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From the Nutrition Advisor of Save the Children
The article about Nestle (Vol. 2, issue 3) contains several misconceptions concerning Nestle’s recent audit conducted in Pakistan. We welcome Nestle’s actions in commissioning an independent audit report, the publication of the findings and the steps that the company is taking to strengthen internal monitoring. However, our reading and interpretation of the audit findings shows a much more entrenched and systematic abuse of the code’s provisions than the treatment given in the article from Nestle, which mentions three breaches.
Specifically:
1. Countries in which Nestle is committed to complying with the code. The report states: "Nestle has committed itself to complying with the Code in all countries outside Europe, the USA and Canada and five developed Asian countries". Resolutions adopted by the World Health Assembly apply to all member states, not just developing countries.
2. Inducements to promote products in the scope of the code. The code states that no material or financial inducements to promote products should be offered to health workers. The Nestle audit states that "Medical Delegates" (the Nestle staff employed to market products in the health care system) can request funds from an imprest account for purchasing "low-cost items of professional utility" for health professionals. The gifts "may be considered part of the normal relations between customers and their suppliers or professional colleagues and/or considered part of the building of general goodwill...". Items worth on average US$20 were given. There is no clear distinction between giving gifts to customers to generate goodwill with Nestle and giving gifts to customers to encourage them to use Nestle products.
3. Medical delegates as technical promoters. The report states that "the main promotional tool used by Nestle Milkpak is Medical Detailing" (p49)... "of course, medical detailing is itself a promotional tool and therefore should have an impact on sales" (p38). The code clearly states in Article 6.2: "No facility of a health care system, should be used for the purpose of promoting infant formula or other products within the scope of this Code."
It is deeply disappointing that almost 20 years after the code’s adoption, Nestle and other infant formula manufacturers still fail to meet its provisions.
Save the Children remains extremely concerned about implementation of the International Code of Marketing of Breastmilk Substitutes and subsequent WHA Resolutions in all countries of the world. The promotion of breastmilk substitutes places a real threat to child survival, which is why we take it so seriously. Save the Children very much hopes that Nestle will be able to give consideration to the points made above and re-examine their marketing approach in Pakistan to ensure that the Code’s provisions are fully respected and infant lives are not put at risk.
Anna Taylor
The article about Nestle (Vol. 2, issue 3) contains several misconceptions concerning Nestle’s recent audit conducted in Pakistan. We welcome Nestle’s actions in commissioning an independent audit report, the publication of the findings and the steps that the company is taking to strengthen internal monitoring. However, our reading and interpretation of the audit findings shows a much more entrenched and systematic abuse of the code’s provisions than the treatment given in the article from Nestle, which mentions three breaches.
Specifically:
1. Countries in which Nestle is committed to complying with the code. The report states: "Nestle has committed itself to complying with the Code in all countries outside Europe, the USA and Canada and five developed Asian countries". Resolutions adopted by the World Health Assembly apply to all member states, not just developing countries.
2. Inducements to promote products in the scope of the code. The code states that no material or financial inducements to promote products should be offered to health workers. The Nestle audit states that "Medical Delegates" (the Nestle staff employed to market products in the health care system) can request funds from an imprest account for purchasing "low-cost items of professional utility" for health professionals. The gifts "may be considered part of the normal relations between customers and their suppliers or professional colleagues and/or considered part of the building of general goodwill...". Items worth on average US$20 were given. There is no clear distinction between giving gifts to customers to generate goodwill with Nestle and giving gifts to customers to encourage them to use Nestle products.
3. Medical delegates as technical promoters. The report states that "the main promotional tool used by Nestle Milkpak is Medical Detailing" (p49)... "of course, medical detailing is itself a promotional tool and therefore should have an impact on sales" (p38). The code clearly states in Article 6.2: "No facility of a health care system, should be used for the purpose of promoting infant formula or other products within the scope of this Code."
It is deeply disappointing that almost 20 years after the code’s adoption, Nestle and other infant formula manufacturers still fail to meet its provisions.
Save the Children remains extremely concerned about implementation of the International Code of Marketing of Breastmilk Substitutes and subsequent WHA Resolutions in all countries of the world. The promotion of breastmilk substitutes places a real threat to child survival, which is why we take it so seriously. Save the Children very much hopes that Nestle will be able to give consideration to the points made above and re-examine their marketing approach in Pakistan to ensure that the Code’s provisions are fully respected and infant lives are not put at risk.
Anna Taylor
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