WHO alerted to potential NZ infant formula promotion breach in Cambodia

By Mark ASTLEY contact

- Last updated on GMT

New Zealand-made Bibere is distributed in Cambodia by Phnom Penh-based Nutrilatt Master.
New Zealand-made Bibere is distributed in Cambodia by Phnom Penh-based Nutrilatt Master.

Related tags: Milk

Concerns have been raised about the promotion practices employed by the Cambodian distributor of New Zealand infant formula brand Bibere.

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.

bibere stage 1 giveaway

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.

phnom penh

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. 

WHO alerted

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.

Related topics: Regulation & Safety, Nutritionals

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Violation of the law

Posted by Elizabeth Zehner,

On behalf of Helen Keller International, a not for profit that focuses on improving nutrition and sight around the world, I'd like to point out that the Bibere Facebook page documents multiple violations of the 1981 World Health Organization's International Code on Marketing of Breast-Milk Substitutes (to which New Zealand is a signatory) and Cambodia's 2005 Sub-Decree 133 on Marketing of Products for Infants and Young Child Feeding and the 2007 Joint Prakas 061 on Marketing of Products for Infants and Young Child Feeding. These laws stipulate that "Any manufacturer and distributor shall not, without prior permission from the Ministry of Health, promote infant and child feeding products." These products are defined in Article 2 to include products for children up to 24 months of age. Promotion of these products is banned at the point of sale, in the hospital, in the health center, or elsewhere. Promotion includes advertising or providing discounts, samples or gifts to mothers, distributors, or health care workers. All information developed to accompany breast-milk substitutes must be provided in the local language. Encouraging optimal breastfeeding is essential in Cambodia, where child malnutrition is tragically high. According to UNICEF, a staggering 40% of children are stunted, a condition caused by poor nutrition during early childhood, and a third of child deaths are caused by malnutrition. The promotion efforts of Export New Zealand Limited documented on the Facebook site (gifts, samples, promotions etc.) violate multiple global and national laws, and endanger the health and nutrition of Cambodian children, and we welcome a reply from the company about steps to remediate the situation.

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In response to Chris Berryman's comment.

Posted by Elsie Lim,

1. The Int'l Code does not specify an age - and since breastfeeding is encouraged up to 2 years and beyond, any product that can be used to substitute breastmilk is within the scope.
2.The sub-decree 133 of Cambodia covers "all products marketed or presented for feeding infant and young children" and "follow-on formulas for infant over 6 months old". We have seen pictures of promotion of Stage 1,2 & 3.

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