The International Code of Marketing of Breast-milk Substitutes was adopted at the World Health Organisation's (WHO) thirty-fourth World Health Assembly (WHA) in May 1981.

"The aim of this Code is to contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breastfeeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution" (Article 1 of the Code).

The Code calls upon governments to: "Take action to give effect to the principles and aim of this Code, as appropriate to their social and legislative framework including the adoption of national legislation, regulations or other suitable measures." (Article 11.1 of the Code)

WHA recommendations

WHA resolutions are recommendations to all Member States of the WHO. This is clearly stated in WHA Resolution 34.22, including the WHO Code, adopted in 1981.

"Resolutions passed after the adoption of the WHO Code have the same status as the Code - they are recommendations to all of its member governments." This was reiterated and reinforced in a statement by the WHO Director General, Gro Harlem Brundtland, to advocacy and industry NGOs in meetings held in November 1998.

Dr Brundtland said that: "The International Code and Assembly resolutions have the same force and the same value. In other words, neither the Code nor any resolution has a real impact and a lasting meaning unless countries implement them according to their national laws and practice. Member States are sovereign; they may, if they choose, implement WHO's recommendations to the letter, they may actually go beyond these recommendations, or they may simply ignore them altogether."

The Scope of the WHO Code

The WHO Code applies to infant food products presented or marketed as breast-milk substitutes. This is clarified in the WHO International Code publication, contained in the integrated explanatory statement (Annex 3) by the Chairman of the WHO Executive Board, read to the delegates of the WHA in 1981, upon which country delegates voted.

The explanation reflects the intent of the drafters. 150 representatives of governments, NGOs, infant food manufacturers and nutrition experts were involved in the drafting process together with WHO and UNICEF.

This important clarification on the Scope of the Code thus was part of the approval by WHO Member States and has not been changed since 1981.

The Code does not apply to complementary foods unless specifically marketed as breast-milk substitutes. Nestlé does not market or present any of its complementary foods as breast-milk substitutes.

Implementation and monitoring of the WHO Code

WHA Resolution 34.22 stresses, in its recommendation to governments, that the adoption of the International Code of Marketing of Breast-milk Substitutes is: "A minimum requirement and only one of several important actions required in order to protect healthy practices in respect of infant and young child feeding."

The WHO Code in Article 11 deals with "Implementation and Monitoring" and makes clear that governments have the responsibility to implement the Code as they find appropriate with respect to the local circumstances. Companies are also asked to monitor their own marketing practices.

Nestlé's instructions for implementation of the WHO Code

Nestlé universally follows all countries' implementation of the WHO Code. Our decision, two decades ago, to voluntarily and unilaterally implement the WHO Code as a minimum in all developing countries is due to the fact that the economic, social and sanitary conditions in most of those countries differs substantially from the situation in developed countries like the USA or EU countries. The initial reason for developing an International Code of Marketing of Breast-milk Substitutes had also to do with the poor situation in the developing world.

Where Nestlé unilaterally and voluntarily implements the WHO Code - in more than 155 developing countries - we apply the Code to all infant food products being marketed or otherwise represented as a breast-milk substitute. That means to starter formula (0 to 6 months) and in the case of Nestlé it also means follow-on formula (6 to 12 months) with the same brand name as a starter formula.

WHO has made clear that follow-on formula does not fall within the Scope of the Code.

Nestlé's monitoring initiatives

The WHO Code asks companies to monitor their marketing practices, and we take our monitoring responsibilities very seriously. We have put various procedures in place in order to do our best to ensure Code compliance. These include:

Governmental verification of WHO Code compliance by Nestlé

Nestlé supports all governments in their efforts to implement the Code as it provides clarity for us and better ensures that all companies meet the same marketing standards. We believe that the major area of improvement in the application of the WHO Code has to do with enforcement, which implies monitoring by governments or under the auspices of governments. We therefore encourage governments to set up official monitoring bodies, and readily cooperate with their monitoring efforts.

Vietnam

In Vietnam the Government has been routinely monitoring compliance by manufacturers of breast-milk substitutes with the Vietnamese regulations implementing the WHO Code for several years. The official body in charge of that monitoring is the State Inspectorate Section within the Ministry of Health.

For three consecutive years, in the years 2000, 2001 and again in 2002, the State Inspectorate has monitored Nestlé's marketing practices and has found them to be in compliance with the Vietnamese Code.

The last official monitoring report issued in September 2002 contains the following conclusions:

"Comments by the Inspectors: Nestlé Vietnam has fully complied with the regulations of the Decree 74/2000/ND-CP of the Government on Trading and Use of Breast-milk Substitutes.

Recommendations from the Inspectors: The Company should continue its good implementation of the Regulations on Trading and Use of Breast-milk Substitutes.

Sanction: none".

Gabon

In Gabon, the General Department of Health within the Ministry of Health and Population has recently investigated Nestlé's marketing practices relating to breast-milk substitutes. Following that investigation, the Ministry wrote to Nestlé Gabon expressing its satisfaction with the way the company complies with the local regulations governing this matter as well as its appreciation of the cooperation Nestlé has extended to the Ministry towards the implementation of WHO's recommendations in Gabon.

The following statement is quoted from the letter from the General Director of Health:

" The results of on-site investigations by my regulatory services show that your Company scrupulously observes Ministerial Directives governing commercial and advertising practices for infant and dietetic foods."