Foro Global sobre Seguridad Alimentaria y Nutrición (Foro FSN)

Thank you for sharing the work programme. Please find below feedback from Save the Children.

Comments on the UN Decade of Action on Nutrition Work Plan

Feedback from: Save the Children

Question 1: Does the work programme present a compelling vision for enabling strategic interaction and mutual support across existing initiatives, platforms, forums and programmes, given the stipulation of Res 70/259 that the Decade should be organized with existing institutions and available resources?

There are some things to admire in the document. Amongst others, we particularly commend:

·         The emphasis on addressing all forms and cases of malnutrition

·         The emphasis of promoting coherence of national, regional and international policies

·         The idea of bringing all nutrition efforts under one umbrella to ensure alignment and common advocacy

·         The intention to develop a global accountability framework and mechanism, across sectors and constituencies

We do however hold concerns which we would like to see addressed; these are listed in some detail across the following questions.

Question 2: What are your general comments to help strengthen the presented elements of the first draft work programme of the UN Decade of Action on Nutrition?

A)     Resources: We welcome the Decade of Action’s efforts to provide clearly-defined time-bound operational frameworks to implement the commitments made at ICN 2 and the 2030 agenda.

We are concerned, however that there is not sufficient emphasis on need for increased resources for nutrition (especially DRM), nor the need to improve the use of existing resources via integrated multi-sectoral and multi-stakeholder working. Save the Children’s research forecasts that even by 2030—the deadline world leaders have set themselves to end all forms of malnutrition—129 million children will still find their physical and mental development stunted by malnutrition.[1] In fact, children living in 53 countries will continue to be malnourished way into the next century.[2]

Increased resources from all stakeholders (national governments, donors and the private sector) are urgently required to speed up progress.  The World Bank estimates that reaching 4 of the 6 World Health Assembly nutrition targets by 2025 will require an additional average annual investment of $7 billion over the next 10 years, of which donors should contribute an additional $2.6 billion. The sooner that these resources are invested, the faster, better, and more sustained the economic and human gains.

Recommendation: Increased emphasis on the need for increased resources for nutrition with a focus on domestic resource mobilisation supported by donors, businesses and others, e.g. strengthen language used for ‘mobilizing financial commitments to achieve rapidly increase resources’

B)      Plans: We are also concerned that the work programme is not yet ‘time bound’ and appears to be more a set of intentions than a work programme. This is most clearly demonstrated by the lack of concrete actions. E.g. desire to “address the increasing amount of emergencies”, but with no clear plan as to how. This is particularly worrying given that the assumption of the DoA is that the WHA indicators will need to be met by 2025; yet there is no explicit indication in the document on how the DoA intends to meet these objectives.

Further, the document mentions a broad range of issues, but it does not go into a prioritisation, nor does it give an idea of which issue to start with or how to start with it. This might not necessarily be a diktat, but rather advice on how to go about prioritising at the country level, with examples of how other countries have had successes or failures to reinforce that.

Recommendation: Rapid development of clear, integrated, prioritised action plan, with timescales, to support activities outlined in the work programmes

C)      Country Specificity & Inclusion: The document does not mention any high-burden countries specifically, or reference how little commitment many of them have made to tackle malnutrition in their domestic spheres (which may threaten the DoA’s goal generally).

Perhaps even more importantly, the world is off-track against its goals because progress has not been inclusive enough. Millions of children miss out on adequate nutrition because of whom they are and where they live. These are the forgotten children who are discriminated against because of their gender, ethnicity, where they live, a disability, because they are forced from their home or on the move, or because of their family’s income. Inequalities in malnutrition are widening between different regions within countries, between the richest and the poorest, and between rural and urban areas. Discrimination and exclusion are helping to create and entrench these inequalities.

With this in mind, we applaud the aim and added value of this work programme to ‘leaving no one behind’, and the emphasis on reaching the most marginalised and most vulnerable in action areas including those on UHC and social protection. However, a  cross cutting set of activities is required in order to reach the furthest behind first, in order to leave no one behind.

Recommendation: Include an ‘action area’ to address inequalities, exclusion and discrimination to ensure no one is left behind. This should include recommendations for governments to:

·         Undertake a multi-sectoral contextual analysis to understand:

-       The national drivers of and trends in malnutrition

-       Which policies and practices will best address malnutrition

-       Which groups of people are most marginalised and vulnerable to malnutrition and the barriers they face to improving their situation

·         Translate global goals into national targets, with adequate resources and plans that lay out how each country will reach its goals for all groups of society,  based on the national context and trends

·         Lay down appropriate policies and plans to reach those targets, for all groups of society

·         Work with relevant sectors and stakeholders throughout

·         Ensure appropriate finances are in place

D)     Legal Frameworks: The right to food is a basic human right. Governments have an obligation to ensure all citizens have access to sufficient quantities of food, of sufficient quality and cultural acceptability to meet their needs. States also have a binding obligation, enshrined in international law, to respect, protect and realise children’s right to survival. The UN Convention on the Rights of the Child obliges states to do everything they can to prevent children from dying. To meet this commitment, states need to tackle malnutrition. Yet, many countries lack a legal framework that promotes child survival, and those that do often fail to implement it.

Recommendation: Strengthen the emphasis on the legal frameworks for child survival; possibility of using framework from Save’s “Unequal Portions” report (see p.25) http://www.savethechildren.org.uk/sites/default/files/images/Unequal_Portions.pdf]

E)      Language: The definition of terms in the work plan could be improved. For example, the word “resilience” is included without an attempt to define what is meant by the term (for we know resilience is used widely across the sector in a multitude of different contexts.

F)      Action Areas: The action areas are welcome in their ambition and structure, but we would propose some changes as per the below:

·         Action area 1: food systems focus is important but it fails to address the income challenge for those working in agriculture and the fact that not everyone works in or profits from agriculture. It is quite production focused, but we know most people will still need to purchase most food. Explicit reference to the need for agriculture to increase incomes on the one hand and enable availability of affordable nutritious foods on the other is needed. Leading on from this, there is not enough attention given to market failure, and its impact on private sector involvement in food systems. There is also little reference to livestock, the associated environmental challenges and the disease risk and its link to malnutrition

·         Action area 2. This area would benefit from being more specific about what nutrition actions it refers to. There is no reference for example to the detection, referral and treatment of acute malnutrition – referring to the compendium of action on nutrition would be a good start here.

·         Action area 3: There is minimal reference to evidence here. While we would be broadly supportive of what is proposed it could go further and reference the need for the size of transfers to enable households to afford nutritious foods and health and water services, the need to ensure households with children under 2 are covered. It could also go further to talk about the need for shock responsive social protection that can scale up and down in times of need to protect nutrition

·         Action Area 4: Trade and investment are indeed important, but given the gridlock at the WTO, and the recent endangering of TTP, TTIP and NAFTA, should we be linking trade so explicitly to food policy? We do not see many successful examples of this occurring.

·         Action area 5: Is there more that could be done to support exclusive breastfeeding in the informal sector?  How about in the agricultural sector itself - contract farming for example?  What should the private sector be accountable for/ what more could be done around maternity rights and support?

·         Action Area 6: We would like to see this area strengthened. A reporting structure to involve civil society would be welcome as a start here – at present the accountability framework is unclear.

Question 3: How could this draft work programme be improved to promote collective action to achieve the transformational change called for by the 2030 Agenda for Sustainable Development and the ICN2 outcomes? What is missing?

·         We welcome the guiding principle to provide an inclusive umbrella for all relevant stakeholders to consolidate, align and reinforce nutrition actions, but we feel more detail is needed on how the actors listed on page 3 (SUN, Zero Hunger etc) will be engaged in practice.   For example, will joint activities be scoped? Will a joint work plan be developed, under the Decade of Action framework? How will the Decade of Action support the strides of these existing efforts?

·         We also welcome the guiding principle to engage with a wide range of stakeholders, including civil society organisations. Again, we would like to understand better how this will be carried out in practice, including key actors like the CSM of the CFS, the SUN CSN and CIVICUS?

·         We question the low level of ambition regarding member states to identify and commit to achieve ‘one of more’ nutrition targets… ‘one or more’ recommendation of the ICN2 framework , as this does not feel  ambitious enough for SDG2  to be met (para 42).

·         We welcome the development of a publically-accessible commitment repository and urge this to be made available as the soonest opportunity, as a vital mechanism for the DoA.

·         We would encourage the DoA secretariat to report all commitments, including those that are voluntary, through the repository.

·         We suggest more detail is added on the recruitment, remit and activities of nutrition champions, as vital actors in the DoA.

·         We would like to know how will the ‘smart commitments for action’ be compiled and shared?

·         We would like clarification regarding the suggested establishment of action networks, including logistical arrangements, and we urge confirmation that civil society will be included within them (para 49)? We strongly advise these are multi-sector action networks, that complement and engage existing mechanisms such as SUN movement.

·         We welcome the emphasis on evidence informed advocacy and communication (para 61-66), but we strongly advise against the development of new networks of advocates. Many active networks exist, namely the SUN movement, Every Woman and Every Child, …. Resources should be invested in these existing structures to enable them to support the DoA advocacy approach, rather than developing duplicative structures or efforts.

·         We recommend that the one shared visual identity developed uses SDG2 primary framing, whilst retaining linkages and accountability sharing with other related goals ( SDGs 3,5,6 for example)

·         We recommend that some mention at least is made of the various auxiliary issues that impact on nutrition, including climate change, water supplies, over population, urbanisation and food security

Question 4: Do you feel you can contribute to the success of the Nutrition Decade or align yourself with the proposed range of action areas?

We are looking forward to contributing to the DoA, but in order to identify concrete activities we need a clearer structure and timeline in order to constructively engage; there also needs to be a better governance system, including the involvement of civil society as reviewers of progress/accountability officers.

We will be happy to involve ourselves in the action areas, building upon our on-going work, particularly on social protection/nutrition education and the promotion of nutrition governance, and would see ourselves as active contributors to any additional action area that might be added on inclusion. We will also continue to be active in the advocacy networks, with efforts focused on:

·         Sufficient, appropriate and best use of existing funding for nutrition

·         Better coordination and understanding of policies to tackle malnutrition, with an inclusion lens

·         Increased accountability for action on nutrition

·         Improvements in new born and infant nutrition, including through the promotion of exclusive breast-feeding

·         Disaggregation of data and the requirement for a participatory approach to continuous data collection

Question 5: Do you have specific comments on the section on accountability and shared learning?

We recommend one database is used to capture all commitments submitted in the DoA, not just those from Member States.              

Inputs from Katherine Richards, Jo Grace, Natalie Roschnik, Christophe Belperron, Christopher Twiss, Hugh Bagnall-Oakeley, Claire Blanchard