Intended for healthcare professionals


Nestlé's violation of international marketing code

BMJ 2000; 321 doi: (Published 14 October 2000) Cite this as: BMJ 2000;321:959

The auditors respond

  1. Sunil Sinha, director (
  1. Emerging Market Economics, London E14 9XP
  2. Nestlé UK, Croydon CR9 1NR
  3. International Code Documentation Centre, PO Box 19, 10700 Penang, Malaysia
  4. Department of Paediatrics, University of Naples, Naples 80131, Italy

    EDITOR—Yamey did not give an accurate summary of the findings of our audit of Nestlé's infant food marketing practices in Pakistan.1 It should be clarified that we did not investigate the allegations made by Syed Aamar Raza. What we undertook was an audit of policies, procedures, and operational systems, cross checked by internal and external surveys. Whereas we concluded that Nestlé Milkpak's operations are in compliance with the letter and spirit of the World Health Organization's code of marketing of breast milk substitutes, Yamey focused on the violations of the code that we did find, implying that our conclusion is not justified by the facts.

    We found that Nestlé Milkpak had in place a consistent framework of policies, procedures, and work instructions to ensure compliance with the code, that the code is embedded in the culture of the company, and that Nestlé tried to mitigate pressure from the marketplace that may have led to code violations.

    Yamey did not discuss the nature of the three instances of violation identified in our audit. The gifts offered to health professionals amounted to a jar of instant coffee and some non-medical books. The failure to disclose financial assistance to health professionals was actually a failure to disclose such assistance to the heads of their institutions. The bonuses that were provided to sales staff were from one distributor that had failed to separate infant formula products from other products when calculating staff bonuses and whose sales account for less than 2% of Nestlé Milkpak's total infant formula sales.

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