Prevent conflicts of interest in reducing malnutrition Irma Hidayana, MPH Published at The Jakarta Post, March 1st , 2015

Since the 1970s, the Health Ministry had a great community-based nutrition program,

named Family Nutrition Improvement Program (Usaha Perbaikan Gizi Keluarga, or

UPGK). The UPGK has been improving community access to nutrition for infants

and young children through its services and educational programs and also through

the integrated health services post (Posyandu). Three years ago, a new similar

nutrition improvement program, named the First 1,000 Days of Life Movement

(HPK), was initiated by the government as part of the global Scaling Up Nutrition

(SUN) movement in developing countries. Both the UPGK and the HPK programs

are similar except for in the promotion of business partnerships in reducing

malnutrition in the first 1,000 days of a childs life in the HPK program.

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A moral commitment to support optimal breastfeeding must be prioritized as the

foundation of any types of industries contribution.

Invitations to the private sector to participate in the HPK were believed to be part of

an effective solution to address malnutrition problems in Indonesia. Partnering with

the business sector was part of the SUN initiative that calls for multi-sector

collaboration during the first critical 1,000 days of a childs life. However, involving

the private sector in a non-profit program has been criticized because the private

sector is not a social agency and, therefore, all they are investing in is their marketing

strategy to earn profits. The issue is closely linked to trust and conflict of interest

key barriers along the critical path to optimize all programs in improving child

nutrition in this country.

Despite the controversies, the HPK task force is ready to move ahead to

partner with business in reducing malnutrition problems. According to the Global

Nutrition Report launched here on Feb. 9, there is a need to develop stronger

accountability with better data and more transparency, as well as stronger feedback

systems to improve nutrition. As the SUN committee discussed in the global

guidelines on conflict of interest in mid-February, the HPK task force itself should

prepare a set of ethical principles. To ensure trust in partnering with the business

sector and as a safeguard in delivering the HPK programs, the national guidelines

should follow six key ethical principles: integrity, justice, responsible activity,

accountability, sustainability and transparency.

First, stakeholders, including business partners, should act with integrity and

abstain from engaging in grey area practices, such as promoting breast milk

substitutes. Second, justice: remind stakeholders, especially industries, that a moral

commitment to support optimal breastfeeding must be prioritized as the foundation of

any types of industries contribution.

Third, the responsible activity principle a commitment to comply with

international legal frameworks and, where applicable, domestic laws. Thus business

partners must follow the International Code of Marketing of Breastmilk Substitutes

and, importantly, business entities and their associations that have violated the code

should not be accepted as partners in the HPK program. Business partners also

should follow the health law, Government Regulation No. 33/2012 on exclusive

breastfeeding and other relevant regulations at the provincial or regency level.

Fourth, the commitment to ensure sustainability of natural resources and the

environment in producing complementary feedings products. Since industries can

produce high-quality, low-cost commercially produced fortified complementary foods

within the HPK program, they must incorporate locally grown resources, follow

environmentally friendly production, packaging and distribution of these products.

This principle should be implemented in accordance with the food self-sufficiently

program initiated by President Joko Jokowi Widodo at the end of last year.

Last, but not least, is the principle of transparency to encourage businesses to

produce high-quality, low-cost, commercially complementary foods in a transparent

manner to build trust and prevent any conflict of interest in reducing malnutrition.

Furthermore, monitoring compliance with these ethical principles should be

the governments responsibility to ensure business partnerships in the HPK program

are effective in reducing malnutrition problems in Indonesia.

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