Nestlé violates international marketing code, says audit

BMJ 2000; 321 doi: (Published 01 July 2000) Cite this as: BMJ 2000;321:8
  1. Gavin Yamey
  1. BMJ

    An external audit of Nestlé's infant food marketing practices in Pakistan has found three violations of the World Health Organization's code of marketing of breast milk substitutes. The company has promised to correct these and develop more formalised tools to help its managers to monitor compliance with the code.

    Nestlé commissioned the audit from the consultants Emerging Market Economics after a former employee in Pakistan, Syed Aamar Raza, publicised internal company documents and alleged that these showed code violations (19 February, p 468). The code prohibits giving material or financial inducements to health professionals, but the audit found two examples of Nestlé delegates offering such gifts.

    The company also failed to disclose the financial assistance it had given to health professionals to attend conferences. No staff should receive commissions or bonuses based on the sales of products covered by the code, but Nestlé breached this rule, the auditors said.

    Despite these violations, the audit's executive summary states that “the operations of Nestlé Milpak are in compliance with the letter and the spirit of the WHO code.” Anna Taylor, nutrition adviser to the charity Save the Children, said: “The audit reveals that Nestlé is still violating the code.” The audit suggests, she said, that Nestlé uses health systems facilities to promote their products, a practice banned by the code.

    Other organisations are angry that the auditors did not contact them, or mothers in Pakistan, to investigate company practices.

    Hilary Parsons, corporate affairs manager at Nestlé UK, said: “During the external survey the auditors interviewed 64 health professionals. They had hoped to interview mothers in hospitals, but we understand that the hospitals had a policy of not permitting contact with the mothers.”

    A summary of the audit is on Nestlé's website at; Baby Milk Action's website is at

    Embedded Image

    (Credit: SYED AAMAR RAZA) This photo allegedly shows mothers in Pakistan carrying free Nestle samples; the audit found no evidence of inappropriate gifts to mothers

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