Baby Milk Action - CEM February 2004

Baby food industry offensive against South African law

Background:

Health campaigners in South Africa are asking for help. Can you send a message to help protect infants in South Africa?

The South African Government is attempting to introduce regulations on the marketing of breastmilk substitutes in line with international standards adopted by the World Health Assembly. It is doing no more than required of it under Article 11.1 of the International Code of Marketing of Breastmilk Substitutes and Article 24 of the Convention on the Rights of the Child.

So why are the regulations being labeled in the media as 'radical' and the Government accused of being the 'nanny state'? Don't the infants of South Africa deserve the same protection against aggressive promotion of bottle-feeding as those in other countries that have already implemented the World Health Assembly requirements?

The reason for the attack on the provisions in the proposed "Regulations Relating to Foodstuffs for Infants and Young Children" is they will help to ensure mothers receive information independent of pressure from baby food companies - and so affect attempts to grow the artificial infant feeding market and company sales . In country after country, the industry has battled to stop the World Health Assembly's marketing requirements from being implemented in national measures. See the report: Checks and Balances in the Global Economy: Using International Tools to Stop Corporate Malpractice ' Does it Work? for Case Studies from 7 countries for further details (available in the 'Latest News' section of http://archive.babymilkaction.org/). Where regulations have been introduced and are being enforced, breastfeeding rates are increasing, which feeds through to reduced infant mortality and morbidity. Where the industry has successfully blocked regulations, aggressive marketing remains widespread and has to be targeted with other campaigns, such as pressure from the Nestlé boycott.

The industry has been preparing to oppose the South African regulations for some time.

Nestlé formed a so-called Nutrition Institute in South Africa in 2001 with the expressed purpose of promoting infant formula for HIV infected mothers in violation of World Health Assembly Resolutions which say that HIV-infected mothers should receive independent information so they can balance the risks between HIV transmission through breastfeeding and the transmission of life-threatening infections through artificial feeding (see the Campaign for Ethical Marketing action sheet September/October 2001). Unlike the industry implies, not all infants breastfed by HIV-infected mothers become infected ' indeed research from South Africa has shown that if infants are exclusively breastfed ' with no formula, water or other foods introduced ' it has no more risk of infection than an exclusively formula-fed baby (Refs: Coutsoudis, A., et al (1999). 'Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa: a prospective cohort study.' The Lancet 354 (471-476). (Available on http://www.thelancet.com/ - register and search for Coutsoudis to find the paper and Coutsoudis, A., et al (2001). 'Method of feeding and transmission of HIV-1 from mos to children by 15 months of age: prospective cohort study from Durban, South Africa.' AIDS 15 (379-387).)

Breastfed babies in poor conditions, whether their mothers are infected with HIV or not, have much lower risk of dying as a result of diarrhoea or respiratory infections. Where water is unsafe an aritificially-fed child is upto 25 times more likely to die as a result of diarrhoea than a breastfed child.

The proposed South African regulations will ban the sort of aggressive promotion seen across southern Africa, such as Nestlé promotional leaflets claiming 'Growing is thirsty work', which imply mothers have to give bottles of its formula because of the heat! (see an example from Botswana on the June 2003 action sheet). Under the regulations infant formula and follow-on formula will have to display the message: "Breastfeeding provides the best food for your baby and reduces the risk of diarrhoea and illnesses" and "Before you decide to use this product, consult your doctor or health worker for advice".

In November 2003, the baby food companies in South Africa formed the Infant Feeding Association. According to the Star newspaper the Infant Feeding Association (IFA), claims the regulations: " would infringe on the manufacturers' right to freedom of speech and mothers' rights to information."

The irony is that there is nothing in the proposed Regulations that are not already contained in the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly. Companies are required under Article 11.3 of the Code to abide by the Code's provisions 'independently of government measures' and claim to do so ' despite the evidence to the contrary.

The baby food companies are powerful and have influence, but you can help to stop them by sending a message of support to the authorities in South Africa. There is a deadline of 26 February, but still send a message if it will arrive after this date.

A suggested letter is given below. You can send an email of support to the authorities via Baby Milk Action, by emailing it to campaigners in South Africa at tna1@telkomsa.net giving your address and name so they can put this into a letter on your behalf. Please copy this to mikebrady@babymilkaction.org

Only conventional letters are being accepted by the authorities, but you should also send your email toand the South African health authorities at nhis@health.gov.za

If you can send a conventional letter, please fax this to +27 12 326 4395 and/or mail it to (with a copy to Baby Milk Action, 23 St. Andrew's Street, Cambridge, CB2 3AX, UK):

For the attention of the Director: Nutrition,
Director-General of Health,
Private Bag X828,
Pretoria,
0001,
South Africa.

You can also send a letter to the South African embassy in your country, also marked 'For the attention of the Director: Nutrition, Director-General of Health.'

Suggested letter:

Dear Director,

I would like to commend you for taking steps to implement the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly in South Africa.

The proposed "Regulations Relating to Foodstuffs for Infants and Young Children" will help to protect infants and young children, and their parents in South Africa.

Your action is a welcome sign that the Government takes its responsibilities under Article 11.1 of the International Code seriously. As you are no doubt aware, implementing the Code and Resolutions is also seen as an action helping a Government to fulfill its obligations under Article 24 of the Convention on the Rights of the Child.

I am aware that the regulations do not ban the marketing of breastmilk substitutes, they only ban their promotion to ensure parents receive independent information. This is in line with the provisions of the Code and Resolutions and national measures already introduced in many countries.

Media reports of an attack on the proposed Regulations by the Infant Feeding Association are extremely disturbing. Companies are being asked to do nothing that is not already required of them under the Code and Resolutions. Indeed, Article 11.3 of the Code requires them to abide by the Code's provisions 'independently of government action.' Such contempt for international standards and avoidance of their responsibilities, does the baby food companies no credit. It is clear they put their own profits before the health of infants.

I wish you well in your efforts to protect your population and hope to read in the near future that the regulations have been approved.

Nutricia promotion in China planned for March

Baby Milk Action's suggested letter to the man ultimately responsible for the malpractice Jan Bennink, CEO, NUMICO (Nutricia, Milupa, Cow&Gate), PO Box 1, 2700 MA Zoetermeer, The Netherlands. Fax: +31 79 353 9620 (You could cut and paste the text below into your letter or into the Numico on-line comment form - click here):

Dear Jan Bennink,

I am contacting you as reports suggest that Nutricia, part of the NUMICO company, will shortly be breaking Chinese Law and World Health Assembly marketing requirements by launching a new promotion for its baby milks in China.

Article 5.4 of the International Code of Marketing of Breastmilk Substitutes specifically prohibits companies from distributing gifts "which may promote the use of breastmilk substitutes" and the Chinese law forbids propaganda promoting breastmilk substitutes.

It is, therefore, a great concern that Marc de Rouw, director of Nutricia China has told RTL4 TV (20 February 2004) that the company will be offering free CDs to mothers who buy Nutricia baby food during March and April and that the CD carries a pack shot of Nutricia formula and promotes the brand name "Kissing my Baby" which is used on the range of milks, including infant formula for use from birth.

Such aggressive promotion will undermine breastfeeding and impact on infant and young child health.

I ask you to stop this promotion immediately.

This case demonstrates institutionalised disrespect for the World Health Assembly marketing requirements and I ask you to comment on the steps NUMICO will take to ensure that its systems are changed to stop all existing and future violations.

Baby Milk Action adds:

In addition to writing to Numico, you can write to the European Commission. As well as violating the International Code and Chinese law, Nutricia is violating a European Union Council Resolution requiring companies to abide by the Code wherever they operate. Previous complaints using the Council Resolution have been ignored by the European Comission responsible for overseeing it, which has not reviewed its operation despite a call from the European Parliament for it to do so (see press release 23 November 2000). All the same, we should attempt to use the Council Resolution to persuade the Commission to meet its obligations.

The Council Resolution on the marketing of breast-milk substitutes in third countries by Community-based manufacturers (92/C 172/01) states in part (click here to download the full text as a pdf):

Whereas in May 1981 the 34th World Health Assembly adopted as a recommendation the International Code of Marketing of Breast-milk Substitutes; Whereas a considerable volume of these products is sold to third countries by Community-based manufacturers;

Whereas it is considered very important that marketing practices in third countries should not discourage mothers from breastfeeding;Whereas the application of the International Code provides without doubt an excellent way to achieve this in these countries;

Whereas the Community cannot legislate for these countries; whereas it is nevertheless necessary to encourage compliance with the International Code of Marketing of Breast-milk Substitutes when these products are placed on sale in export markets, in so far as this does not conflict with the provisions in force in the countries concerned;

Whereas the Community can offer an effective support to the competent authorities of these countries in their efforts to apply the International Code in their territory,

HAS ADOPTED THE FOLLOWING RESOLUTION:

1. The Community will contribute to the application of appropriate marketing practices for breast-milk substitutes in third countries.

Suggested letter to the European Commission (You could cut and paste the text below into the European Union on-line comment form, marking it to the attention of the Commission President - click here):

Dear President,

I am contacting you as reports suggest that Nutricia, part of the NUMICO company, based in European Union Member State of the Netherlands will shortly be breaking Chinese Law and World Health Assembly marketing requirements by launching a new promotion for its baby milks in China. The infant milk brand "Kissing my Baby" is to be promoted by free gifts of CDs according to media reports.

Through Council Resolution 92/C 172/01, the European Union requires European companies to abide by the World Health Assembly's International Code of Marketing of Breastmilk Substitutes in countries outside the European Union.

Clearly this Resolution is not being respected.Numico's marketing practices in China should not discourage mothers from breastfeeding. I would be grateful if you could give effective support to the competent authorities of China who are applying the International Code in their territory through their law, by taking action to stop Numico's planned promotion campaign.