Of the many upheavals caused by the Trump administration internationally, launching a diplomatic campaign against breast-feeding might seem one of the oddest (and pettiest). Yet at the recent gathering of the World Health Assembly, the World Health Organization’s governing body, the Trump administration waged a concerted effort to weaken a seemingly perfunctory resolution promoting breast-feeding. According to the New York Times, the administration went so far as to threaten the United States’ trade relations with and military assistance to Ecuador because of that nation’s leadership in supporting the resolution.
This course of action has been met with bewilderment, with many chalking it up to the Trump administration promoting particular corporate interests or to President Trump’s personal disgust with breast-feeding. But Trump is not the first Republican president to target breast milk as part of advancing a broader conservative agenda. More than 30 years ago, it was Ronald Reagan trying to undermine attempts to promote breast-feeding. His goal was the same as the Trump administration’s: to stop any international regulatory actions that might constrict corporate prerogatives, regardless of the potential effects on public health.
Breast-milk substitutes, such as infant formula, have long been profitable and controversial. Introduced in the late 19th century by companies such as Nestlé, breast-milk substitutes were marketed as emblematic of modernity — and they launched what would become a billion-dollar industry. However, starting in the 1930s, international public health officials began amplifying the voices of parents worried about safety. Their concern: that without access to clean water and proper storage, replacing breast milk with substitutes led to increased disease and death rates among infants. From the 1950s to the mid-1970s, critics of breast-milk substitutes tried to address the issue through organizations like the Pan American Health Organization, with little success.
Starting in 1974, left-leaning think tanks, journalists and consumer groups in England and the United States entered the fray, lobbing sharp criticism at multinational firms selling breast-milk substitutes. They targeted Nestlé in particular, the largest company in the industry and one of the world’s biggest multinationals. After meetings, pamphlets and lawsuits failed, a group of U.S. activists organized a consumer boycott of Nestlé, launched July 4, 1977.
The Nestlé boycott soon went global, piquing the interest of high officials at the World Health Organization. Over the next several years, consumer activists from Malaysia to the United States prodded and worked with the WHO (and UNICEF) to craft the International Code of Marketing of Breast-Milk Substitutes. The code called for restrictions on a range of corporate promotional techniques, such as incentivizing doctors to hand out free infant formula samples to new mothers.
To make the WHO-UNICEF code of conduct a reality, the World Health Assembly needed to vote on its ratification. But the Reagan administration stood in the way. Although the code was not legally binding and enjoyed widespread support even from Reagan’s conservative ally Margaret Thatcher, the United States cast the sole vote against the code.
At the time, many critics assumed that a Republican administration was siding with the parochial profit motives of one industry. Yet from the vantage point of the Reagan administration and its ideological partners at the Heritage Foundation, the challenge was bigger.
Less concerned with a single industry, conservatives instead worried about the future of the world economy. Writing in a journal for another conservative think tank, the American Enterprise Institute, Kenneth Adelman, then deputy U.S. representative to the United Nations, called the WHO-UNICEF code a “stunning defeat . . . to Western interests, health groups, and corporate enterprises.” Meanwhile, Jeane Kirkpatrick, the U.S. ambassador to the United Nations, feared the rise of an “iron triangle” of nongovernmental organizations, U.N. officials and Global South governments intent on waging international class war against private enterprise. Ultimately, what the right worried about was the rise of an international regulatory state.
The administration’s concerns about the wider world economy did not stem from mere paranoia. Consumer activists did indeed hope to create a global regulatory architecture, with the United Nations as an important part.
Across the globe, corporate accountability advocates lauded the WHO-UNICEF code as “probably the greatest consumer victory ever.” As Anwar Fazal, then president of the International Organization of Consumer Unions, proclaimed in a 1982 interview, the “infant formula campaign gave us a model for global organizing.” Fazal’s words were backed with action, as NGO coalitions quickly arose and began pressing the United Nations to pass codes of conduct for pesticides and pharmaceuticals.
Throughout the early 1980s, the campaign for global regulation intensified, and so too did the opposition from the pro-corporate right. The Heritage Foundation produced numerous reports warning that multinational companies were “under attack by the U.N.” in alliance with “anti-capitalist” consumer groups.
Heritage urged the Reagan administration to target the United Nations, including the World Health Organization. A 1986 report lauded already-enacted U.S. cuts to the United Nations, stating that reductions in U.S. funding should be used to “force WHO to spend its reduced funds on health rather than politics.” This pressure worked, and the withholding of U.S. contributions ended up slashing the WHO’s budget by a quarter during the second half of the 1980s.
WHO officials viewed the cuts as an attack on any effort to curb corporate power. The agency’s head, Halfdan Mahler, explained in 1987 that he was being pressured by governments to rein in the WHO’s challenges to multinational companies. While a pesticides code of conduct did make it through the Food and Agriculture Organization, the hope of a medicines code died — as did aspirations for making the United Nations into a worldwide corporate watchdog. In the early 1990s, the WHO moved away from challenging corporate power, and a special U.N. agency developed to study and potentially regulate multinationals was essentially disbanded.
Today, the United States is once again pushing back against measures — especially ones promoted by international organizations — that might limit multinational corporations’ ability abroad to advertise and sell profitable products. Attacking breast-feeding is part of the same push against consumer and environmental regulation that has been waged by officials like Mick Mulvaney and (until recently) Scott Pruitt at home. It also follows in the vein of the rejection of the Paris climate accord, an agreement that contains at least modest provisions to advance the interests of poorer nations. Scholars, policymakers and journalists would do well to focus less on Trump’s seeming heresies on the global stage and more on the many profound continuities between his administration and past conservative crusades.