London. -- Fifteen years ago the Paris-based international Herald Tribune published an editorial article that asked in its first line, "Does Nestle make chocolates and kill babies?" It caused a minor European storm and, after a follow-up article, its author was threatened with arrest if he should ever set foot again on Nestle's home turf, Switzerland.
Nestle is the world's biggest manufacturer of baby food, and the controversy has swirled around its elegant headquarters on the vine-covered shores of Lake Geneva ever since.
This week the industry organization, the international Baby Food Manufacturers, which includes Nestle, met in New York with James Grant, the executive director of UNICEF and equivocated once again. Yes, they said, we will stop all free and cut-price promotional supplies of breast-milk substitutes to hospitals and maternity centers, but only if governments tell us to. Once again the companies that pose world-wide as the disinterested friend to mothers has passed the buck.
The story actually began a couple of years before the Herald Tribune column appeared, when in a British medical journal Derek Jellife, a well known expert on infant nutrition, published an article, "Commerciogenic Malnutrition?"
Dr. Jellife argued that commercial substitutes for breast milk were raising the infant-mortality rate in countries as far apart as Tanzania and Guatemala. Too often, he noted, bottles were unsterilized, water impure and the powder overdiluted. The breast, on the other hand, produces a product of ideal and inimitable biochemical composition, free from infection and conferring protection from viral and bacterial attack. Moreover, mothers, while breast-feeding, are less likely to get pregnant again.
War on Want, a British charity, sharpened the debate with a polemical attack written by a journalist, Mike Muller, provocatively entitled "The Baby Killer." A Swiss group translated it and reissued it on Nestle's doorstep.
Nestle took the group to court with a criminal libel suit. It won on a narrow point of law, but lost the moral battle. The judge admonished Nestle to "rethink fundamentally its advertising practices in developing countries. Its advertising practices, up to now," he observed, "can transform a life-saving product into one that is dangerous and life- destroying."
The Swiss advocacy group expanded its lobby into a world-wide organization, the international Baby Food Action Network, which now boasts 70 national groups. It fought hard to persuade the World Health Organization and UNICEF to back an international Code of Marketing of Breast Milk Substitutes. This was approved almost unanimously in 1981 by governments voting in the World Health Assembly. Out went direct advertising. Out went inadequate labels. Out went saleswomen dressed as nurses. Out went free samples. Or at least that was the idea. At the time it looked as if the baby-food industry was going along with all this.
Ten years later it is all too obvious that compliance has been, to put it kindly, patchy. Only the Danish firm, Dumex, the Dutch Lijempf and the French Tacquemaire, have come close to implementing the code. Nestle, Wyeth/AHP, the Japanese Meiji and the German Hipp have barely given it time of day, arguing that for one of them to start the ball rolling would give the others an unfair advantage (an unfair advantage to keep the infant-mortality rate high?).
The Baby Food Action Network today summarizes the stalemate in 21 pithy words: "In most countries mothers and health workers are still being brainwashed away from breast feeding by the commercial promotion of inferior substitutes." James Grant of UNICEF, in a recent report, adds his own observation: "Reversing the decline in breast feeding in the developing world could save the lives of an estimated 1.5 million infants every year."
Education, of course, is partly the answer -- in the industrialized world, after a steep decline in the immediate post-war years, there is now a pronounced trend toward breast feeding, as women have become convinced of its real value. But just as important, particularly in vulnerable Third World societies where advertising and free promotions can overwhelm the gullible into believing that breast isn't best and isn't modern, self-restraint on the hard-sell by the baby-food industry is vital.
This week's decision is an enormous setback, seemingly contradicting assurances given to UNICEF and WHO as recently as May. The quiet but effective subversion of Third World hospitals and maternity clinics is to continue.
Meanwhile, the author of the original Herald Tribune column reflects, as the unceasing summer rain beats on his study window, just how long it takes to win a battle that should have been settled 15 years ago in that Swiss courtroom, if only the world was peopled by those who cared first for humankind and only second for their company and its balance sheet.
Jonathan Power writes a column on the Third World.