المشاورات

Invitation to an open discussion on the political outcome document of the ICN2

The Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO), in cooperation with IFAD, IFPRI, UNESCO, UNICEF, World Bank, WTO, WFP and the High Level Task Force on the Global Food Security Crisis (HLTF), are jointly organizing the Second International Conference on Nutrition (ICN2), a high-level conference at FAO Headquarters, Rome, from 19 to 21 November 2014. More information is available at: www.fao.org/ICN2.

A Preparatory Technical Meeting was held in Rome on 13-15 November 2013 to feed into the ICN2, drawing upon a series of regional conferences and technical background documents as well as from the outcome of three online thematic discussions (Social protection to protect and promote nutrition, Nutrition-enhancing agriculture and food systems and The contribution of the private sector and civil society to improve nutrition).

Two documents are expected to come out of the ICN2 - a political outcome document and a framework of action for its implementation.

The zero draft of the political outcome document, prepared by the FAO and WHO Secretariats, will be further developed by a Joint Working Group (JWG) of regional representatives of FAO and WHO Members for adoption by the ICN2 in November.

We now invite you to provide your comments on the zero draft of the political outcome document available in the six UN languages through this public online consultation.  In providing your inputs, please focus on the set of questions formulated below. A template for providing comments can also be accessed here.

This open consultation will give an opportunity for a broad range of stakeholders to contribute to the Conference and its impact.

The comments received will be compiled by the Joint ICN2 Secretariat to inform the work of the JWG.

We thank you in advance for your interest, support and efforts, and for sharing your knowledge and experiences with us.

We have a tight deadline, so we encourage you to send us your comments on the document as soon as possible.

We look forward to your contributions.

FAO/WHO Joint Secretariat

 

Questions:

  1. Do you have any general comments on the draft political declaration and its vision (paragraphs 1-3 of the zero draft)?
  2. Do you have any comments on the background and analysis provided in the political declaration (paragraphs 4-20 of the zero draft)?
  3. 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)?

Commitments:

21.

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

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

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

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

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

Commitment VI: encouraging contributions from all actors in society;

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.

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.

23.  

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

 

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FAO/WHO Joint Secretariat

Dear Members,

On behalf of FAO/WHO Joint Secretariat we would like to thank all participants for their active involvement and their insightful comments on the political outcome document of the Second International Conference on Nutrition (ICN2).

The online discussion gathered a wide range of  views, allowing this process to be highly participatory and benefit from important inputs from food security and nutrition stakeholders representing Member States, UN organizations, individual academics, civil society and the private sector.

A Joint Working Group of regional representatives of FAO and WHO Members is now considering all inputs received and based on these and other comments will develop the final version of the political outcome document for adoption at the ICN2 in November.

For more information please see the following documents:

- Background and statistics (EN FR ES)

- Summary of the discussion (EN FR ES)

- Contributions received, available in the proceedings and on this weboage

To know more about the Second International Conference on Nutrition (ICN2) please visit the website.

Thank you again for your participation.

The FSN Forum Team

Action Against Hunger

Action Against Hunger | ACF International (ACF)1 is ‘profoundly’ concerned that this first draft of the “Rome Accord” is by and large a ‘manifesto’ from a food perspective, without specific propositions for multi-sectoral solutions in the areas of nutrition, health systems, water and sanitation, education, family planning, social protection, and governance that are so urgently needed in large- scale nutrition sensitive interventions and programmes. Acute malnutrition (wasting), the most deadly form of hunger, is mentioned only in passing - the zero draft fails to recognize that the prevalence rate of wasting has stagnated since 1990, as acknowledged in the WHO report January 2014, and does not make sufficient commitments on wasting to significantly reduce these rates and put the world on a path to ending child deaths from this condition, which can be done within in a generation with urgent action now.

During the first International Conference on Nutrition (ICN) in 1992, governments pledged to make all efforts to eliminate and reduce substantially, before the next millennium, starvation and famine; widespread chronic hunger; undernutrition, especially among children, women and the aged; micronutrient deficiencies, especially iron, iodine and vitamin A deficiencies; diet-related communicable and non-communicable diseases; impediments to optimal breast-feeding; and inadequate sanitation, poor hygiene and unsafe drinking-water. ACF believes the ICN2 deserves an equally encompassing and ambitious commitment.

The second International Conference on Nutrition (ICN2), unlike the first ICN, appears instead to avoid an accountable plan of action for nutrition, based on a broad consultation with all actors. ACF believes that the ICN2 needs to draft a plan of action, foster an in-depth discourse on factors beyond the food perspective and propose accountable commitments. Doing anything less places the ICN2 at risk of being perceived as becoming a lost opportunity.

ACF acknowledges the efforts by FAO and WHO to organise the ICN2 and appreciates the intent of the organisers to establish a more effective bridging of nutrition-sensitive issues to nutrition-specific interventions across sectors. ACF would like to see the food and nutrition security of infants and young children more firmly recognized as an important priority of the ICN2 agenda: in particular a recognition of the health, social protection, water, sanitation and hygiene (WASH) and livelihoods approaches in support of children under 5 years old who have fallen ill with severe acute malnutrition or wasting. 70% of these children live in Asia, largely unaffected by major conflicts or sudden onset crisis but rather in contexts of chronic depravation, which underlines that wasting cannot be labelled as just an emergency issue but one in need of urgent attention by ICN2 as a development crisis. The ICN2 must recognise that action on malnutrition requires equally prevention (food systems, education, public health, social action) and treatment for micro-nutrition deficiency and wasting. For the latter the ICN2 needs clear defined commitments and a plan of action that includes  increased coverage and access to treatment for acute malnutrition for all.

The definition of malnutrition offered in this zero draft is a too general and too biased  food system approach. This definition however needs to be extended to include the concepts such as utilisation and individual dietary diversity scores. There needs to be explicit conceptualization in support of social and inequality drivers of malnutrition. The ICN2 must find ways to stipulate improved diets and equitable utilization, based on local action in all sectors: health, livelihoods social protection, water and sanitation, care practises and rights to adequate food.

ACF is concerned about the current lack of sufficient transparency of the ICN2 process. With only eight months to go, inadequate dialogue is taking place between the ICN2 member states and civil society actors through appropriate channels. ACF is actively engaged with many civil society working groups and alliances, and reaffirms our commitment to engage further on the elaboration of the “Rome Accord” and related processes.

ACF sees the proposed “Rome Accord”, while discussing many aspects of nutrition issues, as too vague  in many  areas  and  needs  to move  to  accountable  commitments  and the  setting out  of concrete plan of actions for nutrition. The ICN2 process, thus far, does not yet set up governments on a future path to ensure “better nutrition to all”. As such, ACF urges the organisers to push for an open discussion about the plan of action in addition to the consultation on the political outcome document. The framework of action must be a legacy of the ICN2 after November 2014 that rallies governments and international platforms to take accountable collective and individual actions to end malnutrition.

ACF hopes that by opening a discussion on the “Rome Accord” the organisers are signalling their firm commitment to a fully transparent road map leading to the ICN2 this November and actions beyond. We hope the organisers will open the ICN2 process to civil society in the declared spirit of reaching a “consensus around a global multi-sectoral nutrition framework including concrete steps to improve nutrition for all”.

Specific contributions to draft Rome Accord in order of paragraphs

1.   Do you have any general comments on the draft political declaration and its vision

(paragraphs 1-3 of the zero draft)?

The definition of malnutrition needs to be extended to include specifically  acute malnutrition or wasting. Thus far the concept of utilisation and diversity at the individual level is underplayed and not further taken up in the latter part of the draft nor in the commitments. The definition of malnutrition offered in this draft is too general and too related to agriculture and food. There needs to be explicit conceptualization in support of non-product driven action aimed at improving diets and utilization, based on local action in all sectors: health, livelihoods social protection, water, sanitation and hygiene, care practises and rights to adequate food.

In paragraph 2, bullet 2: ACF would like to complete the statement on nutrition trends (stunting and wasting) by citing the Lancet (2013) which states that there is near to no progress since 1990 on the wasting burden globally. In 1990 there were 58 million, or 11% of children worldwide, affected by wasting at any one time. In 2011 this figure was persistently high at 52 million or 8%. 70% of these children live in Asia, largely unaffected by major conflicts or sudden onset crisis but rather in contexts of chronic depravation, which underlines that wasting cannot be labelled as just an emergency issue but needs urgent attention by ICN2 as a development crisis.

There is a need for the Rome Accord to broaden out the analysis to  non-food based causes protracting the nutrition crisis. The FAO Committee on Agriculture noted that increased food production, while often necessary, did not guarantee a decrease in the number of malnourished people (FAO, 1979). The text touches on social and health causes but more depth and breadth of analysis should be devoted to these issues. By referring predominantly to products and food production, the Accord runs the risk of following the misplaced assumption that increased production and value chain regulation will automatically lead to better nutrition of all. The ICN2 must address the multiple drivers of malnutrition. Intensified production without addressing the social and governance issues, might even cause possible harm to nutrition status (for instance, where smallholder investment shifts towards cash crops concentrated to fewer actors and thus reducing the dietary diversity of many, increasing the workload of women and/or increasing diseases related to the use of agro-chemicals). Thus the concept of the  Right to Adequate Diet / Food (quality and quantity) would be desirable in any subsequent draft of the Rome Accord (in accordance with the ICN 1 held in 1992).

ACF calls for  reference to the right to adequate nutrition as protected, among others, by article 25 §

1 Universal Declaration of Human Rights, article 11 International Covenant on Economic, Social and Cultural Rights, article 24 (c) Convention on the Rights of the Child and article 12 § 2 Convention on the Elimination of All Forms of Discrimination against Women. We support other contributors in the call for the right to adequate food and nutrition for all to be considered a cornerstone of the ICN2 and any action plan stemming from it.

The utilization pillar of food security should be further explored, since it inequalities with in utilisation are a major contributor to malnutrition especially from a gender perspective. The Rome

Accord cannot be limited to access, availability, and technology only. If the current food system is analysed as unable to provide adequate food to all and at all times it is not only due to access to and availability of food, it is also due to a problem of utilisation and equity in the repartition of this food. Moreover, if food production is constrained by resource and ecological sustainability, it is also because many large scale agricultural systems are not resilient, sustainable nor responsive to local needs. This should be clearly mentioned.

Further on to the above point the implication of climate volatility on malnutrition should be acknowledged in some more details in paragraph 3. Climate volatility is likely to have a greater impact on rates of severe stunting, which are estimated to increase by 23% (in central sub-Saharan Africa) to 62% (in South Asia)  (Lloyd, Kovats, & Chalabi, 2011). By 2050, compared to a scenario without climate change, child malnutrition could increase by 20% (International Food Policy Research Institute - IFPRI, 2009).

There is no section on the significance that smallholders can have for improvements to nutrition. It would seem to be relevant to include some information on this in this document - more specifically the role in growing complementary food for children of 6 to 24 months. The ICN2 could highlight the available evidence that smallholder agricultural development leads to more effective food utilisation and dietary diversity.

Smallholder agricultural interventions can be made more sensitive to nutrition in two key ways; by reducing female disadvantages in farming, for example poor access to inputs, seasonal credit and technical assistance, thereby increasing women’s returns from their farming, and through this giving them more opportunity to spend on the nutrition, health and care of their children — and themselves. The other is either to promote home gardens and small livestock keeping in order to encourage more diverse diets at the household level and especially under the control of the women, or advance breeding of local adopted crops to increase their nutritional value and added minerals and vitamins, otherwise a combination of these two.

ACF would like to see in this section of the Accord a more balanced approach that reaches beyond the Food System approach and opens a genuine discussion of the multiple threats of malnutrition (health, socio-economic, rights and there alike).

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

Paragraph 5: The ICN2 must propose and be monitored in how far it is addressing the specific nutrition needs over the life cycle more specifically the ‘the window of opportunity of the first 1000 days’  to prevent impaired child growth, create healthy conditions for women during pregnancy and that put the growing child at a lower risk of suffering from chronic diseases in adulthood. In addition, global action needs to be reinforced by the ICN2 that targets maternal health and can help to prevent low birth weights and stalling progress in later child development, create healthier environments, lower workloads and production focus to raise availability and utilization of adequate

diets. The text so far does not mention adolescents, recognised by the Lancet (2013) as a key target group for nutrition interventions, further attention is needed to this age group.

There are a range of proven direct and indirect nutrition interventions that could be included in the final Accord for this ‘the window of opportunity’. These include the promotion of breast feeding and optimal complementary feeding (guaranteed by a right to adequate food agenda), the increase of micronutrient interventions and strategies to improve family and community nutrition and reduction of disease burden (e.g. promotion of hand washing and strategies to reduce the burden of malaria in pregnancy). (For further information, see ACF International Manual, Maximising the Nutritional Impact of Food Security and Livelihoods Interventions, 2011).

ACF believes the ICN2 would make a very significant contribution for a better nutrition for all if it contributes policy options that have the potential to bridge various sectors rather than repeating the disjointed sector approach that has led to a fractured and inefficient response in the past. For instance strengthening the health system to provide treatment for acute malnutrition where it is needed most by the worst affected populations or strengthening the education system - for sustainable human resources for nutrition across the relevant sectors; sensitising the general population on good nutrition at an early age – primary school focus as secondary school attendance is patchy.

The ICN2 must encourage ministerial working groups that engage at the local, national and international level to make commitments for sufficient financing for tackling malnutrition allowing sustainable nutrition specific and nutrition sensitive actions to grow and develop. These working groups must be adapted to local needs and include the Ministry of Finance among others.

Paragraph 6:  The draft accord does not make specific links to likeminded platforms such as the SUN Movement and REACH

Paragraph 11: Seasonality, it seems important to include some discussion in the Accord on the effects of seasonal wasting, hunger and food access and availability, which is the reality for many children in low income countries and considers all pillars of food and nutrition security. It is well known that the poorest households – even those relying predominantly on small scale agriculture for their livelihoods – are reliant on the market to purchase food once their harvest runs out. It

would be encouraging to read more in this draft on interventions and policies that aim to reduce the hunger gap by ways of food and seed storage, or how to reduce dependency on markets, especially during the hunger gap with interventions such as Inventory Guaranteed Credit Schemes (Warrantage), building storage solutions, guarantee affordable and adequate food processing on village level, social safety net transfers and the like to increase food and nutrition security during seasonal deprivation.

The gains made during the prosperous times of year are often negated by forced sales of assets and other coping mechanisms families are forced to undertake to survive during the hunger season. Seasonal changes in the local market can push vulnerable households closer to a threshold beyond which they cannot afford to cover their basic (qualitative and quantitative) dietary needs, eroding their resilience and preventing investment in their livelihoods. The care giver should increasingly be educated on the dietary needs of growing children so that they can make the best choice for planting, selling, saving and purchasing food commodities throughout the annual cycle.

The ICN2 should point to ways and needs of how to strengthen these self-generated safety nets linking rural smallholder with urban relatives and food markets to progress nutrition security.

Paragraph 19: Given national and international NGOs play a very important role in the fight against malnutrition, the ICN2 process and this Accord should mention NGOs as a part of the civil society and their important role in the process of reaching a consensus around a global multi-sectoral nutrition framework.

3.   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)?

Paragraph 21,

Five out of seven commitments in this section are related to the food system. This is unacceptable for an outcome document of an International Conference on Nutrition. The commitments must relate to an agreed and accountable Action Plan on ending malnutrition in all its forms.

The ICN2 member states must declare to work individually and collectively towards this goal with a strong emphasis on wide consultation across all stakeholders.

NEW  Commitment (an additional commitment proposed)  agree on accountable country action plans on the multiple threats of malnutrition through a coordinated multi-sector approach which addresses all casual pathways by 2016 (including action to make health systems, water and sanitation, education,  family planning, social protection, and governance more nutrition sensitive.) Agree on regional and global coordination, monitoring and support.

Commitment I: must emphases the analysis presented in paragraph 3 and 8 where the Accord plays at the complexity of causes and lack of accountability that drive the nutrition crisis, by proposing an alignment of the global and national nutrition action plans within a rights approach and re-affirm the progressive realisation of existing commitments that enshrine the Right to Adequate Food such as the Declaration of Human Rights, Convention on the Rights of the Child and Convention on the Elimination of All Forms of Discrimination against Women .

Commitment II: the Accord ought to go further and state that the undersigned will commit to the progressive realisation making all relevant sectors (see commitment 0) more nutrition sensitive, equitable and  create healthier environments, enabling all to access and utilise nutritious foods all year round.

Commitment III: making all relevant sectors provide safe, healthy and nutritious food in a sustainable and resilient way, particularly in light of climate volatility;

Commitment IV: ensuring that nutritious food, health and education is accessible, affordable,

utilised and acceptable with dignity through the coherent implementation of public policies aimed at the eradication of malnutrition in all forms.

NEW Commitment: recognises that action on malnutrition requires both prevention (food systems, education, public health, social action) and treatment for micro-nutrition deficiency and wasting. For that latter the ICN2 needs clear defined commitments and a plan of action that includes  increasing coverage and access to treatment for acute malnutrition for all.

Commitment V: establishing governments’ leadership and financing for eliminating multiple threats of malnutrition and align where appropriate with regional and global governance structure to work towards an eradication of malnutrition globally.

Commitment VI: encouraging contributions from all actors in society including populations most affected by malnutrition, and civil society;

ACF welcomes the link with the post-2015 agenda, however we would like to have a more specific statement of intent for the ten-year plan of action to be integrated into the global development efforts for post-2015. They must also be part of efforts to achieve the targets set already by the World Health Assembly in reducing malnutrition.

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1 Action Against Hunger | ACF International is a leading civil society organisation engaged in over 40 high burden countries, able to bring experience and expertise in key areas relevant to the Second International Conference on Nutrition (ICN2). ACF has worked on the integration of nutrition, livelihood, food security water, sanitation, hygiene and health for over three decades, at all levels from grassroots to national policies and related global arenas, as practitioners, partners and respected analyst of the local, national and global response to nutrition.

Klaus Kraemer

Sight and Life
Switzerland

Comments on the Rome document for ICN-2 from Sight and Life:

·         Overall, would like to see more clarity around the outcomes for the meeting.

·         Would also like to see more specificity/direct linkages to clarify the relevance of the outcomes for developing country policymakers.

·         Clause 2, RE: “micronutrient deficiencies have not improved,” though there is still work to be done, we’ve made tremendous progress. Take vitamin A as an example. In 1999, only 16 percent of children were receiving the necessary two annual doses of vitamin A; by 2007, that figure had more than quadrupled to 72 percent. Today, in some countries, 100 percent coverage has been achieved.

·         Clause 3. Causes of malnutrition described are too narrow and just food-focused not considering care and health.

·         Clause 6. Refer to other initiatives/commitments, such as Scaling up Nutrition, Nutrition for Growth, World Health Assembly, Zero Hunger.

·         Clause 7. Refer to WHA targets for 2025.

·         Clause 9. A food system has many entry points and does not have a base (agriculture). In the food system, each actor and sector has a function and the whole is greater than the sum of its parts because of the synergy created among well-functioning parts. When one part is unable to contribute to 100% capacity, the system as a whole compensates for this lag.

·         Sustainable and equitable food system by definition are resilient; endurance and remaining productive is inherent in the definition of sustainability, thus term resilient is redundant.

·         Clause 10. Consumption of a diverse and balanced diet, such as vegetable oil and animal source foods, leads to a healthy intake of saturated fats. Food processing technologies that convert naturally occurring fats into forms (i.e., trans fat) that are detrimental for health should be avoided.

·         Not all people can access a balanced diet because of lack of knowledge and resources. The nutrient profile (density) of food can be a lens used to examine the healthiness of our food system. Food fortification shall be considered as a cost-effective and safe approach to increase nutrient density of foods.

·         Clause 11. Advanced packaging technologies should be considered to reduce food spoilage and wastage.

·         Clause 12. Policies should encourage private-public-partnerships to co-create public goods such as improved nutrition and health.

·         Private sector role in facilitating a nutritious food system is evident

·         Clause 13. Rural livelihoods need improvements, including access to quality health services, education, safe water, sanitation, improved housing (i.e., non-dirt floors, non-leaky roofs), and social protection programs. 

·         Clause 15. Nutrition interventions must be evidence based. Nutrition assessments are required to understand what the nutritional gaps are (lack of energy, protein, micronutrients) or essential fatty acids) and cost-effective interventions (e.g., fortification, supplementation) should be designed to fill these nutrient gaps. Supplementation with micronutrients and provision of food supplements shall be provided for the most vulnerable, women and their children.

·         Clause 17. Advancing the nutrition agenda in political circles will require a multisector approach via task forces, technical advisory groups. Effective strategies for multisector alignment, financial management, and shared objectives need to be tested and implemented.

·         Advancing the nutrition agenda also requires a reframing our nutrition story. We need science that will help us explain how the health and education systems affect nutrition outcomes. A nutrition lens in addition to the development lens is needed too.

·         Political commitment is not completely lacking at country level. Would be beneficial to highlight that greater commitment is needed while at the same time acknowledge and highlight country success stories, noting that political commitment can translate into positive difference on nutrition outcomes.

·         Clause 20. We urgently need a systematic approach to scaling up of interventions and this can be achieved through implementation science. Many of the evidence-based interventions work under tightly controlled conditions, but we lack knowledge in taking them to scale.

o   There is also a need to recognize and effectively support human capacity to take programs to scale, including leadership training for policy makers and program managers. Organizational behavior theories, rewards and compensations and certifications systems, continuing education and mentorship programs need part of our discussions for improving capacity in nutrition. 

o   We require new assessment tools suitable for the field for rapid and reliable assessment of the (micro)nutrient status of populations.

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

We believe this is a great effort that is being made and we are very pleased to be able to make contributions.

In general, we observed that there is many valuable aspects in the document, but overall it is ambiguous in many ways, many definitions are not well established. Examples: malnutrition-it is not clear and it does not exactly define that overweight and obesity is part of malnutrition, it refers only to “overconsumption”; safe food- leads to think it is regarding to only processed foods and that traditional fresh grown foods from the different localities do not meet in this concept).

It is not based on the best interest of the child nor children´s rights; children are even mentioned as “consumers” but not as right holders. Overall human rights are not mentioned, only economic, social and cultural rights; which is very important but it is also important to mention and to base all the proposals and policies regarding human rights.

Breastfeeding is only mentioned once in the whole paper when it is one of the most effective measures for malnutrition; we believe it needs to be reinforced.

Accountability of private sector is not mentioned at all, nor the importance of conflict of interest when regarding industry involvement and partnerships, industry is only partially mentioned as part of the problem when it has been a big part of the problem for NCD´s and for undernutrition as well.

Marketing to children is not mentioned and it needs to be very clear that is a very strong issue regarding nutrition in children.

Some words can be complemented: sugars- for free sugars or added sugars; safe food- for safe nutritious food; regulations- for strong regulations; healthy food- for healthy, natural and fresh food.

In the commitments part VI, it does not establish if it is including private sector and what would the role be.

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

Paragraph 4 establishes elimination of malnutrition is imperative for ethical, political and economic reasons but not for the best interest of the child, nor for the child´s rights, nor for human rights.

Paragraph 5 does not recognize the importance of the protection of women and children particularly when breastfeeding. Instead of using word “including” it can be “specially” women and children. Breastfeeding is only mentioned in paragraph 7, when it is one of the most important effective measures for malnutrition.

Paragraph 8 only mentions Economic, Social and Cultural Rights; Human rights need to be mentioned too.

Paragraph 13 mentions safe food, it can be substituted for “safe nutritious food”.

Paragraph 14 where it says “Reliable and relevant nutrition information, sensitive to cultural norms and preferences, needs to be effectively disseminated to improve behaviour and practices”, the idea is confusing. The food that needs nutrition information is usually processed food, then the sentence is followed by sensitive to cultural norms and preferences… it leads to think that processed food´s nutrition information needs to be sensitive to cultural norms and preferences, when what it needs is to warn about the risks of intake and inform consumers of the real contents of it, allowing the population to make real informed decisions.  On the same paragraph, when it talks about regulation, it can say “strong regulation” instead. On the last part, where it talks about local food cultures, it is better if it establishes “local foods and cultures”.

Paragraph 15 must establish that the “partnerships” must be without conflict of interest and it must clarify that these “partnerships” must be for the public interest.

Paragraph 19 must specify the role of private sector, the importance of the public interest and the conflict of interest.

Paragraph 20 must include monitoring on programmes and policies. Also it must include industry´s form of accountability.

3.      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:         

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

                Food production that allows countries their own sustainability and sovereignity, coming from small and medium producers.

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

Nutritious fresh, natural foods.

 Commitment VI: encouraging contributions from all actors in society;              

                Is not clear is all actors include private sector. If it does, what would the role be of private sector and the regulations they need to follow on, as well as the forms of accountability.

Norway

Permanent Norwegian Mission in Geneva
Switzerland

Norwegian comments: ICN2 zero draft outcome document

General comments

  • Norway welcomes international work on the inter linkages between global food security and nutrition and their effects on human health. ICN2 should build on ongoing work and forge these important inter linkages.
  • Norway supports the need for strong political leadership and multi-sector action in nutrition, and supports joint efforts by the health and agriculture/food systems communities.
  • ICN2 should make a significant contribution to a Post 2015-agenda in this field.
  • The multiple threats of malnutrition are a major threat to sustainable development and increased welfare for the people of the world.
  •  Norway strongly supports the right to food and believes the outcome document/Framework of action needs to contain strong rights based language.

Overall Comments to the Zero Draft

  • The document should have a human right-based approach and frame the document on the international human rights obligations. The commitment to fight hunger, ensure adequate food and nutrition and fair distribution of food, needs to be at the heart of the document.  
  • To the extent possible, use internationally agreed language in order to avoid unnecessary discussion and confusion about scope and content. The document needs to be cleaned in terms of precise and correct terminology, not least in terms of the medical aspects of nutrition and its terminology and aetiology.
  • The zero draft should include a more stringent reference to achievements made in WHO and FAO within the scope of food security and nutrition, on which we want to build on, and how the nutrition agenda could be advanced through a more holistic approach.
  • The gender perspective must be included and be mainstreamed into the document. Women make essential contributions to food security and nutrition, and need to be ensured equal access to resources and access to nutritious food and health.
  • We would like to see a shorter, better structured and more precise document. The document should be forward looking, setting the agenda and the mechanisms for action.  The health perspective need to be adequately covered. The framework of action needs to be clear on what we seek to do and achieve.
  • The new plan of action should set goals with targets and indicators that can be measured – and establish a framework for financing and accountability for action. In addition, the framework of action should try to identify cross-sectorial cooperation, action and commitments. It would be helpful if an analysis be made of the different challenges faced by men, women, girls and boys in food security and nutrition to be used in the plan of action.
  • Governments with the public and private sector all have responsibility to produce food system solutions that support nutrition.  
  • A clarification of the the term “food systems” is called for. ICN2 can add value by defining and including the need to reform the food systems to progressively realize the right to food for all.
  • We favour to use the words nutrition, health, food security and food systems in the title of the document.  It reflects the multidimentional and multisectoral approach that needs to be taken to properly address nutrition.

Specific Comments to the paragraphs:

Para 1

This para must make clear that malnutrition is a major cause of death and disability and has major impact on the economy.

Para 2

 To bullet point on women and anemia: Please insert; 1/3rd of all women of “reproductive age” suffer from anaemia

To bullet point on obesity; More precise language is called for.

To bullet point on Socio economic differences; These are large and exist within countries, but also between countries (vital to establish an international responsibility for action).

Para 3

This para introduces the concept “food systems”.  This paragraph is key to the document and should serve as the anchor and focus of the outcome document. 

Para 4

This para needs to recognize that the right to adequate food and nutrition is a human right.

Para 5

This para needs more precise language on special need and target groups, such as the pregnant and lactating woman, infant and young children, and to the importance of exclusive breastfeeding and the benefits of continued breastfeeding .(i.e. first 1000 days to the age of 2 years as a window of opportunity, people suffering specific diseases, school age children, etc).

Para 6

This para is vague in reference to “renew the commitments”. This para should refer to updated commitments and policies in WHO and FAO, such as targets on nutrition made by the WHA in 2012. The para should also refer to the responsibility/obligation of the FAO Committee for food security (CFS) in nutrition. This paragraph gives an opportunity to raise the need to include nutrition into the Post 2015-agenda.

Para 7

Make a reference to the WHA 65 Global Action Plan o NCDs, adopted by all member states and by so has authority. We propose to split para 7 into two parts, where the first part deals with maternal, infant and young child nutrition and health, and the second part deals specifically with NCDs and refers to the global NCD targets. If we call for renewed commitments, we also need to be clear on reporting on those commitments. 

Para 9 – 20 are critical and need to be more precise and ordered.  These recommendations should be focused on the development of food systems (including taking into account the smallholder farmer/producer into the food systems, social protection and promotion of breastfeeding).

Para 9

A definition of “food systems” could be set out prior to para 9. ”Food systems” is a key concept for the rest of the document, and highlighting and explaining the concept will help advance the global understanding of the key role food systems have for enhancing nutrition. In order to avoid the vague concept of “good nutrition”, a rephrasing of the first sentence is suggested; “Recognize that progressively achieving the right to adequate food for all requires more sustainable, equitable and resilient food systems. Further, we believe aquaculture has a huge potential to ensure safe and healthy food to the benefit of nutrition and peoples health. Please include “aquaculture” in the last sentence of the para.

Para 10

Nutrition and health should be important considerations in decisions on primary food production and processing. The responsibility of actors/participants in food production and processing should be highlighted. Food processing that negatively effects health and nutrition should be avoided. We suggest to rephrase the last part of the paragraph (after the semi-colon) to: “food systems should enable improved nutrition by providing year-round access to safe and nutritious foods, promoting healthy diets and avoiding food processing that negatively affects nutrition and health.” Further, the inclusion of support to enhanced research into nutrient rich crops, is called for.

Para 11

Text on the reduction on food loss and food wastage and the protection of food safety must be developed. In addition, we suggest to replace the word “seeds” in para 11 with “genetic resources” as this is a more precise term that includes animals and fish. Further, replace “and storage loss” with “throughout the food chain”).

Para 12

In this paragraph distinction should be made between traditional versus modern value chains. Reference should be made to “Health in all policies” which is a well-known approach in public health policies.

Para 13

This para is unclear and mix different issues. The content of this paragraph could be included elsewhere in the document.  We miss a clear emphasis on benefits of exclusive breastfeeding and continued breastfeeding, and on the importance of breastfeeding promotion, protection and support. The paragraph should also include language on the need for competent personnel in nutrition and breastfeeding in the healthcare system. Support to small holder farmers to increase the quantity, quality and value of production as well as store, market and enhance total productivity as part of food systems, should be reflected (either here or in para 9). Language on women’s role in food production and the economy should be included.

Para 14

Food and nutrition in a cultural context should be addressed. Proper nutrition labelling is important in order to help consumers make informed decisions about healthy choices, healthy diets and healthy lifestyles. Public information must be made available to make informed decisions. Regulation of advertising, legislation on the right to food, regulations of food systems and taxations are legal means to regulate towards more healthy and nutritious food. We would like to see language on this included in the document. This is necessary in order to promote positive changes in eating behavior toward healthy foods.

We are pleased to see that reference has been made to the responsibility of governments to protect consumers, especially children, from misleading commercial messages promoting unhealthy foods. The term “energy-dense, nutrient-poor foods” is, however, better and more frequently used than “energy-dense, but nutrition-poor”. At the end of this sentence, instead of “…which can induce addictions….”, use “…which can induce unhealthy dietary habits”.

Para 15

Interventions and partnerships for improving maternal and child health and nutrition deserves a full paragraph by itself. Language on incentives for production of positive processed foods – weaning foods, bio-fortification etc could be included.

Language on social protection and safety nets to protect the nutritionally poor (access and equity) should be included in this paragraph.

Para 16 or 17

Necessary to include language on the need to develop international support and cooperation on food safety assessment and management.

Para 20

To establish better data and an accountability system to enhance and monitor action is critical.  Just recognizing this is not enough – accountability mechanisms need to be defined, and regular reporting need to take place on achievements made. Goals, targets and specific indicators need to be established, that can be measured and a followed up in reviews and action cycles. This will set the stage for the Post-2015-agenda on nutrition.

Para 21

This para should include a section on developing, introducing and expanding the use of special targeted foods for special needs groups such as supplements for pregnant/lactating women; weaning foods etc.