Monitoring compliance with the International Code of Marketing of Breast-milk Substitutes and Vietnamese Regulations (Decree 100)

The Access to Nutrition Foundation (ATNF) is a not-for-profit organization, based in The Netherlands, that was established in 2013 to develop and publish the Access to Nutrition Indexes (ATNIs). The first Global Index, launched in 2013, scored and rated 25 of the world’s largest food and beverage manufacturers on commitments, performance and disclosure on addressing obesity, diet-related chronic diseases and undernutrition. The ATNI is intended to (1) enable companies to benchmark their own performance against international standards and best practice and compare themselves to their peers and (2) provide an objective source of information for all stakeholders to use to evaluate companies’ responses to two of the world’s most pressing public health challenges.

ATNF decided to pilot, for the 2015 Global Index, an assessment in x countries of whether those companies that make breastmilk substitutes (BMS) conform fully with the provisions of the International Code of Marketing of Breast-milk Substitutes, subsequent WHA resolutions and local regulations, in order not to undermine optimal infant and young child nutrition which are major factors in combating obesity, undernutrition, morbidity and mortality. Evidence is increasing that the initiation and duration of breastfeeding may influence obesity in later life,[1]  and that breastfeeding can prevent hundreds of thousands of infant deaths and protect children throughout their lives, Breastfeeding provides strong immunity to children, reducing the risk of certain illnesses and the need for antibiotics and other medicines.[2] Vietnam was chosen as one of the countries for the pilot studies because all of the major breastmilk substitute manufacturers being assessed by ATNI sell products in the country and because promotion of exclusive breastfeeding is increasing, as evidenced by the passage of a new governmental decree (Decree 100) regulating the marketing of BMS products. In Vietnam the exclusive rate of breastfeeding for infants less than six months of age was under 20 percent in 2010,[3] but over the course of 4 years, the estimated percentage of exclusive breastfeeding for infants less than six months increased to roughly 24.3 percent,[4] possibly associated with activities such as the Alive and Thrive program, which has been a joint program with UNICEF and the Government of Vietnam.