Baby Milk Action CEM - Company Responses

Responses to the violations on the Campaign for Ethical Marketing action sheet November 2006

This page was last updated on 27 March 2007.

Please keep writing to the companies concerned (background information, contact details and suggested letters are given on the action sheet). Please forward any responses you receive to us, even if they are the same as the ones given here.

Response to our action: "Tell baby food companies not to oppose the Philippines government's moves to protect infants".

Abbott
Nestlé
Novartis (Gerber)
Wyeth (SMA)

Background:

Baby food companies in the Philippines are opposing the Revised Implementing Rules and Regulations introduced by the Department of Health to give force to the World Health Assembly International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions.

Our suggested letter to companies was as follows:

As you know manufacturers of baby foods your should abide by the provisions of the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly.

I am very concerned to learn that the US Chamber of Commerce and certain pharmaceutical companies have embarked on a campaign to try to strike down the Implementing Rules and Regulations (IRR) for the marketing of baby foods introduced by the Philippines Department of Health in July 2006.

I ask that your company publicly distance itself from these attacks and instead gives an undertaking to fully support and abide by the IRR and to call on the rest of the industry to do the same.

I also ask that you act immediately to review your baby food marketing practices and end any and all violations of the IRR and the International Code and Resolutions immediately.

Please confirm that you will take this action.

Abbott's response

Abbott is a leading member of the Pharmaceutical and Healthcare Association of the Philippines (PHAP). Abbott's response to supporters of the campaign is given below in its entirety.

Abbott claims to support the International Code of Marketing of Breastmilk Substitutes. It does not respond to the questions about why it is violating it and why it is challenging the government's regulations.

Dear ****,

Thank you for your recent correspondence concerning the marketing of baby food in the Philippines. Abbott is committed to the nutritional health and well-being of babies, and we advocate breastfeeding as the first choice for infants - because we agree that breastfeeding is the best form of infant nutrition.

We also are dedicated to the highest standards of manufacturing and marketing - and to complying with all applicable laws and regulations in the countries where we do business. This includes following the World Health Organization International Code of Marketing of Breastmilk Substitutes as it is legislated and implemented locally.

Abbott's high-quality infant formulas help to ensure optimal infant nutrition when breast milk is not available, not chosen, is discontinued, or is supplemented. We remain committed to working with interested parties to educate parents and health care professionals about all available feeding options.

Thanks again for your interest in Abbott.

Best regards,
Consumer Relations.

Nestlé's response

Nestlé Philippines contacted Baby Milk Action directly, objecting to its inclusion in the campaign. We had stressed in our article that Nestlé was not party to the legal action, but still wished it to condemn the attack on the IRR and stop its aggressive marketing. Nestlé claimed it supports and abides by the regulations and our allegations are out of date. We responded in detail standing by the evidence of malpractice. It is interesting to see how Nestlé misrepresents Baby Milk Action's position in this letter - which was copied to others - as well as its own.

The reply Baby Milk Action received from Nestlé (dated 14 November 2006) is given below in its entirety. Click here to download a scan of the letter. Comments from Baby Milk Action appear [****like this****].

Baby Milk Action's internet postings: "Help the Philippines stand up to company bullying" and "Tell baby food companies not to oppose the Philippines government's moves to proect infants"

Dear Mr Brady,

We are writing to you to express our disappointment at reading the communication you have recentlyh posted under the above-mentioned captions on your website "Campaign for Ethical Marketing-November 2006".

As you well know, Nestlé has supported, and in writing, the Philippines Health Ministry's revision of the rules on marketing of infant formula and follow-on formulas. Thus, your using allegations about Nestlé which are almost 10 years old, in an attempt to link Nestlé to "companies bullying" the government about the rules, brings discredit to your efforts [***Baby Milk Action comment: The evidence presented included current examples of Nestlé malpractice (click here) and Nestlé had opposed some aspects of the RIRR***].

We are indeed surprised that you keep putting forward allegations that are completely outdated: the allegation about Nestlé threatening a TV station in the Philippines for having aired criticisms was brought up in 1997 (almost 10 years ago!) [***Baby Milk Action comment: This was cited as an example of the type of pressure the media is under to keep quiet***], the one about Nestlé employing nurses to promote artificial feeding directly to mothers at home was brought up in 1998 [***Baby Milk Action comment: The fact that Nestlé continues to target mothers in the community demonstrates its failure to act on reports of violations***] and the allegation about direct marketing to mothers through the advertising firm OgilvyOne's marketing campaign was brought up in 1999 [***Baby Milk Action comment: This past malpractice was not referred to, but good of Nestlé to remind people***], etc. Either the allegations are about practices or communication materials that we have discontinued years ago, and Nestlé informed you about such discontinuation, or they have been clarified as being inaccurate or untrue in previous exchanges of correspondence with you [***Baby Milk Action comment: Simply untrue - current practices were referred to and on past issues Nestlé's responses have been inadequate and have not led to an end to the practices***]

In the Philippines (as in every developing country), Nestlé complies with the provisions of the WHO Code or with those of the national regulations giving effect to the WHO Code, whatever is stricter. For instance the Philippines' Milk Code (promulgated under Executive Order 51) allows advertising of follow-on formulas. Nestlé Philippines has nevertheless never advertised follow-on formuulas in the Philippines. Moreover, with a view to minimizing risks that mothers may confuse breastmilk substitutes with baby foods or dairy products for older babies, Nestlé has refrained from marketing infant formulas and follow-up formulas under brands used for its other categories of products for babies. In actual fact Nestlé has been, and still is, the only infant food manufacturer in this country that implements such strictures. [***Baby Milk Action comment: pictoral and documentary evidence of how Nestlé does promote infant and follow-on formulas in breach of World Heatlh Assembly marketing requirements in the Philippines is given on the campaign sheet and described in our letter below***].

Early this year, the Department of Health revised the Implementing Rules and Regulations (IRR) of the local Milk Code. The Supreme Court, upon petition of the Pharmaceutical and Healthcare Association of the Philippines (PHAP), has however issued a Temporary Restraining Order suspending the application of the revised IRR.

The PHAP is a business association whose members include the country's leading pharmaceutical companies and medical service providers. Nestlé Philippines is not a member of the PHAP. As you youself stat it, "Nestlé is not a party to the court case".

Furthermore, over the last 20 months when the revision of the Implementing Rules & Regulations was debated at various levels in the Philippines, Nestlé Philippines has abundantly and consistently manifested its support for the Government's efforts to promote breastfeeding and strictly enforce the implementation of the Milk Code. We would indeed welcome an early implementation of the reforms and earnestly hope that revised rules will be efficiently enforced, and in an even manner. [***Baby Milk Action comment: Note that Nestlé says 'revised rules' and not 'the revised rules' as it has opposed some aspects of the IRR***].

We therefore hope that in reporting on the current status of the matter in the Philippines you will not erroneously include Nestlé when making allegations of "companies bullying" governmental efforts to make regulatory changes to the marketing of infant foods, but rather make clear that Nestlé is the one company supporting stricter government enforcement [***Baby Milk Action comment: We are bringing Nestlé's letter to the attention of readers of our action sheet. However, we have asked Nestlé to state clearly whether it supports the IRR has drafted or not (see letter below). We have had no response. The media has reported Nestlé opposition to some provisions***].

We take the liberty of copying the Secretary of Health, Mr Francisco F. Duque, with this letter, as we have on several occasions been given the opportunity to share our position on this matter with his Department of Health. [***Baby Milk Action comment: Clearly Nestlé was wishing to discredit Baby Milk Action by putting its misrepresentation of our position before the Secretary of Health and others on the contact list***].

Very truly yours,

NESTLÉ PHILIPPINES, INC.

D NANDKISHORE
Chairman and CEO

Copy:

Secretary Francisco F. Duque, M.D., Department of Health of the Philippines, Manila.

Dr. Jean-Marc Olivé, WHO Representative in the Philippines, Manila.

World Health Organisation, Geneva.

As Nestlé had written to the Secretary of Health, we saw this as an opportunity to set the record straight about our allegations over Nestlé's on-going malpractice in the Philippines and in other countries.

Baby Milk Action's detailed response is given below. Click here to download as a pdf.

Dear D. Nandkishore,

Nestlé violations of the World Health Assembly baby food marketing requirements in the Philippines and globally

I am responding to your letter of 14 November 2006 in which you expressed ‘disappointment’ regarding our Campaign for Ethical Marketing in support of the Philippines government’s Implementing Rules and Regulations for the Milk Code.

I will go through the points raised in your letter in turn.

Nestlé and the Philippines regulations

You state in your letter that you have supported, in writing, the IRR. Yet I understand that Nestlé has in fact opposed the marketing restrictions on products for children up to two years of age, arguing that these should only apply to products for children up to one year of age. Further, I understand Nestlé is opposing a draft bill passing through Congress that encompasses the IRR provisions, in favour of a bill setting out its own weaker provisions.

Could you confirm that Nestlé has now changed its position and is supporting restrictions on the marketing of baby foods for children up to two years of age and all other provisions in the IRR? Can you further confirm that Nestlé will drop its opposition to the bill encompassing the IRR provisions currently being considered by the legislature? We will gladly publicise your response alongside our Campaign for Ethical Marketing action.

Nestlé violations in the Philippines

You claim in your letter that our criticisms of Nestlé marketing in the Philippines are based on allegations that are almost 10 years old. This is simply untrue. For example, we have highlighted the packaging of Nestogen 1 infant formula, as currently on sale in the Philippines, which has the idealising claim that it contains ‘Brain Building Blocks’.

This is a reference to the Long Chain Polyunsaturated Fatty Acids (LCPFAs) in the formula. It states on the reverse of the label:

“DHA - Experts recognize DHA as essential for brain development and good vision.”

This is an idealizing claim that is not supported by scientific evidence. The influential Cochrane Library has reviewed studies used to back claims such as this and concluded:

"At present there is little evidence from randomised trials of LCPUFA supplementation to support the hypothesis that LCPUFA supplementation confers a benefit for visual or general development of term infants. Minor effects on VEP [visual evoked potentials] acuity have been suggested but appear unlikely when all studies are reviewed. A beneficial effect on information processing is possible but larger studies over longer periods are required to conclude that LCPUFA supplementation provides a benefit when compared with standard formula. Data from randomised trials do not suggest that LCPUFA supplements influence the growth of term infants."

See http://www.cochrane.org/reviews/en/ab000376.html

Article 9.2 of the International Code states very clearly: “Neither the container nor the label should have pictures of infants, nor should they have other pictures or text which may idealise the use of infant formula.”

Nestlé not only uses idealizing text and logo, its health claim does not stand up to scrutiny. We call on Nestlé to stop using health and nutrition claims to promote its products.

Other violations featured included gifts of Nestlé umbrellas given to Barangay health workers in 2006. You are correct that we reminded people that Nestlé has a long history of targeting mothers in the community, but surely it is relevant to demonstrate that although we have repeatedly raised these issues with Nestlé, the company continues with similar practices.

It is not only our allegation that Nestlé aggressively promotes breastmilk substitutes in the Philippines. We referred to a 2003 German Television programme about Nestlé marketing in the Philippines that also found evidence of violations and we linked to the programme so people could view it for themselves.

Nestlé violations in other countries

You state in your letter: “In the Philippines (as in every developing country), Nestlé complies with the provisions of the WHO Code or with those of the national regulations giving effect to the WHO Code, whatever is stricter.”

It is very disappointing to see Nestlé continues to make claims such as this despite the ruling made against it by the UK Advertising Standards Authority (ASA). Nestlé was warned in a ruling against an anti-boycott advertisement not to repeat claims suggesting it markets infant formula ‘ethically and responsibly’ or that its policies on infant formula marketing are in accordance with the WHO Code (the World Health Assembly marketing requirements). The ruling came after a two-year investigation, one of the longest ever conducted by the Authority. While this ruling was published by the ASA in 1999, Nestlé has not made the required changes to its policies and practices to justify its claims. It is regrettable that we are unable to call on the ASA to enforce its ruling when Nestlé makes similar claims elsewhere as its mandate only covers UK advertising, but we ask that you respect the ruling nonetheless and stop making false claims about Nestlé and the WHO Code.

Monitoring conducted by the International Baby Food Action Network (IBFAN) around the world finds Nestlé to be responsible for more violations of the marketing requirements than any other company. Practices documented include: advertising of breastmilk substitutes, free samples and supplies, gifts to health workers and mothers, information materials for health workers not restricted to scientific and factual matters, sponsorship of health workers creating conflicts of interest, promotion of baby clubs to mothers and labelling violations.

The most recent global monitoring report, Breaking the Rules, Stretching the Rules 2004, had evidence from 69 countries. Nestlé has not made required changes to policies and practices and we have reported other significant cases of violations since the report. Examples include Nestlé targeting pregnant and lactating women in China in ‘nutrition corners’ in supermarkets with nutritional supplements and milks for older babies. In India, our partners exposed in 2006 Nestlé organising symposia for health workers and sponsoring cultural events for medical students in breach of Indian Law, as well as distributing leaflets on infant formula to parents in a clinic.

Nestlé is in court in India for failing to put required warnings on infant formula labels in Hindi. While you may correctly point out this case began in 1995, the delay in reaching a conclusion has been caused by Nestlé taking the Indian Government to court in an attempt at striking down regulations implementing the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions. Nestlé action against the Indian Government has failed enabling the court case on labelling to resume.

Nestlé’s refusal to substantiate its claims

Baby Milk Action has invited Nestlé to attend an independent, expert tribunal in the UK where its marketing and IBFAN’s evidence of malpractice can be examined in depth, with expert witnesses called by both sides. Nestlé is so far refusing to even set out its terms and conditions for participating. We have held a number of debates with Nestlé (UK) at universities and other fora and the company has lost every vote as its claims do not stand up to scrutiny when exposed by our documentary evidence. We now understand the Nestlé (UK) Head of Corporate Affairs is refusing to participate in future debates.

This refusal to submit its claims to scrutiny occurs not only with regard to events proposed by Baby Milk Action. In November 2000 the European Parliament Committee on Development an d Cooperation invited Nestlé to participate in a Public Hearing into its baby food marketing activities in Pakistan, alongside IBFAN and UNICEF’s legal officer. Nestlé refused, sending instead a consultant contracted by the company who could not answer questions regarding Nestlé’s policies being out of line with the International Code and Resolutions.

We have recently seen that Nestlé has received a poor score in the Global Accountability Report produced by the One World Trust. This rated Nestlé’s transparency and accountability in four areas and the company highest score was a little over 50% in just two areas. The quality of Nestlé’s information disclosure policy was evaluated with a score of 0% (zero percent).

The fact that Nestlé violates the World Health Assembly marketing requirements in a systematic manner and is found to be the worst of the baby food companies in doing so has led to groups in 20 countries launching boycotts of the company’s products as a way to put pressure on it to change. Nestlé is one of the four most boycotted companies on the planet, according to a survey conducted by GMIPoll. In January 2005 Nestlé received a shaming award in a global internet vote coinciding with the World Economic Forum for its irresponsible behaviour.

Given this pattern of behaviour and Nestlé’s on-going aggressive marketing in the Philippines, we see no reason to change our Campaign for Ethical Marketing action sheet.

However, if you can provide a statement of unequivocal support for the IRR and will drop your opposition to similar provisions in the bills currently being debated, we will certainly report this. At the same time we call on you to stop immediately the violations in the Philippines referred to above and, in particular, give an undertaking to stop using health and nutrition claims to promote formula.

I am copying this letter to the same circulation list as your letter to me as well as Nestlé. S. A. Chief Executive Officer, Peter Brabeck-Latmathé, who claims he investigates any hint of a violation of the marketing requirements.

Yours sincerely,

Mike Brady

Campaigns and Networking Coordinator
Baby Milk Action

CC: Secretary Francisco F. Duque, M.D., Department of Health of the Philippines, Manila.

Dr Jean-Marc Olivé, WHO Representative in the Philippines, Manila.

World Health Organisation, Geneva.

Peter Brabeck-Letmathé, Chief Executive Officer and Chairman, Nestlé S. A..

Novartis's response

Novartis (Gerber) was sent the following letter by Baby Milk Action in acknowledgement of its stated commitment to abide by the World Health Assembly marketing requirements. The statements had gained it entry to the FTSE4Good ethical investment listing, but the reply suggests nothing has changed in its practices.

Click here to download Baby Milk Action's letter.

Dear Mr. Vassella,

Gerber commitment to FTSE to abide by the World Health Assembly marketing requirements for baby foods and bottle and teats

Baby Milk Action understands that Novartis has been admitted to the FTSE4Good listing following undertakings that your Gerber subsidiary will meet the criteria for the marketing of baby foods, feeding bottles and teats.

It is very welcome if Gerber will bring its policies and practices into line with the criteria, which reference the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions of the World Health Assembly as minimum requirements for all countries.

As we have discussed with FTSE, our welcome of this news has to be tempered with the apparent lack of changes in Gerber marketing to date.

Failure to comply with the criteria

Checking the website www.gerber.com we see that there have been no changes to the site since Novartis was admitted to the FTSE4Good listing, despite this happening over 4 months ago. Feeding bottles and teats continue to be advertised on the site in breach of the Code’s provisions. This is done in a very aggressive way with idealizing claims suggesting that Gerber bottles and teats are equivalent to breastfeeding. All such advertising has to be removed before we can say that Gerber’s undertaking to comply with the marketing requirements have substance.

It is also necessary for Gerber baby food information and labelling to reflect the World Health Assembly 1994 position that complementary feeding should be fostered from about 6 months of age, reiterated in 2001 when the Assembly stressed the importance of exclusive breastfeeding until 6 months of age.

In addition, we have documented how Gerber has targeted mothers directly, encouraging them to sign up to a Gerber baby club in China. This is a breach of Article 5.5 of the International Code.

We ask that Gerber indicate to Baby Milk Action that it accepts these activities are in breach of the Code and Resolutions and will stop them with immediate effect.

Opposition to implementation of marketing regulations in the Philippines

We are concerned that Gerber, as a member of the Pharmaceutical and Health Care Association of the Philippines (PHAP), is party to a legal action against the Ministry of Health in the Philippines. PHAP is attempting to strike down the Implementing Rules and Regulations (IRR) which give force to the Code and Resolutions in the country.

We ask that Gerber make a clear public statement in the Philippines and internationally that it does not support the legal action and wishes the see the regulations implemented. Failing to do so will suggest that Gerber’s claimed acceptance of the Code and Resolutions as minimum standards is false.

Are Gerber’s commitments to FTSE4Good of value?

We very much hope Gerber will be setting an example to the rest of the industry and will meet the commitments it has given to achieve a FTSE4Good listing.

We have already publicly welcomed your stated commitment to change practices and hope we will be able to report changes are indeed being made to practices.

If the above action is taken we will be able to conclude that Gerber is indeed delivering on its commitment. If it is not, we will have to advocate that Novartis be excluded from the FTSE4Good listing at the next review for taking no visible action.

For the sake of infant health and the well-being of their families, it is our wish that Gerber does deliver on its commitment.

We look forward to hearing from you.

Yours sincerely,

Mike Brady
Campaigns and Networking Coordinator
Baby Milk Action

CC: FTSE.

The response we received from the Chief Executive of Gerber is included below in its entirety. Baby Milk Action's comments appear [***like this***]. Click here to download the letter.

Dear Mr. Brady,

Your letter to Dr. Daniel Vasella Chairman and CEO Novartis AG, has been referred to me for response as I work in Gerber Products Company, which markets the products you referenced.

At Gerber, we have worked very hard to understand and align ourselves with the WHO International Code of Marketing of Breast Milk Substitutes. We do not market infant milk formula (IMF). We provide five certified lactation educators on a 24 hour per day availability through our Gerber Parent Resource Center (1-800-4-Geber). We receive approximately 350 breastfeeding contacts each month. We offer products to support the breastfeeding experience for mothers. [***Baby Milk Action comment: It is for health workers to advise parents, not companies with a vested interest in selling products - Gerber markets feeding bottles and teats as well as complementary foods***]

We support breastfeeding in our consumer and professional materials, and on our website. Here is a sample of text from www.gerber.com.

"As the Company that helps mothers and fathers raise happy, healthy babies, Gerber Products Company knows that breastfeeding provides the best nutrition for young babies, and confers other benefits as well. Breastfeeding can help lower a baby's risk for developing allergies and infections and may even decrease his or her risk of obesity later in life. Breastfeeding is a wonderful opportunity for bonding between mother and child." [***Baby Milk Action comment: This statement does not excuse the idealizing promotions of feeding bottles on the site, which undermine breastfeeding***]

We also are very mindful of the WHO Code in our guidance regarding the introduction of complementary foods. Our marketing practices in the Philippines are in compliance with our global standards. We are not engaged in any campaign to the contrary. We do participate in local industry trade organizations as a part of normal practice. In this instance, it appears that the primary debate you refer to is around the marketing of infant milk formula, which is not a part of our product portfolio. [***Baby Milk Action comment: This is misleading. The regulations cover products for children up to two years of age, not just infant formula for infants up to 6 months of age. In other words, products within Gerber's portfolio***]

We take our responsibilities to market ethically very seriously. We acknowledge your concerns and have discussed them with our local team. We will continue to monitor our marketing practices and our advoacy efforts to ensure that our messages to mothers are in support of breastfeeding. [***Baby Milk Action comment: This assurance is insulting. Gerber has not responded to the points raised, such as the violations of the marketing requirements on its website and elsewhere. Nor has it made the statement requested in support of the Philippines regulations***]

Sincerely,

Kurt Schmidt
President and CEO

Wyeth's response

Shamelessly, Wyeth suggests its legal action against the government's marketing regulations is to protect infants!

Your e mail sent to the Wyeth UK website was forwarded to me for a reply.

It has been Wyeth's policy to adhere to the aims and principles of the WHO Code since it was first adopted in 1981. Wyeth has always recognized that breast milk is best for babies and the WHO Code was intended to protect and promote breast-feeding and to ensure the proper use of breast milk substitutes. Wyeth also abides by the provisions of national codes in all countries where we market infant formula products. Wyeth supports and adheres to Executive Order #51 of the Philippines which is the national law to implement the WHO Code. The Implementing Rules and Regulations (IRR) proposed for adoption in the Philippines go far beyond the WHO Code or subsequent WHA Resolutions. [***Baby Milk Action comment: The Code was adopted as a 'minimum requirement', not a maximum standard as Wyeth suggests. It is for the government to decide what measures are required to implement the Code and Resolutions as a minimum***]

Wyeth, as a member of the Pharmaceutical and Health Care Association of the Philippines (PHAP) agrees with PHAP's concern that the IRR will have serious consequences for the health of Filipino babies and young children. The IRR would selectively ban all promotions of highly nutritious milk-based products for older infants and young children who are on mixed diets, whereas the Code does not ban promotions, it regulates marketing of infant formulas. Importantly, the focus of the WHO Code is on breast milk substitutes, not products for the older ages that the IRR covers. There is a need for highly nutritious products for these older infants and young children because the typical complementary foods do not meet nutrient needs. The IRR will remove information that mothers need in order to make good food choices, and would apply at a time when her baby is most vulnerable to nutritional deficiencies, namely 6 to 24 months of age or beyond. [***Baby Milk Action comment: The Code applies to all breastmilk substitutes and subsequent Resolutions relate to baby foods for older babies. Promotion is not the same as information. As PHAP advertisements placed to win public support show, the industry gives misleading and idealising information to undermine breastfeeding***]

The IRR would also require products to be labeled with hazard warnings that WHO has considered and found unnecessary [***Baby Milk Action comment: This claim is simply bizarre***]. The IRR also fails to address key issues that are mentioned in the Resolutions such as support for the working mother so that she can continue to breast-feed, water quality so that mothers can safely prepare weaning foods for their children, and training of parents in proper preparation and use of formulas. [***Baby Milk Action comment: None of this is the responsibility of companies - they are limited to providing scientific and factual information to health workers***].

Wyeth is committed to providing nutritious formulas for infants and young children who need them. Wyeth is committed to working with Philippine health professionals to improve infant and young child health, and Wyeth has had a steadfast and continuous commitment since even prior to the WHO Code to market its formula products in an ethical, responsible manner.

Yours sincerely,

Beverly Halchak
Senior Director Nutrition Policy