While the present interest in nutrition (including the Decade) is most welcome, sustainable responses to all forms of malnutrition will in my view require a local approach involving all actors. The food and health sectors should be held accountable for jointly supporting local authorities to make this happen, and donors to co-fund their efforts.
The illusion that standard interventions can provide a response should not be encouraged any further. Clearly common principles should guide the process of developing and implementing local strategies, but applied to specific contexts will result in local specific and pragmatic strategies, which will draw on the array of tools and interventions developed in the last decades.
There is no question that evidence is needed to help policy-makers make appropriate decisions but this evidence should be practice-based and take on board the experience of local actors. Multi-disciplinary teams from local centers of expertise would be best placed to review and document promising practices and assess their impacts on health, jobs and social equity, diets and environment (the different dimensions of sustainable development).
Regarding funding, local strategies to address all forms of malnutrition would help articulate needs and resources> Relevant government institutions could then explore how best to pool existing resources and ensure convergence of relevant programmes and project, in collaboration with civil society actors. Centers of expertise could reorient their activities to support and learn from local processes. And last but not least the private sector should play an active role in removing constraints and supporting solutions.
One of the challenges to address is the inconsistency, contradictions and asymmetry of laws, regulations and procecdures at local level. Lawyers and institution experts are needed to revisit this context.
Another one is the conflict of interest underlying some of the so-called "nutrition interventions".
As the saying goes, nutrition is way too important to be left to nutritionists, health to health staff and food to the food sector. Unless people and local institutions become real actors in local development processes, it is highly unlikely that the Decade will achieve its intended purposes.