Although the current foreign policy of the United States was not formally announced until June 11, 2018, in The Atlantic Daily [https://www.theatlantic.com/politics/archive/2018/06/a-senior-white-house-official-defines-the-trump-doctrine-were-america-bitch/562511/] to be We’re America, Bitch, the doctrine had been evident to observers for some time. Now, reports have emerged about its role in the 71^st World Health Assembly (WHA) convened in Geneva this past May.

On July 9, 2018, The New York Times reported on its front page that the US delegation from the Department of Health and Human Services (HHS) opposed a resolution by member nations to encourage breastfeeding as an international principle of infant health.

The principle underlying the resolution was based upon four decades of health data and information from across the globe as the best way to promote the health of infants and young children. A 2006 study in the independent medical journal Lancet indicated that breastfeeding would prevent 800,000 child deaths per year and result in $300 billion per year in health cost savings. What prompted the US to oppose this measure?

First, it needs to be clear that the health assembly’s objective was designed and intended to promote breastfeeding as the preferred care practice but not as a rule to bar processed infant food supplements. This, however, did not satisfy the corporate interests of industry associations. According to its website (05/16/2018), the International Dairy Foods Association (IDFA) urged the delegation from HHS headed by Secretary Alex Azar to stand against nations that would exclude industry stakeholders from policymaking participation and challenge WHA’s guidance discouraging the consumption of processed dairy products by children. Principal members of IDFA include Abbott Laboratories, Yoplait, Borden, Kroger, Land O’Lakes, and Nestle.

An anonymous spokesperson for HHS was quoted:

The resolution, as originally drafted, placed unnecessary hurdles for mothers seeking to provide nutrition to their children. We recognize not all women are able to breast feed for a variety of reasons. These women should have the choice and access to alternatives for the health of their babies, and not be stigmatized for the ways in which they are able to do so.

Not to be outdone, the President tweeted on 07/09/2018:

The failing NY Times story today about breastfeeding must be called out. The U.S. strongly supports breastfeeding but we don’t believe women should be denied access to formula. Many women need this option because of malnutrition and poverty.

Nor was this the President’s first encounter with the breastfeeding issue. During a deposition in 2011, an attorney requested a break—denied—to pump breast milk. Upon leaving the room, Trump said the woman was “disgusting”—a comment not later denied in a 2015 CNN interview.

According to multiple news reports of the Geneva meeting, Ecuador was poised to be the resolution’s initiating sponsor but withdrew following bare-knuckled threats by some members of the US delegation concerning that nation’s military aid and trade provided by the US. In what may only be described as pulp fiction spy lore, Russia substituted for Ecuador to become the resolution’s sponsor and did so without complaint from the HHS delegation.

The swaggering doctrine We’re America, Bitch was proudly displayed at the WHA meeting as US representatives also sought to include the term “evidence based” in references to initiatives promoting breastfeeding. In practice, this would mean that research would have to involve double-blind studies, providing a control group with breast milk and another with breast milk substitutes. This is a practice that scientists find morally and ethically prohibited. Its having been proposed by the US raises the concern that such research would be encouraged in the US.

Our readers are urged to dig more deeply by reading The New York Times account: https://www.nytimes.com/2018/07/08/health/world-health-breastfeeding-ecuador-trump.html

Your editors thought this captured perfectly the meaning of We’re America, Bitch!

With special thanks to our blog maven, Caryn Sever.

Categories: Health Care, Issues, National