Table 1

Status of South Africa’s legal measures aligned with provisions in ‘The Code’

Categories monitoredLegal provisionsScore
Scope (out of 20)BMS products covered up to age 36 (months)Complementary foods includedBottles and teats included20
Monitoring and enforcement (out of 10)Identifies who is responsible for monitoring complianceDefines sanctions for violationsRequires that monitoring and enforcement should be independent, transparent and free from commercial influence8
Informational/ educational materials (out of 10)Informational/ educational materials from industry prohibitedThe benefits and superiority of breastfeedingMaternal nutrition and preparation for and maintenance of breast feedingThe negative effect on breast feeding of introducing partial bottle-feedingThe difficulty of reversing the decision not to breastfeedProper use of infant formulaSocial and financial implications of its useHealth hazards of inappropriate feedingHealth hazards of inappropriate useRisk of intrinsic contamination of powdered formulaReference to proprietary productsPictures or text idealising BMS4
Promotion to general public (out of 20)AdvertisingSamples to publicPromotional devices at point of saleGifts to pregnant women and mothersContact with mothers20
Promotion in healthcare facilities (out of 10)Overall prohibition on use of healthcare facility for promotionDisplay of covered productsDisplay of placards or posters concerning covered productsDistribution of any material provided by a manufacturer or distributorUse of health facility to host events, contests or campaignsUse of personnel provided by or paid for by manufacturers and distributors10
Engagement with health workers and systems (out of 15)Overall prohibition of all gifts or incentives to health workers and health systemsFinancial or material inducements to promote products within the scopeFellowships, study tours, research grants, attendance at professional conferencesFellowships, etc, not prohibited but must be disclosed to the institutionProvision of free or low-cost supplies in any part of the healthcare systemDonations of equipment or servicesDonations prohibited only if they refer to a proprietary productProduct samplesProduct information restricted to scientific and factual mattersSponsorship of meetings of health professionals or scientific meetings13
 Labelling (out of 15)Prohibition of nutrition and health claimsThe words ‘Important Notice’Statement on superiority of breast feedingStatement on use only on advice of a health workerInstructions for appropriate preparationWarning against the health hazards of inappropriate preparationWarning that powdered formula may contain pathogensPictures that may idealise the use of infant formulaRecommended age for introduction of the productImportance of continued breast feeding for 2+ yearsImportance of no complementary foods <6 monthsImage/text suggesting use at <6 monthsImages/text that undermines or discourages breast feeding or compares to breast milkMessages that recommend or promote bottle-feedingProfessional endorsements12
Total score87/100
  • Green indicates that the provision is included in the national legal measures (R991); red indicates that the provision is not included in R991.