, we seek to protect, promote, and support optimal feeding for infants and young children. Manufacturers and distributors of breastmilk substitutes, on the other hand, have a fiduciary duty to increase their profits through increasing sales and, therefore, increasing use of breastmilk substitutes. These different missions clearly cannot be reconciled. We therefore call upon all HCPAs to commit to ending sponsorships from companies that market breastmilk substitutes by the end of 2024. As representatives of international and regional HCPAs signing this call to action, we pledge to support and assist our member associations to end sponsorship from companies that market breastmilk substitutes through training, advocacy for policy development and implementation, information dissemination, and monitoring. Aggressive marketing of breastmilk substitutes threatens our capacity to deliver quality care. Every HCPA's primary concern must be the health and wellbeing of every newborn, child, and mother. Only by working together can we neutralise the threat posed by sponsorship. We declare no competing interests. For the WHO Guidance on Ending the Inappropriate Promotion of Foods for Infants and Young Children see https://apps.who.int/iris/bitstream/handle/10665/260137/9789241513470-eng.pdfFor more on the 71st World Health Assembly see https://www.who.int/about/governance/world-health-assembly/seventy-first For the WHO Guidance on Ending the Inappropriate Promotion of Foods for Infants and Young Children see https://apps.who.int/iris/bitstream/handle/10665/260137/9789241513470-eng.pdf For more on the 71st World Health Assembly see https://www.who.int/about/governance/world-health-assembly/seventy-first