A video with edited highlights of the press conference launching the global monitoring report Breaking the Rules, Stretching the Rules (BTR) 2014 will be available in due course.

This will include the presentation by Annelies Allain, Director of the IBFAN International Code Documentation Centre, giving an overview of the trends identified in the monitoring, as described in the launch press release. I also spoke on what is being done to try to stop violations – and how people can help with this.

You can download the abridged version of the report free of charge: Breaking the Rules 2014 in brief.

Here is the text of my talk as drafted:

BTR 2014 in briefBefore I say anything else, I would like to encourage everyone to read through the BTR In Brief from cover to cover. It is interesting to flip through, but well worth spending an hour or so reading the text.

Like the full BTR it is an impressive piece of work. But I would like you to read it not just to see how thorough IBFAN’s work is. Looking in detail at the strategies reported shows how sophisticated the baby industry is.

The industry has put a great deal of thought, time and money into how to undermine breastfeeding and make formula seem like a wonder product.

Look at the great lengths these companies take to ensure these messages reach pregnant women and mothers. You may find their ingenuity impressive. I also hope you will be outraged.

Whether you know about the International Code of Marketing of Breastmilk Substitutes and subsequent World Health Assembly Resolutions or not, I hope it is obvious that these strategies are simply wrong. They have been developed with one aim : to sell more products. And to sell more formula, companies are undermining breastfeeding.

They are no friends of mothers who use formula either. The cost of all this advertising and promotion goes onto formula, making it even more expensive. At the same time, these mothers are misled into buying unnecessary products such as Growing Up Milks. They are simply being ripped off, as we say in the UK.

The evidence in the reports produced by ICDC speaks for itself. These are the companies’ own materials.

I want to spend a few minutes talking about what can be done to stop these harmful practices. To tell you what IBFAN is doing.

But first let me say, just in case there is any doubt, IBFAN is not alone in suggesting that baby milk companies violate the marketing requirements. Save the Children produced the report Superfood for Babies in 2013 with its own monitoring evidence from countries including China, India and Pakistan. Chinese television has exposed bribing of health workers.

Even initiatives that praise companies for having policies that sound good are critical.

In Nestlé’s latest Creating Shared Value report, launched at its shareholder meeting here in Switzerland last month, it refers to the Access to Nutrition Index or ATNI. Nestlé is pleased to report that ATNI named Nestlé as on of the top three performers in providing consumers with access to nutritious products. However, Nestlé has not been transparent with his shareholders. The ATNI profile on Nestlé says this: “The company should take immediate action to ensure that its practices are in full compliance with the International Code in all countries.”

I raised this omission with Nestlé’s Chairman, Mr Peter Brabeck-Letmathé at the compay’s shareholder meeting last month, on 10 April, in front of the 2700 shareholders. I asked him to make the changes required to end the violations documented in the Breaking the Rules report and the reports by Save the Children and others.

The response is very illuminating. Mr Brabeck asked Mr Luis Cantarell, Head of Nestlé Nutrition to respond.

Mr Cantarell said that 90% of the violations in Breaking the Rules reply comply with Nestlé’s own policies.

So this is problem number one. Company policies produce violations.

These are not mistakes or the actions of rogue employees. These practices are in line with company policies by their own admission. I say they are ‘systematic’, because they are produced by the company’s systems.

What can be done when companies get away with breaking the rules? Tell the world. That’s why we are here today. And encourage people to take action.

Baby Milk Action operates what we call the Campaign for Ethical Marketing. We produce action sheets and ask members of the public to write to the Chief Executives of the companies responsible. This does yield some results – and when companies do not change, we can see their justification for their practices. We have detailed correspondence with Nestlé – the biggest company – Danone – the second biggest – and many of the other companies.

Nestle Nan formula - Thailand 2013What we find is that executives do not accept the validity of the Code and Resolutions. This is a letter from Nestlé Global Head of Public Affairs from 3 March this year. I had written specifically about the claims Nestlé uses on labels to idealise its products. You will see examples on page 35 of the brief – you can see others on a poster we have produced.

Nestlé claims its formula is the ‘natural start’, ‘the gentle start’ and ‘protects’ babies.

Formula is not the natural start, breastfeeding is.

Babies fed on formula are not protected, they are more likely to suffer short and long-term illness than breastfed babies. In conditions of poverty they are more likely to die.

Nestlé claims to support breastfeeding. It claims to respect the Code. So will it stop these practices?

No, Marie Chantal Messier responded by saying that ‘Nestlé has always done its utmost to comply with the WHO Code as implemented by national governments’. Note these words: ‘as implemented by national governments’.

Many governments have not yet implemented the Code. Or their implementation may be weak, incomplete or not monitored. Often this is because of pressure from the industry.

So problem number two is the Code and Resolutions are sometimes not being enforced through legislation.

There is a more fundamental problem, however.

The Code is very clear. It is not only addressed to governments. It is addressed to companies as well. Article 11.3 states:

Independently of any other measures taken for implementation of this Code, manufacturers and distributors of products within the scope of this Code should regard themselves as responsible for monitoring their marketing practices according to the principles and aim of this Code, and for taking steps to ensure that their conduct at every level conforms to them.

When you call the companies for a response to the Breaking the Rules report and they say that they abide by the Code as implemented by governments, please come back at them by saying: ‘What about article 11.3? How can you claim to abide by the Code and ignore your own responsibilities set out in the Code?’

So problem number three is companies are not meeting their own obligations to abide by the Code and Resolutions as minimum standards in all countries.

Where there are laws they can be effective. The BTR in Brief gives the examples of labels being changed following South Africa’s new regulations on page 29. We heard just last week that Nestlé had changed its labels in India after food safety authorities seized formula products for breaking the law in October 2012.

Companies cannot be trusted to do what is right. There needs to be action to force them to comply.

Where laws are lacking or ineffective it falls to civil society and the media to hold these powerful corporations to account. We have some successes, which I can tell you about later if you wish.

In the case of Nestlé, we also target it with a boycott campaign. This is because of the scale of its violations. However, executives continue to reject the four-point plan we have put to it to bring policies and practices into line, which could see the boycott called off.

Nestle-Free Zone mugMore pressure is needed so today we announce a new campaign. We invite people to declare their homes and workplaces to be ‘Nestlé-Free Zones’. We have a logo that you can display. We are also developing a range of resources you can use to spread the word, such as mugs.

We are also encouraging people to keep their distance from these companies. The World Health Assembly said in Resolution 58.32 in 2005, ‘ensure that financial support and other incentives for programmes and health professionals working in infant and young-child health do not create conflicts of interest’.

We have been hearing about how companies over sponsorship and gifts to health workers.

This is a particular problem now in the UK. Nestlé entered the market in 2012 when it took over the SMA brand and competition with Danone has intensified. They are trying to bypass the restrictions many health facilities have on company representatives meeting with staff by holding their own events at hotels and other venues and inviting staff there. So we have a “Say NO to formula company sponsorship” campaign.

DanoNO logoHere we are targeting Danone sponsorship.

Danone jumped into second place in the global market with the takeover of the Nutricia, Milupa, Aptamil and Cow & Gate brands in 2007. We put a four-point plan to Danone at that time. It rejected that plan, but has made some promises to try to escape a boycott. As it says on page 35, Danone gave a global undertaking in May 2012 to stop distributing materials for the public through the health care system. We are watching. But it is not enough. There are many Danone violations in the BTR report.

So don’t partner with this company. When Danone comes calling, say DanoNO.

So I’ve talked about three problems: the violations are deliberate, arising from company policies not being in line with the Code and Resolutions; there is a lack of enforcement in too many countries; and companies do not meet their own responsibilities under Article 11.3 to bring policies and practices into line.

The solutions? Better regulation. To achieve that, IBFAN provides training on the Code and Resolutions and campaigns for legislation. We expose what companies are doing – that is why we are all here today. And where regulation is lacking or not enforced – action by the public can force changes.

People can support the Nestlé-Free Zone and the DanoNO campaigns.

Danone nurses uniformHealth workers can also take action in saying they will not accept sponsorship, funding and gifts from baby food companies.

[Left, from BTR in brief : Danone provides nurses uniforms embroidered with Danone Baby Nutrition in the neonatal ward of one of a premier hospital in Addis Ababa, Ethiopia. The uniforms, modeled here by ICDC staff, not only provide free advertising for the company but medical endorsement of its products, and could give the impression that it generously pays nurses to serve in the hospital.]

In that regard we welcome the new position statement from the International Society for Social Pediatrics and Child Health.

We have with us today Olivier Duperrex from ISSOP to tell us more.

The statement calling for an end to sponsorship is clear:

Sponsorship by its nature creates a conflict of interest. Whether it takes the form of gift items, meals, or help with conference expenses, it creates a sense of obligation and a need to reciprocate in some way. The ‘gift relationship’ thus influences our attitude to the company and its products and leads to an unconscious unwillingness to think or speak ill of them.

Click here for the press release from ISSOP, which links to the full statement.

Click here to join Baby Milk Action.