Global forum on food security and nutrition

Alexandrina Sirbu, Romania

Open discussion on the first draft work programme of the UN Decade:  

Goals such as the ending hunger or malnutrition in all their forms seem to be not really compelling. Also should be different approach between hunger, malnutrition and food security in terms of nutrition and food availability.
Nutrition Decade addresses to important topics but tools for SMART achievements on the engagement and support all thereof are generally. For instance, at paragraphs 17 and 18 is pointed out that an approach will ensure that solutions are equitable and people-centred and in the same time the priorities and specific actions will depend on the interest expressed by potential actors. What happens if stakeholders have not resources or interests to do it?
 
Overall I positive appreciate the areas of the actions, which are comprehensive and succeed many of problems related sustainable food system, health and nutrition, social protection and education to be carried out for changing/improving food consumption models.

Regards,

Alexandrina Sirbu

Professor, PhD -

"Constantin Brancoveanu" University
FMMAE Ramnicu Valcea
39 Nicolae Balcescu Bld.
240210 Ramnicu Valcea, Valcea County – Romania

Manuel Moya, International Pediatric Association, Spain

One main issue of Nutrition Decade is to end hunger and all forms of malnutrition, undernutrition and obesity will be mainly considered  due to the fact that micronutrient malnutrition deserves specific actions nor always feasible. Undernutrition and obesity are quite different or even antagonist situations but their origin is the same: inappropriate nutrition which enables us to deal with both in a general and individual preventive frame. In high-income countries (HIC) overweight and obesity are the predominant form, in low-and middle-income countries (LMIC) traditionally undernutrition in all its forms has been the foremost one, but presently this coexists with a steady trend in obesity , ie the ‘double burden’. Because of the long term consequences of malnutrition adequate nutrition should be a target in the first 1000 days of life that could be extended to all children under five.

As said by the FAO Director-General (UN General Assembly, 20th September 2016, New York) the preventive action ‘start at country level’. This is a crucial point and many of the individual four preventive points that should be carried out by the primary health care provider acting directly on malnourished people are hardly impaired without this national support.

There have been significant advances related to malnutrition in the last decades (UN Agencies) as is the pediatric undernutrition recoil (1990 30.2%; 2015 19.3%)  (1), although this not occurring with obesity. It is worth considering that if there are good preventive programs why has obesity been increasing until now and will continue up to 2030 or even 2060 (2): Probably the reasons are: Too many plans/ guidelines not all with the desirable quality and wide covering, the flow from global directions to individual level is slow moving even in HIC with integrative approaches, the difficulty of applying evidence criteria for assessing preventive effectivity. Therefore the continuous evaluation of the applied procedures is far from generalized. Labeling (Flabel in EU), fast food advertising, taxes for sugary drinks, school-lunch programs for malnutrition, epigenome-wide association study (EWAS) and so many others, still have an unknown impact on obesity reduction. In HIC the specific budget for prevention is considerably lower than that of acute care. In LMIC nothing is done apart from punctual and small actions, consequently in a few decades obesity there will be an added problem to the treatment lag of these regions. The country-driven plans are probably the top priority.

 

1. 
   Unicef, WHO, World Bank Group. Levels and trends in child malnutrition. Key findings of the 2015 edition. Unicef/jmedashboard 2015.
   
2. 
   Sabin MA, Kao KT, Juonala M, Baur LA, Wake M. Viewpoint article: Childhood Obesity-looking back over 50 years to begin to look forward. Journal of Pediatrics and Child Health S1 (2015) 82-86. Doi: 10.1111/ipc.12819.
   

Claudio Schuftan, PHM, Viet Nam

This Decade document is unfortunately quite disapointing. It has no teeth. It repeats all the old

(predictable) remedies and cliches. It is jargony. It too often states the obvious.

 

By paragraphs:

 

4, 38, 54. multistakeholder platforms are taken as a given. Will not more people oppose this? The conflicts of interest (CoI) issue has not been solved...

 

9. "Leaving no one behind"… You know the quote that says that this is not an accident.

     The para also speaks of a "global accountability framework": where is such to be found?

 

12, 13, 15, 38, 41, 44, 54, 67, 69, 73.  “Stakeholder” is used over and over. In many of these places, using rights holders and duty bearers is what is called for.

 

12. The SUN initiative is mentioned casually…without quoting what some of its detractors object.

 

13. 31. Speak of CSOs or NGOs as the same. It should say (private interest CSOs (PICSOs). It mentions ”an enabling environment” for HR and the RTF. Only enabling? Isn't it to be the cornerstone?

 

13. The para only says “management of CoI”. Will we demand stronger language on CoI?

 

14. Speaks of  “an enabling environment” for HR and the RTF. Will we demand stronger language?

 

16. Cross-cutting area #4 calls for “trade and investment for improved nutrition”. How? Does past experience teach us something?

 

17. Asks for “fostering policy dialogue…to ensure that solutions are equitable and people-centered”. This is not what the HR framework calls for! Claim holders demand!

 

19. Paragraph sooo weak..

 

20. Calls for “strengthening local food production especially by small holders”. This is not what we stand for. Language already a consensus puts central emphasis on small holders.

 

29. Mentions “nutrient dense foods”. Which? RUTF?

 

30. This para on nutrition education is sooo weak and naif. Could have been written in the 1970s.

 

31. “Lead by example” ????

 

34. Are only “coherence and flexibility” needed??

 

35. “Achieve global food and nutrition through trade", i.e. “appropriate trade agreements”? What is that?

 

38. “Multistakeholder governance mechanisms should avoid Coi”. We certainly need stronger wording here.

 

41. “Member states are encouraged to translate the commitments of ICN2”. Just encourage?? (Then in para 42 there is a call for them to actually commit…. A contradiction).

The mention of SMART here is a gimmick, just for show.

 

43. The call is “to raise the level of ambition”. Only? Need stronger language?

 

45. Speaks of a “commitments repository in FAO and WHO”? Would this work and be binding?

 

47, 48. The call here is for “champions” and “action networks”; seems to me wishful thinking. I may be wrong.

 

54. “SUN will provide opportunities”? How many years has SUN been on? What to show for?

 

59. “The Decade will strengthen the capacities at community level as appropriate? Meaning what? Far from what we are asking for re empowering clim holders and duty bearers...

 

63. Calls for “Evidence-informed advocacy”. What gimmick is that? Does scientific evidence convince politicians?

 

64. What “visual identity” is referred here to?

 

69. We read “FAO/WHO will consult with the private sector” …for governance issues? This sentence is in the governance section!! Needs to be deleted. No private sector in governance.

 

Table 1. Proposes a “reformulation” of foods group. We all know what Monteiro and Cannon say about this giving BIG Food a way to whitewash their image and the public still staying hooked on ultrprocessed foods.

The table also proposes a nutrition sensitive issues group. We all know this was invented as a (bad) substitute for what are the social determinants of nutrition.