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[MANILA, 26 July 2007] - United Nations agencies, Philippine health authorities and multinational milk companies are in a heated legal battle for the hearts, minds and breast-feeding habits of Filipino mothers. Infant milk formula is among the top three consumer products in the Philippines. Last July, the Philippine Health Department imposed a ban on the advertisement and promotion of breast-milk substitutes. Multinational milk companies responded by requesting a temporary restraining order on the policy's implementation and have challenged the constitutionality of the move in a complaint against the Health Department now being heard by the Supreme Court. How the Philippine Supreme Court finally decides the case will set an important regional precedent adjudicating developing-world public-health concerns up against developed-world corporate profits. Test The case is being widely viewed as a crucial test of corporate social responsibility toward developing-country consumers. At issue is the United Nations Children's Fund (UNICEF) recommendation that mothers should breast-feed their newborns exclusively for the first six months and continue to breast-feed for two years or more with appropriate complementary solid foods. UNICEF also cites scientific studies that found that bottle-fed infants in disease-ridden and unhygienic conditions are between six and 25 times as likely to die of diarrhea and four times as likely to die of pneumonia as breast-fed infants - statistics based on the disastrous public-health experiences witnessed in some poor African countries where strong marketing campaigns persuaded mothers to opt for infant formula over breast-feeding. In Asia, the Philippines is one of the largest markets for infant formula, and the likes of Nestle USA, Abbot, Wyeth and Mead Johnson all have significant sales in the country. Filipino mothers spend about US$469 million annually on infant formula, while multinational milk companies spent nearly $89 million on advertising - not inclusive of the travel, sponsorship and other perks they often provide to health professionals who promote their products. Statistics show the milk companies' advertisements have trumped UNICEF's public-service announcements. As of 2003, only 16 per cent of the 2 million babies born in the country were exclusively breast-fed for at least four to five months. More recently, the Philippines had the lowest breast-feeding rate among 56 countries in a demographic health survey monitoring behaviors over the past 10 years. Health experts, including UNICEF, the World Health Organization (WHO) and the Philippine Health Department, attribute as many as 16,000 infant mortalities per year in the Philippines from infections and diseases associated with using breast-milk substitutes rather than breast-feeding during an infant's first six months. Under both Philippine law and the International Code of Marketing of Breast-Milk Substitutes, health service providers are banned from promoting infant formula. Advertising agressive and false Government health authorities, UNICEF and the WHO have all blamed aggressive and sometimes false advertising messages by milk companies for the extraordinarily low levels of breast-feeding in the Philippines. In countries where consumer spending power is lower, such as Cambodia, breast-feeding rates are higher because of the absence of aggressive milk-company advertisements, according to a UNICEF representative. In Thailand, where consumer spending power is comparatively high, fewer than 5 per cent of mothers breast-fed their infants in the first six months. Breast-feeding rates are also falling in Indonesia and Vietnam, as both countries become more prosperous and targeted by milk companies, according to UNICEF statistics. Formulaic response In response, the Philippine Health Department last year implemented the so-called Revised Implementing Rules and Regulations (RIRR) of the 1986 Milk Code, which already regulated the promotion and advertisement of infant formula but was never fully implemented and was loosely enforced. The RIRR aims to ban formally the use of text and images of babies and adults in the promotion of infant formula and also looks to impose sanctions on health professionals who receive perks from milk companies to promote their products to new mothers. When milk companies represented by the Pharmaceutical and Healthcare Association of the Philippines (PHAP) balked against the move, the Supreme Court at first refused a petition the lobby group submitted last July to restrain the implementation of the RIRR temporarily. At the time, the decision was cheered by the Health Department, UNICEF and the WHO, as well as other non-government organisations advocating child rights and breast-feeding. Soon thereafter, however, the US Chamber of Commerce of the Philippines wrote a scathing letter to President Gloria Macapagal-Arroyo, expressing the group's broad concern about the RIRR, which it alleged would put "at risk" the country's "reputation as a stable and viable destination for investment". "We know you would want to avoid such a situation occurring," Thomas Donohue, president and chief executive officer of the US Chamber of Commerce wrote in the letter, dated August 11, and reviewed by Asia Times Online. He requested that Arroyo's government "re-examine" the regulation and even offered the help of chamber members in drafting new regulations for the industry. Around the same time, US Trade Representative officer David Katz paid a private visit to Health Department Undersecretary Alexander Padilla to express his reservations about the imposition of the RIRR, Padilla said in a recent Asia Times Online interview. Four days later, the Supreme Court backtracked and granted the PHAP the temporary restraining order it had originally requested. The justices apparently took into consideration the milk companies' argument that they would stand to lose P10 billion (US$222 million) if the RIRR were immediately implemented and that this would force them to reduce their in-country workforces. Legal questions over the constitutionality of the RIRR's restrictions on advertising are now being weighed by the Supreme Court, in a landmark case that will adjudicate between public-health and commercial rights in the country. UNICEF and the WHO recently indicated that the court's decision could set an important precedent for how milk companies are allowed to promote their products in other countries in the region. At the same time, the Philippine government is carefully monitoring the case because several of the plaintiff multinational milk companies - particularly those that belong to PHAP - are also big pharmaceutical producers that work directly with the Health Department on medicine-access issues. Philippine officials have no doubt noted with caution the recent fracas in Thailand, where the military government decided to produce generic versions of antiretroviral AIDS drugs patented by US companies and Washington, tit for tat, imposed trade sanctions on a range of Thai export products. Further information
pdf: http://www.atimes.com/atimes/Southeast_Asia/IG25Ae01.html