Global forum on food security and nutrition

91.Helen Medina, US Council for International Business, United States of America

The United States Council for International Business (USCIB) would like to thank the Food and Agriculture Organization of the United Nations (FAO) for the opportunity to submit comments on the Maximizing the Impact of the UN Decade of Action on Nutrition.  USCIB promotes open markets, competitiveness and innovation, sustainable development and corporate responsibility, supported by international engagement and regulatory coherence.  Its members include U.S.-based global companies and professional services firms from every sector of the economy, with operations in every region of the world.  With a unique global network encompassing the International Chamber of Commerce, the International Organization of Employers and the Business and Industry Advisory Committee to the OECD, USCIB provides business views to policy makers and regulatory authorities worldwide, and works to facilitate international trade and investment.

It is indisputable that nutrition provides a vital foundation for human development and is central to meeting one’s full potential.  Nutrition is also important from an economic point of view. Hunger and under-nutrition weaken the mental and physical development of children and adolescents. This in turn lowers the work capacity and income potential of adults and leads to huge social and economic costs. According to estimates by a 2013 FAO report, hunger and under-nutrition cost the global economy an estimated 2-3 percent of global gross domestic product, equivalent to $1.4-2.1 trillion per year.

So what is the private sector doing on nutrition? For starters, the private sector is a key actor in providing nutrition from investing in agriculture; to improving the social, economic and environmental practices in farming and the supply chain; to mobilizing, innovating, and finally delivering agricultural products and food.  As an employer, the private sector also has a vital role in increasing the livelihoods of society as a way to address poverty, malnutrition and under-nutrition. But that’s not the whole picture. It’s far from it and more can be done. One stakeholder alone can’t solve complex nutrition challenges.

The importance of good governance policies and regulations that support private sector involvement in agriculture should not be underestimated. Access to finance and empowering women is also crucial for improving nutrition around the world. Women are often the family’s primary caretakers and they tend to invest in their children’s health. It’s therefore important for governments to promote policies that help women become farmers, traders and entrepreneurs. Promoting trade and investment in agriculture is also crucial for combating global hunger. There is significant evidence from UN reports that demonstrate increased trade, particularly in the agriculture and food industry, raises the standard of living in developing countries and improves the performance of national economies, all of which are necessary for healthy societies.

Additionally, multi-stakeholder partnerships should be encouraged. More and more of these types of approaches are widely recognized as necessary to increasing the scope of financial and human resources in order to tackle nutritional challenges on a large scale. The private sector often partners with governments and researchers to innovate and create new tools for farmers that improve nutrition. It is essential for all stakeholders to work together and develop a global food system that improves people’s nutrition in a sustainable way. We are committed to public-private partnerships that support nutrition strategies and to preserving natural resources to continue to grow food which is necessary for nutrition.

The 2030 Sustainable Development Agenda provides a terrific opportunity for the private sector to demonstrate the central role it plays in nutrition and society. While government has been successful in outlining a visionary mission for global development, businesses have the unique ability to bridge the capacity gap to reach the impact and scale necessary to meet the SDGs and in particular those that relate to nutrition. Partnership between the public and private sectors, at both the global and at national levels, is vital in creating an effective strategy and successfully implementing it to achieve these goals.

USCIB has been at the forefront of this initiative. Last year USCIB launched Business for 2030, an online platform showcasing business engagement with the SDGs.  We invite you to review what business is doing to meet the 2030 goals including those related to nutrition. 

92.Celeste Naude, Cochrane Nutrition, Centre for Evidence-based Health Care, Stellenbosch University, South Africa

Cochrane Nutrition

Comments for the Online Consultation on

“Maximizing the Impact of the UN Decade of Action on Nutrition”

Cochrane Nutrition fully supports the UN Decade for Action on Nutrition to catalyze and sustain intensified and concrete actions to fix our food systems, end hunger and malnutrition and ensure that high quality, diversified and more sustainable diets can be accessed by all people, especially vulnerable groups. We welcome the opportunity to provide comments for this online consultation initiated by the UNSCN.

The UN Decade for Action on Nutrition has the potential to foster and strengthen the political will, accountability and inter-sectoral collaboration needed to translate the commitments of ICN2, the SDGs and the Global Nutrition Targets into effective actions in the form of policies, programs, and partnerships, accompanied by  feasible implementation plans, to improve nutrition and food security.

Critical activities for inclusion in the Work Programme for the implementation of the UN Decade of Action on Nutrition to reach the 2025 global nutrition targets

Cochrane Nutrition would like to raise three activities related to use of evidence and research approaches:

1. Activities that emphasise the value of using synthesised evidence for translating knowledge into effective, implementable and scalable actions to reach nutrition targets. 

Finding and implementing effective, scalable and sustainable solutions to address the complex, multi-sectoral nutrition burden is challenging for all stakeholders, particularly since decision-makers often have to deal with diverse and competing interests. Readily prepared syntheses of quality-appraised evidence, such as systematic reviews, deliver valuable support to decision-making by integrating findings from many studies to give a clearer and more comprehensive picture than any single study can produce.

Global synthesised evidence can be combined with national, sub-national or local evidence on service use, practice, costs, policy and organisational factors to inform decisions on what actions are effective and how to best implement and deliver these actions. Training of all stakeholders and organisations in using synthesised evidence can facilitate evidence-informed decision-making (EIDM).  EIDM involves using research evidence with expertise, resources, and knowledge about contextual health issues, local context, and political climate to make intervention, policy and program decisions. This systematic and transparent inclusion of research evidence in decision-making can strengthen nutrition actions, promote the provision of effective and efficient nutrition interventions and services, and support a more responsible use of financial and human resources.

2. Activities that support methodological research innovations to advance our knowledge on the ‘how’ questions - how do we implement an appropriate combination of actions (nutrition-specific and nutrition-sensitive) at scale, in an equitable way in different contexts?

We know a lot about the multi-faceted aetiology of malnutrition and about effective nutrition-specific interventions options.  But many questions still remain about how best to address some of the complex emerging and underlying drivers of malnutrition, especially when different forms of malnutrition coexist as is the reality in many countries. Furthermore, we face challenges on implementation and delivering impact, especially for prevention. Low intervention coverage and poor quality of implementation continues to contribute to poor nutrition outcomes in developing countries, and delivery itself needs to be improved. The effects of interventions depend on the extent to which they are implemented, as well as the dependability of their implementation. These two factors are enormously dependent on the capacity of ‘coalface’ workers, the quality of frontline facilities and organisation of intervention delivery platforms. To address these complex questions requires developing and applying innovative research approaches for both primary research and evidence synthesis. The ongoing work in this area needs support and growth to generate the required knowledge for solutions and actions to enable countries to reduce their nutrition burdens.

3. Activities that support and improve the quality of primary nutrition research and evidence synthesis

Nutritional epidemiology research has expanded over the last 50 years, and the number of trials and observational studies in nutrition has increased exponentially. Generally, this growth has not led to better quality or more useful research results, and duplication, as well as redundant efforts have characterized many research initiatives. Although there have been several activities to enhance nutrition research prioritization, design, management, reporting and interpretation, many of these aspects still need to be improved.  A strong interdependence between nutrition and the complex biological, physical and social systems that affect nutrition outcomes contributes to the difficulties of executing nutrition studies and synthesizing this evidence. As we answer nutrition research questions, there is a need to better understand and consider potential biases, as well as interactions with other systems, to improve nutrition research in general.

Cochrane Nutrition would also like to emphasise three research areas:

1. Activities to ensure that policies and programs to improve nutrition include cost-analyses. Understanding cost implications of interventions is a very important dimension for analysis of program delivery and implementation, and a key tool for policy and prioritization.

2. Activities and mechanisms to assist countries to ensure that public policies are coherent from food production through to consumption, and across sectors to meets people’s nutrition needs and promote safe and diversified healthy diets. Food system policies and interventions, particularly in trade and markets, should be designed in consultation with both food system stakeholders (e.g. agriculture, post-harvest, retailers, consumers) and health stakeholders to ensure they seek to balance health and nutrition with profitability and are coherent with health policies.

3. Activities to address the knowledge gap on effective actions to fix our food systems. The current knowledge base on food system interventions is sparse and more focussed research is needed to identify the ‘best buys’ within the different types of food systems, from industrial to rural, that enable all people to access healthier foods. More focus is needed on interventions that reduce commercial exploitation of people’s biological, psychological, social, and economic vulnerabilities enabling healthier diets.

Actions to accelerate and improve the quality of commitments from the various actors; Roles of public and private actors in monitoring their implementation

Greater emphasis on the role of civil society in monitoring implementation, improving governance and accountability of policies and commitments is needed. As consumers in food systems, an informed civil society can help to create the demand needed for healthier food systems.

Actions and contributions from other relevant forums, such as the CFS and the UNSCN

Supportive forums can provide the platforms needed to identify and pull together a critical mass of nutrition champions (in districts, countries and regions) to identify gaps, coordinate actions, strengthen collaborations, and monitor impacts within the shared framework of the ICN2 outcomes, the SDGs, and the Global Nutrition Targets.  Once identified and committed, the critical mass of all stakeholders can collectively work with the relevant forums tobuild leadership, advocate for and create demand for enabling environments, more resources and better governance to support the multi-level changes required for improved nutrition.  The forums are also in a position to promote knowledge sharing across borders and to build the leadership needed to put nutrition on the agenda and keep it there – strong and active nutrition champions within all sectors (private, civil society, academic, government, NGO etc.) can be identified and can be instrumental to build the coherence needed across sectors. Supportive forums can assist nutrition champions with prioritization of actions and competing interests.

Cochrane Nutrition looks forward to further engagements, and is committed to partnering to implement the Work Programme for the implementation of the UN Decade of Action on Nutrition.

Daniela Küllenberg de Gaudry, Cochrane Germany

Celeste Naude, Centre for Evidence-based Health Care, Stellenbosch University, South Africa; Co-director: Cochrane Nutrition

Solange Durão, Cochrane South Africa, South African Medical Research Council, South Africa; Co-director: Cochrane Nutrition

on behalf of Cochrane Nutrition, http://nutrition.cochrane.org/