In this section, you may find new materials that have been published on the topic of ‘Improving nutrition through accountability, ownership and partnerships’, since the date of the event. We continually select major new publications and articles that add up to the policy points discussed in this briefing.
Nourishing Millions: Stories of Change in Nutrition
In recent years, the world has seen unprecedented attention and political commitment to addressing malnutrition. As nutrition rapidly rises on the global agenda, guidance is urgently needed on how to design, implement, and evaluate nutrition-enhancing policies and interventions. Nourishing Millions: Stories of Change in Nutrition brings together the most intriguing stories about improving nutrition from the past five decades. These stories provide insight into what works in nutrition, what does not, and the factors that contribute to success.
The Access to Nutrition Index 2016 (ATNI) – A Strong Second Showing
IFPRI Development Highlights, 27/01/2016
ATNI collects data (including a big chunk of self-reported) from 25 of the largest food and beverage companies in the world. This is the first report since 2013 (19 of the 25 companies are featured in both 2013 and 2016 reports, although the numbers are not comparable since there are many new questions). I am a fan because, like the Global Nutrition Report, ATNI seeks to both shine a light on practices and commitments and also to serve as a beacon on the way forward. The index scores companies across 7 categories, with an additional breast milk substitutes (BMS) category for the companies that derive more than 5% of their sales from baby foods.So what are the key findings of the newly released 2016 report (the second after the first in 2013)?
According to a recent blog post by Lawrence Haddad, Chair of the Foresight Lead Expert Group and Patrick Webb, Policy and Evidence Adviser for the Global Panel, more attention needs to be placed on the data gap about what people actually eat. Food systems already fail the 795 million people who are hungry, the 2 billion who currently suffer micronutrient malnutrition, and the 1.9 billion who are overweight and obese. Firstly, data on food consumption (not supply) is both limited and poor. In this regard, efforts need to be expand and improve data collection to record what people in different places actually eat. Secondly, good data on the “food environments” in which consumption choices are made is lacking. In his opinion, indicators are needed to describe and track the areas where policy actions need to be focused: 1) What food options are consumers presented with? 2) What shapes the options available? 3) What affects the choices made, in the context of relative prices, income, personal preferences and societal norms? 4) What are the health and nutrition consequences of those choices?
Cara Flowers from the Sun Civil Society Network attended the Committee on World Food Security (CFS) and took away several key messages on how food and nutrition community can achieve greater security: 1) Climate change must not be ignored, although politicians have been complacent about the link between food, nutrition, agriculture, water and climate change. The UN Conference of the Parties (COP 21) negotiations and agreement in Paris must be a success; 2) Women are vital. After all, 55 % of hunger gains are attributable to women; 3) Communities must be at the centre, leading the way through designing, monitoring and implementing the actions that will support them most effectively. Additionally, local communities must be given freedom to own data and collect their own. This is linked to accountability for the SDGs; 4) Conflict and war could exacerbate the current situation of food insecurity and malnutrition. The new Committee On World Food Security framework for action in protracted crises is a step in the right directon; 5) Hunger and malnutrition are social justice issues which need more than technical responses; 6) Malnutrition affects everyone and we must build partnerships, alliances and work in cooperation on this.
Two participants shared their experience of the SDAC Global Nutrition Report launch. The participant from Namibia explained, “It was a fascinating meeting, laden with current, former and future “Honorable” MPs trying to figure out what they can do to advance nutrition. I shared the SADC outcome data for the 8 indicators showcased in the GNR and I located the 15 countries in terms of whether they were signatories to SUN and N4G and where they ranked in the HANCI index.” The participant from South Africa noted, ” South Africa’s nutrition picture is much worse than it should be for its GDP and poverty levels. It now has a similar stunting rate (24%) to Kenya (26%) which has a GDP per capita level that is one-sixth of South Africa’s! Exclusive breastfeeding rates are 8%. Wow. The WHA global target is 50%. The prevalence of overweight and obesity is 54%. The country’s leaders have finally woken up to this (although it is not clear why—the Deputy President Cyril Ramaphosa and the Minister of Health Motsoaledi may have something to do with it). “
The Global Nutrition Report 2015 is a report card on the world’s nutrition—globally, regionally, and country by country—and on efforts to improve it. It assesses countries’ progress in meeting global nutrition targets established by the World Health Assembly. The 2015 report makes it clear that global progress to reduce malnutrition has been slow and uneven. Nearly half of all countries face multiple serious burdens of malnutrition such as poor child growth, micronutrient deficiency, and adult overweight and obesity. The second in an annual series, the Global Nutrition Report 2015 also highlights the critical relationship between climate change and nutrition, as well as the pivotal role business can play in advancing nutrition. It considers how countries can build food systems that are more nutrition friendly and sustainable.
The Global Nutrition Report put out a call for submissions on the 2014 Nutrition Country Profiles earlier this year. Two submissions have been published on the report website. The first new submission was received form David Hong (Kenya) of the One Acre Fund, on ‘Collaborating with farmers to improve nutrition at scale: A case study of orange-fleshed sweet potatoes (OFSP) in Kenya’. The second new submission is from Erin Homiak (Mozambique) from Concern Worldwide, on ‘Addressing Gender Inequality to Accelerate Improved Nutritional Outcomes: Reflections from Mozambique’. Both are available online.
Despite consensus on actions to improve nutrition globally, less is known about how to operationalize the right mix of actions nutrition-specific and nutrition-sensitive—equitably, at scale, in different contexts.In recent years, momentum has been building to “scale up nutrition”. Responding to the sobering words of the 2008 Lancet Nutrition Series, the Scaling Up Nutrition (SUN) movement emerged in 2010, with 55 countries now having signed up. The Nutrition for Growth summit in June 2013 led to $23 billion in pledges. The current reality, however, is that coverage of nutrition-specific interventions is poor in most parts of the world where they are most needed, as is the state of the major under-lying determinants of nutrition (i.e., food security, women’ status, poverty, equity, access to adequate health care services, water, and sanitation).Although there is a strong consensus on what needs to be done, much less is known about how to operationalize the right mix of actions in different contexts, how to do so at a scale that matches the size of the problem, in an equitable manner, and how to do so in ways that link nutrition-specific and nutrition-sensitive interventions. The primary objective of this article is to synthesize what is known about scaling up in general from nutrition and other disciplines in order to distill critical elements to guide actions that focus on scaling up impact on nutrition.
As the UN post-2015 summit in September approaches how does the current draft of the SDGs shape up with respect to nutrition? Asma Lateef, Director of Bread for the World Institute with Jennifer Thompson and Joanna Francis of Concern share their reflections. All are members of the International Coalition on Advocating Nutrition (ICAN). The target to “end malnutrition in all its forms” in the final draft post-2015 Sustainable Development Goals (SDGs) reflects a sea-change since the adoption of the Millennium Development Goals (MDGs) following the Millennium summit in 2000. The international community now understands and is responding to the evidence about the devastating personal and societal costs of undernutrition. It is now clearer than ever that undernutrition in the critical 1,000 days between a woman’s pregnancy and her child’s second birthday robs children of future income and opportunity. It perpetuates the cycle of poverty and inequality. The 2008 and 2013 Lancet Series on Maternal and Child Nutrition as well as studies by the World Bank and the Copenhagen Consensus have documented the most cost-effective interventions and the significant benefits to taking action to prevent or treat malnutrition.
Healthy dietary patterns are a global priority to reduce non-communicable diseases. Yet neither worldwide patterns of diets nor their trends with time are well established. Poor quality of diet is a major cause of mortality and disability worldwide. International food programmes have traditionally focused on food security and micronutrient deficiency, but the diet-related health burdens due to non-communicable chronic diseases (NCDs) are now surpassing those due to undernutrition in nearly every region of the world. This trend has raised the global concern of a so-called nutrition transition and convergence toward less healthy diets globally, with growing attention on the need to improve transnational food policies and overall diets. However, the differences in dietary patterns across the world, and how such dietary patterns are changing with time, are not well established. An improved understanding of dietary patterns and changes around the world is crucial to inform, design, and implement strategies to reduce national and global diet-related diseases.
People in Mali, Chad, Senegal and Sierra Leone enjoy healthier diets than their counterparts in the United States, the United Kingdom, Japan or Canada, according to a study published in The Lancet Global Health this spring. Using self-reported diet surveys from 187 countries that are home to 89% of the world’s adult population, researchers led by Fumiaki Imamura from the University of Cambridge analyzed the intake of healthy foods such as fruit, vegetables, legumes, whole grains, and fish, as well as foods containing fiber and omega-3s. They also looked at the consumption of unhealthy foods such as sugary drinks, saturated fats, sodium, and processed meats. Taken all together, Sub-Saharan Africa, particularly West Africa, ranked better than wealthier regions in North America and Europe, probably because of a diet comprised of lean meats, vegetables, legumes, and staple starches, with less processed foods than countries that fared worse ((such as the US and Russia).
Dr. Namukolo Covic, IFPRI in Ethiopia, writes on the issue of nutrition and agriculture and asks, if Africa has the potential to produce all the food the continent needs, why does it faces a heavy burden of food insecurity, undernutrition and an increasing problem of obesity?The Comprehensive Africa Agriculture Development Programme (CAADP), the African Union programme from NEPAD, implemented based on the 2003 Maputo Declaration is indispensable to achieving food and nutrition security. CAADP has huge potential and sets key targets – to improve children’s nutrition status and reduce stunting to 10% and underweight to 5% by 2025 – but experience has shown that an increase in food does not necessarily correlate with increase in nutrition outcomes. NEPAD with FAO, as well as several other development partners have sought to make CAADP more nutrition sensitive through mainstreaming nutrition in the National Agricultural Investment Plans. Dr. Covic asks if Africa is a recipient of multiple nutrition initiatives, such as SUN, REACH, ARISE, SPRING, Biofortification etc., what role can research play within CAADP for more adequate diets and positive nutrition outcomes? In her opinion, “nutrition researchers must engage with the CAADP processes especially at national level to generate context specific evidence to inform policies and programmes, monitor and evaluate progress. I would urge international researchers to work with African researchers and institutions such that while evidence is generated, capacity is developed for continued generation and use of such evidence as an integral part of the process to sustain progress.”
The growing epidemic of obesity and related Non-Communicable Diseases (NCDs) of diabetes and cardiac arrests have become a daily fare in OECD country media (e.g. here). Obesity and undernutrition now co-exist in a large number of countries (Figure 1). Indeed under business as usual obesity will outstrip undernourishment in numbers: 795 million are estimated to be hungry by FAO in 2014  , but more than 1.9 billion adults, 18 years and older were overweight according to WHO in 2014. Of those, 600 million were obese (11 percent of men and 15 percent of women are obese) and the numbers are growing . But these transitions in development have not received the attention they deserve in the UN agenda for eradicating extreme poverty and achieving sustainable shared prosperity.
Following the initial idea of the Topsector Horticulture and Starting Materials, an explorative study has been conducted by LEI Wageningen UR within the Food & Business Knowledge Platform (F&BKP) on the potential of the Fruits & Vegetables Sector for Food and Nutrition Security. Although there are many initiatives and programmes to support the horticultural sector in Africa, among which several key programmes of Netherlands Embassies, this study is among the first endeavours to explore the relationship with food and nutrition security. Here is the report: “How does the Fruit and Vegetable Sector contribute to Food and Nutrition Security?”
The international conference No More Food to Waste – Global action to stop food losses and food waste – was held in The Hague, the Netherlands from June 16-19, 2015. It brought together global leaders from international agencies, businesses, investment groups, research institutions and civil society. During the symposium they could share their experiences and partner in the field of the reduction of food loss and waste throughout the supply chain while improving the sustainability of the food system. During this event, the Postharvest Network1 together with the Food & Business Knowledge Platform (F&BKP) organized a side event on Thursday June 18 on the topic of Agrofood supply chain efficiency for food & nutrition security. One of the most important challenges addressed during the session was that when food losses occur in a supply chain, there is not one single problem or owner to address. A typical supply chain involves several actors and there is no one actor that is responsible for the total supply chain. Comprehensive chain alliances are thus of importance. For the reduction of losses and value chain improvement, actors in the chain – input suppliers, producers, traders, processers, retailers, but also the government – need to collaborate and different expertise like cooling, processing, logistics, will be required. See the study here.
Benin’s wet tropical forests are full of riches. Ebony, shea and mahogany trees tower over verdant foliage, home to mongoose, warthogs, chameleons. The country’s 3,000 plant species include baobab trees, whose fruit that has six times the vitamin C of an orange and leafy green vegetables rich in iron. And traditional religious leaders believe that there is more in the forest – sacred spirits and precious medicines that can cure any ailment. The leaves of the kinkeliba bush are eaten for liver problems, bright yellow Cochlospermum planchonii flowers treat female infertility and the sacred garlic pear is used as an antiseptic. Given the wealth of that store cupboard, it’s clear that there’s a link missing in a country where 12% of households are food insecure and malnourishment is prevalent. Typically, deficiencies are tackled via nutrition programmes that provide supplements or artificially fortified food. But university lecturer Flora Chadare is proposing to map the edible plants in Benin’s dense rainforests to prove that they can provide all the vitamins and minerals that people need. “Reports show these plants are high in micronutrients,” says Chadare. “So why not improve the way they are consumed to help nutrition?”
The June update of the Harmonised Framework analysis of vulnerability concludes that approximately 7.5 million people will face food and nutrition crises between June and August. The CILSS/Agrhymet map shows elevated vulnerability in areas facing security crises (northern Mali and the Lake Chad Basin) and areas hosting large numbers of refugees and displaced persons (Burkina Faso, Chad, Mali, Mauritania and Niger). Areas near centre of the Ebola outbreak (Liberia and Sierra Leone) also register higher risk of food insecurity and malnutrition.
Leith Greenslade from the MDG Health Alliance responds to the important question: “How can we make sure that nutrition has the policy, financing and program architecture needed to drive the major advances that are so desperately needed to achieve the ambitious, new Sustainable Development Goals (SDGs) by 2030?” Greenslade underlines the importance of learning from the history of the Millennium Development Goals (MDGs). While it is commendable that nutrition does have it’s own goal 2 (to end hunger, achieve food security and improved nutrition and promote sustainable agriculture), and an ambitious target 2.2 (by 2030, end all forms of malnutrition, including achieving, by 2025…), it is yet to be decided which indicators will be used. In sum, Greenslade suggests, “If these new policy, financing and program opportunities are aligned, nutrition has the architecture for impact that was missing under the MDGs and is better placed than ever before to achieve its development promise.” The June update of the Harmonised Framework analysis of vulnerability concludes that approximately 7.5 million people will face food and nutrition crises between June and August. The CILSS/Agrhymet map shows elevated vulnerability in areas facing security crises (northern Mali and the Lake Chad Basin) and areas hosting large numbers of refugees and displaced persons (Burkina Faso, Chad, Mali, Mauritania and Niger). Areas near centre of the Ebola outbreak (Liberia and Sierra Leone) also register higher risk of food insecurity and malnutrition.
Key stakeholders of the Global Alliance for Improved Nutrition met in Berlin recently to consider two preponderant topics: (i) how can governments make nutrition a higher political priority in their own countries; (ii) how can nutrition truly become a central element in the post-2015 development agenda. The stakeholders recommend three broad approaches: (i) harnessing markets through robust and sustained private sector involvement; (ii) bridging the data gap by addressing the issues of availability, more and better data, and money allocated to the sector, as well as the evaluation of private-sector work in this field; (iii) looking beyond the health sector means that nutrition should not be addressed in a silo, but synergies should be sought with other government departments to promote its virtues.
The East Africa launch of the Global Nutrition Report was hosted in Dar es Salaam by the SUN Civil Society Networks of Tanzania, Kenya, Uganda, Ethiopia, Burundi, and Rwanda, along with government, UN representatives, donors, private sector, Tanzania political aspirants and media. 50 participants from six countries with active SUN Networks, and similar nutrition profiles, came together to highlight shared challenges and successes in working to defeat malnutrition in the region and chart a course for improved action on nutrition in the region. The objectives of the roundtable were to: (i) Review the Global Nutrition Report 2014 in comparison to the region’s status; (ii) Enhance accountability on the East African situation and advocate for increased commitment and accountability towards nutrition.
The European Commission shall partner with the Bill & Melinda Gates Foundation and establish a new fund to tackle the global challenge of undernutrition in six countries: Bangladesh, Burundi, Ethiopia, Kenya, Laos and Niger. EU Commissioner for International Cooperation and Development, Neven Mimica, confirmed the EU’s commitment in supporting partner countries to reduce the number of children who are chronically undernourished by at least seven million by 2025. and its commitment of €23.5 million for the new initiative: the National Information Platforms on Nutrition (NIPN). The initiative will provide partner countries with the tools to better monitor progress in the reduction of undernutrition, improve information and analysis about nutrition, and enable partner countries to develop well-informed and effective national nutrition policies as a result. It will also allow stakeholders to coordinate and align their support with those policies and improve effectiveness, in order to achieve greater impact going forward.
Baroness Verma, DFID’s Parliamentary Under Secretary of State, announced that the UK government is unlocking £115 million of a £280 million matched funding initiative, as part of the UK’s Nutrition for Growth commitment. Within two years, more than 50% of the UK’s matched funding commitment (£156 million) has been unlocked as a result of new investments made by the Bill and Melinda Gates Foundation and the Government of Canada. These unlocked funds enable the UK to invest in more high impact nutrition specific interventions up 2020. At this stage, the UK is firmly on track to meet their ambitious Nutrition for Growth commitments of tripling core spending over period 2013 to 2020. UK spending on nutrition specific programmes increased from £42m in 2012 to £69m in 2013 compared to a 2010 baseline of £25m. The Bill and Melinda Gates Foundation is going beyond its Nutrition for Growth commitment and will double its nutrition spending to 2020 to USD 761 million unlocking £115 million of UK funds.
In its latest report, ‘Panorama of Food Insecurity in Latin America and the Caribbean 2015 ′just released (29/5/015), FAO named Barbados, Cuba, Dominican Republic, Guyana, St. Vincent and the Grenadines and Suriname among countries in Latin America and the Caribbean that have made that major step. Latin America and the Caribbean pioneered the proposal of eradicating hunger by 2025, a goal adopted in 2005 with the Hunger Free Latin America and the Caribbean Initiative and then fully incorporated into CELAC Plan for Food Security, Nutrition and Hunger Eradication. The report also notes that in order to sustain efforts and continued commitment to food and nutrition security, efforts should also be incorporated in the upcoming agenda of the Sustainable Development Goals (SDGs).
Melinda Gates, co-founder of the Gates Foundation, said that her foundation — the world’s largest private foundation — will be “more than doubling down” on nutrition investments in the lead-up to the 2016 Summer Olympics in Rio de Janeiro, Brazil. Gates said, “If we want to cut [childhood deaths] in half … nutrition underlies more than half of those deaths and so it’s fundamentally important.” Gates Foundation will invest in the “preconception period” — ensuring that adolescent girls have access to proper nutrition before getting pregnant by promoting breast-feeding and fortifying foods. It will conduct nutrition research, invest in advocacy in country to engage with ministers of health and agriculture, and also target investments in data and evidence.