Thank you for the opportunity to provide comments on the first draft of the Work Programme of the UN Decade of Action on Nutrition, 2016-2015.
The Global Obesity Centre (GLOBE) is a research group based in the Centre for Population Health Research at Deakin University and a WHO Collaborating Centre. Our vision is to catalyse improvements in population health, with a focus on obesity, through innovative research that empowers people and enables healthier environments.
Comments are arranged according to the headings and numbered paragraphs of the draft Work Programme.
Background
The background should explicitly acknowledge the contribution of climate change to malnutrition. Also it should indicate that this workplan is building on the acknowledged double burden of under-nutrition and overnutrition such that synergistic programmes and policies are sought.
Paragraphs 3 and 4
- Including the global nutrition and diet-related NCD targets from ICN2 and the SDGs (currently in the footnote on page 2) would (1) focus the work programme and (2) better represent the full scope of malnutrition the programme seeks to address
Aims and added value
Paragraph 9
- There is an overemphasis on policy in the aims and consequent underemphasis on programmes and financial commitments. National and international policies are a critical part of the change that is required to combat malnutrition but will need to be implemented together with complementary financial commitment and innovative programmes.
Paragraph 11
- Advocacy, networks and accountability appear to be the main value adds of the work programme.
- In addition to “Put in place an accessible and transparent mechanism for tracking progress” we recommend a point on shared communication of successful initiatives in order to spread progress more rapidly.
- Significant value would be added by including support for sourcing finance.
- The Nutrition Decade could also add value by incentivizing creativity and calling for innovation.
- With global nutrition and diet-related NCD targets already in place, It will be important to prioritise tracking and achieving in addition to the already stated setting impact and outcomes.
Guiding principles
It was difficult to determine what the guiding principles are from paragraphs 12 to 15. To make the principles clearer we suggest
- Focusing paragraph 12 on taking action that builds on existing efforts
- Focusing paragraph 13 on equity (addressing malnutrition for all people everywhere)
- Adding a new paragraph on synergistic partnerships (participation with all actors who are committed to reducing all forms of malnutrition)
- Joining paragraphs 14 and 15 to form a principle of creating enabling environments (helping partners and people remove barriers to action)
Action Areas
Paragraph 17
- This paragraph could strengthen the localized approach mentioned in sentence two more by identifying ways of financing, evaluating and sharing such programs.
Paragraph 18
- Acknowledge rather than map existing nutrition-related initiatives and movements. Mapping would be a huge under-taking that will hinder action. Also, develop mechanisms to strategically build on successful existing initiatives.
Action area 1
Paragraph 19
- We endorse the food systems approach but note that work on marketing, retailing and consumption is under-emphasised in the work programme. Suggestions follow for strengthening these areas.
Paragraph 20
- It is hard to see the value of international guidelines and standards on healthy diets given those that WHO already have in place. These should be updated and promoted as a supportive piece of work but not an action area of the work programme
Paragraph 21
- Nuts and seeds have been left out of this and other paragraphs listing the food groups that the work programme will focus on. They should be included as important part of a healthy diet
Paragraph 22
- Some of the background information on Food safety could be included in the background section rather than here
- Join with paragraph 23
Make action area 2 action area 5
- While this is an important action area, most preventive action happens outside the health system. Also treatment represents a response so action areas 3-5 should be promoted in the list because they focus on prevention
Action area 3
- This action area is missing a paragraph on reducing marketing, particularly to children, which should be considered a social protection activity
- A greater emphasize needs to be placed on teaching children horticulture and food purchasing skills
Action Area 5
- Food retail environments need to be included here
Action Area 6
- The commercial determinants of malnutrition need to be recognised and actions are needed to help countries manage conflicts of interest and achieve transparency in policy-making, political donations, programme financing and related areas.
Means of implementation
Paragraph 42
- It is not clear why countries commit to (1) (2) or (3). Achieving in country nutrition targets implies mobilizing financial resources for domestic action. ‘And’ requires a greater commitment and would achieve a greater collective impact.
Paragraph 46
- This is the first mention of the Nutrition Decade Secretariat. They should be introduced in the background.
Nutrition champions
Paragraph 47
- Governments may prefer to be invited rather than declared as Nutrition Decade champions
Funding modalities
What incentives can the Nutrition Decade provide to encourage funders to support innovative programmes to combat malnutrition?
Paragraph 56
- The World Bank estimates do not include costs of scaling up effective programmes for obesity prevention or reducing marketing. Theses should be estimated so countries can address malnutrition in all its forms.
Paragraphs 64-66
- We see the value of a visual identity for the Nutrition Decade but recommend this is kept low key. The specific and specialized campaigns mentioned in para 66 may be counter to not establishing new structures as mentioned in para 67
Accountability and Shared Learning
- Will there be a country to champion Nutrition Decade at the UN General assembly?
- What accountability will be in place for financial commitments?
Paragraph 75
- How will the UN system identify good practices to support evaluations?
Table 1
- Addressing the impact of climate change on fruit, vegetable and animal sources of foods should be a topic or more explicit in existing topics
Table 2
- A forum on financing is needed in the first biennium
Prof. Colin Bell