Thank you for the opportunity to comment on the zero draft political outcome document. We applaud the inclusion of malnutrition in all its forms and believe that it is of paramount importance to not only treat and prevent the occurrence of malnutrition but also build sustainable food systems to ensure long-term impact.
Please consider the following comments for consideration:
Paragraph 1: Thank you for acknowledging the threat that malnutrition poses to individual and societal well-being. However, we suggest that the paragraph be altered to include an acknowledgment of the growing problem of obesity, the critical period of development during the first two years of life, and the economic costs of malnutrition. Please replace the paragraph with the following: “Acknowledge that malnutrition poses one of the greatest threats to people’s health and well-being. Malnutrition—undernourishment, micronutrient deficiencies, unbalance diets, obesity—imposes unacceptably high costs on individuals, families and societies. In particular, malnutrition early in life–from pregnancy through early childhood—restricts the attainment of human potential, negatively impacts human physical and cognitive development, and increases susceptibility to non-communicable diseases. Malnutrition also impacts economic growth and can cost a country as much as 11 percent of Gross Domestic Product.
Paragraph 2: Please replace the word “modest” with “insufficient” in the first sentence so it reads: “Note, with profound concern, that recent decades have seen insufficient and uneven progress in reducing malnutrition…”
Under bullet number 5: “about a third of all women suffer from anaemia,” please add more on how this is linked not only to poor maternal nutrition but also to newborn mortality, such as: “Poor maternal nutrition is a contributing factor to maternal, infant and child mortality. Stunted mothers are more likely to give birth prematurely and have an underweight baby, and fetal growth restriction is a cause of 800,000 deaths in the first month of life each year (Lancet).”
Please change bullet number 6 to read: “Obesity and overweight in children and adults has dramatically increased and is projected to reach epidemic proportions in the next several years. In addition, the incidence of non-communicable diseases related to diet has been rising rapidly all over the world.”
Paragraph 5: Thank you for recognizing that women and children have specific needs, especially during particular phases of life. The consequences of malnutrition during the critical 1,000 day “window of opportunity” from a woman’s pregnancy to her child’s second birthday are irreversible, and can cause long-lasting damage. Maternal nutrition and support are therefore crucial to break the intergenerational cycle of malnutrition and build the foundations of healthy individuals and societies. We suggest adding the following in bold:
5. Recognize that nutritional needs change over the life cycle, and certain groups, including women and children, have specific needs, especially during particular phases of life, including the 1,000 day window of opportunity from a woman’s pregnancy to her child’s second birthday.
Paragraph 10: Please change the first line to read: “Acknowledge that food systems must produce more nutritious food…”
Paragraph 18: Thank you for recognizing that a framework for collective commitment, action and results is needed to reshape the global food system to improve people’s nutrition. However, the sentence: “Governments should take responsibility for leadership on nutrition,” should be expanded to include an emphasis on the need to develop responsible food policies. We recommend changing the sentence to: “Governments should take responsibility for leadership on nutrition by developing food policies that at a minimum do not harm people’s nutrition and ideally are aimed at improving nutritional status.”
Paragraph 21: It is critical to make the commitments to action list more specific and ambitious. We suggest the following commitments be added to the list:
- We will ensure policies, investments and incentives that affect food systems provide an enabling environment for the effective implementation of nutrition policies and programs, including adopting a “do no harm” policy in order to mitigate any negative externalities of food systems.
- We commit to leveraging local food systems and engaging local populations to support the adoption of sustainable and nutritious diets, including by establishing markets for smallholder and family farmers, developing urban food systems to meet the needs of the local population, leveraging traditional/indigenous crops, and supporting women engaged in local and smallholder food production systems.
- We commit to accelerating progress to achieve the 2012 WHA nutrition targets at national levels.
- We commit to establishing (or enshrining, if already established) a multi-sectoral coordination mechanism for nutrition to ensure that policy decisions are owned by all relevant ministries and have domestic budget lines for nutrition; as well as appoint a government nutrition focal point who is responsible for ensuring that the country’s nutrition efforts effectively engage the whole of government and external stakeholders.