Why a resolution to encourage breast-feeding scared Trump team

The push by United States delegates to the World Health Organization to water down or scrap a simple resolution meant to encourage breast-feeding in underdeveloped countries was many things — bullying, anti-science, pro-industry, anti-public health and shortsighted, to name afew.

But it was not surprising. In fact, it’s just one of several recent examples of the Trump administration’s zeal for badgering weaker countries into tossing public health concerns aside to serve powerful business interests. The baby formula industry is worth $70 billion and, as breast-feeding has become more popular in more developed countries, the industry has pinned its hopes for growth on developing nations.

As The New York Times reported Sunday, the resolution in question stated, simply, that breast milk is the healthiest option for infants, and that steps should be taken to minimize inaccurate marketing of substitutes.

President Donald Trump’s contention Monday on Twitter — that women need access to formula because of malnutrition — defies both science and common sense: The overwhelming balance of evidence tells us that breast milk is far more nutritious than formula. Among many other benefits, it has the potential to ward off diarrheal diseases and respiratory infections, both of which are prevalent in low-income countries.

Unethical marketing practices on the part of formula makers is a long-standing and well-established problem that has contributed to a decline in breast-feeding in low-income countries. As of 2015, less than 40 percent of babies younger than 6 months old were being breast-fed in developing countries. Doubling that proportion could save hundreds of thousands of lives.

In wealthier countries, formula is a safe option and can sometimes be a godsend. But it is also nutritionally inferior to breast milk in every way. Among other things, it contains none of the antibodies

In wealthier countries, formula is a safe option and can sometimes be a godsend. But it is also nutritionally inferior to breast milk in every way. Among other things, it contains none of the antibodies available in a mother’s milk. In the developing world, those shortcomings can be far more devastating to a child’s health.

available in a mother’s milk. In the developing world, those shortcomings can be far more devastating to a child’s health.

Ecuador was set to introduce this uncontroversial measure when the United States threatened “punishing trade measures” and a withdrawal of crucial military aid unless the country dropped it.

Common sense ultimately triumphed in this round of bullying, and the measure passed without much alteration — thanks, oddly enough, to Russia. But American officials are using the same tactics in similar situations, and there’s still concern that they could succeed on those fronts.

In March, U.S. trade representatives threatened to withdraw American support for the Colombian peace accord and Colombian ascension into the Organization for Economic Cooperation and Development unless Colombian health officials dropped several efforts to cut prescription drug prices. The measures Colombia is considering have all been permitted by the World Trade Organization, but pharmaceutical companies have pressured countries not to employ them, often by acting through American trade representatives.

Federal officials have proposed changes to global trade policy that would prohibit such measures, and that would also thwart other efforts to expand access to newly developed and urgently needed tuberculosis medications. Tuberculosis is still at epidemic levels in many low- and middle-income countries, claiming 1.7 million lives in 2016 alone, according to the World Health Organization.

It’s tempting to call this approach to public health Trumpian, simply because it has all the key hallmarks: an obvious bow to rich and powerful companies, disregard for the needs of people who are poor or sick or both, and zero attention to potential long-term consequences. But, while they might not have gone so far when it comes to baby formula, previous administrations were just as guilty as the current one when it came to drugs.

Both the Obama and Clinton administrations also sought to keep drug prices high in low-income countries — the former by preventing generic markets in India and elsewhere, and the latter by supporting policies that kept the prices of HIV medications much higher than they neededtobe.

In the case of HIV, persistent global protest ultimately turned public opinion and, as it happens, the course of medical history. The United States carved out exceptions for HIV medications and allowed a generic market to emerge, which in turn sharply curbed the epidemic itself.

Should U.S. officials prevail in the current case, the outcome will be easy enough to guess: People will suffer. Industry profits will not.