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. 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. 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. 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. 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. 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. 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. 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. Key policy actions and measures
to promote healthy diets and nutrition
(142 countries)
10. Regional differences in implementing key policy actions
to promote healthy diets and nutrition
% of countries
11.
12. 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
13. 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
14. 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?