In an email to DairyReporter, the International Baby Food Action Network International Code Documentation Centre (IBFAN-ICDC), which works to assist the implementation of law based on the World Health Organization (WHO) International Code of Marketing of Breast Milk Substitutes (WHO Code), said it was “appalled” by promotional events depicted in photographs on the Bibere Cambodia Facebook page.
Photographs appear to show representatives wearing branded shirts handing out gift bags containing Bibere infant formula to women - some expectant mothers.
Another image (below) appears to show a father being gifted a bag of Stage 3 Bibere products at Royal Phnom Penh Hospital in the Cambodian capital.
IBFAN-ICDC questioned, however, whether Export New Zealand Ltd, the Auckland-based company behind the Bibere brand, was aware of “what is happening on the ground in Cambodia.”
Speaking with DairyReporter, Chris Berryman, director, Export New Zealand, said the company was "not aware of this Facebook page."
It has asked its Cambodian distributor, Phnom Penh-based Nutrilatt Master, "to make changes,” he said.
"We appreciate you bringing this matter to our attention," Berryman said. "We have taken the required steps to have our distributor comply with WHO guidelines."
In an email, Tim Sovannara, managing director, Nutrilatt Master, acknowledged IBFAN-ICDC's concerns and apologized.
"I'm so sorry about that mistake [promoting stage one infant formula],” said Sovannara.
"I will keep in mind to remind of this issues,” he added.
While Export New Zealand Ltd's efforts are "somewhat encouraging... these blatant violations of the Code and the national law should not have happened in the first place," IFBAN-ICDC added.
"The Code clearly states that manufacturers and distributors are responsible for monitoring their marketing practices to ensure compliance with the Code at every level."
“Many provisions” of the WHO Code are incorporated into Cambodia's Sub-Decree 133 on Marketing of Products for Infant and Young Child Feeding.
Sub-Decree 133 was devised “to ensure breast milk substitutes are properly used only when they are necessary and based on adequate information.”
Under the regulation, manufacturers and distributors of breast milk substitutes, such as infant formula, are prohibited from promoting their products “without prior permission from Ministry of Health.”
Manufacturers and distributors are also prohibited from donating or distributing breast milk substitutes to health workers, hospitals or health centers without Ministry of Health authorization.
IBFAN-ICDC has shared its concerns with the WHO Regional Committee for the Western Pacific (WPRO).
Berryman said Export New Zealand Ltd "will be happy to provide WHO with answers to any further questions they may have when they contact us directly."
In a statement sent to DairyReporter, James Rarick, a WHO technical officer in Cambodia, said it has been “working in close collaboration” with the Cambodian Ministry of Health and other partners to “strengthen enforcement” of Sub-Decree 133.
According to Rarick, the Ministry of Health currently works with the Ministry of Commerce, Ministry of Information and the Ministry of Industries and Handicrafts to ensure Sub-Decree 133 compliance.
An Oversight Board was, however, recently established to “improve the coordination” between the departments, he added.
"While these are positive developments, we still really need all the support we can get to shine the light on violators - and also to monitor the outcomes of formal complaints that are made through the system,” said Rarick.