by Heather Vogell
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A ProPublica research revealed that the Biden administration has slowly pushed more than a half-dozen nations to reevaluate or delay infant formula rules that were intended to safeguard the public’s health.
In the European Union, the U. S. opposed an effort to reduce lead levels in infant solution. In Taiwan, it sought to change tagging that highlighted the health benefits of feeding. And in Colombia, it raised the issue that caused a common formula shortage at a manufacturing facility in Michigan in 2022.
” Infant formula companies want to sell more child formula”, said Marion Nestle, professor emerita of diet, food research and public health at New York University. I find it incredibly disturbing that institutions are supporting and assisting them in their business enterprise over the common health interest.
The interference, documented in business letters sent during President Joe Biden’s first two years, represents the latest chapter in the federal government’s long-running support for the multibillion-dollar method business, even as the Biden administration has formally promised a different approach.
As ProPublica reported earlier this year, the United States has frequently used its diplomatic and political strength to thwart work by developing nations to protect the health of their youngest children.
Through open data, scientific exploration and other resources, ProPublica found evidence of such meddling in 21 countries, plus Hong Kong, Taiwan and the European Union, over years. In many instances, countries either tabled or changed proposed solution regulations after the U. S. lodged objections.
Global health has a lot of potential. According to experts, industry advertising, which is subject to a lot of foreign regulations, frequently misleads parents about the benefits of formula products and that promotions like free samples, discounts, and giveaways can cause mothers to stop breastfeeding too soon. That, according to research, can increase the risk of long-term illnesses like diabetes and obesity and make babies more susceptible to life-threatening infections.
The Biden administration changed the way the United States handles trade, respecting foreign governments ‘ efforts to pass regulations rather than imposing them right away, according to the Biden administration’s statement to ProPublica in January. The Trade Representative’s Office stated that it is” committed to making sure our trade policy works for people, not blindly advancing the will of corporations.”
But the documents, obtained from the agency’s own files through a records request, suggest those corporations still have outsized clout when it comes to baby formula regulation.
For instance, formula company representatives arranged a conference call with USTR staff to protest Kenya’s legislation that sought to impose restrictions on formula advertising in early 2021. A trade group’s 10-page position paper criticizing the Kenyan measure was shared by industry consultants.
Then, in correspondence with Kenyan officials, U.S. officials raised similar issues. ” Can Kenya explain the need for this provision”? they asked about one advertising-related measure, according to agency records. Kenyan officials questioned whether they had consulted with industry figures, including food processors and retailers. Additionally, officials suggested a number of changes to the proposed law, including recommending that Kenya replace the warning about potential contamination with one that focused solely on” the health risks of inappropriate preparation, storage, and use.”
Officials in Kenya reacted, rejecting that suggestion and several others. Kenya needed to pass regulation, they said, because the formula industry “was not voluntarily adhering” to international guidance. According to Kenyan officials, less than half of infants under six months old were breastfed exclusively, and the country was attempting to raise the rate to 75 %.
Eight other letters that Biden and eight others sent to the USTR were turned down by the USTR’s office for an interview. Additionally, a spokesperson declined to respond to written inquiries. Requests for comment were not addressed to the White House.
The pro-industry letters are the result of a policy-making process where manufacturers are encouraged to comment. The World Trade Organization, an international forum for settling trade disputes, has a tracking system that the U.S. Department of Agriculture uses to “notify industry and other users when potentially adverse foreign regulations” arise. Companies can then “provide input into official U. S. government comments”.
Multiple agencies, including the USTR, consider that feedback as they hammer out the official U. S. position, which experts say carries weight because of the country’s economic and diplomatic power. The foreign nation that first sends the regulation a letter with comments, frequently accompanied by questions. ( The USDA did not respond to inquiries about the Biden-era formula letters. )
Historically, the U. S. often lodged objections to new formula rules in public at the WTO. According to research, the United States questioned proposed formula regulations in WTO forums more than 30 times before 2020, a high proportion of times more than any other nation, even those whose foreign formula producers are based.
A Long History of U. S. Interference
The U. S. has interfered in efforts to regulate baby formula in at least 21 countries, Hong Kong, Taiwan and the European Union, ProPublica found. The meddling occurred over decades across presidential administrations.
George W. Bush, 2001-2009After formula manufacturing debacles killed nine babies, injured nearly two dozen in Israel and sent 54, 000 to hospitals in China, U. S. officials criticized Israel‘s new safety standards for imports, records show. U.S. officials advised the Philippines to halt a breastfeeding campaign and new advertising regulations and opposed a formula label warning in South Africa.
Barack Obama, 2009-2017U. S. officials criticized new formula marketing regulations in Vietnam, Thailand, Malaysia and Indonesia. In response to the earlier contamination scandal, they also criticized China’s efforts to ensure the safety of formula imports. Trade officials criticized the possibility that a Hong Kong initiative might result in” significant commercial loss for American companies.”
Donald Trump, 2017-2021U. Despite reports, U.S. officials threatened to withhold military aid from Ecuador if a proposed World Health Organization resolution was not supported by breastfeeding. The U. S. ambassador later denied the threats. The U. S. also criticized formula advertising restrictions in Singapore, Thailand, Egypt, Rwanda, Kenya and Uganda. Additionally, efforts to limit the amount of formula toxins in Taiwan and Turkey were met with resistance from officials.
The Biden administration, however, has relied almost entirely on the trade letters, keeping its critiques of formula regulation largely out of public view, according to ProPublica’s analysis of WTO meeting minutes and other documents. The nine missives, in fact, surprised even experts in public health who follow such developments because they were so untidy.
” Oh my goodness”, said Jennifer Pomeranz, a New York University professor and expert in public health law and food policy. ” I did not know it was this extensive”.
The letters frequently ask for the scientific justification for a country’s proposals. They also contain an implicit threat. If the U. S. feels a nation’s regulations are not justified, it can initiate a legal fight over trade agreements.
The United States reacted to the European Union’s efforts to lower the amount of lead in formula, a neurotoxin that is toxic to children, in a letter from May 2021. According to European officials, the change was based on a risk assessment conducted by a European food safety agency, adding that” this measure is deemed necessary to ensure a high level of human health protection.”
The U. S. was n’t convinced. ” We suggest the EU wait”, U. S. officials said. They cited the ongoing efforts of a global food standards body, which was considering lead limits for a variety of foods. ( The U. S. Food and Drug Administration, which has no lead limits for formula, told ProPublica it “has been evaluating to what extent if any, infant formula contributes to dietary lead exposure among the very young”. )
The U. S. also questioned the science behind proposed limits on cadmium, a probable carcinogen, in formula. The U. S. has no such limits.
The EU passed both measures anyway.
Other recipients, however, have acceded to the U. S. ‘ requests.
Taiwan, for example, changed a proposed formula labeling law after the U. S. objected to language that said,” Breastfed babies are the healthiest babies”. Taiwanese officials switched to wording the U. S. suggested in a 2022 letter:” Breast milk is the best food for your baby”.
The change, while subtle, makes a difference, said Nestle, who is not related to the formula company of the same name. ” These statements may seem identical, but the formula industry wants formula to be viewed as equivalent to or better than breastfeeding”, she said.” ‘ Healthiest ‘ can seem stronger, and that’s all it takes for formula companies to fight it”.
The industry trade group, the Infant Nutrition Council of America, claimed its members support breastfeeding but “believe parents should have access to truthful, balanced information on all suitable infant feeding options.” Formula makers also meet regulatory and “nutritional science” requirements in countries where they sell products, the group’s statement said.
Requests for comment were not responded to by Abbott and Mead Johnson.
Formula is still crucial when babies lack access to breast milk, to be sure. However, breastfeeding has long been a top priority for the World Health Organization because of its well-known advantages for infants ‘ health and cognitive development. Infant deaths among breastfed children are lower, according to a number of studies. Mothers who breastfeed their children also lower the risk of some cancers.
David Clark, former legal specialist with UNICEF and an international public health law consultant, said interventions like those of the U. S. can have a” chilling effect” on countries ‘ efforts to regulate formula marketing and protect breastfeeding. ” It’s like the bully in the playground”, he said. ” The U. S. is a big, powerful country”.
In 2021, the U. S. sent Colombia questions as it was considering a limit on microbiological contaminants. The country has yet to adopt the measure, said Rubén Ernesto Orjuela Agudelo, an infant nutrition expert at the National University of Colombia. He claimed that this rule is required.
In 2023, the U. S. sent a letter to Mozambique, challenging a proposal that sought to limit the information formula makers can provide to “higher level healthcare professionals” — a key target of industry lobbying. Trade officials took issue with the country’s description of formulas as “ultra-processed products with high sodium content” that contribute to long-term health problems.
The status of the measure is unclear. The country’s embassy did not answer questions from ProPublica.
Lori Wallach, director of the Rethink Trade program from the the American Economic Liberties Project, said that Biden’s trade representative, Katherine Tai, has made a significant effort to reduce corporate influence at USTR. However, Wallach speculated that some career trade officials may still be “marching along the corporate drums that have been kicking their stuff for decades.”
Correction
The name of the global organization that has long advocated breastfeeding was originally misspelled in this story on July 22, 2024. It is the World Health Organization, not the World Trade Organization, or WTO.
