by Ms Tracey Wagner-Rizvi,
The Network for
Consumer Protection in Pakistan
Development and Cooperation
22nd November 2000
President and Members
of the European Parliament,
I am very pleased to
have been invited to present to you information about how transnational
corporations based in and exporting from the European Union are
affecting the health and survival of infants in Pakistan and around
I represent a public
interest group called The Network for Consumer Protection in Pakistan.
We are a member of the International Baby Food Action Network
(IBFAN), a global network
of over 150 groups in more than 90 countries. IBFAN has been working
for more than 20 years for implementation of and compliance with
internationally agreed marketing standards for the baby food industry.
I come here today with
three requests of the European Parliament:
That the Council
Resolution and Export Directive on the marketing of breastmilk
substitutes are reviewed so that they become effective tools
to stop malpractice by European companies, wherever they operate
outside the European Union.
That the European
Union does all that it can to support full implementation
of the International Code of
Marketing of Breastmilk Substitutes and subsequent, relevant
Resolutions adopted by the World Health Assembly by every
country as minimum requirements and works to incorporate these
measures in international frameworks, such as Codex Alimentarius
and the World Trade Organisation agreements.
That a framework
is set up, as proposed in the Code of Conduct paper, with
an appropriate legal basis, so that governments, public-interest
groups and individuals in third countries have a clearly defined
set of procedures to follow to report violations.
Although we are discussing
infant feeding in the context of dry regulations, the issue is
actually about ensuring that mothers everywhere, including in
Europe, are protected from commercial exploitation and enabled
to make informed decisions about infant feeding.
WHO and UNICEF estimate
that reversing the decline in breastfeeding could save the lives
of 1.5 million infants around the world every year. Where water
is unsafe an artificially-fed child is up to 25 times more likely
to die as a result of diarrhoea than a breastfed child. Indeed,
in a country like Pakistan, where nearly half the population does
not have access to safe drinking water, breastfeeding, which provides
protection against infections, can make the difference between
life and death.
1. The European
Union Council Resolution and Export Directive
The European Union's
adoption of a Council Resolution and Directive has great potential,
but let me share my experience of what happens when you try to
In January 2000, The
Network registered a complaint concerning labelling. The Export
Directive says that "products shall be labelled in an
appropriate language and in such a way as to avoid any risk of
confusion between infant formula and follow-on formula".
Our complaint stated that complete information in the local language
(Urdu) is not available on the labels of Nestlé's Pre-Nan
and that the colouring and design of the labels of Pre-Nan,
Nan 1 and Nan 2 are similar to the point of being easily
confused. Because only 24% of women in Pakistan can read, there
is an increased likelihood of a mother giving this product (Nan
2) to her baby instead of this product (Nan 1). The
higher level of salt and protein allowed in follow-on formula
exacerbates the risk of dehydration and increases the renal solute
Nestlé is fully
aware of the risks of such marketing and has promised for many
years to phase out such product branding. Yet these products were
introduced into Pakistan less than three years ago -- that is,
more than 5 years after the adoption of the Export Directive.
The Netherlands Embassy
say they have taken up the matter with Nestle but we are still
awaiting a promised response from the company. I bought these
in Islamabad on Sunday. This one was manufactured as recently
as August . As you can see, the labels still violate the Directive.
I also complained to
the European Commission because the Council Resolution says the
Community will contribute to the application of appropriate marketing
practices for breastmilk substitutes in third countries and references
the International Code as the standard. Despite several
exchanges of correspondence, the Commission has been unable to
inform me who is the competent authority for registering complaints.
As the International Code itself calls upon Non-Governmental
Organisations (NGOs) to bring violations to the attention of concerned
manufacturers and relevant authorities, then why does not the
Commission? When the Council Resolution was adopted in 1992, IBFAN
was led to believe that NGOs were included under the term "competent
Sadly, other IBFAN
groups in many other countries have faced similar difficulties.
Reports have been made to the Commission and/or national authority
as appropriate for violations in Argentina, Hungary, Indonesia,
Kenya, Russia, Ukraine and Tanzania with no resulting action being
of the International Code and Resolutions in legislation
I now come to my second
point about the need for strong national legislation backed up
by international frameworks. As the author of two reports about
Pakistan in the last two years, I would like to explain the complex
and devious ways that companies seek to expand markets in countries
like Pakistan with scant regard for the impact on health and,
when exposed, the lengths to which they will go to suppress evidence
in order to maintain their company reputation.
Our evidence comes
from extensive independent monitoring of company compliance with
the International Code and Resolutions. Our nationwide
survey covered 33 cities and towns, visiting 217 health facilities,
562 medical stores and interviewing 662 mothers and numerous health
workers. A conservative estimate of one-to-one encounters is more
than 2,500. We collected 400 specimens of promotional and informational
materials and other objects. We also analysed product packaging.
The findings, published
as the report "Feeding
Fiasco", showed that not a single company was abiding
by the International Code and Resolutions. It is necessary
to keep in mind when discussing violations of the International
Code, some of which appear insignificant to the uninformed,
that each violation can result in a mother making decisions that
will put her child's life at risk.
We found products that
were not labelled in the correct language. Specialised formulas,
such as Al-110 for lactose intolerant babies, being promoted
to doctors as "A nutrition that helps prevent diarrhoea"
when diarrhoea is more likely due to infection and mothers
are best advised to breastfeed. We found gifts being given to
doctors as inducements to promote products. One of the five company
representatives we interviewed spoke of "Jackpots"
- doctors or hospitals which will recommend a company's products
for 6 months or a year in exchange for a cash payment. One hospital
was even known as a "Lactogen hub" as promotion
there had been so securely sewn up by Nestlé.
The company representatives
we interviewed during the survey all wished to remain anonymous.
Shortly before Feeding Fiasco was released, however, a
former employee of Nestlé, Syed Aamar Raza, came forward with
internal company documents that further substantiated the evidence
published in Feeding Fiasco and again demonstrated the
institutionalised nature of the malpractice. Executives' signatures
appear on cheques used to bribe doctors and on the sales targets
set for marketing staff, among many other things. Examples were
subsequently published as the report "Milking
Nestle has gone to
great lengths to keep this evidence out of the media. They have
attempted to intimidate Syed Aamar Raza and have attacked his
character in an attempt to distract from the substance of the
These two reports are
not unique. Monitoring in other countries by IBFAN and others
have exposed routine and systematic violations of the International
Code and Resolutions around the world. If any of you have
any doubt that there is a need for enforceable instruments implementing
the International Code and Resolutions please read these
reports. Companies have a moral obligation to abide by these measures,
but are not legally bound until governments enact legislation
to that effect. With legislation comes the power of enforcement
and questions of interpretation can be resolved in the courts.
The Government of Pakistan
has been preparing legislation to regulate baby food industry
marketing since 1992. The delay in enactment has been caused at
least in part by the interventions of the baby food industry,
especially by Nestle. These companies have complained about the
proposed law's "draconian clauses" and that the proposed
law was being "shoved down the throat" of the industry.
Their lobbying against the law has seen key sections weakened
and the independence of monitoring bodies challenged. Industry
representatives continue to meet with the Minister for Health
and even the highest office of the land, the Chief Executive General
I am appalled that
Nestle shows such disregard to the democratic process and this
Committee that it has refused the invitation to appear on the
panel here today, especially when Nestlé's Chairman, Helmut Maucher,
told shareholders last year that the company welcomed these hearings.
Instead we have a gentleman who can only speak about his very
narrow experience with the company as a consultant for a short
period earlier this year.
I would like to comment
on the audit he prepared into the marketing practices of its Pakistan
subsidiary. I have with me a detailed analysis of the audit report,
the study's methodology and its findings, which is being publicly
launched today. In short, the audit is a whitewash. For example,
it uses Nestle's widely criticised interpretation of the International
Code and subsequent Resolutions rather than the interpretation
used by World Health Assembly and UNICEF. Its methodology is biased.
Its conclusions are not supported by its findings. Too much evidence
has been ignored. The company should answer these charges and
address the real issues. Why are they not prepared to do so?
3. "Code of Conduct"
As my third request,
I would like to ask all MEPs to support the Committee in fully
implementing the provisions in its Code of Conduct paper. The
framework proposed could go a long way to implementing the
International Code and Resolutions globally and protecting
infant health . The European Union has a special role to play
to ensure that the economic interests of companies in the world's
richest countries do not take precedence over the health and well-being
of the citizens of the rest of the world.