Free samples and supplies

Companies are breaking the rules by ...

giving samples or supplies to mothers, health workers or health care facilities. Mothers receive samples either directly from company sales representatives (see p.xxx) or from health workers or health care facilities. Some samples are given in sachets, but most of the time, mothers receive a full tin. Health workers receive samples most often via com;pany sales representative. Rarely did a health worker reply that a sample was given for professional evaluation or for research, the only two circumstances in which samples are permitted according to Article 7.4.

Samples receibed by mothers in Indonesia and in Hungría.

Companies are also breaking the rules by giving free supplies. Companies that belong to the International Association of Infant Food Manufacturers (IFM) pledged as far back as 1991 to work towards the goal of ending free and low-cost supplies. Yet, in 1997, there were instances of supplies of infant formula given to health care facilities in 19 of the countries surveyed. Donations of follow-up formula and complementary foods have also been taking place.

Supplies of Similac in Costa Rica.

Chart 1 shows in which countries mothers and health workers received samples and health care facilities received supplies of infant formula. A company appears on the chart as giving free supplies in any country where such a practice was reported one or more times. Any donation numbering 10 or more units, or smaller amounts if given on a regular basis, is reported as supplies. Smaller, non-regular amounts are listed as samples to health workers.

The following companies also give samples or supplies of infant formula: Alter (Spain), Aponti (Germany), Fasska (Bangladesh), Francexpa (Benin), Heinz (Colombia), Kasdorf (Argentina), Milco (Dominican Rep.), Nam Yang (Korea), Pliva (Croatia), Sancor (Argentina), Sari Husada (Indonesia).

Companies give samples and supplies of follow-up milks or complementary foods as well. For example, Nestlé free samples of complementary foods were reported as given to health workers in 11 countries, and to mothers in 8 countries. Samples or supplies of follow-up milks are given in Indonesia by Lyempf, Mead Johnson, Morinaga, Nestlé and Nutricia/Cow & Gate, Sari Husada. Wyeth gives samples or supplies of follow-up milks in Colombia, Thailand, Nicaragua and Venezuela.

Samples are often given to health workers by company sales representatives during regular visits. Wyeth’s distributor in Malaysia delivers samples to clinics with an invoice indicating a charge of 10 sen per tin (approximately US$.03). One doctor’s invoice amounted to US$1.00. "Of course the company does not collect", he said. Mead Johnson also gives samples to clinics on a regular basis. A delivery van driver stated that every month he delivers samples of O-Lac, Enfalac, Enfapro and Prosobee to more than 30 clinics in one city in Malaysia.

Some samples carry the explicit statement "medical sample, not to be sold" and some companies give health workers small sample-size tins. In most cases, however, ordinary tins are distributed to health workers.

Samples received by mothers
and health workers in Argentina.

Some examples of free supplies being given in various facilities are as follows. In Gabon, the Pediatrie de Melen, a paediatric clinic, receives supplies of Nestlé’s AL110, Guigoz and Cerelac every month. Another clinic receives supplies of Nestlé Guigoz, Nativa, Prenativa, and Cerelac as well as Danone’s Galliasec and Pregallia once every two months.

In Côte d’Ivoire, the Formation Sanitaire Abobo Sud receives a carton of 50 sachets of Nestlé Cerelac and 60 sachets of Nutrexpa Blevit every month. Every four months, the PMI de Cocody receives Nestlé Guigoz and Danone/Diepal Nursie.

A paediatric clinic in Germany regularly receives cartons of infant formula from Hipp, Humana, Milupa and Nestlé. In Guatemala, the Hospital Latinamericano reported receiving 24 tins each of Abbott Ross Similac, and Mead Johnson Prosobee, Enfamil, and Enfamil AR. Four clinics in Solo, Indonesia receive supplies of Enfamil. Two receive 40 tins each month and the other two 40 tins in 3 months. The Mahayuparaj Hospital in Chiang Mai Thailand receives four dozen tins of Snow Brand and Meiji infant formula each month as well as four dozen tins of Wyeth S-26 quarterly.

In Malaysia, Dumex, Farley’s, Friesland/Dutch Baby, Abbott Ross, Nutricia/Cow & Gate, Lyempf, Milupa, Snow Brand and Wyeth may claim that they do not give free supplies. For this report, however, they were included as doing so because of their arrangements to supply infant formula to hospitals as and when requested. The companies may not automatically deliver supplies on a regular schedule as before, but hospital personnel are assured that free formula is available with a phone call. The result is no different from the old practice of automatic deliveries. Free formula is always available and there is no incentive for staff to encourage breastfeeding.

In Thailand, many hospitals still use the rotation system. Hospitals receive donations from a number of companies that take turns giving supplies. In some cases each company gives only once or twice a year. In other cases, each company donates monthly. Whichever system, the hospitals have enough free formula to routinely feed newborns. Some hospitals make up gift baskets for the mothers to take home, which include a tin of the donated infant formula.

According to a 1997 survey published by the Hong Kong Cosumer's Council, 100 percent of hospitals reported that baby milk companies give free supplies.

Promotion in Health Care Facilities
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