EGM on SDG 2: Lara Nasreddine Statement

Lara Nasreddine

Professor of Nutrition at the American University of Beirut

Session 2: Target 2.2 -End all Forms of Malnutrition

The world is NOT on track to meet the nutrition targets. The reasons are far too many but I will attempt to reflect on this by examining what worked and what did not work towards curbing malnutrition. Three main points come to my mind which will be the focus of my intervention: 

• First, the need for strategic alignment in policies and multi-sectoral interventions 
• Second, the chronic need for better and time-relevant data to inform policies 
• Third, the importance of building the resilience of food systems against vulnerabilities and sudden shocks. 
  
  

Synergy and coherence between multisectoral policies
One of the important key learnings so far is that “ Working in silos does not “work”, and that fragmented interventions do not work, even if these were properly designed, monitored and implemented. In other words, “the whole is not equal to the sum of its parts”.  A recent FAO report showed that only few individual policy elements by themselves seem to directly impact the prevalence of malnutrition, while significant impact depends on synergy and coherence between multisectoral policies. And here I am not referring to food production policies but rather to policies pertinent to the food system in its totality. 

This undoubtedly requires that policymakers and key stakeholders work collectively towards this common goal.  This can be illustrated by few successful examples in the EMR, namely the trans fat and salt reduction interventions in some of its countries. Unfortunately, in many LMICs, a multisectoral approach is often hindered by the lack of adequate governance mechanisms among concerned entities whether from government, NGOs or the multilateral system.   Coordination and objectives amongst and between these key stakeholders are often inadequate, particularly in fragile contexts, and this limits implementation efforts as well as impact. 


Chronic need for better and time-relevant data
How can we tackle dietary and nutrition issues if we do not know what people eat?    

Despite significant progress in the availability of food consumption data around the world, such data remain limited, especially in LMIC. For instance, a recent review on food consumption practices in countries of the Eastern Mediterranean region highlighted the magnitude of the problem when it comes to the data’s availability and quality.  Data on what people eat is crucial to identify gaps in dietary intakes, including inadequacies in micronutrients or excessive consumption of less healthy foods, all of which would inform the design of policies aimed at improving diet quality.   This data would also ensure than no one is left behind since it will help identify specific population sub-groups that are at a higher risk of malnutrition.  It is therefore important that countries, harness the needed political will and resources to institutionalize routine dietary data collection. 

This is even more important in contexts where dietary patterns are changing because of the nutrition transition or other reasons. Lebanon is a live example of such changes where the economic and financial crisis that started in 2019 has severely undermined food and nutrition security of the population. The data provided by the national food consumption survey that we have conducted in 2013 may not represent the current situation anymore. And this is why, another key learning is related to the dire need for time-relevant data, especially when sudden but long lasting shocks occur. 

Timely data can also contribute to the identification of unexpected problems linked to policy implementation. For instance, many of the policy efforts that tackle the problem of undernutrition seem to have contributed (possibly indirectly) to higher rates of overweight. Future food policy designs should be cognizant of this potential impact, and it is only through time-relevant data that this can be monitored. Such impact assessment is not commonly performed. A recent SR on the EMR has identified  almost 300 school-based nutrition programs in the region, but only less than 20 had assessed the program’s outcomes or impact. 


Building the resilience of food systems
It is important to acknowledge that todays’ global context is characterized by an increasingly complex landscape of challenges. Experts talk of polycrises! 

The increased convenience of ultra-processed foods, the lack of affordability of healthy diets and the increasing urbanization are amongst the well-known challenges. But also the shaken food and energy markets, and the high vulnerability of food systems to shocks and disruptions arising from conflict, climate change, and economic contraction represent fast growing threats to the delivery of heathy diets. Acknowledging that these drivers of malnutrition are becoming the world’s “new normal”, national strategies should evolve towards building the resilience of food systems against vulnerabilities and shocks. The establishment of national networks that engage with various levels of governments would represent an important starting point to build resilient multilevel governance mechanisms. Going back to the past or what I like to call “Going back to the future” in terms of traditional diets and traditionally anchored food systems may also teach us something about resilience.

In today’s world that harbors extremes, from man-made famines to the global epidemic of obesity, there is a dire need for concerted efforts to address the complexities of achieving SDG 2 and improve nutrition for all, with no one left behind.