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.