The way the food system is currently managed will have to undergo a major overhaul to allow for sufficient improvements in nutrion to be achieved – concluded the meeting in advance of the Second International Conference on Nutrition (ICN2) next year.
On a conceptual level five recommendations were built prior to and reaffirmed by the meeting:
- Continue building a common vision for nutrition at all levels to enhance international cooperation and solidarity and to ensure that attention will be paid to nutrition
- Build institutional capacity and promote collaboration across all sectors
- Need for better data and metrics for better policy making
- Improve value chains for nutrition
- Aligning nutrition objectives with food and agriculture goals
Strong emphasis was put on policies and the political economy, based on the belief that small step projects are important, but without wide-spread policy change scaling up of nutrition efforts will not be achieved. There was consensus regarding the importance of multisectoral approaches as well as gender-specific and sustainability issues in order to transform the food and agriculture system towards more healthier diets.
The meeting was jointly orginised by FAO and WHO from 13 to 15 November 2013 in Rome. Over the course of the three-day meeting, experts reviewed agricultural food and nutrition policies since the first International Conference on Nutrition in 1992 and shared stories from successful nutrition-improvement policies and programs in various countries. The outcomes of the discussion will contribute to the ICN2 high level meeting in 2014.
// Main discussions’ highlights
Lessons learned presented by countries included:
- The importance of legislating performance indicators across ministries and the importance of ministries working together at decentralized level, jointly funded by central and local governments, with strong CSO involvement. This approach was widely seen as successful to build family-oriented bottom up stakeholder networks
- The potential of cash transfers and school feeding programs as entry points for nutrition enhancing ag-based programming and the importance of public private partnerships
- The SUN-movement and its positive efforts to develop multisectoral plans at local level. However it is critical that many plans are not yet implemented and governments were urged to turn these into action
- The issue of vulnerability and the importance of targeting populations that have not benefited from the positive trends in per capita energy availability and income growth. The data must be disaggregated according to income quintile as opposed to simply reporting national level prevalence rates, the goal being to target specific disadvantaged population groups so as to reduce inequality in nutrition outcomes
- The importance of getting policies right by making social inclusion, equity, women and children explicit considerations, and by making sure that nutrition is mainstreamed in policies across sectors
- Placing citizens at the center of the policy formulation process and encouraging them to come together in movements to address different aspects of nutrition
- Advocacy and communication through established nutrition networks
- Governments acting as inspirers, stimulators, incubators and conveners
- The recognition that civil society, parliamentarians and other stakeholders are part of the political process and that political commitment is essential to scaling up nutrition
Nutrition enhancing agriculture and food systems panel looked into why agriculture is currently not nutrition promoting. Three key reasons were provided:
- Nutrition is nobody’s sector__ As such it is a question of ownership. There is no nutrition ministry or sector that was ultimately responsible
- Nutrition goals may conflict with other goals__ How to convince farmers and consumers to change their behavior towards better diets and a sustainable food system?
- Market signals__ The market was not telling us that we needed to work for nutrition, also consumer behavior was not always rational
Key concerns in the pathways from agriculture to nutrition included:
- Food availability in terms of quality as well as quantity, with the warning that availability does not ensure good nutrition
- Income can be in kind or cash
- The relative prices of food and food versus nonfood goods
- Time allocation for women. Evidence shows the most limiting factors of nutrition sensitivity in agriculture is lack of time among women
- Consumer preferences and the issue of palatability
- Nonfood factors needed to improve nutritional status: access to clean water, childcare, primary healthcare. Interventions in these areas need to be done in conjunction with nutrition-enhancing activities in agriculture
Emphasis was placed on breaking the 2-way causal link between the processing industry and the consumer preferences. The question of what shapes consumer awareness and consumer “wants” was raised repeatedly, as was the related question of the degree to which food prices affect consumption. Although food prices are an important determinant of demand, there is also some level of choice in most countries.
It was claimed, that changes in value chains could improve nutrition. Solutions to very specific problems within the context of a broader diet approach should be identified. However, the issues of responsibility for implementation and identification of public or a private good, that required government or private sector and/or civil society intervention, remained unclear. Better multisectoral action and improving of nutrition governance and policy coherence were needed.
Role of the public sector:
- Offsetting the costs and/or defraying the risks associated with the adoption of new business models by value chains actors
- Promoting consumer demand for more nutritious food, and, in particular, foods that are naturally rich in micronutrients
- Developing and supporting mechanisms to alleviate the integrity and failings of value chains
- Legislating regulations that permit and facilitate the marketing of more nutritious foods on the basis of their potential nutritional benefits, whilst at the same time minimising the risk of false claims
- Providing support for and/or put in place mechanisms to make more nutritious foods more available, affordable and acceptable to low-income consumers
Role of the private sector:
- The private sector was a key player in food systems and could provide valuable lessons regarding how to create pronutrition consumer demand
- The “food industry” is a multiple business. The largest 20 food multinationals control only approximately 10 per cent of the global supply
- The food industry has a vested interest in promoting consumer health in regards to longevity of profits
Points made in favor of avoiding private sector participation included the claim that the food industry had historically been an impediment to consumer health. Civil society representatives criticized that negative outcomes of the current global agricultural model, highlighted during a UNSCN seminar on ’Nutrition and Sustainability’ before the meeting, were repeatedly downplayed during the conference.
Social protection programmes were stressed to often have poverty and equity objectives. However not all of them should necessarily have nutrition objectives, and stunting not necessarily be a prime indicator of impact. If nutrition was identified as a potential objective for a social protection programme, the design should take into careful consideration the target population and the aspects of nutrition to be addressed.
// Members’ concerns and way forward
Some member states, such as the US, formulated concern regarding the disconnection they felt between the technical discussion held and the reality on the ground. Given that the ICN2 meeting will be a political forum calling for country commitments, they felt that the preparatory meeting had missed the opportunity to really review country experiences and lessons learned in order to prepare specific country plans. Germany, Norway and France also emphasised the necessity to involve member states, private sector and civil society much stronger in the upcoming preparation of ICN2. Italy and Spain expressed specific concern that the ICN2 process seemed not yet linked with the post-2015 development agenda, which they see as necessary to achieve the ambitious objectives.
WHO and FAO assured member states that they will be more involved through the inclusive intergovernmental process which is about to start. WHO and FAO will lay out a roadmap, showing how to link up ICN2 with other events/initiatives, such as the post-2015 development agenda, and provide guidance on how outcome documents would look like.