Spotlight on baby milk-makers
2003-01-17 18:27
Paris - Manufacturers of powdered baby milk, including food giants Danone of France and Nestle of Switzerland, frequently violate an international code of conduct when they sell their products in west Africa, a study published in the British Medical Journal (BMJ) says.
The code aims at ensuring that infant formula is not aggressively marketed in poor countries with the use of gifts, glitzy claims or misinformation that could prejudice breast milk, which is far more nutritious for a newborn, as well as free.
The charter was adopted in 1981 by the World Health Assembly - the parent body of the UN's World Health Organisation (WHO) - but few countries in west Africa have carried out their promise to transcribe it into national law and implement it.
The researchers carried out a random check in the Togolese capital Lome, and in Burkina Faso's capital, Ouagadougou, and western city of Bobo-Dioulasso, and uncovered a long list of violations.
Of clinics and hospitals that they monitored, nearly one in seven had received promotional gifts from manufacturers, such as pens, highlighters, measuring tapes and stethoscopes, as well as donations of breast-milk substitutes which were dished out to mothers free-of-charge.
Promotional material for infant formula was found in 16 percent of health facilities, and special displays to market these products were found in 44% of shops and stores checked.
Ninety percent of health providers the researchers interviewed had never heard of the code, while almost two-thirds of mothers had never been given any advice on breastfeeding.
Forty brands of infant formula violated the code's labelling rules, which, among other things, require the manufacturer to include a statement about the benefits of breastfeeding, give instructions for the appropriate preparation or storage of formula milk, or warn the mother about possible health hazards if the milk is used inappropriately.
The biggest offender was French company Danone, which sold 21 of the 40 brands, followed by Nestle of Switzerland, a favourite target of breast-milk campaigners, with 11. The other eight brands were made by other national and international manufacturers.
The study lays much of the blame with the governments, noting that they had a duty to set up monitoring systems and provide information and training to support the code, and (in Togo's case) to transform the code into law.
However, "the burden of compliance" lay with the manufacturers themselves, it adds.
"They should not use healthcare systems to provide mothers with free samples of their products, disseminate promotional materials containing incomplete and biased information, and promote the use of breast milk substitutes among health professionals and mothers of young infants.
"Manufacturers must not use distribution points to promote their products. They must stop using the news media to idealise the use of breast milk substitutes. Lastly, they must label their products according to the directives of the code."
The authors say violations are especially worrying given that these very poor countries have among the highest infant mortality rates in the world.
Every year, malnutrition caused by inadequate breast feeding causes the death of some 3,300 babies in Togo, accounting for a quarter of all infant deaths, while the figure in Burkina Faso is 6 200, or 11% of all infant mortality, they said. The figures come from studies published in 1999 and 2000 respectively.
The study, which is published in Saturday's issue of the BMJ, was led by Victor Aguayo of the New York-headquartered charity Helen Keller International.
It monitored compliance at 43 health facilities and 66 sales outlets and included interviews with 186 doctors and nurses and 105 mothers in 16 towns or cities.
In an editorial, the BMJ said that corporations had repeatedly vowed to obey the code, but the new study "provides further evidence that many manufacturers fly in the face" of it. - Sapa-AFP
- SAPA