Reflection Paper on Formula for Disaster

I. Brief Background Information

In 1981, Prof. Esteban Bautista of UP Law Center drafted the Philippine National Code to regulate the marketing of breast milk substitutes, breast milk supplements and related products. For five years, it was lobbied for the passage of the Philippine Code to the Batasan Pambansa lawmakers. And in October 1986, President Corazon Aquino signed Executive Order 51 or the Milk Code.

When EO 51 took effect in 1987, Wyeth introduced follow-on formulas for six-month-old babies. But as 1990s came, improvements on the Milk Code's IRR were made including a ban on follow-on formula that undermined breastfeeding as guided by World Health Assembly (WHA) Resolutions stating: "follow-on or follow-up formulas are unnecessary because after six months, the baby starts to take complementary foods together with sustained breastfeeding."

In 1992, the Senate passed Republic Act 7600 or the Rooming-In/Breastfeeding Act which cites that breastfeeding could save the country valuable foreign exchange that would otherwise be used for milk importation.

In 2000, Task Force Milk Code's resolutions were overturned by an Administrative Order issued by then secretary of Health Alberto Romualdez, allowing milk manufacturers to be engaged in all forms of breastfeeding activities such as education, production and development of breastfeeding materials.

In 2003, the National Health and Demographic Survey found that only 16% of Filipino infants were exclusively fed with mother's milk, a sign that the breastfeeding culture is declining. According to experts, this is a public health emergency.

In 2006, the Pharmaceutical and Healthcare Association of the Philippines (PHAP) filed a suit against the Secretary of Health and all who signed the revised IRR. PHAP petitioned for a temporary restraining order on its implementation but was denied by the Supreme Court.

On August 11, Thomas Donahue--President and Chief Executive Officer of the United States Chamber of Commerce--wrote to the President Gloria Macapagal-Arroyo saying that the RIRR "would have unintended negative consequences for investors' confidence in the predictability of business law in the Philippines."

The Supreme Court overturned its previous decision and imposed a TRO on the RIRR on August 15, 2006. And after a month, the office of the Solicitor General petitioned the Supreme Court to lift the TRO. To settle things out, on June 19, 2007, the Department of Health and PHAP presented oral arguments before the SC.

E.O No. 51 states that Health Care Systems--governmental, non-governmental or private institutions or organizations--cannot be used to promote infant formulas and requires health workers to inform mothers about the risks of infant formula. Yet, in the documentary made by UNICEF (United Nations Children's Fund), it is clear that there has been a poor compliance to the law, thus, violating these.

The documentary shows a government-owned children's hospital where promotional products from Milk companies can be found in strategic places. Also, a city health nurse named Jonah Buenviahe was interviewed, confirming that there are doctors and health workers who receive giveaways from Medical Representatives and incentives like airconditions, air fare to go places, food donations, sponsoring even the non-medical related events like outings and Christmas party--a practice which is also prohibited in the Milk Code.

A Medical Representative who was also interviewed admitted that they often target private doctors because they prescribe the high end products unlike in health centers, they can only offer the low end milk.

The documentary explores an urban poor community in Sitio San Roque in Brgy. Pag-asa, Quezon City. Despite the benefits of breastfeeding like it strengthens the bond between mother and child, does not cause any single centavo, and can prevent mothers from getting pregnant again too soon, parents nowadays disregard these benefits and instead invest on infant formulas--a norm even those who are in urban poor communities like Sitio San Roque practice.

A factor of such norm is the aggressive marketing strategies