Saturday, December 19, 2009


By James Achanyi-Fontem
Coordinator,IBFAN Cameroon
Authorities of the United Nation Fund for Population Activities, UNFPA, have drawn the attention of the Ministry of Public Health in Cameroon to the importance and place monitoring of the International Code on the marketing of breastmilk substitute in the regulation and promotion of child survival.
The information filtered from a working session organised by the Minister of Public Health, Andre Mama Fouda, on Thursday, 1oth December 2009 in Yaounde with the head of the communication service of the ministry and a senior journalist of Cameroon Tribune.
The UNFPA drew the attention of the minister to an article on activities organised by Cameroon Link (CAMLINK) following the training of trainers’ course by IBFAN Africa in Douala on the World Breastfeeding Trends Initiative. The minister was informed that code monitoring was an alert system that keeps formula producers from health facilities, thereby giving the opportunity to breastfeeding mothers to remain attached to World Health Assembly regulations and recommendations by the World Health Organisation. Cameroon Tribune has earlier published a news investigation on company violations of the Cameroon national code issued as law on the 1st December 2005.
A formula production company during that period sponsored a workshop of paediatricians in Limbe and used the trade mark of Bledina to advertise the workshop in violation of articles of the international and national code on the promotion and marketing of breastmilk substitutes in the country.
The same company consolidated its violation with an advertorial in the Eden Newspaper of Wednesday, 9th December 9 – Monday, 14th December 2009. Cameroon Link had during the WBTi training called on the government to create a regulatory committee with the appointment of a national coordinator to check such lapses throughout the country.
In reaction to the flagrant violations world wide through scientific meetings and workshops, a UNICEF Baby Friendly Initiative statement on formula company-funded study days was issued in the United Kingdom.
UNICEF Baby Friendly Initiative had recently received several enquires regarding study days sponsored by formula milk industries. These days range from holding study days nutrition company institutes serving as bridges to reach health staff caring for babies within public and private.
The Baby Friendly Initiative requires that all health-care facilities seeking Baby Friendly accreditation adhere to the International Code of Marketing of Breastmilk Substitutes. Information on formula milks provided to health professionals in order to allow them to support mothers who do not breastfeed, should be scientific, factual and free from promotion.
Health professionals are the ideal conduit for promoting formula milk. They engender public trust and respect and have easy access to virtually all new mothers and babies. The ‘halo effect’ of having mothers associate the company brand with a health professional is highly valued. However, for this to happen, the companies need access to those health professionals. As recently, and in the last 10 years before the publication of the code, company representatives had free access to many health-care premises and they induced health professionals to attend their talks with hospitality and free materials.
The Cameroon Code forbids any penetration of health facilities by company delegates to advertise their brand and donate materials or organise meetings. The companies have now opted the indirect version of sponsoring activities of health professionals in very attractive tourism facilities as an incentive.
With increased support for breastfeeding in the health services, health professionals have gradually become much more aware of the real purpose of this ‘generosity’ and its negative effect on breastfeeding and efforts to support informed choice. Subsequently, much of this easy access to health professionals still has to be stopped in countries like Cameroon.
Sponsored study days are a highly effective mechanism for circumventing workplace controls on access by company representatives and so gaining direct access to health professionals. The study days no longer directly focus on breast and bottle feeding, which would only arouse suspicion, but rather are specialist in nature, focusing on, for example, allergy or growth, thus reassuring prospective participants of their legitimacy. Participants are asked to register for the study day, so providing the company with contact details for future promotional opportunities. At the event itself there are opportunities for introductions, closing statements, odd lectures by company representatives and promotional materials that can be given to everyone who attends. The result of this is health professionals who are highly aware of the company’s brand and product, informed of the product’s key selling points, in possession of company materials and possibly well disposed to the company providing them with ‘free’ education. If any of this is then passed on to parents, the company’s outlay can be justified to shareholders as being designed to increase profits.
The Baby Friendly Initiative standards do not expressly prohibit health professionals’ attendance at formula company study days. However, attendance is strongly discouraged. Any health professional considering attending such a day should ask themselves whether attendance is really necessary for their education, whether it is compatible with their Code of Conduct and responsibilities to implement best practice and what effect their attendance could have on the families they serve. For more information visit the Code Monitoring page at