全球粮食安全与营养论坛 (FSN论坛)

"Efforts to reduce food waste in consumption and storage losses can significantly contribute to reduce food and nutrition insecurity. "

Needs more specification here. Needs more focus on food waste though-out the entire value chain, not only storage losses and consumption food waste.

Creo que el incremento de la preocupación por la nutrición que se ha producido en los últimos años es muy importante y muy positivo. La realización de la ICN-2 precisamente en el período de definición de la agenda de desarrollo post-2015 puede dar un mayor impulso a la entrada a fondo del enfoque nutricional en esta agenda.

Sobre el capítulo 2, en los elementos necesarios para la generación de entornos favorables para combatir la malnutrición echo en falta la coherencia de políticas. Son muchos y diversos los ámbitos de política en los que se adoptan decisiones que tienen un impacto sobre la malnutrición: desde la regulación de los mercados financeros que especulan con materias primas alimentarias hasta las políticas de promoción de los agrocombustibles, pasando por la regulación de la publicidad de determinados alimentos o los criterios de compras públicas de alimentos para instituciones educativas, sanitarias y de otros tipos, etc. Sin un avance decidido en la coherencia de políticas va a ser difícil poder luchar contra la malnutrición desde sus causas. El apartado 2.2. habla de políticas coherentes, pero creo que esto, siendo importante, no cubre el enfoque de impulsar la coherencia  en todas las políticas.

En el apartado 3.1. se abordan los sistemas alimentarios. Me parece que es un punto clave en la lucha contra la malnutrición. En este apartado de afirma que "las metas y objetivos de nutrición deben considerarse junto con las demás funciones y finalidades de los sistemas alimentarios". En mi opinión, la finalidad de alcanzar una decuada nutrición para toda la población debería estar en la cúspide de los sistemas alimentarios, debería ser la clave de bóveda, debería informar y orientar la toma de decisiones. Cada actuación, cada eslabón de la cadena alimentaria, cada actor que participa debería cuestionarse si contribuye o no a ese fin primordial de mejorar la nutrición. Por tanto, no se trata de poner el objetivo de nutrición junto a las demás funciones y finalidades de los sistemas alimentarios, sino por encima de ellas.

Me resulta muy interesante el enfoque de establecer incentivos a las dietas sanas. La realidad es que, en términos generales, una dieta sana y equilibrada suele resultar más costosa que una dieta nutricionalmente inadecuada. A la larga, esto cuesta mucho dinero por las intervenciones de asistencia sanitaria que se requieren para hacer frente a los problemas generados por la malnutrición. Invertir recursos con carácter previo -en forma de incentivos a las dietas nutricionalmente saludables-, además de ser positivo desde un punto de vista de salud, puede ser también rentable económicamente para un país.

1. Do you have any general comments on the draft Framework for Action?

The draft is well written and covers every aspect

2. Does the Framework for Action adequately reflect the commitments of the Rome Declaration on Nutrition, and how could this be improved?

Yes

3. Does the Framework for Action provide sufficient guidance to realize the commitments made?

Yes

4. Are there any issues which are missing in the draft Framework for Action to ensure the effective implementation of the commitments and action to achieve the objectives of the ICN2 and its Declaration? 

Yes. Though it is mentioned as monitoring and updation at several places in the document appropriate word may be 'nutrition surveillance' which includes continuous assessment, analyses and action. Efforts have been made by FAO, NIN (India) and the then IDRC. May be this needs to be strengthened and activated espcially in India.

Please refer to:   Hanumantha Rao D, Vijayaraghavan K and Rameswar Sarma KV. “Development of Nutrition Surveillance System” Nutrition News (1998), 19 (1). 

Sincerely,

K.V.Rameshwar Sarma,

Scientist 'F' (Retd.)

National Inst. of Nutrition (ICMR); India

Presently @ Novi, MI. US. 48275

My general view is that some important point are missing in this document specially when it comes to the sustainanle measure to reduce stunting.

For example when we look stunting level in some countries and intrahousehold food sercurity and diversity it's appear that poorest household are more affected.

in west africa for example in Mali and Niger we keep talking about Sikasso or Maradi paradoxe meaning that food secure areas with high stunting burden. apparently we think about behaviour change etc.. however when you look for example Household Economy Analysis data in those area its appear clearly that more the 60% of household are either very poor or poor with low productive capacity cultivating arrournd 0.5 to 1 ha. they food production is not enough to cover yearly need and their icome are used to buy stapple food. only margin amount is used to access diversify food or education or health. We know that diversified diet , health and education are key  deteminant of undernutrition.

I think that the 3.2 social protection should have include priority taking into account the facilitation of land access and technical support for cultivation to very poor and poor household to increase their own production and their relisience.

For example  government autorities or municipalities could put at disposal of poorest household some ha and subisdize the seeds, engines in lieu of given cash transfer or food transfer only without no perspective. 

Undernutrition is mostely an economic access issues that everything. please refer to some cost of the diet study done somewhere in west africa (burkina faso, Mali etc..) you could see that based on local accepted food a balanced diet for children under 2 is so expensive that no poor or middle class could afford it.......

Thank you very much for inviting us to comment this important document.

Mahamadou Tanimoune

Programme Officer (Nutrition)

WFP Kigali,  Rwanda

Mobile :+250 (0)735-806-156

VSAT: 1356-2450

Bonjour à vous toutes et tous

J'ai lu avec un grand intérêt le projet de déclaration de la CIN2 que je trouve complet et qui répond à la majorité des attentes. A ce titre, je propose qu'un paragraphe devrait être consacré au rôle/place (cruciale) de la société civile dans le cadre de ce projet.

Je porte à votre connaissance qu'on a créé une Association en 2012: Association Marocaine pour la Promotion du Mode de vie sain et la lutte contre l'obésité ''AVieSaine''  dont la mission s'inscrit parfaitement dans les objectifs de la CIN2.

Cordialement

Dr. Mustapha MAHFOUDI MPH

Lauréat de l'Université de Montréal-Canada /Santé Communautaire

Consultant en Santé Publique

Président de l'Association Marocaine pour la Promotion du Mode de Vie Sain et de Lutte contre l'Obésité ''AVieSaine"

Dear FSN Forum members,

Questions:

1.       Do you have any general comments on the draft Framework for Action?

-          While the draft comprehensively captures the multidisciplinary facets of nutrition issues including social, environmental and health aspects, the need for sustainable use and management of natural resources (i.e. forests) in a broader context for sustainable healthy diets seems to be undervalued.

·         Do you have any comments on chapter 1-2?

-          With reference to Chapter 2.3 Financing for improved nutrition outcomes, Section “Better results for the investments” (Page 6 of the draft), the need for nutrition-specific interventions and investments in “relevant sectors” is addressed. The draft currently displays “agriculture, education, health, water, sanitation, hygiene, etc.” as related sectors. It would be important to include “sustainable natural resources management” as one of the key-sectors where the appropriate investments should be made, especially targeting smallholder farmers, fisher folk and forest communities.

As an example, woodfuel plays an important role in ensuring nutrition security. The State of World’s Forests (SOFO) 2014 reveals that about 2.4 billion of the world’s population use woodfuel for cooking. It also addresses that boiling water is by far the most common way to sterilize water and, it is estimated that about 765 million people (10.9% of the global population) use wood energy to sterilize their water.  

·         Do you have any comments on chapter 3 (3.1 Food systems; 3.2 Social Protection; 3.3 Health; 3.4 International trade and investment)?

*  Chapter 3 Intro.

-          additional words in bold below are suggested to be added:

(Page 6) “Addressing malnutrition requires a common vision and a multi-sector approach that includes coordinated, coherent and complementary interventions in food and agriculture systems, sustainable use of natural resources, environment, health, social protection, education and other sectors.”

*  3.1 Food systems

-          additional words in bold below are suggested to be added:

(Page 8) “Diverse diets that combine a variety of cereals, legumes, vegetables, fruits, nuts, edible insects and animal-source foods will provide adequate nutrition for most people to meet their nutrient requirements, although supplements may be needed for certain populations, e.g., during humanitarian emergencies.”

(Page 9) “Better storage, preservation and processing (including food fortification) for crops, livestock, fish, forest foods or gathered foods, at the farm level or commercially, can also do so.”

(Page 10) Under “Priority actions”,

i) “Promote backyard/homestead gardening, agroforestry, forest food farms, fish farms and small animal management, including ecologically appropriate varieties with high nutritional value, as a potential source of income and of fresh local produce.”;

and

ii)“Integrating explicit nutrition objectives into agricultural, sustainable natural resources management and other sectors’ strategy policy and programme design and implementation and research agendas, to ensure that: they are not detrimental to nutrition; and opportunities to improve nutrition are well utilized.”

(Page 11) Under Section 3.1.1 Food environments, “Increase availability, affordability and consumption of wholegrains, fruit, vegetables, nuts and seeds.”

*  3.2 Social Protection & 3.3 Health

-          N/A

*  3.4 International trade and investment

-          additional words in bold below are suggested to be added:

“The availability of and access to healthy foods should be ensured through nationally appropriate combinations of imports and domestic production, and investments in food production, especially by smallholders. There should be effective incentives for farmers, fisher folk and forest communities to produce sufficient healthy foods (e.g., fruits, vegetables, forest foods, and animal source foods such as fish and wildlife) to be sold at affordable prices.”

·         Do you have any comments on chapter 4-5?

-          With reference to Chapter 4. Accountability Mechanisms, Section 4.1.1 National Level, additional words in bold below are suggested to be added:

 “Within the context of the national plans of action on nutrition developed or updated, governments should formulate, adopt and implement strategies and programmes to achieve the recommendations of the Framework for Action, taking into account their specific problems and priorities. In particular, ministries of food, health, agriculture, environment, natural resources (forestry, fisheries), trade, social welfare, education, employment, information, consumer affairs and planning should formulate concrete proposals for their sectors to contribute to promoting better nutrition.”

2.       Does the Framework for Action adequately reflect the commitments of the Rome Declaration on Nutrition, and how could this be improved?

-          As commented during the online discussion session on the draft Rome Declaration on Nutrition in May 2014, the importance of “sustainable management of natural resources” (i.e. forestry, fisheries and aquaculture systems) in ensuring sustainability of nutrition security should be addressed in both the Declaration and the Framework for Action.

3.       Does the Framework for Action provide sufficient guidance to realize the commitments made?

-          The Framework for Action can be shortened – currently, it is a 28-page draft. A shortened version with a concise list of concrete actions may be more effective in realizing the commitments made.

4.       Are there any issues which are missing in the draft Framework for Action to ensure the effective implementation of the commitments and action to achieve the objectives of the ICN2 and its Declaration?

-          The human rights aspect in the context of the Right to Food recognising that unclear and/or unequitable land tenure rights are threats to the fundamental right of everyone to be free from hunger should be taken into consideration as part of the draft Framework for Action.

Dear Sir/Madam

This is just to share what I thought is better for this document.

In 2.2 Better governance,

Second element the multi-sectoral coordination, the coordinator  has to be strong enough in power to coordinate all responsible sectors.

Element three:- to have effective implementation the above mentioned powerful body is mandatory.

In Accountability Mechanism section

4.1.1 the focus should not be only on research focus has to be given to integration of nutrition into school and higher education curriculum.

Thanks 

Belaynesh Yifru Mulugeta (MD, MSc-GH)

Senior Health and Nutrition Advisor

ENGINE Project| Save the Children International , Ethiopia 

The Food Safety and Quality Unit and the Animal Health Service of FAO have reviewed the zero draft of the Framework for Action for the ICN2 and submit the following inputs to revise the text in section 3.3.6.

3.3.6      Food safety and antimicrobial resistance

While food safety is an intrinsic part of food security (by definition) the significance of this is still poorly recognized. Food safety problems threaten the nutritional status of food insecure populations and particularly vulnerable sub-populations like the elderly, pregnant women and children. Morbidity due to diarrhea, dysentery and other enteric diseases arising from unsafe food, contaminated water and poor sanitation have not declined over the last decades and it has been estimated that between 80-100 percent of children in some African countries are chronically exposed, through their diets, to aflatoxins , which,  beside being potent carcinogens, are thought to be a contributing factor to stunting. Food safety needs to be integrated into the global food and nutrition security agenda if we are to make significant progress in improving nutrition.

As food systems evolve, so do the challenges to food safety. One emerging food safety issue of global concern is antimicrobial resistance (AMR). Antimicrobial drugs are essential for both human and animal health. In food producing animals antimicrobial drugs are critical for animal health and welfare, and therefore contribute to supporting the livelihoods of livestock farmers and to economic development. However, the use of antimicrobials in animals is also an important factor in the wider development of resistance in zoonotic bacteria which are carried by animal reservoirs and can be transmitted through the food chain, such as Salmonella, Campylobacter, E coli and other Enterobacteriaceae.  AMR now poses a growing threat to human health and globally, it is estimated that 500,000 people die each year from infections caused by antimicrobial resistant bacteria. The social and economic costs are also huge.

With the current rates of increase of the world population, which is projected to reach 9 billion by 2050, ongoing trends in urbanization and rising incomes, the demand for animal sourced foods is increasing exponentially.   To meet the demand, beef production will need to increase by up to 70 per cent by 2050 and fish by 40 per cent by 2021, mostly through production intensification. This is likely to lead to increased usage of antibiotics and thereby increased risks of AMR emergence and spread, if it is not accompanied by improved animal management, health and husbandry practices. 

AMR emergence and spread is closely linked to human and animal health, to food production systems and agro-ecological environments. Addressing AMR therefore requires a holistic “One Health” approach to better understand the drivers  and in the design of effective measures to minimize risks of AMR development and spread.  Over the past decade, there have been significant developments at the international level with respect to understanding and addressing AMR and several initiatives have been led by the FAO, WHO and OIE Tripartite collaboration on AMR. However significant gaps in understanding the issue remain and there are still many challenges with regards to national capacities to translate internationally accepted guidelines and standards into appropriate policies and actions at national level.  FAO and WHO, the lead intergovernmental agencies with responsibility for food and agriculture and human health respectively, have important leadership roles in implementing measures to combat the global threat of AMR.

Priority actions:

§  Raise awareness of the impact of food safety on food and nutrition security.

§  Invest in  strengthening national food control systems

§  Ensure cross-sector participation across health, agriculture and trade for safe, quality foods and coordinated implementation of programmes, including those for food safety emergency response.

§  Raise awareness of AMR and assist countries in developing appropriate policies and measures to address AMR in the food chain. .

§  Ensure that AMR prevention/control measures in food production are accompanied by corresponding measures and controls in in  human medicine.

§  Promote promote prudent and responsible se of veterinary drugs  in animal production.

§  Support primary producers to adopt good animal husbandry and health, management and biosecurity practices to reduce the  need for antimicrobial drugs in animal production.

§  Implement a One Health approach to promote multi-sectoral and multi-disciplinary collaboration and address AMR across all sectors.

§  Progressively phase out non-therapeutic use of antimicrobials, such as the use of antimicrobials as growth promoters.

§  Restrict or eliminate the use of antimicrobials identified as critically important in human medicine, especially the use of fluoroquinolones, and third-and fourth generation cephalosporins in food-producing animals.

§  Support countries to develop national integrated surveillance programmes  to monitor trends in AMR emergence and usage of antimicrobials.

§  Develop alternatives to antimicrobial, including the use of effective vaccines.

I was especially interested in reading the FFA because I am actually working at the French Food Safety Agency  (ANSES) on up-dating the recommendations of the  French National Nutriton-Health Program. As such, my comments are more orientated on malnutrition ( that is to say : unhealthy nutrition not by lack but by excess and bad quality)

1-General comment: All the important issues are covered, with taking into consideration traditional eating habits and locally produced foods to serve as a basis for nutriton recommendation. Also, the draft recognises  that food is situated at the crossing of health, environment and society.(see fig attached)

Comments on Chapter 2: the most importance sentence is : strategies should adress the  people’s dietary sources and the context in which these choices are made: this is very important because advertising and large accessibility are determinant factors in the environment

Comments on chapter 3:

• 3: Actions  
• 3-1 Use traditional food systems. It is important because it is difficult to modify food behaviour.
• Education with school gardens is also important to sensitise children to food
• and food quality.
• 3-1-1 reduce sugar in non alcoholic beverages: sugar per se is not obesogenic, but drinking sweet or sweetened beverages only adds to the energy intake without self-restiction linked to satiety. Therefore it is also a behaviour to be changed for drinking water
• 3-1-2 the proposed actions for sustainable healthy diet are somewhat insufficient: the word contaminant is not pronounced, when we know that several "agro-chemicals" are involved in obesity development
• Develop local nutritous varieties and promoting locally available and affordable foods improves the food environment
• 3-2: a transversal aspect of social protection which deserves reinforcemnt is the maximisation of the social impacts of Food environment
• 3-3 Health: Most of the priority actions are directed to malnutriton meaning deficiency in macro or micronutrients and not to unhealthy diet, obesogenic for which bad quality and/or contaminated transformed food a prominent cause together with unbalanced energy intake. And here is a big absent in the priorities: physical activity . Most European countries uderstant food and physisvcal activity under the word "nutrition"

No comment on chapters 4-5

2-Does the Framework for Action adequately reflect the commitments of the Rome Declaration on Nutrition, and how could this be improved?

Yes but it appears somewhat insufficient with regard to the developpment of obesity and NTDs in some developping countries. The need to access to physical activy and practice it has been mentionned in my comment on 3-3

3-Does the Framework for Action provide sufficient guidance to realize the commitments made?

Yes, but some might be difficult to realise

4-Are there any issues which are missing in the draft Framework for Action to ensure the effective implementation of the commitments and action to achieve the objectives of the ICN2 and its Declaration? 

Missing issues pertain to the development of obesity and NTDs: Physical activity is absent. Sustainable agriculture and healthy food processing and transformation by food industry is insufficient 

b.      Mais il n’est aucunement question du rôle parfois démesuré des transnationales sur les systèmes alimentaires, ce qui a pour effet de fragiliser les systèmes alimentaires locaux et d’ouvrir à voie à des choix qui ne sont pas nécessairement favorables aux populations locales, comme les cultures transgéniques

c.       Au lieu d’aliments « très élaborés », il vaudrait mieux les aliments « ultra-transformés »

d.      Il manque aux actions prioritaires l’importante analyse de l’impact de la mondialisation et de la libéralisation du commerce sur les systèmes alimentaires locaux et la consommation,  de manière à apporter des correctifs appropriés dans la mesure du possible.

5.      Sous « Environnement alimentaire » :

a.       Pour promouvoir une alimentation saine et encourager des choix alimentaires sains, des recommandations ou guide alimentaires sont un outil précieux, préconisé dans d’autres documents de lutte contre les malnutritions, surtout les troubles de surcharge. Cette action semble omise ici.

b.      Lorsqu’il est question de bio-fortification, il n’est jamais précisé si c’est par la sélection naturelle ou le génie génétique, ce qui devrait être précisé.

6.      Sous « Interventions performantes en nutrition » (3.3.1) :

a.       Il nous semblerait important d’insister sur l’intégration souhaitable des actions de nutrition ciblant les mères et les enfants (pour lutter contre la dénutrition) et de celles qui visent la lutte contre les troubles de surcharge et qui concernent généralement les adultes. Ces actions sont rarement reliées dans les services de santé

b.      De même, il est surtout question ici de dénutrition des jeunes enfants et des mères; les actions de lutte contre les troubles nutritionnels de surcharge et la prise en charge nutritionnelle de différentes pathologies afin de préserver un bon état nutritionnel chez les malades sont à peine évoquées

c.       Il faudrait remplacer « dépérissement » par émaciation, terme consacré

d.      Parmi les actions prioritaires pour lutter contre l’anémie, on retrouve l’éducation nutritionnelle à l’école et l’offre d’aliments sains au niveau scolaire et préscolaire. Il nous semble que l’intervention nutritionnelle et sanitaire à l’école mériterait une place privilégiée plutôt que d’être reléguée sous « lutte contre l’anémie »

e.       On parle maintenant d’allaitement « naturel » plutôt que « maternel »? Pourquoi ce changement?

7.      Mécanismes de suivi et de reddition des comptes : ce cadre d’action semble dans un vacuum. On ne perçoit pas son articulation avec les multiples autres plans que les pays ont déjà développé, souvent d’ailleurs à l’incitation de structures internationales. Il n’est pas non plus question de l’intégration de ce cadre avec d’autres initiatives internationales, telles que SUN et REACH, pour ne citer que celles-là.