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Some contributions from WHO

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Chizuru Nishida
Geneva Launch: 2017 Global Food Policy Report
MAR 31, 2017 - 10:30 AM TO 12:00 PM CEST

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Some contributions from WHO

  1. 1. Some contributions from WHO Chizuru Nishida Coordinator, Nutrition Policy and Scientific Advice (NPU) Department of Nutrition for Health and development (NHD) Launch: IFPRI 2017 Global Food Policy Report Palais des Nations, Geneva, 31 March 2017
  2. 2.  Emerging issues impacted on health and nutrition in 80s – 90s  Nutrition transition: increasing overweight/obesity & nutrition-related NCDs  Fetal programming of chronic diseases  HIV/AIDS  Biotechnology — GM foods  Micronutrients beyond the big three  Food safety (i.e. BSE)  SARS, bird flue, H1N1 : AMR, etc  Continuously changing context and focus of global macropolicy environment related to food and nutrition  1990 – Child Summit  1992 – International Conference on Nutrition (ICN)  1996 – World Food Summit  1999 – PRSPs  2000 – MDGs  2001 – WFS+5 (2001)  2002 – Building a World Fit for Children / WHO Global Strategy on food safety / WHO Global Strategy on infant and young child feeding  2004 – WHO Global Strategy on diet, PA and health  2006 – Repositioning Nutrition (WB)  2007 – Ending Child Hunger & Undernutrition (setting up REACH initiative)  2008 – Food price crisis, Pacific Health Summit, Lancet Nutrition Series on maternal & child undernutrition – G7 Global nutrition challenge – MCH (Health Experts' meeting) Ever changing global contexts related to food and nutrition
  3. 3.  Nutrition has gained considerable attention in the international community in recent years as a result of: – Scaling-Up Nutrition (SUN) movement (2008) – Adoption of CIP-IYCN and 6 Global Nutrition Targets by WHA in 2012 – Adoption of 9 voluntary Global NCD Targets and Global NCD Action Plan by WHA in 2013 – High-level Nutrition for Growth Compact (N4G) in 2013  Global Nutrition Report launched in 2014 to monitor N4G commitment accountability  Progress to be measured in Rio in 2016, in Rome in 2017, in Tokyo in 2020 (?) – ICN2 in November 2014 Adopted 6 global nutrition targets Adopted diet & nutrition-related NCD targets − Sustainable Development Goals in 2015 Ever changing global contexts related to food and nutrition
  4. 4.  Nutrition has gained further momentum as a result of: – SDG adopted Global Nutrition Targets (Goal 2, Target 2.2) in September 2015 – UNGA proclaiming Decade of Action on Nutrition (2016 – 2025) in April 2016  Ensure engagement of a whole of governments, international organizations & various stakeholders to facilitate effective implementation of ICN2 FFA with clear timeline  mainstream multisectoral nutrition action across various domains of SDGs to facilitate their achievement  allow a coherent reporting of the progress in tackling malnutrition in all its forms across multiple geographies and food systems Goal: Increase activities conducted at the national, regional and global levels to implement the recommended actions included in the ICN2 Framework for Action aimed at achieving the global targets for improving maternal, infant and young child nutrition and for NCD risk factor reduction to be achieved by 2025 and the corresponding SDG targets to be achieved by 2030 Ever changing global contexts related to food and nutrition
  5. 5. What should the food environment look like to ensure healthy diets and address malnutrition in all its forms? Raised blood pressure 25% Salt/sodium intake 30% Diabetes/obesity 0% Saturated fat  Unsaturated fat  Trans fat  Sugars  Animal source foods  Fruit and vegetables  Ultraprocessed foods …. Fortified food … ? ? ? ? ?
  6. 6. 2009-2010: 1st Global Nutrition Policy Review  123 countries responded  Information on nutrition governance (incl. capacities, coordination mechanisms, surveillance)  Assessment of policies and actions in 6 areas: 1) IYCN (incl SAM/MAM, nutrition & infectious diseases), 2) International Code of Marketing of BMS, 3) School- based programmes, 4) Vitamins and minerals, 5) Obesity and diet-related NCD, 6) Food security and agriculture policies  Data incorporated into WHO Global database on the Implementation of Nutrition Action (GINA) http://www.who.int/nutrition/gina/en/  Results served as background for developing CIP-MIYCN – Final report published in 2013 WHO's work on monitoring policies and actions to promote healthy diets and nutrition • 1993-2001: Monitoring implementation of 1992 ICN commitments  Regular review and monitoring of country progress through regional review meetings between 1992 - 2001  Monitoring of development, operationalization & implementation of multisectoral national plans of action on nutrition addressing the double burden of malnutrition based on 9 strategic actions  WHO Global Database on National Nutrition Policies and Programmes 2016-2017: 2nd Global Nutrition Policy Review  166 countries responded to date (86%)  Information on nutrition governance (incl. capacities, coordination mechanisms, surveillance)  Assessment of policies and actions in 6 areas: 1) MIYCN, 2) Prevention & treatment of acute malnutrition, 3) Nutrition and infectious diseases, 4) School health & nutrition programmes, 5) Vitamin and mineral nutrition, 6) Promotion of healthy diet and prevention of overweight, obesity and diet-related NCDs  Coverage/inclusion of Global Nutrition and diet-related NCD Targets in national policies  Data will be incorporated into GINA  Results will contribute to:  Monitoring of ICN2 FFA implementation  Assessing baseline for the Decade of Action on Nutrition
  7. 7. 2nd Global Nutrition Policy Review (preliminary analysis) (including data for additional 21 countries from GINA) Comprehensive nutrition policy E.g. national nutrition policy, national plan of action on nutrition, food and nutrition strategy (149 countries) Focused nutrition policy E.g. anaemia reduction strategy, IYCF policy (83 countries) NCD/healthy diet policy E.g. national NCD prevention and management plan, diabetes strategy (61 countries) Health sector policy E.g. HSSP, national health plan, child health policy (106 countries) Other sectoral plans E.g. food security policy, food policy (25 countries) Development plan E.g. PRSP, national development plan (53 countries) How comprehensive are the national nutrition plans? Whether other sectoral policies include diet and nutrition targets? Whether national development plans include nutrition? ICN2 FFA  187 countries reported the total of 707 policy documents  149 of 187 countries reported a total of 222 comprehensive nutrition policies and strategies
  8. 8. Global nutrition and diet-related NCD targets Included in national policies, strategies and action plans  Analysis of 707 national plans, policies and strategies in 187 countries
  9. 9. Key policy actions and measures to promote healthy diets and nutrition (142 countries)
  10. 10. Regional differences in implementing key policy actions to promote healthy diets and nutrition % of countries
  11. 11. An example of policy measure to improve food environment SSB taxation  Countries (and cities) implementing (or considering) regulatory action to implement SSB taxation  Colombia  Hungary  Ireland  Philippines  Mexico  Nepal  Portugal  Samoa  South Africa  Srî Lanka  Tonga  UK  Cities in US
  12. 12. Some observations 1. No lack of policy documents related to nutrition or food security  But only one third of those policy documents address nutrition problems comprehensively  Many countries had their solemn governmental pledges to eliminate hunger and reduce all forms of malnutrition during the last few decades  And commitments/pledges have increased in scope, details and multiple reaffirmations of concerns  Making commitments is one thing, but being able to deliver on them has proven more problematic  Even when political commitment is present, there is little ‘buy-in’ from senior officials especially outside of health and agriculture 2. Evidence-informed interventions (esp. nutrition specific interventions) exist, especially for the first 1000 days  But they are not implemented fully nor scaled up in many countries
  13. 13. Some observations 3. Nutrition is still not seen as a foundation for development  Nutrition is often mentioned as an important background, but not as a foundation  Incorporation of nutrition objectives/goals in national development policies is still a challenge – when included, they are often focused on IYCN, but very few on malnutrition in all its forms, in particular on obesity/diet-related NCDs 4. But some transformation has started to happen to improve food environment, to promote healthy diets, and to address malnutrition in all its forms  In addition to implementing actions to promote people's behaviours changes (i.e. dietary guidance, education, counselling, advocacy), countries are starting to take regulatory actions (i.e. reformulation, taxation, TFA ban, restriction of marketing, nutrition labelling) to improve food environment to promote healthy diets  Requesting obesity/NCD concerns to be included when developing Codex guidelines and standards  But not without challenges (i.e. TBT discussion on front-of-pack labelling, regulating marketing of food s for infants and young children) 5. Then what kind of capacities are needed to implement effective actions and measures to respond to these transformations happening to improve food environment, to promote healthy diets, and to address malnutrition in all its forms?

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