Background
Methods
Selection of samples
Baby food companies
Companies’ name | Market share (%) |
---|---|
Nestlé (Thai) Ltd | 40 |
Dumex Thailand Co Ltd. (Danone) | 34.1 |
Mead Johnson Nutrition (Thailand) Ltd | 16 |
FrieslandCampina (Thailand) PCL | 4.5 |
Abbott Laboratories (Thailand) Ltd | 2.2 |
Other | 3.2 |
Data source and data collection
Key informants
Type of key informants | Number |
---|---|
Government official, Central level | 6 |
Government official, Regional level | 6 |
Government official, Provincial level | 16 |
Academic | 2 |
NGOs | 4 |
Total | 34 |
Systematic approach to collecting publicly available information
In-depth interviews
Data analysis
Results
The CPA of baby food companies during the policy process
Strategies | Practices | Number of documents (n = 447) | Number of key informants (n = 34) |
---|---|---|---|
1 Information and messaging | 1.1 Lobby policymakers | 0 | 6 |
1.2 Stress the economic importance of the industry | 9 | 0 | |
1.3 Promote deregulation | 0 | 0 | |
1.4 Frame the debate on diet- and public health-related issues | 60 | 0 | |
1.5 Shape the evidence base on diet- and public health-related issues | 202 | 2 | |
2 Financial incentive | 2.1 Fund and provide financial incentives to political parties and policymakers | 0 | 0 |
3 Constituency building | 3.1 Establish relationships with key opinion leaders and health organizations | 58 | 12 |
3.2 Seek involvement in the community | 103 | 7 | |
3.3 Establish relationships with policymakers | 0 | 7 | |
3.4 Establish relationships with the media | 15 | 0 | |
4 Legal | 4.1 Use legal action (or the threat thereof) against public policies or opponents | 0 | 0 |
4.2 Influence the development of trade and investment agreements | 0 | 0 | |
5 Policy substitution | 5.1 Develop and promote alternatives to policies | 0 | 0 |
6 Opposition fragmentation and destabilization | 6.1 Criticize public health advocates | 0 | 0 |
6.2 Create multiple voices against public health measures | 0 | 0 | |
6.3 Infiltrate, monitor and distract public health advocates, groups and organizations | 0 | 0 | |
Total | 447 |
Information and messaging
Lobbying policymakers
When we were drafting the Act, companies would ask to meet with the Director of [the] Department of Health, Permanent Secretary and Minister. . . (Government official)
The Chair of committee of National Legislative Assembly told me that the company sector had approached him already, but they hadn’t discuss [ed] the matter in detail . . . (NGOs)
I remembered exactly, a baby food company showed up with a media representative. They informed us that they had issued a letter to request a meeting with the Minister in order to provide information, along with the media company . . . When the Minister walked in, they approached him and said, “Today, I came with [baby food company’s representative name] to discuss my concerns over the Act.” Then, the representative of the baby food Association expressed the [ir] concerns toward the Act . . . (Government official)
Stressing the economic importance of the industry
Frame the debate on diet- and public health-related issues
Shaping the evidence-base on diet and public health-related issues
Around the time when the Act was about to be adopted, they [companies] employed some people to publish concerns in the newspaper that the Act . . . Those people who were expressing concerns were not from companies, so I think it’s their tactic to avoid expressing their concerns over the Act. (Government official)
Constituency building
Establishing relationships with key opinion leaders and health organizations
. . . prohibited them [companies] to contact pregnant women, but it was evident that they still contact the pregnant staff anyway. (Government official)
The baby food company was not prohibited from approaching doctors in hospitals, right? So, they [companies] contacted pediatricians to conduct with them Video conferences. (Government official)
Simply put, it had been a long-term built relationship. In the past, doctors and nurses were invited by companies to travel, and they agreed to join the trip. (Government official)
Seeking involvement in the community
[Companies] approached a local leader to participate in 3 Aor 2 Sor [local Health promotion program] . . . but they were also promoting their stage 3 formula [growing-up milk] by showing products off during the event. (Government official)
… Sometimes if they [companies] realized that [health] officers . . . had been trained, they [companies] wouldn’t host an event or violate the regulation in hospitals. However, they [companies] would conduct activities to provide knowledge at the local community instead. Though they [companies] would not mention milk products, they would use words such as supplementary food or healthy food instead. (Government official)
Establishing relationships with policymakers
When it [the Act] was just a draft, I was also [on] one of the committees of National Legislative Assembly. At that time, I noticed how they [companies] were trying to disguise themselves into the committees as well. (Government official)
They [companies] tried to infiltrate the committee [of the Act] or a working group on behalf of the association of baby food companies . . . (NGOs)
When the Act was still a draft, . . . they [companies] sent letters to the Prime Minister, Parliament, and Minister of Public Health to express their opinion that they disagreed with some wordings in some chapters, and they wanted to adjust them into their preferred words. (Government official)
Mostly, when executive people change, they [companies] will approach the new executives. (Government official)
Establishing relationships with the media
Impacts of CPA on Thailand’s the Control of Marketing Promotion of Infant and Young ChildFood Act B.E. 2560
It is obvious that they [companies] can successfully weaken the Act. The main point was that [the Act] doesn’t cover stage 3 formula [growing-up milk] . . . We [Department of Health and network] proposed that [the Act] should cover up to stage 3 formula, right? . . . However, eventually, these tactics [CPA] had weakened [the Act] which only included up to one year old [milk formula] . . . (Academic)
We [Department of Health] were pressured by academics, maternal and child experts, as well as from politicians to amend and lessen [the Act] enforcement . . . Thus, from a perspective of a person who had a strong sense toward these matters, this [the Act] might seem comparatively weak when considering how it was first drafted. (Government official)
The first draft [of the Act] from the Ministry [of Public Health] was fine . . . But when it [draft of the Act] was edited by committees of the Council of State, it [content of the Act] was deducted. One possible reason is that the Act cannot be written with such specific detail and it [content of the Act] had to be removed and replaced with legal wording instead . . . Admittedly, it [content of the Act] did not cover all expected details as first launched from the Department of Health [first draft of the Act] . . . (Government official)
On the other hand, some key informants thought that CPA did not have any impact on law implementation and law enforcement because it depended on the processes of the Department of Health.I went to [government organization] [to] explain [about the Act] because [government organization] sent a letter that showed their [government organization] concern. They [government organization] said that a representative of the company had already approached them [government organization]. (Government official)
In terms of advocating [the Act], we [Department of Health] can perform our work following the timeline and our processes without interruption. In term [s] of content, as I said, it was up to the vast majority of the committees [of the Act]. When we [Department of Health] launched guidelines or recommendations, it [guideline or suggestion] would follow the vast majority of the committees’ opinion [of the Act]. (Government official)
The public responses to CPA of baby food companies
I embedded the awareness among [lactation consultants] to not only promote breastfeeding, but also [lactation consultants] to protect [breastfeeding] . . . So . . . they [lactation consultants] confirmed that [if there is any contact with companies] they will refuse immediately . . . they [lactation consultants] weren’t interested in any incentive. (Government official)
If we [DOH] know [that companies have contacted the official department] and we [DOH] are able to fix it on time such as [government organization], we will be able to revert the situation because [government organization] was one of organizations that the cabinet needs in order to get their [government organization] approval on the Act. At first, we sent [draft of the Act] to them [government organization] and they [government organization] disagreed with it, but when we approached them [government organization], they [government organization] then agreed with it. (Government official)
After implementation of the Act, there is a working group for which the Department of Health played a role as the Secretariat and sought information to support policy implementation and enforcement.… The Department of Health had gathered [letters or questions from companies or other non-industry stakeholders] beforehand, and then [Department of Health] analyzed their [companies’ or non-industry stakeholders’] opinions and reactions, in order to plan our [Department of Health] course of action. [I] think that it was a team of the Deputy Director-General [of Department of Health] . . . At that time, the draft [of the Act] was still under the consideration of National Legislative Assembly where they [Department of Health] still had to explain [about the Act to National Legislative Assembly] and some documents were still withheld by National Legislative Assembly. And there were questions periodically about the Ministry’s opinion and editions [on the draft of the Act] to conform with opinions from the Royal College, milk companies, and Associations or Government officials.
There is a working group, with the Department of Health as a secretariat . . . when there were issues, we [working group] will find information to provide support [issues] . . . (Government official)
They [companies] tried to be a part of committees or working groups . . . but the committee considered it inappropriate to allow industrial stakeholders to be involved in policy processes or creating law enforcement’s details . . . It would be as if we allowed alcoholic drinks or tobacco companies to be part of policy making process which is ironic. They tried to offer their [companies] hands but we deemed it inappropriate . . . (NGOs)
At the local level, they [locals] didn’t know. If someone gives them something or provides support, they considered it as a good thing. But this time, I conducted conferences in my district in a meeting-like manner . . . and then I invited locals in order to explain [about the Act] . . . Sometimes, they [locals] didn’t understand, but [I] tried to explain to them, because joining [meeting] only once, they might [locals] not understand . . . as it [the Act] is hard to understand . . . (Government official)
At first, they [companies] phoned us to raise issues where [I] didn’t interrupt because it was rude . . . Mostly, [I] told [companies] to send a letter in order to mitigate conflict . . . (Government official)