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Canada helps stall formula safety guidelines
The Codex Alimentarius Commission — the UN body
responsible for setting standards for food products — met in Houston,
Texas, on December 4 to 8, 2006. Betty Sterken of INFACT Canada
attended the meeting to help develop recommendations to reduce the
risks associated with the intrinsic contamination of powdered infant
formula by pathogenic organisms E. sakazakii and Salmonella.
The intrinsic contamination by the highly
pathogenic and heat resistant bacteria, Enterobacter sakazakii has
been found in as many as 14 per cent of powdered infant formula tins
tested.
E. sakazakii is a highly virulent bacteria which
is resistant to the high-temperature processing methods used in food
production. If infants, especially those who are newborn, low-birthweight
or premature, are infected with E. sakazakii, it can cause meningitis,
necrotizing entercolitis, and sepsis, and is potentially fatal. As a
result of reports of baby deaths from E. sakazakii contamination in
recent years the Food and Agriculture Organization (FAO) and the World
Health Organization (WHO) have declared this a significant public
health hazard and have convened two expert meetings on the issue: one
in 2004 and more recently in January of 2006. After reviewing the
scientific evidence the 2006 meeting produced a report noting that
both manufacturers and governments must act to reduce the health risks
associated with the intrinsic contamination by E. sakazakii. Studies
reviewed by the meeting noted that up to 14 per cent of formula
packages may be contaminated by the bacteria.
A number of outbreaks of E. sakazakii have been
reported in industrialized nations; however, the full extent of the
problem is unknown because in the poorer nations of the world the
capacity to track illness and death related to E. sakazakii is
lacking. The bulk of the world’s powdered infant formula is consumed
in these nations, and mortality outcomes for formula-fed infants in
these regions is outrageously high. There is no data for the number of
these deaths caused by E. sakazakii but its significance to infant
mortality figures cannot yet be ruled out.
After the joint FAO and WHO meeting, the World
Health Assembly in 2005 requested that the Codex Alimentarius
Commission work urgently to develop standards to reduce the risks
associated with E. sakazakii. This included the need to inform parents
and care givers that the products are not sterile through the use of
warning labels on formula packages. The Houston Codex meeting in
December was to tackle these tasks.
Canada had chaired a drafting working group to
develop the hygienic standard for powdered formulas in Ottawa in May
2006. At that meeting, agreement was reached on a number of key infant
health protection measures which were to be included at the Houston
meeting. These were:
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Incorporating the International Code of
Marketing of Breastmilk Substitutes and relevant resolutions of the
World Health Assembly as a risk reduction measure to minimize the
unnecessary use of infant formula and protect breastfeeding,
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Requiring infant formula labels to carry
warnings that powdered infant formula is not a sterile product and
may contain pathogens capable of causing serious illness.
The May 2006 meeting had also agreed that the
recommendations would apply to all infant formula marketed for infants
and young children: infant formula, formula for specific medical
purposes, and follow-on formula for older children.
Despite the fact that there had been little or no
opposition to these decisions in May, the representative from Canada,
whose job it was to develop the draft for discussion in Houston,
omitted these key infant protection measures from the draft text.
Instead Canada presented a position that limited
the scope of the standard to formula for infants at "greatest risk,"
meaning babies who are premature, low-birth weight and under the age
of two months. This is despite the fact that E. sakazakii has caused
illness in infants as old as 12 months. The draft also left out the
inclusion of the International Code and sufficient warning labels.
Ultimately, Canada was unable to gain support for
limiting the scope of the draft, but essential time was wasted in
debate on an issue that had already been decided months before. There
was no time left to advance the draft on key health protection
inclusions, the International Code and warning labels. Canada had the
opportunity to contribute positively to the protection of infant
health, but utterly failed to do so. Could the chummy relationship of
Canada’s Head of Delegation with the representative of the
International Special Dietary Foods Industries be the reason? INFACT
Canada will be advocating to have infant health protection measures
reintroduced into the draft when the Codex Working Group meets again
in May or June of 2007.
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