Foro Global sobre Seguridad Alimentaria y Nutrición (Foro FSN)

1. Do you have any general comments on the draft political declaration and its vision (paragraphs 1-3 of the zero draft)?  

The examples of malnutrition listed in paragraph 1 are undernourishment, micronutrient deficiencies, unbalanced diets. The term “unbalanced diets” doesn’t exclusively imply overnutrition or excess caloric consumption so the inclusion of “obesity” in the list of examples is recommended. 

In paragraph 2, statistics are provided for undernourishment, undernutrition, and micronutrient deficiencies but the point on obesity could be strengthened with statistics instead of just saying “obesity in children and adults has been going up quickly…” as well as including some statistics on prevalence of NCDs like diabetes and heart disease.

Expand the point on “different types of malnutrition co-exist in most countries” to include a description of the two extremes at opposite ends of the spectrum (e.g. ranging from stunting and wasting to overweight and obesity).

Paragraph 3 focuses on the negative nutrients we are consuming more of with processed foods (e.g. saturated and trans fats, salt, sugars) but should also describe the declining consumption of fibre.

Another challenge on the food system to provide safe and nutritious food for all will be population growth.

1. Do you have any comments on the background and analysis provided in the political declaration (paragraphs 4-20 of the zero draft)?   

Paragraph 9 should further emphasize the environmental impact of food systems by making the following edit.

“Food systems - …….determine the quantity as well as quality of the food supply in terms of nutritional content, diversity, and safety, and environmental impact.”

Paragraph 10 describes the need for an adequate supply of fruits and vegetables, unsaturated fat and animal source foods.

Although animal sources are higher quality protein, plant sources currently contribute to more than half of protein intakes globally and are an acceptable and affordable part of the diet in almost every culture around the world. Therefore, there is also a need to ensure availability and encourage consumption of complementary plant protein sources in order to meet nutritional needs. Plant protein sources are also relevant from the perspective of population growth and environmental sustainability.

In addition, paragraph 10 focuses on nutrients to avoid (sugars, saturated and trans-fats, salt) but does not emphasis the need for fibre and nutrient dense foods.

An alternative wording for Paragraph 10 could be “Acknowledge that food systems should produce more nutritious nutrient dense food, not just more food, and guarantee an adequate supply of fruit and vegetables, fibre and high quality protein unsaturated fat and animal source foods while avoiding excess of sugars, saturated and trans-fat and salt;...”

Paragraph 16 should also make reference to initiatives that are “culturally acceptable”.

Julianne Curran, PhD

Director of Nutrition, Scientific and Regulatory Affairs

Pulse Canada

1212-220 Portage Ave

Winnipeg, MB  R3C 0A5

1. Do you have any comments on the background and analysis provided in the political declaration (paragraphs 4-20 of the zero draft)?   

We would like to support the statement in para 19:

The United Nations system must work more effectively together to enhance international cooperation and solidarity to improve nutrition and support national efforts to accelerate progress against malnutrition

In this light and for an appropriate focus on both food and nutrition security ETC suggests to incorporate the rights angle taken by the UN Special Rapporteur on the right to food – see http://www.srfood.org/en/official-reports. In his recent final report the rapporteur includes a sector-by-sector list of recommendations and in so doing addresses various comments on the ICN2 Zero Draft.

His conclusion says:

The eradication of hunger and malnutrition is an achievable goal. Reaching it requires, however, that we move away from business as usual and improve coordination across sectors, across time and across levels of governance. Empowering communities at the local level, in order for them to identify the obstacles that they face and the solutions that suit them best, is a first step. This must be complemented by supportive policies at the national level that ensure the right sequencing between the various policy reforms that are needed, across all relevant sectors, including agriculture, rural development, health, education and social protection. In turn, local-level and national-level policies should benefit from an enabling international environment, in which policies that affect the ability of countries to guarantee the right to food – in the areas of trade, food aid, foreign debt alleviation and development cooperation – are realigned with the imperative of achieving food security and ensuring adequate nutrition. Understood as a requirement for democracy in the food systems, which would imply the possibility for communities to choose which food systems to depend on and how to reshape those systems, food sovereignty is a condition for the full realization of the right to food. But it is the paradox of an increasingly interdependent world that this requires deepening the cooperation between States.

Texts such as the above in our opinion rightly stress the urgency of the matter and also convincingly argue that “business as usual” will not do.

In our view, the draft political declaration presents a good opportunity for accelerated and concerted action on multiple threats of malnutrition. However, its vision could benefit from inclusion of a notion of urgency, persistency of the problem, as well as – beyond stating its unacceptability and injustice – the fact that the matter is of avoidable and preventable nature by reasonable and known means, many of which remain within the remit of systemic approach to good governance and redistribution of power and resources at local, national and supranational level.

We agree that the causes of malnutrition are complex and multidimensional, indeed, as the draft political declaration state; however, the ‘causes of the causes’ of such a state, have not been adequately and clearly brought to a limelight – the past and current food and agriculture systems failed to address hunger and malnutrition due to unfavourable economic and political choices and have neglected to systematically and sustainably put health and nutrition for all at the heart of their decision makers. In this regard, ‘access to food’, ‘right to food’ and ‘adequacy’ should come upfront when listing key determinants of malnutrition and inequalities at population level (strongly referred to the UN SR Right to Food). Moreover, the vision would benefit from a stronger alliance of the – so it seems – predominant food and farming sector with health and social systems at large, objectives of the fight against poverty and social exclusion as well as advancement of gender equality and a strong human rights protection in all approaches towards food and nutrition - from a point of 'curative' but mostly 'preventive' way and mindset.

Furthermore, to go beyond ‘just’ focusing on the whole food and agriculture system that is to say the traceable food supply chain and actions across sectors to ensure coherence with health and equity, due consideration should be given to the entire enabling food environment so that a healthy and nutritious choice is an easy one.

We very much value a specific focus put on increasing the rate of exclusive breastfeeding in the first six months as well as support towards adequate supply of (fresh) fruit and vegetables, having seen a slow but persistent decline in political commitment towards these objectives and misguided agricultural subsidies that favour intensive production of products not considered to contribute to healthy and sustainable diets (such as the recent reform of the EU Common Agricultural Policy or the US Farm Bill).

In addition to recognising that ‘nutritional protection is provided to people who are food (EPHA add. and nutrition) insecure, unable to purchase the (EPHA add. adequate amount and/or type of) nutritious foods they need, have special needs, or are nutritionally vulnerable for other reasons’, it should be made clear that by no means people should find themselves in a situation of food and nutrition poverty in the first place. Of course, any emergency food aid is welcome when it is needed and necessary in unfortunate conditions but its temporary character should not be seen as a long term solution; neither should it replace or overshadow structural systemic good governance policies on a government side to address, mitigate and prevent such insecurities or inequalities through a variety of available measures.

When considering ways how to reshape and fix our broken and unsustainable food system to improve people’s nutrition and ultimately health and well-being, the entire food supply chain has to be scrutinised, including food environments in which people make food and nutrition-related decisions, how the foods are advertised and marketed, especially to the most vulnerable consumers such as the child population, young parents, people on low income or minorities, among others. For better health and nutrition, the length of the food supply chain has to be considered – with the short(er), local, regional food production-consumption links found supporting healthier food options, reducing food waste, price volatility and ever-increasing power and market concentration in the agri-food sector.

This would bring us to another macro-economic level of influence in food and agriculture system - international ‘free’ trade agreements aimed to remove trade barriers, such as tariffs but also regulatory or harmonization framework of existing and future regulations aimed to guide production of foods considered safe, healthy, nutritious or environmentally-friendly; how the food could be grown, produced, processed, distributed, advertised and so on. The already happening increase in food commodification, globalization and disappearing diversity in our diets (usually towards cheaper and more convenient but unhealthy, western-type, highly-processed and intensively farmed) may be only further aggravated by such trade negotiations as the current Transatlantic Trade and Investment Partnership (TTIP) between the US and the EU. In parallel with discussing policies on investment and subsidies to be aligned with nutrition goals, taxation policies could be used to support such an objective – favourable or no VAT for products clearly contributing to a healthy diet, increased taxes on foods considered unhealthy and which consumption should be discouraged – especially among the most vulnerable population groups who tend to consume relatively more of such products (aka ‘heavy users’ according to the food and drink industry) as compared to the general population and therefore taking a significantly heavier toll of the poor diet-related burden of disease.

In addition to all the above suggested issues, the vision for a food system that cares for people’s nutrition, health and equity should take into account the issues of antibiotics’ over- and misuse in the livestock production system and these adding to this emerging public health threat, overproduction and overconsumption of animal proteins as compared with insufficient supply and consumption of fruit and vegetables, whole grain and legumes. It should also be emphasised to consider various health, social and environmental ‘externalities’ of the current food and agricultural production and consumption systems, that is to say both short- and long-term consequences of the current system that favours unsustainable cheap highly-processed and intensively-farmed calories and trades away regulatory power to a handful of agri-food multinationals accountable neither to governments, international institutions nor citizens but to their shareholders.

Having said that, we welcome the following statement ‘(EPHA add. before interests of industry) Governments are obliged to protect consumers, especially children (EPHA add. and other  highly vulnerable consumers), from misleading commercial messages (EPHA add. and financially appealing/attractive activities) promoting energy-dense but nutrition-poor foods, which can induce addictions and heighten the risk of disease’. Indeed, according to a ‘good governance-for-health’ approach, all relevant ministries and departments, together with whole-of-society actors should coordinate towards a shared goal of agriculture-food-health system.

For our comments on specific committments, please do see the attachment enclosed. 

The ICN2 Zero Draft political outcome document is splendid. I would attribute this to the approach that was adopted from the very start - collecting the views and opinions of a wide range of stakeholders. The product is an authentic and well-articulated document, on which dialogue can occur. Also, it fits into the post-2015 development agenda.

Thank you so much. Let the dialogue begin.

1. Do you have any general comments on the draft political declaration and its vision (paragraphs 1-3 of the zero draft)?       

In my opinion the Zero Draft is rather comprehensive in including both sides of the malnutrition scale, and recognizes the co-existence of over- and undernutrition. This is especially significant seeing that the MDG’s was mostly related to undernutrition.

1. Do you have any comments on the background and analysis provided in the political declaration (paragraphs 4-20 of the zero draft)?       

The recognition and emphasis on the importance of food quality in addition to quantity is well accentuated.

The recommendation of cross-cutting initiatives and collaboration between different sectors to enhance quality of food (produce more and increase availability of nutritious foods) (paragraphs 11 to 20), while improving the ability of people to acquire these foods (improved food security) (somewhat hidden in paragraph 13) highlights the importance of the whole food system, from agricultural activities to dietary guidelines.

Paragraph 10 – it could be valuable to specify industrially produced Trans Fatty Acids instead

Paragraph 10 – avoiding processing that reduces or adversely affects nutrition should not be taken out of context, and should refer to only those processing that negatively affects nutrition. Processing, i.e. fortification, freezing, drying etc. might in fact directly and indirectly improve nutrition.

Paragraph 14 – consider removal of the statement which can induce addictions and heighten risk of disease, as it does not add value to the statement and is questionable.

1. Do you have any comments on the commitments proposed in the political declaration? In this connection, do you have any suggestions to contribute to a more technical elaboration to guide action and implementation on these commitments (paragraphs 21-23 of the zero draft)?

Please provide your comments in the appropriate fields relating to these commitments:

Commitment I: aligning our food systems (systems for food production, storage and distribution) to people’s health needs;

This is a very powerful commitment – but it needs buy-in from various sectors who might not be sensitised to the importance and role of nutrition within their scope of work. A strong awareness component is required to inform i.e. agriculture on its role within nutrition, beyond food volumes, domestic production and GDP. Similarly health should also be aware and involved in nutrition, and not simply on the health-related consequences of malnutrition.

Commitment II: making our food systems equitable, enabling all to access nutritious foods.          

Access is a difficult aspect, as it relates not only to the physical availability of the nutritious food (through production or logistics), but also to the ability of people to afford or procure these foods. The food system also has a big role to play in job creation and improving food security through income generation.

Commitment III: making our food systems provide safe and nutritious food in a sustainable and resilient way;        

Sustainability is very high on the global agenda and it is important that it be included in the design.

Commitment IV: ensuring that nutritious food is accessible, affordable and acceptable through the coherent implementation of public policies throughout food value chains.          

Very ambitious, but predictable commitment

Commitment V: establishing governments’ leadership for shaping food systems.                

Very important – Adequate leadership is required

Commitment VI: encouraging contributions from all actors in society;               

It is pivotal to get all sectors in society involved, and high on the agenda should be creating awareness of the complexity and importance of nutrition within each sector.

Commitment VII: implementing a framework through which our progress with achieving the targets and implementing these commitments can be monitored, and through which we will be held accountable.

Although this is a very valuable commitment target, it is possibly the most difficult to attain as a baseline is required to measure progress.

22. Commit to launch a Decade of Action on Nutrition guided by a Framework for Action and to report biennially on its implementation to FAO, WHO and ECOSOC.

Agree

23. Commit to integrate the objectives and directions of the Ten Year Framework for Action into the post-2015 global development efforts.

Agree

Hettie Schönfeldt

Associate of the Institute of Food, Nutrition and Well-being

Professor: Department of Animal and Wildlife Sciences

University of Pretoria

The International Agri-Food Network (www.agrifood.net) comprises member associations from right across the food chain, from producers, to input providers, to cooperatives and food companies. For this reason, the zero draft has sparked considerable interest in our community.

Like many who have already commented, we would also wish to see a significant reframing of the text and we hope that governments will take the opportunity to work towards a more focussed draft.

I will begin by offering some general comments on the text, namely that it seems to be lacking on three major themes:

1. The Zero Hunger Challenge

2. Gender

3. The fact that livelihoods and making a living are good for nutrition

It will be important for the text to embody these themes if the goals of ICN2 are to be met. 

Further thoughts:

-       Synergies & related disciplines: Key driving bodies and stakeholders should consistently underscore the valued roles for nutrition as an integral component with related disciplines such as health, agriculture, education, environment, finance, gender, diversity, and other key development factors.

-        The PSM Committee on Nutrition: The Private Sector Mechanism has agreed a position paper that can be found on the IAFN website http://www.agrifood.net/wp-content/uploads/IAFN-Nutrition-Paper-January-...

The position paper outlines a number of key guiding principles and focus areas: Policy, Communications and Outreach; Research & Development; Nutrition & Health; Empowerment of Women; Agriculture Production & Extension.

-       ICN2: The run-up to the event should establish and maintain open, transparent platforms for the private sector and interested stakeholders to stimulate discussions in preparation for the 2014 high level meeting in Rome in November to frame the new nutrition policy framework. It is essential that proper modalities are identified in the next few months

In addition, I would echo the thoughts raised in the forum from the fertiliser industry, that input industries can bring quantifiable and qualitative improvements to the availability of macro and micronutrients in the food we eat.

Thank you for this opportunity to provide input.

Katy

Comments on the background and analysis provided in the political declaration, paragraphs 4-20

4.   IDF suggests that dietary risk factors may account for more than 10% of the global burden of disease and disability, as stated in this paragraph. Of the estimated 8.3% of adults that have diabetes in 2013 about 90% are affected by type 2 diabetes, which has obesity as one of its main risk factors. For this reason, we believe that 10% is a low figure that does not comprehensively reflect the global burden of disease and disability.

5.   IDF agrees that nutritional needs change during the life cycle and suggests that this paragraph has to reflect that nutritional choices at all stages of life have long-term health consequences. IDF also recommends including elderly people among the groups that have specific nutritional needs.

7.   We recommend dividing this paragraph into two: one on the overweight-related commitments and another one on under nutrition commitments. In the current paragraph the overweight-related commitments (halt the increase in the prevalence of overweight in children under five and reverse the rise in obesity and diabetes) are hidden between the markers more closely linked with under nutrition. We also believe that the commitment “halt the increase in the prevalence of overweight in children under five” needs to be stronger, and propose “reverse the rise in the prevalence of overweight in children under five” instead.

9.   IDF strongly recommends that this paragraph adds “marketed” to the list of procedures food undergoes within the food systems, as it has an obvious impact on nutrition and consumer choices and preferences.

IDF applauds the content of the rest of the paragraphs, specially the proposals of nutrition as a goal of all developing countries, empowering the consumers to make healthy food choices and facilitation of healthy food practices by Governments. IDF recognises that nutrition policy and programmes are generally poorly developed; we also support that Governments should take responsibility for leadership in nutrition and that an effective coordination across all stakeholders is needed to tackle this issue.

Comments on the proposed commitments, paragraphs 21-23

21. IV. IDF would like this commitment to reflect that nutritious food needs to be more accessible, affordable and acceptable than it is now, while poorly nutritious food needs to become less affordable. Only this will help achieve our goal of the healthier choice becoming the easiest one for consumers around the world.

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1 Global Health Observatory (GHO). http://www.who.int/gho/ncd/risk_factors/obesity_text/en/

2 Maternal and child under nutrition and overweight in low-income and middle-income countries. The Lancet 2013. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2960937-X/fulltext

Dear FAO Moderator

It gives me great pleasure to attach our contribution to the forum [copied below and attached].  All the best and lookng forward to attending the meeting in November 2014.

Dr. Nawal M. Al Hamad, MD, PhD

WHO Temporary Regional Nutrition Adviser, EMRO

Director, Food and Nutrition Administration,

Ministry of Health, Kuwait.

 

1. Do you have any general comments on the draft political declaration and its vision (paragraphs 1-3 of the zero draft)?

The committee has touched on all forms of malnutrition from all angles; it exposed its weaknesses evaluating it with rational justification as well as reconfirmed the solutions on which it built its vision to end it.

1. Do you have any comments on the background and analysis provided in the political declaration (paragraphs 4-20 of the zero draft)?

None          

1. Do you have any comments on the commitments proposed in the political declaration? In this connection, do you have any suggestions to contribute to a more technical elaboration to guide action and implementation on these commitments (paragraphs 21-23 of the zero draft)?

The commitments proposed in this zero draft is excellent. Although governments  sign the declaration but political will is lacking because no commitment.  UN and WHO cannot enforce this on governments ...that's the problem

Please provide your comments in the appropriate fields relating to these commitments:         

21.Commitment I: aligning our food systems (systems for food production, storage and distribution)to people’s health needs;    

None

Commitment II: making our food systems equitable, enabling all to access nutritious foods.     

Agree

Commitment III: making our food systems provide safe and nutritious food in a sustainable and resilient way;              

Agree

Commitment IV: ensuring that nutritious food is accessible, affordable and acceptable through the coherent implementation of public policies throughout food value chains.            

Agree

Commitment V: establishing governments’ leadership for shaping food systems.            

Agree

Commitment VI: encouraging contributions from all actors in society;              

Agree

Commitment VII: implementing a framework through which our progress with achieving the targets and implementing these commitments can be monitored, and through which we will be held accountable.             

Agree

22. Commit to launch a Decade of Action on Nutrition guided by a Framework for Action and to report biennially on its implementation to FAO, WHO and ECOSOC.     

Agree

23. Commit to integrate the objectives and directions of the Ten Year Framework for Action into the post-2015 global development efforts.   

Agree

Please find my comments in the attached comment form.

This document is a good start. However, I would like to see the concepts more clearly defined, and more attention to health systems, equity, social safety nets and poverty reduction, in addition to food systems. The commitments as stated are too vague to lead to operational strategies.

Thank you for giving us the opportunity to react.

Best wishes,

Hélène Delisle, Ph.D.

Professeur titulaire et directeur de TRANSNUT

Centre collaborateur OMS sur la transition nutritionnelle et le développement

(WHO Collaborating Centre on Nutrition Changes and Development),

Département de nutrition, Faculté de Médecine

Pavillon Liliane-Stewart, Université de Montréal

CP 6128 succ. Centre-ville,

Montréal Qc Canada H3C 3J7