Friday, February 23, 2007

Media studies in the Philippines

Part of the reason our partners in the Philippines call for international help in defending the government’s regulations for the marketing of baby foods, is that it is difficult for journalists there to run stories that are critical of big advertisers.

We have documented how television stations have been threatened in the past with the loss of Nestlé advertising for reporting on concerns over its marketing and referring to the Nestlé boycott.

We have strategies that work to break through the wall of silence. Your messages of support and the celebrity endorsements we have received have made front page stories in the Philippines. A few days ago a demonstration by our partners was also picked up in a national paper. See:

However, it is an unequal struggle. While it is difficult for campaigners to gain coverage, the baby food companies are simply paying for advertising space arguing that mothers need ‘information’ on infant formula. They gain both coverage that campaigners find difficult to achieve AND give the media another financial reason not to upset them.

One article is addressed to ‘Dear Mothers’ and says breastfeeding is best, but mothers need information on infant formula for when they cannot breastfeed.

The advertisement list includes things like if the mother has a breast or nipple problem or cannot provide enough milk. These are cases where a mother needs independent advice from a health worker or mother-support network, because with support such problems can be overcome. The cause is usually due to poor latch on which a mother can correct with experienced help.

The companies prey on these problems and build up a mothers fears in their ‘information’ materials. As in these advertisements, they present formula as the solution if a mother has difficulties, not support for breastfeeding.

The World Health Assembly International Code of Marketing of Breastmilk Substitutes gives responsibility for advising parents to health workers and prohibits companies from advertising, other forms of promotion or seeking direct or indirect contact with mothers.

As the companies state in their advertisement, there is a legitimate market for infant formula. There will be times when they are necessary. Marketing restrictions do not stop formula from being sold. They stop the promotion and require labels to have accurate and clear instructions and warnings. This is to benefit all mothers. The argument from the companies is a bogus one, but because they pay for the advertising space, they are given prominence.

In this reality, we must be grateful to the journalists and editors who have given space to the health advocates side of the issue. But for whatever reason, some newspapers have run articles defending formula promotion, even misrepresenting the position of UNICEF.

A paper had to publish a response from the UNICEF Representative in the Philippines last month after running an article claiming ‘UNICEF reports’ cited the Philippines as having breastfeeding rates amongst the highest in the world. A couple of key facts from Dr. Nicholas Alipui:

* 19-20 percent of under 5 deaths or 16,000 deaths in the Philippines could be prevented by appropriate infant and young child feeding.

* The national Demographic Health Survey 2003 shows an increased incidence of diarrhoea among children from 7 percent (1998) to 11 percent (2003) as the exclusive breastfeeding rates in the country declined from 20 percent (1998) to 16.5 percent (2003).

Dr Alipui went on:

“UNICEF supports the Philippines Department of Health’s efforts to strictly control the marketing and promotion of artificial breastmilk substitutes, in conformity with international accepted standards as defined by the World Health Organisation. This is vital in a developing country like the Philippines were excessive glamorization and exaggerated health claims ascribed to artificial breastmilk substitutes induce poor families to abandon the cheapest, safest and healthiest source of nutrition for their young children – breastfeeding.”

Sounds like the sort of thing Baby Milk Action says, doesn’t it? That is because we know what we are talking about. Nestlé and friends may sometimes try to suggest they are only criticised by us - a bunch of activists - but in reality we are simply the outspoken section in a range of health advocates.

As a Non-Governmental Organisation funded by membership and grants from trusts and development organisations, we are answerable only to our members, board of directors and accountants. This gives us the freedom to bring people onto the streets when necessary, to run campaigns such as the Nestlé boycott and to be a little blunter when exposing the shameful practices of companies that put their own profits before infant health. Without political master or corporate partners to worry about upsetting, we can organise letter writing campaigns to support governments and to put pressure on companies. See:

But make no mistake. We are not mavericks making unreasonable demands on companies. The strategies we devise are to complement those of the broader health community who may not have the same freedoms.

The regulations we monitor and call for companies to abide by were adopted by the World Health Assembly, made up of the world’s health ministries. The regulations we and our partners in the Philippines are defending, were introduced by the Department of Health (DOH) there. The claims we make are backed by hard evidence and scientific research.

Here is what Dr. Alipui said in his letter to the paper about the Philippines regulations:

“The revised IRR of the Executive Order 51 supported by DOH seeks only to regulate the marketing of breastmilk substitutes. The revised IRR will enable mothers to make informed choices based on accurate and reliable information. Impartial information cannot come from parties that stand to make profit from one choice or another. And if mothers make truly informed choices about the feeding of their children, then nobody can make them feel guilty.”

Our aim is the same at that of UNICEF and the World Health Assembly: to protect infant health and the right of mothers (all mothers) to independent information, through implementing globally agreed marketing standards.

Our petition of support and delegation to the Philippines Embassy in London has helped to get this issue onto the front page of the papers in the Philippines. See past blogs, such as:

UNICEF’s response has brought the issue onto the letters page of another paper, attempting to undo the damage caused by a misleading article.

All very well for raising awareness, but meanwhile the industry opens its cheque book and runs full colour advertisements.

So we must continue to call on your help and support our partners, the government and mother and their families in the Philippines. At present the industry has succeeded in having the new marketing regulations suspended. The case continues, even with the assassination of the government lawyer defending the case (by people still unknown). See:

This is the reality we face in every case, powerful vested interests defending their profits, regardless of the impact on infant health. It is never easy, but we have won through in other countries and with your support we will win through here. Become a member of Baby Milk Action or send a donation. Or buy something from our shop. Over half our income comes from people doing just that and every penny helps. Also tell people what is really going on. Direct people to this blog and our website

One hundred mothers demonstrated outside the offices of the baby food companies in the Philippines last week to raise awareness of how they had been misled by company promotion and their infants suffered as a consequence. Some will be bringing legal action for compensation.

If you are a journalist you can cover this story. I wrote about this in my blog on Monday.

UNICEF Philippines sent the following out yesterday. With a picture.

Photo caption: Philippines mothers protest deceptive marketing of infant formula companies, which leads to at least 16,000 deaths in the country every year.

Copyright: UNICEF/PHI/2007/J Bondoc

Click here for a hi-resolution version.

---UNICEF Philippines press release

In the Philippines, mothers demand truth about infant formula

Over 100 formula feeding mothers and their babies protested in front of infant formula manufacturers’ offices, claiming milk advertisements have deceived them into giving their babies infant formula instead of breastmilk.

“My message to the milk companies is to stop deceiving those who buy infant formula,” says Nadine Sylvano, mother of five children. “They say that their milk is good for children’s brains, will make children healthy, stout and give strong bones. But it’s not true.”

“My breastfed child did not get sick often but this one, almost every month I have to bring her again to the hospital because she is sick again,” Sylvano observed.

When asked why she did not breastfeed her fifth child, Sylvano replies, “Because I did not have milk from my breasts.”

Sylvano’s experience is a common one. According to the National Statistics Office, 31 per cent of mothers in the Philippines do not breastfeed because they believe that they do not have enough milk.

Only 16 per cent of babies four to five months of age are still exclusively breastfeeding.

Even though UNICEF and WHO recommend exclusive breastfeeding in the first six months of life, half of all babies in the Philippines are exclusively breastfed for less than one month.

Aggressive advertising and marketing of infant formula has undermined mothers’ confidence in their ability to nourish their children, claims Innes Fernandez, convenor of Save Babies Coalition.

“They were all cheated, they were all beguiled by all this false advertising, marketing activities that seduce them to buy their formula, believing the testimonials of celebrities so they were always hoping and wishing that they would have healthy babies,” Fernandez adds.

Milk companies aver that they also advocate for breastfeeding but want to give consumers a choice.

“We believe… breastfeeding is best for babies,” says Andrew Santos, Vice-President of Wyeth Philippines. “What we have there are products that if the Mom chooses, or if for some reason she cannot breastfeed, then she is given that on her own decision, to be able to, or the paediatrician especially, to make a choice.”

Fernandez counters, however, that even medical doctors are unable to make an informed choice about infant feeding.

Dr. Lester Lora, who used to manage the maternal and child health programme in the Department of Health, says that even she was not properly informed about breastfeeding.

“During our time, nobody taught us [in medical school] about breastfeeding. Instead, we were taught how to prepare infant formula,” Dr. Lora says.

As a result, she herself fed her three sons infant formula and blames it for their lifelong battles with various diseases, from diabetes to ulcerative colitis.

UNICEF has been supporting the Philippines Department of Health to more strictly enforce the National Milk Code, which regulates the marketing of breastmilk substitutes. However, in 2006, the Pharmaceutical and Healthcare Association of the Philippines, made up of milk companies among others, succeeded in appealing to the Supreme Court for a temporary restraining order on the Code’s revised implementing rules and regulations.

In the meantime, infant formula advertisements continue to make claims of health and cognitive benefits.

“Stop all these false claims,” demands Fernandez.

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