Who decides about our health?
Baby foods, nutritional supplements and the "Codex Alimentarius"
Codex Alimentarius is the name of a global food-standard setting body that is attached to the Food and Agriculture Organisation of the United Nations' WHO. The deliberations in Berlin this past week of a committee charged with developing guidelines for vitamin and mineral supplements have shown progress towards a risk based approach for regulating vitamins and minerals. This is a positive development in view of the substantial agreement that had persisted in the past, for an RDA-based approach which would be disastrous for both consumers and industry, but especially for public health world wide.
Two days before the beginning of the week-long discussions which took place in Berlin from 4 to 8 November 2002, the Dr. Rath Foundation had organised a large conference attended by over 2500 people, where the results of scientific studies were made available. The studies and the personal successes of people taking vitamin supplements on the advice of Dr. Rath prove the overwhelming importance of changing from a pharmaceutical and symptom-based approach to illness to a nutrition based, cellular-level approach. Perhaps more importantly, Rath's conference brought together a group of representatives of organisations from several countries, all concerned with preserving freedom of choice for natural methods of prevention and cure.
Two days later, on the morning that saw the beginning of the official Codex conclave, many of the participants in the Rath event were demonstrating outside the gates of the building hosting the meeting, loudly demanding that their health choices be respected.
Meanwhile, delegates from about 50 of the Codex member countries started to deliberate standards for baby foods. Agreement on this issue was as elusive as it has been for years, maybe more so now than ever. The greater issue of globalization can be observed, neatly compressed into the Codex "microcosm" for everyone to see. Multinational pharmaceutical and food industries, with the backing of a number of industrialized countries, try to pave the way for the global free sale of their products. This is greatly resisted by most of the developing countries and by consumer advocates who believe that babies are best fed on mother's milk. Developing nations believe that they should not be forced by an international standard-setting body to accept baby foods which are too expensive for most of their starving population and which, from a nutritional point of view, are admittedly inferior to "the real stuff".
These nations are worried that their traditional, natural foods and especially the practice of mothers breast feeding their children will be swept aside by the promotional abilities of the multinationals. An understandable worry, in the light of the "civilizing" progress that colonization has forced on the third world for the better part of the past couple of centuries. Their economies are in shambles despite, and some say because of, "structural adjustment" measures forced on them by the IMF and the World Bank. Their agriculture unable to develop because local production cannot compete against agricultural subsidies given to their own farmers by economic empires such as the US and Europe. It seems that after a long sleep, the developing countries are waking up and are resisting. They perceive the imposition of standards made for global industries as an effort to re-establish colonial domination on the part of the industrialized nations.
Vitamin and mineral supplements
Days of deliberations brought little visible progress. Towards the end of the three-day conclave the subject of food supplements was once again on the agenda. Although the issue of supplements is in many ways quite different from that of baby foods, the same worries prevail with developing nations. They see vitamin and mineral supplements as another "blessing" to be bestowed on them by the same hated multinationals, the giant global pharmaceutical and food industries. We must view the Codex discussions on food supplements against this backdrop.
The proposal for a guideline on vitamin and mineral supplements, first made in 1994 by the German Codex delegation, seeks to extend the philosophy of control so prevalent in that nation and in much of the rest of continental Europe, to the whole world. The draft proposes to set strict limits on the composition and potency of these extra nutritional foods, relegating everything exceeding "nutritionally necessary" dosages to the world of medicine, a world which today is clearly dominated by pharmaceutical interests.
To be fair, some progress has been made over the years, at least on the issue of dosages, towards a consensus that would safeguard the rights of consumers to take care of their health in a manner consistent with their own choosing. More often than not, consumers see their nutritional needs in a way that differs remarkably from "official recommendations", and so do some medical doctors, witness the research of Dr. Rath, Linus Pauling and many others.
Scientific approach to limits
Early in the discussions of this particular Codex session, the importance of a scientific approach to regulation was stressed by FAO, the Food and Agricultural Organisation, and the WHO. The majority of delegates agreed that such an approach would be possible and indeed desirable. Risk analysis and risk management, an emerging branch of science, is part and parcel of such a scientific approach. Yet, on food supplements, the German chairman Rolf Grossklaus proposed to "protect consumers" for the next four or five years by establishing both lower and upper limits to product dosages, while waiting for the squadrons of risk managers to get up to speed.
Two options were to be discussed, RDA-based limits and risk based scientific evaluation. Needless to say, no agreement could be reached which path to follow. While most of the industrialized nations including Europe and the US asked for a risk based scientific approach, the feeling among some of the African, Asian and South American developing nations was that this would open their markets to a host of products they could not control, a division of opinion reminiscent of the discussions on baby foods.
When discussing the preamble of the draft guideline, remarkably, the South African delegate strongly stood up for the free availability of supplements, to the extent of lambasting the participants for what she called a hypocritical approach to health and even a "return to the dark ages". In the face of scientific data indicating that supplementation is potentially life saving, Ms. Booyzen said, Codex should not be thinking of putting limits on safe products such as vitamin and mineral supplements. She suggested, quoting scientific studies, that supplements might be useful to prevent many of the diseases of civilization, the so called degenerative diseases which are due to sub-optimum supplies of certain nutrients in the body.
This was a refreshing new development, warmly welcomed by non-governmental delegations and observers concerned with consumer choice. In the more than lively discussion that followed, several delegations echoed the European Union representative who stated in full earnest that anything with preventive, let alone curative, properties must be considered a medicine and is therefore outside the Codex mandate and is not part of the things to be legitimately discussed by the Committee.
An obvious contradiction
The discussion brought a glaring, basic contradiction inherent in our health policy into plain view: We are told to eat fruit and vegetables, possibly five helpings a day, to stay healthy and to prevent heart disease and even cancer, yet we may not take the nutrients we seek in the form of supplements for the same purpose! It is another way of saying that "there is a pharmaceutical monopoly on medicine and health, that must not be touched". Food has nothing to do with health, according to this particular twisted view, and before you may even obtain high power nutritional support, you must first get sick!
Respecting the existence and the overriding character of that pharmaceutical monopoly, the Codex Committee on Nutrition and special dietary foods could not agree on the purpose of supplementation. Nutrients, after all, have nothing to do with prevention, which remains exclusive territory of pharmaceutical medicine. The preamble of the proposed guidelines therefore remained open to discussion. Chairman Grossklaus then proposed to concentrate on the issue of possible dosage limits so as to afford some temporary "protection" to consumers, but found that a divided assembly could not make up its mind.
What's the score
The "scorecard" of the discussions on dosage limits confirms our suspicions of a "larger game" going on in the background, unseen and unacknowledged by many of the participants. Far from living up to its fragile consensus on the necessity of introducing scientific risk management into decision making on public health, the committee's members again divided into two opposing camps.
The European Union and its member states voiced support for the "second option", that of letting science decide where the dividing line should be drawn between what is allowed and what is not. They were supported by Australia, New Zealand, the US, South Africa, Japan, Switzerland, Canada, the UK and, remarkably, Russia, Korea and Peru. Norway was adamant, on the other hand, that its citizens should not have access to any supplement of vitamins and minerals that contains more than the RDA, the recommended dosage which is associated with an absence of the classical deficiency diseases such as scurvy, also called the "sailors' disease". No matter that scurvy was eradicated when the British Royal Navy started following the advice of James Lind, who said eating a few lemons could prevent and even cure the dreaded disease. The Vikings found allies for their restrictive views in Brazil, Indonesia, Thailand, Benin, Malaysia and Nigeria.
In view of such widespread discord, the Chairman of the Committee could not but concede defeat and propose that the guideline should "remain on step three" of the eight-step approval procedure. He invited governments once again to make written comments on the draft text before, one year from now, the Committee will consider the matter anew. Unfortunately, or should we say fortunately, there was no time left to continue discussions.
In conclusion, and in a more than one sense, consumers and the health food industry as well as natural medicine were "saved by the bell". What remains to be done is a lot of education on the beneficial and indeed life saving character of nutritional supplementation. While a year may seem to be a long time to some, there is great urgency to act.
Codex, globalization and the pharmaceutical monopoly on health
The issue should also be examined in a broader context. Codex Alimentarius and its proposed guidelines are but the tip of the proverbial iceberg. The discussions mirror the deadly embrace of two giants - global pharmaceutical and food industries allied with "western medicine" on the one hand and the age-old traditions of herbalism and "traditional medicine" with the more recently developed nutritional approach of "cellular medicine" on the other. Clearly, the Codex issue cannot resolve until there is a recognition of the fact that medicine must not be monopolized by any one particular system.
We need to approach health from a viewpoint of plurality, and that includes abandoning the currently widespread insistence of western governments that "foods must not be used to cure or prevent any disease". Codex cannot escape its responsibilities for our health by saying "we deal only in foods", or, put into different words, "medicine is none of our business". A balance must be struck between prevention based on nutrition and traditional means on one side and the pharmaceutical approach to health on the other.
Globalization of health care under the domination of our particular brand of pharmaceutically dominated "scientific western medicine" will inevitably lead to a broadening of the conflict we observe in these discussions. Insistence on a pharma-centered approach to health has turned out to be so wasteful that governments are now unable to bear its costs. The system is breaking down, western populations are killed by diet-related scourges such as heart disease and cancer, while the use of supplements for preventive purposes is officially frowned upon. At the same time, properly approved and prescribed pharmaceutical drugs have become the third or fourth most widespread cause of death in the "civilized" nations.
What to do?
The forces proposing a pluralistic approach to health must wake up and start working together. Time is short. One year, the time that will pass before this particular Codex Committee is to meet again, is nothing in the time scale of legislative developments. For the sake of our health we should advocate our right to choose - loudly if needed - to eat real food, preferably organic, to use nutrients for prevention and to return to scientific medicinal traditions that have stood the test of millennia and have served us well. We must combine these age-old scientific traditions with new research and knowledge of biochemistry, but we should also be wary of "scientific adventures" such as genetic modification of our foods, the invention of ever new "xeno-biotic" drugs, the poisoning of our environment in the name of "pest control" and "weed killing".
Let's get to work to build a great alliance. Codex is the spark, but the real prize is our health, if not the survival of our children and of future generations.
Rome, 9 November 2002
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