Breast Beating

The G8 has the interests of the rest of the world at heart – until they conflict with its own.

By George Monbiot. Published in the Guardian 5th June 2007

It is time once again for that touching annual ritual, in which the world’s most powerful people move themselves to tears. At Heiligendamm they will emote with the wretched of the earth. They will beat their breasts and say many worthy and necessary things – about climate change, Africa, poverty, trade – but one word will not leave their lips. Power. Amid the patrician goodwill, there will be no acknowledgement that the power they wield over other nations destroys everything they claim to stand for.

The leaders of the G8 nations present themselves as a force for unmitigated good. Sometimes they fail, but they seek only to make the world a kinder place. Bob Geldof and Bono give oxygen to this deception, speaking of the good works the leaders might perform, or of the good works they have failed to perform; but not mentioning the active harm. They refuse to acknowledge that what the rich nations give with one finger they take with both hands.

Look at what is happening, right now, in the Philippines. This country has many problems, but one stands out: just 16% of children between 4 and 5 months old are exclusively breastfed(1). This is one of the lowest documented rates on earth, and it has fallen by a third since 1998(2). As 70% of Filipinos have inadequate access to clean water, the result is a public health disaster. Every year, according to the World Health Organisation, some 16,000 Filipino children die as a result of “inappropriate feeding practices”(3).

These are the deaths caused only by acute results of feeding children with substitutes for breastmilk. A summary of peer-reviewed studies compiled by the campaigning groups Infact and Ibfan suggests that breastfeeding also reduces the incidence of asthma, allergies, childhood cancers, diabetes, coeliac disease, Crohn’s, colitis, obesity, cardiovascular disease, poor cognitive development, ear infections and poor dentition(4). Switching from bottle to breast could prevent 13% of all childhood deaths(5): a greater impact than any other measure. Panaceas are rare in medicine, but the mammary gland is one.

Both the government of the Philippines and the UN blame the manufacturers of baby formula for much of the decline in breastfeeding. These companies spend over $100m a year on advertising breastmilk substitutes in the Philippines, which equates to over half the department of health’s annual budget(6). Those who appear most susceptible to this advertising are the poor, who are also the most likely to be using contaminated water to make up the feed. Some spend as much as one third of their household income on formula. Powdered milk now accounts for more sales than any other consumer product in the Philippines(7). Almost all of it is produced by companies based in the rich nations.

Since Ferdinand Marcos was deposed in 1986, the government of the Philippines has been trying to stand between these corporations and vulnerable mothers(8). It has failed. It plugs one loophole; the formula companies find another. Baby Milk Action, one of the world’s most impressive public health campaigns, has compiled a dossier of breaches of the marketing code drawn up by the World Health Organisation. Formula companies have been dispensing gifts to both health workers and mothers, running promotional classes and meetings and advertising their wares on television and in magazines and papers(9,10). These practices, though mostly legal in the Philippines, are all discouraged by the code(11).

In February this year, the Pharmaceutical and Healthcare Association of the Philippines (PHAP), which represents multinational companies, ran a series of advertisements expressing concern for women unable to breastfeed their children. The campaign was described by the UN’s special rapporteur, Jean Ziegler, as “misleading, deceptive, and malicious in intent”. He claimed the adverts “manipulate data emanating from UN specialized agencies such as WHO and UNICEF … with the sole purpose to protect the milk companies’ huge profits, regardless of the best interest of Filipino mothers and children.”(12)

Last year, in the hope of arresting this public health disaster, the Philippines Department of Health drew up a new set of rules. It prohibited all advertising and promotion of infant formula for children of up to two years old. It forbade the formula companies from giving away gifts or samples or from providing assistance to health workers or classes to mothers(13). The new rules seem stiff, but they all come straight from the WHO’s code. PHAP, whose members include most of the world’s biggest pharmaceutical companies(14), went to the supreme court to try to obtain a restraining order. When it failed the big guns arrived.

The US embassy and the US regional trade representative started lobbying the Philippines government. Then the chief executive of the US Chamber of Commerce in Washington – which represents three million businesses – wrote a letter to the president of the Philippines, Gloria Arroyo. The new rules, he claimed, would have “unintended negative consequences for investors’ confidence”. The country’s reputation “as a stable and viable destination for investment is at risk.”(15) Four days later, the Supreme Court reversed its decision and imposed the restraining order PHAP had requested. It remains in force today. The government is currently unable to prevent companies from breaking the international code.

So the Department of Health asked a senior government lawyer, Nestor Ballocillo, to contest the order. In December Ballocillo and his son were shot dead while walking from their home. The case remains unsolved: Ballocillo was working on several contentious issues. Last month the US regional trade representative paid another visit to the Philippines government(16). The department of health now appears to be wavering. In two weeks’ time the campaigners trying to promote breastfeeding will present their arguments to the Supreme Court to try to get the order lifted, and the formula companies will try to stop them. If the companies win, thousands of children will continue to die of preventable diseases.

The pressure to which the US government and the US Chamber of Commerce have subjected the government of the Philippines is at odds with almost everything the G8 now claims to stand for: the millennium health and education goals, the eradication of poverty, fair terms of trade. But the G8 nations will pursue their stated objectives only to the point at which they collide with their own interests. Away from their sentimental summits, they pull down everything they claim to be building.

The G8 demands action on climate change; the World Bank, controlled by the G8 nations, funds coal burning power stations and deforestation projects. The G8 requests better terms of trade for Africa; Europe and the United States use the world trade talks to make sure this doesn’t happen. The G8 leaders call for the debt to be reduced; the IMF demands that poor nations remove barriers to the capital flows which leave them in hock. The G8 leaders simultaneously wring their hands and wash their hands. We have done what we can; if we have failed, it is only because of the corruption of third world elites.

The question is no longer whether the undemocratic power the G8 nations exert over the rest of the world can be used for good or ill. The question is whether it will cease to be used.


1. Baby Milk Action, 9th November 2006. International campaign aims to save Philippines baby milk marketing law – and infant lives.

2. Connie Levett, 3rd February 2007. Formula for profit seen as recipe for disaster. Sydney Morning Herald.

3. Jean Marc Olivè, WHO country representative, cited by the Philippines Sunday Times, 5th November 2006.

4. INFACT Canada and IBFAN, July 2006. Risks of Formula Feeding: a brief annotated bibliography.

5. Gareth Jones et al, 5th July 2003. How many child deaths can we prevent this year? The Lancet, Vol 362, pp 65-71.

6. AC Nielsen, cited by Maricel E Estevillo, 14th July 2006. Business World, Philippines.

7. Connie Levett, ibid.

8. The current rules are contained in Executive Order 51, passed in 1986.

9. Alessandro Iellamo, WHO Philippines, 30th May 2007. Description of the Bonna Kid Bigay Tibay sa Barangay, 29th May 2007, pers comm.

10. Alessandro Iellamo, May 2007. Philippine Struggle for Child Survival: Call for International Solidarity.

11. World Health Organisation, 1981. The International Code of Marketing of Breastmilk Substitutes.

12. UNHCR, 26th February 2007. Un Special Rapporteur Appalled
with the Deceptive Tactics of Milk Companies in the Philippines.

13. Department of Health, 15th May 2006. Revised Implementing Rules and Regulations of Executive Order no 51. Administrative Order 2006 – 0012.

14. The members are listed here:

15. Thomas J Donohue, 11th August 2006. Letter to Gloria Arroyo.

16. Manila Standard Today, 9th May 2007. Report of visit of Barbara Weisel to Philippines Department of Trade and Industry.