I am keeping the same subject line though this is tangential to the original thread.  Skip the rest if you don't like hair-splitting rants or read on at your own risk.

Jane Kershaw writes: "Since we do not have a one-world government, there is no REAL way of enforcing globally mandates by any world organization.  Each country can decide throught whatever "truth in advertising" laws or trade and/or restraint of trade laws.  When countries have FDA-like governmental control, they can restrict access to medications by requiring pre-approval before marketing, the methods of marketing and the requirements to obtain a medication (or product).  An analogy is that in certain South American countries, you can go to the pharmacy and buy antibiotics without a prescription.  Not in America.  Remember that our FDA saved us from having a bunch of babies with shortened limbs where it was widely used in other countries before they knew about the problem. There has to be a balance between big brother control and freedom of choice.  Remember, Medela is a Swedish company operating globally. Does Sweden restrict it's advertising?"

As someone else has pointed out, Medela is Swiss, not Swedish. I will add that Switzerland is the ultimate haven of market liberalism, and that may well be why Nestlé is happy to keep its corporate HQ there, while Sweden has some of the most restrictive consumer safety and marketing legislation known in the world.  There is no advertising of cigarettes or alcohol or breastmilk substitutes in Sweden, nor are drugs advertised as they are in the United States of America.  Switzerland is not a member of the European Union, either, while Sweden is, so Switzerland is not subject to any joint EU regulations, watered-down though they may be, on marketing.

I don't think my home country (USA) has so much to brag about in consumer protection, since direct advertising to consumers for both pharmaceuticals and for breastmilk substitutes is widespread there.  While there was one doctor who hindered FDA approval of thalidomide, it was still distributed directly to doctors by the manufacturer, who gave it to pregnant women, resulting in the known cases of teratogenic limb reduction that did occur in the US.  And while legislation requiring that a manufacturer show its products to be safe for use in pregnancy was indeed enacted in the US as a result of the thalidomide tragedy, it did not prevent the drug diethylstilbestrol from being given to millions of pregnant women to prevent miscarriage between 1953 and 1971 despite solid evidence from randomised clinical trials showing it had no effect whatsoever on the likelihood of miscarriage.  It continued to be aggressively marketed for nearly 20 years after the research was known, also used for lactation suppression (!), and the second generation of DES offspring are now being followed up for the reproductive health problems resulting from its needless use in a country with a federal regulatory agency for medications.  Thalidomide, OTOH, has turned out to have several valuable therapeutic applications, including treatment of multiple myeloma, which my mother died of nearly 25 years ago when there was no known therapy beyond palliation (amazing what you can find on Wikipedia!). 

Finally, I must remind the list that all South American countries are, in fact, 'in America'.  I myself have a US passport, which is one type of American passport, just like Brazilian, Argentinian, Mexican and Canadian passports are, as well as the passports of the other 30 countries on or around the continents of North and South America.  About one third of the population of the Americas resides in the United States of America; all the other Americans live in the 34 other countries there.  It may seem picky, but IMO it matters.

Time to step back from the computer, and start dinner!
Rachel Myr
Kristiansand, Norway, Europe but not European Union :-)

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