Prevent conflicts of interest in reducing malnutrition


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 child’s life in the HPK program.


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 child’s 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 government’s responsibility to ensure business partnerships in the HPK program are effective in reducing malnutrition problems in Indonesia.



Irma Hidayana is a breastfeeding advocate and a USAID-PRESTASI scholar at Montclair State University, New Jersey. This article is originally published by The Jakarta Post.