背景:母乳喂养对儿童的健康和发育很重要,为了孕产妇健康,在所有国家背景下。然而,母乳替代品(BMS)的全球销售,包括婴儿,后续和幼儿公式,在最近几十年里,“蓬勃发展”。这提高了食品法典委员会(Codex)制定的国际食品标准的重要性,BMS的组成和标签。这些标准似乎受到各国政府的强烈反对,行业和民间社会团体,然而,很少有研究调查食典标准制定过程的政治。本文的目的是了解谁参与决策,以及演员如何制定和竞争修订《后续公式法典标准》(FUF)的提案。
方法:我们采用了涉及两个步骤的案例研究设计。首先,我们列举了政府,工业,公民社会,和国际组织利益攸关方参与特殊膳食用途营养和食品法典委员会(CCNFSDU)的标准制定过程。第二,我们在CCNFSDU会议的FUF标准修订期间对利益相关方的输入进行了框架分析.检索了公开的在线会议报告(2015-2019年),使用理论框架进行分析,并按主题组织。
结果:高收入国家(HIC)的代表人数大大超过其他国家收入类别的代表人数。与其他观察者类别相比,行业代表性更高。成员国代表团的行业代表多于民间社会代表,偶尔也是唯一的成员国代表。行业利益相关者在贸易影响方面提出了论点,科学,灵活的标准。民间社会团体利用公共卫生,科学,和支持母乳喂养的框架。
结论:CodexBMS标准制定程序由HIC和行业团体主导。民间社会代表性有限,以及低收入和中等收入国家(LMICs),建议需要采取行动,大幅增加对他们参与食典的支持。这种代表性可能有助于抵消权力不对称和对婴幼儿食品标准的商业影响。
Breastfeeding is important for the health and development of the child, and for maternal health, in all country contexts. However, global sales of breast-milk substitutes (BMS), including infant, follow-up and toddler formulas, have \'boomed\' in recent decades. This raises the importance of international food standards established by the Codex Alimentarius Commission (Codex) on the safety, composition and labelling of BMS. Such standards appear to be strongly contested by governments, industry and civil society groups, yet few studies have investigated the politics of Codex standard-setting processes. The aim of this paper is to understand who participates in decision-making, and how actors frame and contest proposals to revise the Codex Standard on Follow-up Formula (FUF).
We adopted a
case study design involving two steps. First, we enumerated government, industry, civil society, and international organization stakeholders participating in standard-setting processes of the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU). Second, we conducted a framing analysis of stakeholder inputs during the FUF standard revision in CCNFSDU meetings. Publicly available online meeting
reports (2015-2019) were retrieved, analyzed using a theoretical framework, and organized thematically.
High-income country (HIC) delegates greatly outnumbered those from other country income categories. Industry representation was higher compared with other observer categories. Member state delegations included more industry representation than civil society representation, and were occasionally the only member state delegates. Industry stakeholders framed arguments in terms of trade implications, science, and flexible standards. Civil society groups used public health, science, and pro-breastfeeding frames.
Codex BMS standard-setting procedures are dominated by HICs and industry groups. Limited representation of civil society, and of low- and middle-income countries (LMICs), suggest actions are needed to substantially increase support for their involvement at Codex. Such representation may help to counteract power asymmetries and commercial influences on food standards for infants and young children.