[PPT]PowerPoint Presentationworldbreastfeedingconference.org/13-Dec2016/Clark... · Web viewSource: Euromonitor, 2013; WHO-UNICEF-IBFAN Joint Report on Implementation of the International

Manufacturers’ attempts to get around the International Code of Marketing of Breastmilk Substitutes and Subsequent

World Health Assembly Resolutions.

When is a milk a breastmilk substitute?

David Clark, Nutrition Specialist (Legal) UNICEF, New YorkYeong Joo Kean, Legal Adviser, ICDC, Penang.

© WBC 2. Johannesburg Dec 2016

Before the Code

After six months, a non-breastfeeding mother would introduce complementary food and could continue with the infant formula.

Nestle Nan Infant Food Formula, 1978

Infant formula was the main BMS on the market and was promoted “from birth” without upper age limit.


Code adopted in 1981 Prohibits all forms of promotion of BMSPreamble makes reference to a “legitimate market for infant formula” and “the proper use of infant formula”.Although the scope refers to “breast-milk substitutes, including infant formula”, infant formula is the only BMS product mentioned and defined. Manufacturers thought they could use this to argue that the Code only applies to infant formula, leaving them to invent new “formulas” that they could claim were not covered by the Code’s prohibition on promotion.


And then there were two …

Resulted in cross-promotion whereby mothers of newborns were targeted with promotion of the follow-up formula, since the packaging, branding and labelling so closely resemble that of the infant formula (also known as brand extension).

Age indication -Nan 1 – “from birth”

Nan 2 - “from 6 months” with no upper age limit.


Follow-up milks pronounced “unnecessary”In May 1986, WHA declared “the practice being introduced in some countries of providing infants with specially formulated milks (so-called follow-up milks) is not necessary”(WHA 39.28)

Industry tries to fight backIn 1987, Codex Alimentarius Standard adopted for follow-up formula which stated: “The products covered by this standard are not breast-milk substitutes and shall not be presented as such” (CODEX STAN 156-1987)


But Governments take action to protect their babies:

Countries like Benin (1997) Albania (1999) Ghana (2000) Brazil (2001) Botswana (2005) Gambia (2005) Nigeria 2005) Kyrgyzstan (2008), Fiji (2010), Madagascar 2011), Vietnam (2014), Kuwait (2014), Myanmar (2014) began to specifically include follow-up formulas in their national regulations. How did the companies react?

follow-on formulas now generally have an upper age limit of 12 months ...

Allowing for further brand extension …..


With companies again claiming the new 1,2,3 milks (a.k.a. growing-up or toddler milks) don’t fall under the scope of the Code.

Cross Promotion


Innovative activities to instill perception that product is beneficialExpansion of retail space like this baby race track

Increasing consumer demand for GUMS through

Companies claim the No 3 milks (and 4) can be promoted and they do so aggressively…

Singapore


“Partly due to government restrictions of the marketing of baby formula, manufacturers are increasingly targeting toddler milk formula.”


2011 - Bahrain

Promotion of one GUM product over 2 decades

1999 – Malaysia2016 - South AfricaClean label after law

How companies behave depends on prevailing laws

Labelling


1999 – Oman/ UAE

Promotion in health care facilities

2013 - Ethiopia2000 - UAE

From creating brand awareness to product premiumisation


2007 - Ghana2007 - UAE

Promotion to the public

2004 – Malaysia

In ads for the new millenium, claims became entrenched

“Brain development”“immunity” Help your child realise his full potential ?

“Healthy Bones & Minds depend on the right milk”?

“Enhanced your child’s mental development”


Indonesia/ Philippines / UAECirca 2010 – more claims !!

Small eyes. Big Vision. Improved formulation to improve eye protection

With AA & DHA to awaken the natural ability of your child

Dha & AA to help visual acuity and brain development


2013 - Ethiopia

Feed their potential?

2011 - Lebanon

“Biofactors system – unique age appropriate

combination of nutrients to

support your child’s growth”

WHA 58.32 [2005] - nutrition and health claims are not permitted for bms except where specifically provided for in national legislation(reiterated in WHA 63.23 [2010] and extended to all foods for IYC )


Raising the alarm

“These respondents clearly understood toddler milk advertisements to be promoting a range of products that included infant and follow-on formula and accepted their claims quite uncritically”Breastfeeding Review 2009; 17 (3): 21–30

“The analysis of the primary question in this report reveals exploitation by marketers of confused distinctions by consumers between infant, follow-on and toddler milks, and this indicates an important area of focus for policy and regulation.

A rapid evidence assessment:Does marketing of commercially available complementary foods affect infant and young child feeding?


Recommendation 2: Breastmilk Substitutes

Guidance on Inappropriate Promotion of Foods for Infants and Young Children

World Health Assembly in May 2016 (A69/7)

http://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_7Add1-en.pdf/

“Products that function as breastmilk substitutes should not be promoted. A breastmilk substitute should be understood to include any milks (including soy milk), in either liquid or powdered form, that are specifically marketed for feeding infants and young children up to the age of 3 years (including follow-up formula and growing-up milks)


2016 - post guidance; ads & claims persist

2016– Malaysia


India

Are these breastmilk substitutes or complementary foods?

Look what they’re doing NOW !


Danone GUM Promotion Today

Formula for “1 -6 year olds “? What product is this?

© ICDC 2016

Recommendation 5: Cross Promotion

Guidance on Inappropriate Promotion of Foods for Infants and Young Children World Health Assembly in May 2016 (A69/7)

http://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_7Add1-en.pdf/

There should be no cross-promotion to promote breastmilk substitutes indirectly via the promotion of foods for infants and young children.

Companies that market breastmilk substitutes should refrain from engaging in the direct or indirect promotion of their other food products for infants and young children by establishing relationships with parents and other caregivers (for example through baby clubs, social media groups, childcare classes and contests).

© ICDC 2016

Malaysia

What about cross-promotion through milks for mothers? Lookalike labels create brand recognition, trust and loyalty.

© ICDC 2016

Key takeaway messagesThe promotion of follow-on formulas and growing up milks cross promotes the infant formulas of the same brand.The Code covers all breastmilk substitutes i.e. any milks that are specifically marketed for feeding infants and young children up to the age of 3 years, irrespective of what they are called.There should thus be no promotion of these productsIn the absence of national Code regulations that are specific about the definition of BMS, companies will probably continue to try and promote GUMs.Despite recommendations against cross-promotion of BMS indirectly via the promotion of foods for IYCF, can still occur through promotion of milks for pregnant and breastfeeding women.

© ICDC 2016

© ICDC 2016

Global baby food sales

Big

Money!!!Source: Euromonitor, 2013; WHO-UNICEF-IBFAN Joint Report on Implementation of the International Code, 2016

Likely to rise by 55% to US$ 70 billion by 2019

Milk Formula US$45.0 billion

© ICDC 2016

Growing Up Milks: 50% of the absolute growth, strongest retail sales growth among all

formula milk products

Formula milks US$45 billion

(Euromonitor International, 2015)

© ICDC 2016

Some Marketing TrendsRobust sales performance of toddler milk formula (GUMs) compared to the overall baby food market encourages manufacturers to focus on widening their target audience to older children, in order to retain their customer base for a longer period.Toddler milk formula’s high sales per capita in large emerging markets, notably Indonesia and Thailand, are expected to remain major growth drivers.The five largest markets for toddler milk formula in 2015 are all located in Asia Pacific.Premiumisation is set to be a key factor for growth in developed markets.

(Euromonitor International, 2015)

Documents

[PPT]PowerPoint Presentationworldbreastfeedingconference.org/13-Dec2016/Clark... · Web viewSource: Euromonitor, 2013; WHO-UNICEF-IBFAN Joint Report on Implementation of the International