The World Health Assembly has finally closed a loophole used by infant formula manufacturers to market their product: digital marketing.

Back in 1981, when the International code of marketing of breast-milk substitutes was adopted by the World Health Organization (WHO) and UNICEF, digital marketing did not exist. Updated regulations were introduced in 2012 , but this too was before the widespread targeting of consumers via social media platforms and their targeted algorithms. 

The World Health Assembly approved a resolution on Monday that gives member states the opportunity to get technical support from the WHO on how to implement its guidance on “regulatory measures aimed at restricting digital marketing of breast-milk substitutes”.

The resolution, put forward by Brazil and Mexico, also calls on the WHO Director-General to compile country lessons and challenges in implementing the guidance, and report back on progress in 2028.

“This resolution will help us to push back” against those promoting breastmilk substitutes, Director General Dr Tedros Adhanom Ghebreyesus told delegates in Committee A after they had passed the resolution.

Dr Bruce Aylward, WHO Deputy DG for Universal Health Coverage, added that the WHO was working with partners “to develop artificial intelligence tools that will help you identify violations against national laws to help with the enforcement”.

Global sales of formula milk were estimated to reach $164.76 billion in 2024.

Mothers interviewed by  a multi-country study. reported being “targeted by online marketing and being inundated by marketing for formula milk including promotions prompted by their search behaviour for infant feeding advice and information”.

In addition, a “suite of alternative formulas presents formula milk products as satisfying all possible needs”. 

The committee also resolved to incorporate the World Prematurity Day into the WHO calendar during the discussion on 

Some 13.4 million babies are born preterm, and preterm birth complications are the leading cause of death amongst children under the age of five, according to the resolution.

“With extremely pre-term children, the probability of death in a low income country is over 90% in the first few days of life, and it’s less than 10% in high income countries,” said Aylward.

Sexual and reproductive rights

The resolutions were adopted as part of a discussion on the Global strategy for Women’s, Children’s and Adolescents’ Health, tabled at the WHO executive board. 

The report highlights that countries are off track to reach the targets of the Sustainable Development Goals (SDG) related to maternal, newborn and child mortality by 2030. 

The maternal mortality rate is only expected to drop to 176 deaths per 100,000 live births whereas the SDG target is 70 deaths per 100,000 live births, said Tedros.

“The 60 countries who are not on target, should accelerate. I think focus on the 60 countries will be very, very important. There are proven tools to make that happen.

“But the concern that we have is that, in many countries, investment is declining, especially in maternal health and child health, so our call is to reverse that,” he added.

Poland, on behalf of the European Union and nine candidate member countries, spoke about the need for sexual and reproductive health to have a human rights approach

“The EU reaffirms its commitment to the promotion, protection and fulfilment of the right of every individual to have full control over and decide freely and responsibly on matters related to the sexuality and sexual reproductive health, free from discrimination, coercion and violence,” said Poland. 

“The EU further stresses the need for universal access to quality and affordable comprehensive sexual and reproductive health information education, including comprehensive sexuality education and healthcare services.”

Finland, speaking for its Scandinavian neighbours and several surrounding countries, explicitly articulated that women should have access to safe abortion.

This sentiment was echoed by Germany, which stated: “We are concerned about the growing health disparities, and must ensure a human rights-based approach to health with gender equality and equity at the centre, whilst addressing gender-based and age-related violence. Access to comprehensive SRHR services, including modern contraception, safe abortion and post abortion care and comprehensive sexuality education are essential.”

There was no pushback from countries that would usually object to references to abortion, and the the committee session passed without disagreement.