Sponsorships and gifts from infant formula companies to health professionals: ethical and legal issues

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements of the degree of MSc Med (Bioethics and Health Law) Johannesburg, 2016In South Africa, poor infant feeding practices, particularly the lack of breastfeeding and the unsafe use of infant formula, are some of the contributory factors of ill-health amongst infants. In order to limit the use of infant formula, the World Health Organization (WHO) recommends that countries put in place measures that restrict the marketing and promotion of infant formula by adopting the International Code of Marketing of Breast Milk Substitutes (BMS). In 2012, South Africa adopted the International Code of Marketing of Breast Milk Substitutes (BMS) by promulgating the following: The Regulations Relating to Foodstuffs for Infants and Young Children (R991). This research paper is based on normative research that uses pertinent ethical and legal arguments that support or critique some aspects of the regulations (R991) in South Africa. Various concepts and principles are used to support or refute the claims made. Some of the concepts and principles used include: Undue inducements, conflict of interests, professionalism, beneficence, non-maleficence, autonomy and justice. The researcher argues that unrestricted sponsorships and offering of gifts to health professionals as part of marketing by infant formula companies raises certain, serious ethical concerns. The basis of these concerns is that such practices could result in negative consequences for infants who, by their very nature, are vulnerable and who should be protected from practices that could compromise their health. Gifts and sponsorships, as part of a marketing strategy from infant formula companies to these health professionals, may have the potential to distort the accuracy of the information given to pregnant women, mothers/caregivers regarding infant feeding. To prevent infants from being harmed in this way, health professionals are expected to uphold the fundamental ethical principles of beneficence, non-maleficence, justice and autonomy when dealing with mothers or the caregivers of infants. Unfortunately, the regulations alone are not adequate to ensure that mothers/caregivers practise appropriate feeding methods. Other interventions, such as the educating of mothers, the strengthening and supporting of health policies that promote optimal infant and young child feeding practices, need to be emphasized. It is important that a mother/caregiver get factual and accurate information regarding infant feeding; that said, it is still the mother/caregiver’s choice whether or not to breastfeed the infant. Proper training and advocacy is needed in both the public and private sector to strengthen the effectiveness of the regulations. Continuous monitoring, enforcing of the regulations and corrective measures are all necessary to ensure that the regulations are complied with.MT201