How do you respond to The Guardian's article on infant formula marketing practices in the Philippines?

The allegations in The Guardian article do not represent Nestlé’s culture and business practices. The first and most fundamental expression of our respect for mothers and babies is support for breastfeeding and compliance with the law and our own strict procedures.

Nestlé strongly rejects the allegation that it does not comply with its legal obligations in the Philippines. As everywhere in the world, we respect the WHO Code as implemented by member states or our own policy if it is stricter. We take this matter very seriously. We will investigate all the reported allegations and our employees know that we will take fast and decisive action if any wrongdoing is found.

For us to take immediate action and address any verified incidences of non-compliance, we request that The Guardian shares any evidence that it has with us. We have made the same request to Save the Children, in our response to their report ‘Don’t Push It’.

In 1981 the World Health Organization (WHO) adopted recommendations for member states to regulate the marketing of breastmilk substitutes. In 1982 we became the first manufacturer to introduce a policy, to regulate BMS marketing in developing countries. We updated this policy in 1984, and the boycott against us was dropped. We’ve revised and reinforced our industry-leading policy (pdf, 3Mb) a number of times since.

Did you offer healthcare professionals incentives to promote infant formula?

We deny allegations that we offered doctors, midwives and health workers incentives to attend conferences and encourage them to promote products covered by the World Health Organization (WHO) Milk Code. Both Nestlé Nutrition and Wyeth Nutrition in the Philippines follow clear processes and procedures on compliance with the Philippine Milk Code (EO51).

We only pay expenses to healthcare professionals that directly relate to their attendance and participation in continuing education events, following the principle that support should not be linked to recommending any of our formula products covered by EO51 – from zero to 36 months. Support is limited to registration fees, the hotel and economy plane fares. We only support healthcare professionals – not family members or anyone else – who submit a written request to us endorsed by their manager.

What kind of continuing education events does Nestlé support?

We do organise continuing education events, which the local Milk Code allows us to do. During such events, we only share scientific and factual information to help healthcare professionals deliver the best care for their patients.

Our understanding is that the scientific symposium that The Guardian refers to could be an event organized by the Integrated Midwives’ Association of the Philippines in 2016, which Nestlé did not organize. The activities and information provided at this event were both scientific and factual. We sponsored a number of healthcare professionals to attend, as permitted by Filipino law, EO51 and our own Nestlé policy (pdf, 3Mb).

All Nestlé Nutrition medical reps and Wyeth Nutrition territory managers are trained to comply with the local Milk Code. They know that any violation of the Code and Nestlé Policy could lead to serious disciplinary action.

Is Nestlé’s support for healthcare professionals in the Philippines legal?

Yes. The local Milk Code (EO51) in the Philippines states (Section 7B) that manufacturers and distributors of the infant formula products it covers are not forbidden from disseminating scientific and factual matters to healthcare professionals, provided these do not create a belief that bottle-feeding is equivalent or superior to breastfeeding.

The same law (Section 8E) states that manufacturers and distributors may assist in supporting the continuing education of healthcare professionals. The Supreme Court of the Philippines clarified in 2007 that this can extend to research assistance, scholarships and continuing education, in line with Department of Health rules and regulations.

The Guardian article selectively quotes Section 32 of the Revised Implementing Rules & Regulations of Executive Order No.51 (on implementing the Milk Code) to argue that our support for healthcare professionals is illegal. Section 32 states that it is the responsibility of health workers to promote, protect and support breastfeeding and appropriate young children feeding. Nestlé fully complies with Section 32, both in spirit and in practice.

What about accusations of aggressive infant formula marketing?

In all high-risk markets, of which Philippines is one, we do not advertise our infant formula and follow-on formula products covered by the WHO Code.

Our industry leading policy on BMS marketing (pdf, 3Mb) (also recognised by Save the Children), applies to the entire Nestlé Group and is mandatory for all Nestlé employees and third parties acting under Nestlé’s authorisation. To reinforce this, we regularly train employees and distributors on Code compliance. We have also incorporated Code compliance into our governance structures and it is subject to board level oversight.

Moreover, our policy follows the FTSE4Good Index criteria on BMS marketing, which prioritise 152 countries where there is the greatest risk of malnutrition and infant mortality to infants and young children. Nestlé was the first manufacturer of breastmilk substitutes to apply the Index’s strict 104 BMS criteria for BMS marketing.

As Save the Children recognises in its 'Don't Push It' report, the inclusion of more key industry players in addition to Nestlé and Danone in FTSE4Good could transform the sector and create a new baseline standard for discussions.

Did Nestlé representatives break the law by approaching doctors and midwives?

Healthcare professionals (HCPs) are the only source of information for consumers about products covered by the Philippine Milk Code (EO51). HCPs therefore need reliable and credible scientific and factual information about the products that the Code covers, given the legitimate market for infant formula.

EO51 does not preclude manufacturers and distributors of formula from providing healthcare professionals with scientific and factual information about the products that it covers, as long as they do not imply or create a belief that bottle-feeding is equivalent or superior to breastfeeding.

Some healthcare facilities do not allow medical reps to provide scientific information, or ‘medical detailing’, onsite during working hours. In such cases, the law does not prohibit reps from meeting HCPs offsite.

Do Nestlé representatives ever promote products directly to mothers?

No, our representatives do not make direct contact with mothers, and only interact with healthcare professionals to provide scientific and factual information. We take such allegations extremely seriously, and require evidence so we can investigate and address the matter. If any such practice were uncovered, we would take fast, decisive action.

The article also mentions ‘parenting and nutrition forums’ in hospital canteens and shopping malls, where it is alleged that industry representatives gave out milk samples to mothers and discussed infant nutrition. Nestlé does not hold such activities for parents, consumers and the public for products covered by the Philippine Milk Code.

Read more Read more about our compliance record, including the Bureau Veritas Assurance Statements

Read more Read the PwC Independent Assessment report

Read more Read a summary of our policy (pdf, 53Kb) on the implementation of the WHO International Code of marketing of breast milk substitutes

Read more Read more about our responsible infant food policies

Read more Read more about FTSE4Good

Read more Read more about the Nestlé boycott

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