Context for project

The Global Access to Nutrition Index is published every two years and is made up of several components. One component addresses the marketing of breast-milk substitutes (BMS). This is because ATNI believes that it is essential for companies to contribute to optimal infant and young child nutrition (IYCN). Doing so is critical to achieving global nutrition goals, such as those set by the World Health Organization (WHO) for 2025 on reducing wasting and stunting, and other goals related to combating growing levels of overweight and obesity and reducing deaths and illness related to diet-related chronic diseases. It is also key to delivering SDG 2- Zero Hunger and 3 – Good Health and Wellbeing, which in turn underpins the achievement of many other SDGs.

Nutrition within the first 1,000 days of a child’s life, from conception to two years old, is particularly important. Optimal breastfeeding is a crucial element of IYCN. Scaling up breastfeeding to near universal levels could prevent the deaths of over 820,000 children under five each year. It is for this reason that WHO recommends that babies everywhere are breastfed exclusively for the first six months, at which point safe, appropriate complementary foods (CF) should be introduced to meet the children’s evolving nutritional requirements. WHO also notes that CF should not be used as BMS, and infants and young children should continue to be breastfed until they are two or older. Inappropriate marketing of BMS can undermine optimal IYCN.

How BMS marketing is addressed in the Global Access to Nutrition Indexes

Because of the importance of IYCN, each edition of the Global Access to Nutrition Index includes a BMS marketing sub-ranking that scores and ranks the world’s largest baby food manufacturers. Previous ATN Indexes included four food and beverage sector companies – Danone, FrieslandCampina, Kraft Heinz and Nestlé – and two other companies – Abbott and RB/Mead Johnson Nutrition (RB/MJN). From 2020 onwards, ATNI will assess the ten largest baby food manufactures to cover a larger share of the global baby foods market. Along with the aforementioned companies, the new entrants are: Pepsico, Feihe International, Inner Mongolia Yili Industrial Group and China Mengniu Dairy.

The companies’ BMS marketing policies and practices are assessed using ATNI’s methodology, which measures the extent to which they market their BMS products in line with the recommendations of the International Code of Marketing of Breast-milk Substitutes (The Code) and subsequent relevant World Health Assembly (WHA) resolutions, including WHA 69.9. This element is referred to as BMS 1.

The second part of the assessment is the in-country research studies. ATNI selects two countries for each Index where studies are conducted using the NetCode Protocol. ATNI contracts the international health research company Westat to conduct these studies. This element is referred to as BMS 2.

While the findings and combined results of BMS 1 and BMS 2 can be found in the Global Index reports once published, ATNI releases each BMS In-country assessment report as it is completed.

Latest developments

In recent years, ATNI and FTSE Russell have conducted similar but separate in-country assessments and verifications of companies’ BMS marketing. From 2019 onwards, ATNI provides FTSE Russell data from our studies, to feed into its approach to determining whether BMS companies meet its criteria for inclusion in its FTSE4Good Indexes.

ATNI will continue to apply its own criteria and methodology as previously.

For more information on the agreement between FTSE Russell and ATNI, please read the Frequently Asked Questions (FAQs).

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