1. Development of code into a national legislation in Bangladesh
M Q K Talukder, S K Roy, Khurshid Jahan
Bangladesh Breastfeeding Foundation
One Asia Forum-11, 2nd November 2015
Kuala Lumpur
Development of a strong national legislation for effective implementation of the international Code of marketing of Breastmilk Substitutes is a crucial action to protect, promote and support breastfeeding at country level. Many countries have achieved the task, though facing challenges in the process. One of the shining examples of a stringent national legislation is the legislation in Bangladesh. The speaker,  will share the experience how Bangladesh is an example of a stringent legislation. In this presentation we wish to share how the country achieved this

3. 1984: BMS Code first promulgated as an ordinance
The code stopped open advertisements of infant formula but extensive violation by the milk companies continued
Doctors continued to prescribe infant formula
For two decades the exclusive breastfeeding rate remained stagnant around 45%
The code was weak; did not meet some important WHO code provisions and fell into category 2 as assessed by ICDC

4. The Prime Minister promotes, protects and supports breastfeeding
Inaugurates World Breastfeeding weeks in 2009, 2010 and 2014
Gives directives at the 2009 and 2010 inauguration of WBW to strictly enforce Regulation on marketing of BMS

5. BBF united the professional bodies to strengthen the code
Institute of Public Health and Nutrition (IPHN)
Bangladesh Medical Association (BMA)
Bangladesh Paediatric Association (BPA)
Bangladesh Neonatal Forum (BNF)
Bangladesh Private Medical Practitioners Association (BPMPA)
Obstetrical and Gynaecological Society of Bangladesh (OGSB)
Bangladesh Perinatal Society (BPS)

6. International partners
International Baby Food Action Network (IBFAN)
International Code Documentation Centre (ICDC)
Breastfeeding Promotion Network of India (BPNI)
World Health Organization (WHO)
UNICEF

7. Processes involved in the preparation of the new law
MOHFW and BBF initiated the preparation
BBF had the major responsibility of drafting
Members of the professional bodies and civil societies joined
Relevant Ministries were sent copies of the draft for comment
Inter-ministerial Meeting discussed the draft
Final draft was sent to Cabinet meeting for approval

8. Processes involved in the preparation of the new law
MOHFW and BBF initiated the preparation
BBF had the major responsibility of drafting
Members of the professional bodies and civil societies joined
Relevant Ministries were sent copies of the draft for comment
Inter-ministerial Meeting discussed the draft
Final draft was sent to Cabinet meeting for approval

9. The code in major crisis
The cabinet considered that there can be advertisement and promotion of BMS with prior permission of the Government
The above decision was sent for vetting to the Ministry of Law and Parliamentary affairs

10. Overcoming the code crisis
Frequently visited the Ministry of Law and MOHFW along with VC of BSMMU, BPA President and Secretary
Met key Ministers and the cabinet Secretary
UNICEF and WHO chiefs met key Ministers and the Cabinet Secretary
Prime Minister was briefed

11. Overcoming the code crisis
Arun
5/23/13
to Patti, Annelies, Lida, Ina, me
Dear all,
Please see the note below from Dr Talukder requesting us to intervene with BD Health Minister.
Attachments area
Preview attachment Bangladesh BMS code in crisis.doc
Bangladesh BMS code in crisis.doc

12. Annelies and Patti met Bangladesh Health Minister at WHA in 2013
Dear Professor Talukder,
Both Patti and I saw the Minister and his private secretary and urged him to take a strong stand on the Law. He is a politician and said he would of course but I do believe he was sincere. He said he will follow your advice as always. 
All the best, 
Annelies

13. Final steps to legislation by Parliament
Ministry of Law in discussion with Ministry of Health resubmitted the draft to the Cabinet disallowing the advertisement of the BMS products
Cabinet approved the new Law and sent it to the Parliamentary Committee of Health, which approved with some more stringent provisions
Bangladesh Parliament passed the Law in September 2013 and got approval of the President

15. The Law: 24 clauses Short title and commencement Definitions: 14
Overriding effect of the Act
Restrictions on the matters relating to BMS, infant foods, commercially manufactured complementary foods and accessories thereof
Provisions relating to import, local production, sale
Information relating to receptacle and label
Education or other information
Formation of National Advisory Committee
Functions of the committee
Registration of Infant formula and others
Suspension and cancellation of Registration

16. The Law: 24 clauses Penalty Penalty for repetition of offence
Offence committed by company
Forfeiture of goods, equipments associated with offence
Power of entry
Application of thr criminal code
Application of Act No. 59 of 2009
Special provision to impose fine
Offences to be cognizable and Non-bailable
Power to make rules
Removal of difficulties
Publication of authentic English text
Repeal and saving

17. Title of the Law
Breast milk substitutes, Infant foods, commercially manufactured complementary Foods and the accessories thereof (Regulation of Marketing) Act, 2013

18. The Law covers Breast milk substitutes, Infant foods,
Commercially manufactured complementary Foods
Accessories thereof (Regulation of Marketing) Act, 2013

19. Restrictions No advertisement in any form of designated products
No prescription by health care providers
No distribution of leaflets
No gift by manufacturing restrictions to health care providers
No free sample distribution
Not to give financial or any other incentives by manufacturing industries to anybody, officers and staff of health centre or health workers for attending or participating in seminar, conference, symposium, workshop, training, scientific meeting or education tour

20. Restrictions cont.
Not to provide any financial incentives to attend international conferences organised and sponsored by manufacturers
Not to provide any funds by manufacturers to attend any higher education or engaging in any research
Not to offer financial incentives or any other gifts to any health professionals or any family member thereof

21. Punishment for violation of the Law
Contravention of any provision shall be an offence and shall be punished with imprisonment of maximum 3 years and/or fine up to US$ 6,410
If a child becomes ill or dies from use of any infant formula, complementary infant foods manufactured commercially and any accessories shall be an offence and shall be punishable by 10 years imprisonment and/or with a fine of US$ 64,100