Concern Worldwide welcomes the opportunity to comment on The Rome Accord political outcome document for the ICN2. Cognisant of the potential of ICN2 as a critical moment to garner commitments from Member States, to reshape how the food system is governed and to embed the work taken forward to scale up nutrition in formal government mechanisms, Concern remains committed to working with the organisers to ensure the optimal outcome from the conference. To this end, we believe the paper would be greatly strengthened by being more specific, presenting a clear ambition, supported by concrete targets.
- Do you have any general comments on the draft political declaration and its vision (paragraphs 1-3 of the zero draft)?
Concern welcomes the distinction made between the prevalence of undernourishment and the numbers of people who remain affected by it.
Paragraphs 1-3 highlight and convey the point that there is clearly a lot of work that still needs to be done and the challenges that lie ahead.
In addition to restricting the attainment of human potential and impacts on physical and cognitive development, as the Cost of Hunger Study in Africa highlighted, undernutrition can cost a country as much as 16.5 percent of its GDP. Outlining the economic consequences of undernutrition is important and further emphasises the urgency and imperative to act. This omission should be addressed.
Paragraph 3: the point that malnutrition is complex and multidimensional is stressed. However, the paragraph goes on to focus only on the food system dimensions. Many social and environmental factors such as gender, environmental health, optimal caring and feeding practices etc are key determinants. The paragraph should be expanded beyond the food system to reflect this complexity.
- Do you have any comments on the background and analysis provided in the political declaration (paragraphs 4-20 of the zero draft)?
Women are the main producers of food, and carers for children. As such, women, and their ability and empowerment to support optimal new born, infant and young child feeding, are essential. Gender needs to come out stronger throughout these sections.
Paragraph 4: Elimination of malnutrition in all its forms is indeed an imperative for ethical, political and economic reasons. It is also a matter of human rights. The Rome Accord should be firmly rooted within a rights framework, and reference explicitly the right to food and the right to be free from hunger.
Paragraph 5: We welcome the reference to a life cycle approach and agree that this is needed to address varying nutritional needs. The particular importance of the first 1,000 Days should be acknowledged. The impact of malnutrition during this time is largely irreversible and the consequences last a life time. Adolescence is also a particularly important time for girls if the intergenerational cycle of malnutrition is to be broken. Both should be referenced in the paragraph.
Paragraph 7: Mentions the areas covered by the World Health Assembly (WHA) targets, but stops short of referencing the WHA targets and endorsing. Member State’s continued commitment and support of the WHA targets should be explicitly articulated, as well as recognising the need for commitments that go beyond the WHA 2025 targets.
Paragraph 13: Sanitation should be added after water to read ‘… more equitable access to safe food, water AND SANITATION, income, education and healthcare…’
Paragraph 14: The Code on Marketing of Breastmilk Substitutes is conspicuously missing from this paragraph. We welcome the statement that governments are obliged to protect consumers, especially children, from misleading commercial messages. This should be followed through with a recognition and recommitment to the Code.
- Do you have any comments on the commitments proposed in the political declaration? In this connection, do you have suggestions to contribute to a more technical elaboration to guide action and implementation on these commitments (paragraphs 21-23 of the zero draft)?
Clarity and guidance should be provided in this section as to the linkages between the ICN2 commitments and the broader WHA targets as well as those made at Nutrition for Growth in 2013.
Paragraph 21: While we agree that collective commitment, action and results are needed to reshape the food system, improving people’s nutrition will require a much broader emphasis and focus. Water and sanitation, access to health care, access to education particularly for women, and social protection are all areas that need to holistically be considered as part of an integrated approach in order to sustainably address malnutrition.
Additional commitments that the ICN2 should consider including:
- Ensuring universal access to safe drinking water, sanitation, and hygiene for households, schools, and health facilities. WASH is critical to addressing malnutrition, preventing infections and diseases such as diarrhoea.
- Ensuring that women are supported in optimal breastfeeding through women’s nutrition, education, breastfeeding support, maternity leave, and empowerment. This includes establishing and implementing the necessary work place legislation and incorporating the International Code on the Marketing of Breast-milk Substitutes into national law. Evidence shows that good nutrition during the first 1,000 day window of a child’s life, including early and exclusive breastfeeding for 6 months, followed by continued breastfeeding with age-appropriate responsive feeding with best available complementary foods, has multiple and long lasting benefits from saving more than one million lives each year, to reducing the human and economic burden of diseases, to reducing the risk of developing various non-communicable diseases later in life, to increasing a country’s GDP by at least 2-3 percent annually.
- Ensuring access to sexual and reproductive health services for all women.
- All countries incorporate nutrition outcome targets into national food production goals.
- Ensuring that social protection systems are designed or strengthened in order to address food and nutrition security.
- Ensuring an end to all forms of gender discrimination, recognising this as one of the greatest causes of undernutrition. Action to end hunger must transform societal norms that result in girls eating last and least, that keeps girls out of school, limits women’s income, voice and productivity, and that lead to child marriage. Improving women’s status and role, their access to education as well as their access to and control over resources is key (i.e. land, income, agricultural inputs and agricultural services).
 The Cost of Hunger Study in Africa (COHA) is a project led by the African Union Commission (AUC) and the NEPAD Planning and Coordinating Agency, and supported by the UN Economic Commission for Africa (ECA), and the UN World Food Programme (WFP). COHA is a multi-country study aimed at estimating the economic and social impacts of child undernutrition in Africa.