Countering Industry Lobbying Through Bureaucratic Independence and Coordination: Kenya’s 2021 Infant Formula Regulations

It is well documented that industry lobbying—or corporate political activity—can undermine public health policy and impair public health outcomes. But under what conditions can governments overcome powerful industry lobbying and implement strong public health policy? To contribute to answering this question, this paper conducts a case study of infant formula regulation in Kenya. This is a substantively important case, as aggressive marketing of infant formula can undermine breastfeeding and negatively affect infant health, in particular in the Global South. It is therefore important that governments adopt strong national infant formula legislation but also update and strenghten such legislation through subsequent regulations. The government of Kenya overcame strong and sustained industry lobbying when adopting its 2021 Breast Milk Substitutes (BMS) Regulations. The global formula milk industry sought to influence the formulation of these regulations through various legally required public consultation mechanisms, namely a national public consultation and regulatory impact assessment procedure and a World Trade Organization notification procedure. Kenya’s health ministry was able to largely counter these lobbying efforts thanks to a regulatory decision-making process that excluded actors with ties to the formula milk industry, and that was closely coordinated with other competent state agencies, such as the Kenya Bureau of Standards. On the one hand, our analysis suggests that existing models of public consultation may disproportionally empower large corporations and thus undermine public health regulations. On the other hand, our also analysis demonstrates that health ministries that prohibit conflicts of interest and actively coordinate with other competent state agencies can effectively counter industry lobbying and defend strong public health regulations.