Thank you to the organizers of ICN2 for the efforts to plan and prepare for the event in November 2014, and for the opportunity to comment on the Rome Declaration on Nutrition document. It is critical for ICN2 to focus on a singular objective, to gain commitment and outline actions needed to reshape the global food system to improve people’s nutrition, and agree on a guiding principle that agriculture and food policies must first do no harm.
We applaud the inclusion of malnutrition in all its forms and believe that it is of paramount importance to not only treat and prevent the occurrence of malnutrition but also build sustainable food systems to ensure long-term impact. Moreover, it will be key to approach malnutrition in a comprehensive manner by demonstrating the linkages of nutrition with other relevant sectors of development including agriculture, health, water, sanitation, hygiene (WASH), gender equality, female empowerment, and governance.
We urge the following additions to the document:
A. Paragraph 5: Under bullet point one: “Year-around access to sufficient food, adequate both in quantity and quality, affordable and culturally acceptable, is a key determinant; compounded and often aggravated, in a vicious cycle, by non-potable water, poor sanitation and hygiene, food borne and parasitic infections, and ingestion of harmful levels of chemical contaminants due to unsafe food supplies;” we suggest adding the bolded “and hygiene” above, as it is critical for water, sanitation and hygiene to be addressed together.
B. Under “A vision for global action to end all forms of malnutrition” section:
a. Please include a point that specifically states that this will endorse and commit to actions to meet all of the 2012 World Health Assembly (WHA) nutrition targets.
b. Thank you for recognizing that women and children have specific needs, however, under point (a) when you state: “the elimination of malnutrition in all its forms is an imperative for ethical, political, social and economic reasons, paying particular attention to the special needs of children, women, elderly and disabled people,” please add the line: “especially duringthe 1,000 day window of opportunity from a woman’s pregnancy to her child’s second birthday.” The consequences of malnutrition during the critical 1,000 day “window of opportunity” from a woman’s pregnancy to her child’s second birthday are largely irreversible, and can cause long-lasting damage. Maternal nutrition and support are therefore crucial to break the intergenerational cycle of malnutrition and build the foundations of healthy individuals and societies.
C. Under the “Recognize that” section:
a. We suggest adding a point that reads: “Recognize that a framework for collective commitment, action and results is needed to reshape the global food system to improve people’s nutrition, particularly that of women and young children during the critical 1,000 day window from pregnancy to age 2.”
D. Under the “Commitment to action” section:
a. It is critical to make the commitments to action list more specific and ambitious. We suggest the following commitments be added to the list:
· Accelerate progress to achieve the 2012 World Health Assembly nutrition targets at national levels.
· Governments and donors commit to, and ensure implementation of a long-term, adequately resourced, equitably delivered national minimum package of direct nutrition interventions.
· All countries establish (or enshrine, if already established) a multi-sectoral coordination mechanism for nutrition to ensure that policy decisions are owned by all relevant ministries and have domestic budget lines for nutrition; as well as appoint a government nutrition focal point who is responsible for ensuring that the country’s nutrition efforts effectively engage the whole of government and external stakeholders.
· All countries expand their target nutrition group to include women and children in the 1,000 day window from pregnancy to age 2.
· Nutrition is integrated into national social protection policies for young children, pregnant women, and breastfeeding and lactating mothers.
We would also appreciate your vision on policies, programmes and investment that might help translate such commitments into action.
We recommend the following:
· Normative guidance from FAO/WHO on how agriculture programs, investments and policies can deliver greater nutrition impact and nutrition-centered approaches to agricultural production. Reframe the food debate around the consumer, including education around healthy consumption, affordability and preparation.
· Support and strengthen the Scaling Up Nutrition (SUN) movement.
· Develop long-term funding and technical assistance provision options for countries and communities to address malnutrition, looking to HIV/AIDS, education and other models.
· Build a nutrition data revolution, measuring and understanding what people eat and increasing the quality and quantity of nutrition outcome data and analysis. For example, a new partnership with Gallup could expand their voices of the hungry survey, including Save the Children's cost of the diet survey which evaluates the costs of a nutritious diet in a local context and the extent to which households can afford it. This could be included in official statistics collection, or MICS and DHS surveys, and be expanded via partnerships with telecommunications firms to collect data on production and consumption.
· Level the playing field: agriculture has been focused on producing certain crops (e.g. staples like cereals), which help to grow the economy, but this has led to a neglect of nutritious foods. Most agricultural policies are biased to staple foods; we need to let “healthier” foods become more competitive and accessible.
· Increase control by women of key resources such as land and microfinance–with the idea that women would more likely grow and distribute more nutritious food.
· Governments generally have agricultural policies not “food” policies (e.g. looking at nutrition enhancing efforts within food chains). There are no incentives for this; so we need to focus more on developing food policies, keeping in mind that the private sector is a big player in this arena.
· Education – change the understanding among consumers so that they are more nutrition conscious and create demand.
· Partnerships with multilateral institutions, NGOs and businesses on nutrition and breastfeeding behavior change communication.
· Develop examples of best practice of food and nutrition strategies at a country level which focus on increasing the value proposition for export markets, while focusing on improving access to nutritious food among poor and marginalized groups. This should focus on pre-empting and responding to the challenge of non-communicable diseases, as well as looking at the challenges of increased populations, volatility, etc.
Thank you to the organizers of ICN2 for the efforts to plan and prepare for the event in November 2014, and for the opportunity to comment on the Rome Declaration on Nutrition document. It is critical for ICN2 to focus on a singular objective, to gain commitment and outline actions needed to reshape the global food system to improve people’s nutrition, and agree on a guiding principle that agriculture and food policies must first do no harm.
We applaud the inclusion of malnutrition in all its forms and believe that it is of paramount importance to not only treat and prevent the occurrence of malnutrition but also build sustainable food systems to ensure long-term impact. Moreover, it will be key to approach malnutrition in a comprehensive manner by demonstrating the linkages of nutrition with other relevant sectors of development including agriculture, health, water, sanitation, hygiene (WASH), gender equality, female empowerment, and governance.
We urge the following additions to the document:
A. Paragraph 5: Under bullet point one: “Year-around access to sufficient food, adequate both in quantity and quality, affordable and culturally acceptable, is a key determinant; compounded and often aggravated, in a vicious cycle, by non-potable water, poor sanitation and hygiene, food borne and parasitic infections, and ingestion of harmful levels of chemical contaminants due to unsafe food supplies;” we suggest adding the bolded “and hygiene” above, as it is critical for water, sanitation and hygiene to be addressed together.
B. Under “A vision for global action to end all forms of malnutrition” section:
a. Please include a point that specifically states that this will endorse and commit to actions to meet all of the 2012 World Health Assembly (WHA) nutrition targets.
b. Thank you for recognizing that women and children have specific needs, however, under point (a) when you state: “the elimination of malnutrition in all its forms is an imperative for ethical, political, social and economic reasons, paying particular attention to the special needs of children, women, elderly and disabled people,” please add the line: “especially during the 1,000 day window of opportunity from a woman’s pregnancy to her child’s second birthday.” The consequences of malnutrition during the critical 1,000 day “window of opportunity” from a woman’s pregnancy to her child’s second birthday are largely irreversible, and can cause long-lasting damage. Maternal nutrition and support are therefore crucial to break the intergenerational cycle of malnutrition and build the foundations of healthy individuals and societies.
C. Under the “Recognize that” section:
a. We suggest adding a point that reads: “Recognize that a framework for collective commitment, action and results is needed to reshape the global food system to improve people’s nutrition, particularly that of women and young children during the critical 1,000 day window from pregnancy to age 2.”
D. Under the “Commitment to action” section:
a. It is critical to make the commitments to action list more specific and ambitious. We suggest the following commitments be added to the list:
· Accelerate progress to achieve the 2012 World Health Assembly nutrition targets at national levels.
· Governments and donors commit to, and ensure implementation of a long-term, adequately resourced, equitably delivered national minimum package of direct nutrition interventions.
· All countries establish (or enshrine, if already established) a multi-sectoral coordination mechanism for nutrition to ensure that policy decisions are owned by all relevant ministries and have domestic budget lines for nutrition; as well as appoint a government nutrition focal point who is responsible for ensuring that the country’s nutrition efforts effectively engage the whole of government and external stakeholders.
· All countries expand their target nutrition group to include women and children in the 1,000 day window from pregnancy to age 2.
· Nutrition is integrated into national social protection policies for young children, pregnant women, and breastfeeding and lactating mothers.
We would also appreciate your vision on policies, programmes and investment that might help translate such commitments into action.
We recommend the following:
· Normative guidance from FAO/WHO on how agriculture programs, investments and policies can deliver greater nutrition impact and nutrition-centered approaches to agricultural production. Reframe the food debate around the consumer, including education around healthy consumption, affordability and preparation.
· Support and strengthen the Scaling Up Nutrition (SUN) movement.
· Develop long-term funding and technical assistance provision options for countries and communities to address malnutrition, looking to HIV/AIDS, education and other models.
· Build a nutrition data revolution, measuring and understanding what people eat and increasing the quality and quantity of nutrition outcome data and analysis. For example, a new partnership with Gallup could expand their voices of the hungry survey, including Save the Children's cost of the diet survey which evaluates the costs of a nutritious diet in a local context and the extent to which households can afford it. This could be included in official statistics collection, or MICS and DHS surveys, and be expanded via partnerships with telecommunications firms to collect data on production and consumption.
· Level the playing field: agriculture has been focused on producing certain crops (e.g. staples like cereals), which help to grow the economy, but this has led to a neglect of nutritious foods. Most agricultural policies are biased to staple foods; we need to let “healthier” foods become more competitive and accessible.
· Increase control by women of key resources such as land and microfinance–with the idea that women would more likely grow and distribute more nutritious food.
· Governments generally have agricultural policies not “food” policies (e.g. looking at nutrition enhancing efforts within food chains). There are no incentives for this; so we need to focus more on developing food policies, keeping in mind that the private sector is a big player in this arena.
· Education – change the understanding among consumers so that they are more nutrition conscious and create demand.
· Partnerships with multilateral institutions, NGOs and businesses on nutrition and breastfeeding behavior change communication.
· Develop examples of best practice of food and nutrition strategies at a country level which focus on increasing the value proposition for export markets, while focusing on improving access to nutritious food among poor and marginalized groups. This should focus on pre-empting and responding to the challenge of non-communicable diseases, as well as looking at the challenges of increased populations, volatility, etc.