Fiocruz launches Certification Program for HMB for cooperating countries

The Foundation launched the Fiocruz Certification Program for Human Milk Banks (PCFioBLH) internationally last Monday (9/2). in Brasília. This is a strategic action by the institution, together with the Ministry of Health and the Brazilian Cooperation Agency (ABC/MRE), aimed at strengthening the scientific, productive, technological, managerial and quality assurance capabilities of the Global Network of Human Milk Banks. The initiative aims not only to meet the demands of the Unified Health System (SUS), but also of the cooperating countries in terms of food and nutritional security in the care of newborns and infants. The launch also marks the implementation of the program in Cape Verde, Guatemala and Paraguay. The event will be broadcast on YouTube. 

The launch will be attended by authorities from the four countries. There will be the coordinator of the Global Network of Human Milk Banks, Fiocruz researcher João Aprigio Guerra de Almeida; the director of Fiocruz Brasília, Fabiana Damásio; and the vice president of Environment, Care and Health Promotion, Hermano Castro; as well as Brazilian authorities such as the director of ABC, ambassador Ruy Carlos Pereira; and the director of the Department of Integral Care Management, of the Secretariat of Primary Health Care, Grace Fatima Souza Rosa, among others. The National Health Director of Cape Verde,  ngela Gomes; the Deputy Minister of Hospitals of Guatemala, Sandra Carballo; and the Deputy Minister of Integral Health Care and Social Welfare of Paraguay, Santiago García Destéfano, will be attending remotely.

"The program is a genuine Fiocruz product, funded by Inova, and consolidates three and a half decades in the field of technology development and innovation, based on doctoral and master's theses and research programs developed. The network of human milk banks has grown so much that its quality had to be assured, so that it could contribute even more to the SUS and to other countries," explains João Aprígio, a Fiocruz researcher who has been involved with the subject since the 80s. 

Countries to help certify neighbors

The Program aims to provide the networks of human milk banks in the participating countries with a continuous evaluation system, ensuring the quality of products, processes and services. At the same time, the initiative provides for a dynamic information system on opportunities for improvement. Ensuring access to and the quality of human milk are the pillars of food and nutritional security, explains João Aprígio, and thus certification becomes decisive, in addition to being an innovation in the services of the health systems of the collaborating countries.

The program was launched last year, working first in Brazil, especially Brasília, the only city in the world self-sufficient in human milk, and then in El Salvador, as a prospecting and evaluation program. It is now being implemented in other countries in partnership with ABC.

Cape Verde's network of milk banks has been in operation for more than a decade and is considered a consolidated project, which is why the country was chosen as one of the three initial members for the Certification Program. The measure also launches a new system of collaboration, in a kind of triangulation. "We have always worked with a process of bilateral collaboration. The idea now is to empower Cape Verde to also act when implementing the program in neighboring countries. This generates more local expertise and reduces costs," says João Aprígio. "It is as if they were regional collaborating centers."

The same goes for Paraguay, for the countries in the south of the continent, and Guatemala, where human milk banks have been operating for over 16 years with the support of Brazilian cooperation, for Central America. "Instead of professionals coming to Brazil, they would receive training in their own regions. This expands the response capacity, without losing sight of the networking," adds the Global Network coordinator. 

The implementation of the program in Cape Verde, Guatemala and Paraguay reaffirms the commitment of Brazilian international technical cooperation in the search for alternatives to reduce the deaths of newborns and infants, as well as to prevent the occurrence of chronic non-communicable diseases, in line with the Sustainable Development Goals (SDGs).

After the launch ceremony, there will be sessions on the countries' expectations in relation to quality certification; intersectorality and the integrated actions of state powers; and the contributions of organized civil society, with the participation of the Rotary Club, Lions Club, the NGO Prematuridade, Fibra, Sesi and Senai. In the following days, the foreign delegations will receive training in network management in Brasília, with activities at the Human Milk Banks of the Federal District Network.

First steps over 80 years ago 

Both the Brazilian Network and the Global Network of Human Milk Banks have their origins in a successful initiative launched by the Fernandes Figueira National Institute of Women's, Children's and Adolescents' Health (IFF/Fiocruz) more than 80 years ago, when the unit did not even have that name. The first HMB in Brazil was set up in October 1943, at the then National Institute of Childcare, now the IFF. Its main goal was to collect and supply human milk for special cases, such as premature babies, those with nutritional problems or allergies.

In the 1980s, João Aprígio began working on its expansion. In 1985, Human Milk Banks became a public health issue in Brazil, and a network began to be established. The work paid off, and in 2001 the World Health Organization (WHO) considered the Brazilian Network of Human Milk Banks (rBLH-BR) to be the action that most contributed to reducing infant mortality in the 1990s. In 1998, all banks in the country were integrated into a national network. 

Then came partnerships with other countries, and Brazil became one of the leaders of the international movements in favor of breastfeeding and human milk donation, in a joint effort between Fiocruz and ABC. Initially, the Latin American Network was formed, followed by the Community of Portuguese Language Countries (CPLP) and the Global Network.

João Aprígio visited all countries where the network was implemented, helping to develop it. In recognition of his work, he received the Sasakawa Health Prize in 2001 and the Dr. Lee Jong-wook Memorial Prize for Public Health in 2020. Today, the Global Network of Human Milk Banks comprises 31 countries in Latin America, the Caribbean, Europe and Africa.