WaterAid thanks FAO and the UNSCN for the opportunity to input into the development of the UN Decade of Action on Nutrition work programme.
As articulated in the concept note, the Decade of Action on Nutrition should act as an umbrella for the various initiatives and stakeholders involved in nutrition, unifying different voices and serving as a platform for coordinating and strengthening networks and collaborations across different actors and importantly across different sectors. The Decade of Action on Nutrition should encompass key principles to guide its work, including that of country ownership, the universal nature of malnutrition, shared responsibility, integration and collaboration, equity and sustainability.
Our submission focuses on four recommendations for the work programme:
1. Greater prioritisation of the prevention of undernutrition through improving the environments in which people live: The proposed principle focus areas, or ‘pillars’ for the Decade of Action on Nutrition fail to adequately address prevention of malnutrition, particularly with regards to improving the environments in which people live. Given that 50% of undernutrition is associated with infections caused by poor water, sanitation and hygiene (WASH), greater focus and attention on the underlying causes of malnutrition, particularly WASH, is missing from the proposed framework, yet will be fundamental to improving undernutrition. Pillar 5 suggests that this covers recommendations 50, 51 and 52 of the ICN2 framework for action, however although improving WASH in healthcare facilities is a key component of building strong health systems, universal access to WASH requires action outside of the health sector to ensure every household and community realise their rights to water, sanitation and hygiene. This broader role that the environment plays in contributing to undernutrition needs to be more clearly articulated and prioritised within the principle focus areas of the Decade of Action.
2. Place multi-sectoral collaboration, relationships and networks at the centre of each of the 6 pillars/principle focus areas: The Decade of Action can play an important role in facilitating links among a broad set of stakeholders across multiple sectors, particularly health, education, water, sanitation and hygiene (WASH), agriculture, and social protection, while also linking with the climate change agenda. The Decade should advocate for and support countries to build and strengthen institutional mechanisms and structures for nutrition that allow cross-sectoral working and coordination across ministries, and for the more systematic integration of nutrition into nutrition-sensitive sectors, including through building capacity on nutrition in these sectors. The success of these coordination mechanisms requires high-level political support, such as through the President or Prime Minister’s office, along with human and financial resources to ensure its functioning.
3. Improving data, evidence and accountability: Weaknesses in nutrition-related data and spending, particularly that which is disaggregated by various parameters, is an important barrier to scaling up equitable access to nutrition-specific and nutrition-sensitive actions. Supporting the strengthening of information systems to better collect, analyse, track and share data, making it accessible for all, is essential to maximising the impact of investments, directing limited resources and improving accountability. Better documenting and sharing of lessons, including through more operational research, will also be essential to building the knowledge base of what works, and filling in current gaps in knowledge.
4. Building political will and the critical role of advocacy: The challenge will be to translate this global momentum around nutrition into concrete actions and SMART commitments, both in terms of policy and financial commitments, at regional, national and local levels. An ambitious advocacy agenda should enhance the profile of nutrition as an underlying determinant of sustainable development, linking to other SDGs, while developing high-level champions, including parliamentarians, as a way to leverage national and international financing for nutrition.