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	Breastfeeding Moms boot Nestlé from Maternity Wards by Elizabeth Ben-Ishai Yes Magazine, Public Citizen   October 2012   If breastfeeding is healthier for babies, why are hospitals pushing corporate infant formula, writes Elizabeth Ben-Ishai.   From TIME magazine’s provocative photo of a mother breastfeeding her toddler to the recent controversy surrounding an American University professor who breastfed her baby while teaching a class, how we feed babies often attracts its fair share of media attention.   But while news coverage often focuses on what are perceived as personal choices related to infant feeding, an important piece of the puzzle is often missing from their analysis: the intrusion of massive corporations into the relationships between patients and health-care providers, and the subordination of public-health considerations to profit margins.   Fortunately, advocates and activists are joining forces and putting a spotlight on this missing piece of the puzzle. And momentum is building as hospitals across the country—including all of those in Massachusetts and Rhode Island—are telling the infant-formula industry to take their marketing pitches elsewhere.   Consider this: Across the country, up to 72 percent of health-care facilities with maternity units distribute so-called infant formula to new mothers in industry-supplied “discharge bags,” complete with formula samples, coupons for formula, and marketing materials.   With the many benefits of breastfeeding touted by the Surgeon General and other public-health officials, why would hospitals send a new mom home with a bag full of formula? Because the infant-formula industry, which is worth $3.5 billion in the United States alone, knows there couldn’t be a better marketing tool than hospital freebies that are seemingly endorsed by health-care providers.   Studies show that women who receive infant formula samples in maternity wards are more likely to stop breastfeeding sooner and less likely to breastfeed exclusively. Though all major health care organizations recommend that infants be breastfed exclusively through six months, only 16.3 percent of moms nationwide achieve this goal. Experts agree that one of the obstacles to exclusive breastfeeding is ubiquitous infant formula marketing.   Certainly, families should make their own decisions about how to feed their babies, taking into account a variety of life circumstances and personal preferences that might make them elect to use infant formula instead of breastfeeding. But as far as practicing evidence-based medicine goes, it makes sense for health care providers to recommend the option that is best for their patients’ health. That recommendation is seriously undermined by infant-formula marketing in health care facilities, highlighting the conflict between the ideal goals of hospitals (health) and goals of formula manufacturers (profit). As one humorous comic put it, discharge bags seem to send the message, “Breast is best, but you probably can’t do it.”   This issue strikes a chord that goes beyond this particular product. We look to our health care providers for scientifically based medical advice, not for a sales pitch. So many aspects of our lives are commercialized, from schools plastered with advertisements, to bridges, highways, and roads named for the corporations that make the highest offer. Still, at the very least, shouldn’t our relationships with our health care providers be spared from the encroachment of values that turn every human interaction into one of buying and selling? Shouldn’t we be able to trust that our doctors, nurses or midwives are offering us advice that is best for us, not best for the bottom lines of deep-pocketed corporations?   Fortunately, we are starting to see change on this issue, thanks to many years of work by committed public-health advocates and activists. Recently, Public Citizen, the organization I work for, launched a campaign calling on health-care facilities to stop allowing the distribution of infant-formula samples to new moms. More than 15,000 people have signed Public Citizen’s petition calling on the three major manufacturers of infant formula—Abbott, Mead Johnson, and Nestlé—to stop using health-care facilities to market their products. Some states are leading the charge to get infant formula marketing out of hospitals.   Last fall, Rhode Island became the first state in which all maternity hospitals voluntarily eliminated industry-sponsored discharge bags. This summer, Massachusetts followed suit, with all 49 of its hospitals ending formula marketing on their premises. Massachusetts advocates overcame significant obstacles: In 2005, then-governor Mitt Romney forced the state’s department of health to overturn regulations that would have banned formula discharge bags from hospitals. Most recently, 28 of New York City’s hospitals voluntarily agreed to stop distributing infant-formula marketing materials to new moms.   The movement to ensure that health care facilities promote health, not corporate profits, is gaining speed. It’s time for hospitals across the country to say “no more” to corporate interests encroaching on patients’ access to quality health care.   * Elizabeth Ben-Ishai is a Senior Researcher and Campaign Coordinator at Public Citizen. http://www.yesmagazine.org/happiness/breastfeeding-moms-boot-nestle-from-maternity-wards Visit the related web page
	The backdoor rewriting of the social contract in European Countries by Ha-Joon Chang Cambridge University   Throughout the 1980s and 90s, when many developing countries were in crisis and borrowing money from the International Monetary Fund, waves of protests in those countries became known as the "IMF riots". They were so called because they were sparked by the fund"s structural adjustment programmes, which imposed austerity, privatisation and deregulation.   The IMF complained that calling these riots thus was unfair, as it had not caused the crises and was only prescribing a medicine, but this was largely self-serving. Many of the crises had actually been caused by the asset bubbles built up following IMF-recommended financial deregulation. Moreover, those rioters were not just expressing general discontent but reacting against the austerity measures that directly threatened their livelihoods, such as cuts in subsidies to basic commodities such as food and water, and cuts in already meagre welfare payments.   The IMF programme, in other words, met such resistance because its designers had forgotten that behind the numbers they were crunching were real people. These criticisms, as well as the ineffectiveness of its economic programme, became so damaging that the IMF has made a lot of changes in the past decade or so. It has become more cautious in pushing for financial deregulation and austerity programmes, renamed its structural adjustment programmes as poverty reduction programmes, and has even (marginally) increased the voting shares of the developing countries in its decision-making.   Given these recent changes in the IMF, it is ironic to see the European governments inflicting an old-IMF-style programme on their own populations. It is one thing to tell the citizens of some faraway country to go to hell but it is another to do the same to your own citizens, who are supposedly your ultimate sovereigns. Indeed, the European governments are out-IMF-ing the IMF in its austerity drive so much that now the fund itself frequently issues the warning that Europe is going too far, too fast.   The threat to livelihoods has reached such a dimension that renewed bouts of rioting are now rocking Greece, Spain and even the usually quieter Portugal. In the case of Spain, its national integrity is threatened by the separatist demand made by the Catalan nationalists, who think the austerity policy is unfairly reducing the region"s autonomy.   Even if these and other European countries (for other countries have not been free of protests against austerity programmes, such as Britain"s university fees riot and the protests by Italy"s "recession widows") survive this social unrest through a mixture of heavy-handed policing and political delaying tactics, recent events raise a very serious question about the nature of European politics.   What has been happening in Europe – and indeed the US in a more muted and dispersed form – is nothing short of a complete rewriting of the implicit social contracts that have existed since the end of the second world war. In these contracts, renewed legitimacy was bestowed on the capitalist system, once totally discredited following the great depression. In return it provided a welfare state that guarantees minimum provision for all those burdens that most citizens have to contend with throughout their lives – childcare, education, health, unemployment, disability and old age.   Of course there is nothing sacrosanct about any of the details of these social contracts. Indeed, the contracts have been modified on the margins all the time. However, the rewriting in many European countries is an unprecedented one. It is not simply that the scope and the speed of the cuts are unusually large. It is more that the rewriting is being done through the back door.   Instead of it being explicitly cast as a rewriting of the social contract, changing people"s entitlements and changing the way the society establishes its legitimacy, the dismembering of the welfare state is presented as a technocratic exercise of "balancing the books". Democracy is neutered in the process and the protests against the cuts are dismissed. The description of the externally imposed Greek and Italian governments as "technocratic" is the ultimate proof of the attempt to make the radical rewriting of the social contract more acceptable by pretending that it isn"t really a political change.   The danger is not only that these austerity measures are killing the European economies but also that they threaten the very legitimacy of European democracies – not just directly by threatening the livelihoods of so many people and pushing the economy into a downward spiral, but also indirectly by undermining the legitimacy of the political system through this backdoor rewriting of the social contract. Especially if they are going to have to go through long tunnels of economic difficulties in coming years, and in the context of global shifts in economic power balance and of severe environmental challenges, European countries can ill afford to have the legitimacy of their political systems damaged in this way.   * Ha-Joon Chang teaches economics at Cambridge University.
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