The International Code of Marketing of Breast-milk Substitutes & Its Violators
In August of this year, we reported on an American Academy of Pediatrics endorsement of a Babys ‘R Us pamphlet in which advertisements for baby formula were featured. One of our readers sent us links to several documents discussing the International Code of Marketing of Breast-milk Substitutes.
In 1981 WHO published an International Code of Marketing of Breast-milk Substitutes. The Code was developed starting in late 1979 under joint WHO and UNICEF auspices and involved multiple stakeholders. After several revisions, the code was adopted by the Executive Committee of the WHO in January 1981 and by the World Health Assembly in May of 1981.
The Code runs some 10 pages long and is quite technical in parts. Yet in its preamble it reflects the bold, social vision that animated WHO at the time:
“Recognizing that infant malnutrition is part of the wider problems of lack of education, poverty, and social injustice;
Recognizing that the health of infants and young children cannot be isolated from the health and nutrition of women, their socioeconomic status and their roles as mothers…”
And similarly the strictures put on marketing of breast-milk substitutes are also bold:
5.1 There should be no advertising or other form of promotion to the general public of products within the scope of this Code.
5.2 Manufacturers and distributors should not provide, directly or indirectly, to pregnant women, mothers or members of their families, samples of products within the scope of this Code.
5.3 In conformity with paragraphs 1 and 2 of this Article, there should be no point-of-sale advertising, giving of samples, or any other promotion device to induce sales directly to the consumer at the retail level, such as special displays, discount coupons, premiums, special sales, loss-leaders and tie-in sales, for products within the scope of this Code. This provision should not restrict the establishment of pricing policies and practices intended to provide products at lower prices on a long-term basis.
5.4 Manufacturers and distributors should not distribute to pregnant women or mothers or infants and young children any gifts of articles or utensils which may promote the use of breast-milk substitutes or bottle-feeding.
5.5 Marketing personnel, in their business capacity, should not seek direct or indirect contact of any kind with pregnant women or with mothers of infants and young children.
A brief pamphlet from the International Baby Food Action Network discusses the main points of the code and its subsequent revisions. IBFAN produces a regular report called Breaking the Rules which documents violations of the Code. Various pages of this report are available online and contain pictures of advertisements violating the code. For the page about Abbott, click here.
Based on their studies IBFAN considers Nestle Corporation to be the biggest violator of the Code and has organized an ongoing international boycott of Nestle Products. Baby Food Action, the British affiliate of IBFAN has an excellent page on the Nestle boycott which might serve a resource for other activists interested in boycotts. Nestle had pledged in 1984 to observe the Code in exchange for a seven year suspension of the boycott; this agreement broke down in 1988. The IBFAN website has a history of the boycott. Nestle has published its own version of the story.
In 2007 the Guardian published an expose written by Joanna Moorhead entitled “Milking It” about how Nestle violates the Code in Bangladesh. To quote from the article:
“Here’s how: on [Hospital Pediatrician Dr Khaliq] Zaman’s desk, lots of small pads lie scattered: each contains sheets with information about formula milk, plus pictures of the relevant tin. The idea, he says, is that when a mother comes to him to ask for help with feeding, he will tear a page out of the pad and give it to her. The mother - who may be illiterate - will then take the piece of paper (which seems to all intents and purposes a flyer for the product concerned) to her local shop or pharmacy, and ask for that particular product either by pointing the picture out to the pharmacist or shopkeeper, or by simply searching the shelves for a tin identical to the one in the picture on their piece of paper. “I’d never give these pieces of paper out - when I’ve got a big enough bundle, I take them home and burn them,” says Zaman. But that does not mean every other health worker would do the same.
At least three types of Nestlé formula are among the brands whose tear-off pads are on Zaman’s desk.”
The WTO & the Code
According to the SpeakEasy.org website, a 1983 Guatemalan law implementing the Code was cited by the US as a violation of Gerber’s patent law. The complaint was filed in 1993 and after several years of discussion “in 1995, under threat of a WTO challenge by the U.S. State Department, Guatemala changed its law to allow labelling of imported baby food products that violates WHO/UNICEF guidelines.”
Posted by Matt Anderson
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