Wednesday, 6 June 2012

Pharmacy WHO breach issue update

I had a reply from the CEO of the chemist chain about the formula company branded mats on the baby scales. If you haven't been following the saga, you can catch the previous installments one, two and three. I would again like to point out that this is not an 'anti formula' or 'breast is best' post. I am not making comment on a parent's choice as to how to feed his or her child. This is about exposing the dirty advertising tricks of formula companies and about refusing to stay silent when pharmacies and formula manufacturers work together to put sales and profits ahead of infant health. For more on the advertising techniques of formula companies (which in many ways are similar to those of cigarette companies) see this link.

The reply which I received last week from the CEO of the company - if I'm getting replies from the CEO (or at least from his email account) then someone must be paying attention. To be honest I thought I would get a generic response which is sent to all the crazy people who bang on about the WHO Code.

Here's the reply I received:

Hello Bugs,

My team has raised your concerns with me in an effort to further examine the substance of your query. Please be assured that we welcome all feedback. Further, we use this feedback to review our offer and to look for alternate, improved ways of delivering a superior and personal pharmacy experience. This is in line with one of **** Chemists' guiding principles, 'there is always a better way'.

You have raised some important and valid points. Upon reading the correspondence between yourself and my team I can appreciate and understand your position. I would like to take this chance to explain to you, ours.

**** Chemists has a more than 50 year history in pharmacy. However, we recognise that history counts for very little unless we continue to offer the attentive, professional and friendly service and trusted pharmacists' advice for which we are known. We must do this in a way which exceeds the needs of our customers who both demand, and deserve to be valued. We pride ourselves on our track record for achieving these goals and our reputation for excellence in setting standards for service and contributing to a professional and dynamic pharmacy industry. In doing so we recognise that merely meeting minimum requirements is often not good enough. We strive for best-practice. I acknowledge the intentions of the World Health Organisation's International Code of Marketing of Breast-milk Substitutes and understand the guidelines it contains.

In particular I note section 6.8 "Equipment and materials, in addition to those referred to in Article 4.3, donated to a health care system may bear a company's name or logo, but should not refer to any proprietary product within the scope of this Code,".

The International Code of Marketing of Breast-Milk Substitutes does not counsel against use of formula company logos or branding per se. Some exceptions, as outlined above, are provided for within the Code, which is quite clear both in terms of its provisions and its intent. Our understanding is that use of our hygiene mats do not breach of the provisions or intent of the Code. In addition, the disposable hygiene mats provided for use through ****** Chemists' baby weigh service do not carry formula company logos, rather they carry logos for two baby clubs. On the basis of our assessment we will continue to offer free hygiene mats for the convenience of parents and carers who use the ***Chemists baby weigh service.

We do appreciate that your position appears markedly different to ours. At all times we seek to resolve any issues that may arise to the satisfaction of all concerned. As I said we encourage feedback in the spirit of, "there's always a better way," however in this case, I'm not sure that this is the case. We appreciate your position, and hope that you may be able to appreciate ours - however different the two may be.

If you have any further concerns, or if your complaint is made on the basis of another WHO Code and you would like to discuss this further please feel free to contact me on **phone number***


CEO of chemist chain

You'll notice that he skirts around the issue as to if the chemist chain plans to follow the WHO Code or not. After you get through all of the introductory lip service to going above and beyong and striving for best practice (without actually doing so), you get to the actual argument. First he defends the use of the branded mats saying that it falls within the Code (which it doesn't, see my reply below). Secondly he says that it's not really a breach since the logo is for a baby club, not the formula company. Thirdly he goes on to say that we appear to have 'markedly different' views on the matter - without actually saying how we are different. If the chemist chain is working within the WHO Code, then in what ways are our views different?

Here is my reply:

Dear CEO of chemist chain,

Thank you for your detailed reply to my email; I appreciate the time that you have taken to consider my concerns. I have responded by email rather than by phone as requested as I feel it is preferable for this conversation to be in writing for the clarity of all parties.

The section of the International Code of Marketing of Breastmilk Substitutes (the Code) that you quoted does not apply to the situation at hand.
Article 3 of the Code clearly defines a retail pharmacy as a ‘distributor’ not as a ‘health care system’, therefore sections 4.3 and 6.8 do not apply.
“"Health care system" means governmental, nongovernmental or private institutions or organizations engaged, directly or indirectly, in health care for mothers, infants and pregnant women; and nurseries or child-care institutions. It also includes health workers in private practice. For the purposes of this Code, the health care system does not include pharmacies or other established sales outlets.”

The part of the Code that is being breached by the scale sheets is Section 5.5 which states that infant formula manufacturer’s “Marketing personnel, in their business capacity, not seek direct or indirect contact of any kind with pregnant women or with mothers of infants and young children.“ Article 3 of the Code includes “information services” in its definition of marketing, therefore a baby club is marketing directly to parents and the general public. Thus the advertisement of Baby Clubs run by infant formula manufacturers is in breach of section 5.5 of the Code. By creating and using the branded scale sheets, ****** Chemists is enabling the formula company to seek direct contact with mothers of infants. As stated in the advertising material of this club mothers are encouraged to join the baby clubs if they are ‘looking for advice, reassurance or just have a question’ when they use the baby weigh service.

I quote from your email, ‘In doing so we recognise that merely meeting minimum requirements is often not good enough. We strive for best-practice.’ If this is the case, then why does *** Chemists not follow the WHO Code? In the same paragraph you said that you understand the WHO Code guidelines. If this is the case, then why have you defended the use of the branded mats under sections of the code which do not apply to pharmacies? I can only assume that the way you referred to sections 4.3 and 6.8 means that either you do not understand the WHO Code as you claimed, or that you are trying to mislead me by quoting irrelevant sections of the WHO Code.

You mention that we appear to have different positions on this issue and you have said you intended to explain to me your position. However, it is still unclear to me what your position is, specifically if **** Chemists is willing to work within the WHO Code or not. Your letter explained to me that you thought that ***** Chemists was working within the Code. If this was the case (although it is not because as I explained above the section that you quoted to me does not apply to retail pharmacies) then in what ways do we have ‘markedly different’ positions? To clarify if we have different positions or not: I believe that the WHO Code should be followed. Does **** Chemists believe that The International Code of Marketing of Breast-Milk Substitutes should be followed, or not? If not, then please explain why not.

Thank you again for your time in considering my email.  

As usual I will keep you posted on the outcome.



  1. I did miss this one! Glad I've found it. Love how assertive you are and that you're not willing to accept side steps on the chemists' part.


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