Towards a Decade of Action on Nutrition, 2016-2025

Advancing Nutritionon the Global Agenda

Second International Conference on Nutrition (ICN2) Follow up

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Malnutrition: The problem

Malnutrition – major challenges:

• macronutrients (hunger)

Hunger estimates narrow, conservative

• micronutrient [minerals, vitamins] deficiencies (‘hidden hunger’)

• obesity -> non-communicable diseases

Malnutrition widespread, costly

Hunger decline slower

Developed regions, 2.0%

Southern Asia, 28.8%

Sub Saharan Africa, 17.3%

Eastern Asia, 29.1%

South-Eastern Asia, 13.6%

Latin America and the

Caribbean, 6.8%

Western Asia, 0.8%

North Africa, 0.6%

Caucasus and Central Asia,

0.9%

Oceania, 0.1%

Developed regions, 1.8%

Southern Asia, 34.3%

Sub Saharan Africa, 26.6%

Eastern Asia, 20.0%

South-Eastern Asia, 7.9%

Latin America and the

Caribbean, 4.6%

Western Asia, 2.3%

North Africa, 1.6%

Caucasus and Central Asia,

0.7%

Oceania, 0.2%

Total = 1015 million Total = 805 million

1990–92 2012–14

Changing regional distribution of world hunger, 1990-2014

Slower progress on hunger since 2006

Food price decline ends• Bio-fuel mandates, subsidies• Economic growth in South greater demand• Easier credit more financial speculation• Food commodities as financial asset class• Economic slowdown after 2008• Climate change, weather hits food production• Resource and environmental constraints

But malnutrition still widespread

Undernutrition among children under 5 years of age

WastingWasting among children under 5 years old

StuntingStunting among children under 5 years old

Underweight childrenUnderweight children under 5 years old

Undernutrition declining, but not fast enough

Wasting trends

Stunting: new SDG indicator?

Underweight children

Hidden hunger at global level

Anaemia

Vitamin A deficiency

Iodine

Child, maternal malnutrition worst social burden

Regions

Child, maternal

malnutritionUnderweight Overweight, obesity

Total DALYs (‘000s) Total DALYs (‘000s)DALYS per 1000

populationTotal DALYs

(‘000s)DALYs per 1000

population

1990 2010 1990 2010 1990 2010 1990 2010 1990 2010

World 339,951 166,147 197,774 77,346 313 121 51,613 93,840 20 25

Developed regions 2,243 1,731 160 51 2 1 29,956 37,959 41 44

Developing regions 337,708 164,416 197,614 77,294 356 135 21,657 55,882 12 19

Africa 121,492 78,017 76,983 43,990 694 278 3,571 9,605 15 24

Asia 197,888 80,070 115,049 32,210 297 90 12,955 34,551 9 16

Latin America & the Caribbean

17,821 6,043 5,292 979 94 18 5,062 11,449 26 36

Economic costs of malnutrition unacceptably high @ 5% of GDP

• Under-nutrition, micronutrient deficiencies cost 2-3% of global GDP

• Total output loss, healthcare costs due to NCDs, for which obesity is key risk factor, aboutUS$47 trillion over next 2 decades

• Total costs of malnutrition may be as high as 5% of global GDP, equivalent to US$3.5trn or US$500/person/year

• Poorer countries -> higher malnutrition costs

Economic costs of obesityby McKinsey Global Institute (2014)

About 1.9~2.1 bn people overweight (including about a third [BMI] obese),

i.e. 30% of global population

Comparative economic burden armed conflicts ($2.1 trillion)

smoking ($2.1 trillion)obesity ($2.0 trillion)

Overweight, obesity rising rapidly

Nutrition transition: malnutrition patterns

change with diets, lifestyles

Overlapping burdens of malnutrition

Child stunting

Child micronutrientdeficiencies

Adult obesity

16 countries

16 countries

18 countries

66 countries

40 countries

No significant malnutrition problems: 15 countries

Child stunting: 82 countries

Child stunting

82 countries

Child micronutrient deficiencies:138 countries

Child micronutrientdeficiencies

138 countries

Adult obesity: 74 countries

Adult obesity

74 countries

Multiple faces of malnutrition now

• > 800m people hungry in 2012-14

• > 2 bn suffer micronutrient deficiencies

• Children: 161m. stunted, 51m. wasted, 99m. underweight

• 45% of 6.9m. child deaths annually linked to malnutrition

• 42 m. overweight children < 5 years

• 2.1 bn overweight, ~700 m. adults obese

Why improve nutrition?Malnutrition Greatly impedes fulfillment of human potential Slows development Burdens national health and fiscal systemsWeakens economic, social and cultural fabric of

nationsImproving nutrition not only moral imperative,

but also Improves productivity, economic growth Reduces health care costs Promotes education, intellectual capacity, social

development

Better nutrition: Why? How?

• Malnutrition costs lives, money

• Healthier diets need better food systems

• Health, education, water, sanitation, lifestyles, etc. needed

• Appropriate policies, incentives, governance

• Sustainable food systems central

• Without full employment, decent work, need social protection floor for right to food [Sen: SP to ensure entitlements]

Reform food systemfor better nutrition

– Better food production to ensure:

more available, accessible, affordable, diverse, nutritious

– Improving processing, supply chains

– Helping consumers choose well

– Sustainable production, consumption

– Women (mothers, caregivers) key

– Improving governance: nutrition orphaned

Recent progress

• Strengthen international cooperation– Zero Hunger Challenge (ZHC)– Scaling Up Nutrition Movement (SUN)– UK-Brazil G8 Nutrition ‘Summit’– UK Global Panel– US Global Nutrition Strategy– ICN2, 19-21 Nov. 2014• Improve policy coordination• Decade of Action, 2016-2015

ICN2 outcomes

Rome Declaration on Nutrition

commitment for more effective,

coordinated action

Framework for Action

technical guide for

implementation [see Info Note]

Ten ICN2 commitmentsEradicate hunger and prevent all forms of malnutrition

Increase investments

Enhance sustainable food systems

Raise the profile of nutrition

Strengthen human and institutional capacities

Strengthen and facilitate, contributions and action by all stakeholders

Ensure healthy diets throughout the life course

Create enabling environment for making informed choices

Implement commitments through Framework for Action

Integrate vision and commitments into post-2015 agenda

ICN2 Framework for Action 60 recommendations

• Enabling environment for effective action• Sustainable food systems promoting healthy diets• International trade and investment• Nutrition education and information• Social protection• Health systems delivery of direct nutrition interventions

and health services to improve nutrition• Water, sanitation and hygiene• Food safety • AccountabilityGovernments have primary responsibility for action,

in dialogue with a wide range of stakeholders

Developing and implementing national nutrition plans and policies 1

1. Official government adoption & political commitment/support

• Adequate nutrition budget allocation• Effective, high profile advocate

2. Inter-ministerial/sectoral coordination• Influential office leading process located in

government• Effective coordination among relevant ministries,

agencies• Dedicated budget for operations• Representation of all concerned stakeholders00

3. Capacity to effectively implement plans• Appropriate prioritization of activities• Mobilization of relevant sectors, ministries

Developing and implementing national nutrition plans and policies 2

4. Disconnect between national policy priorities and regional/provincial level policy priorities

5. Lack of human capacity in nutrition6. Lack of appropriate monitoring & evaluation

mechanisms7. Lack of reliable national nutrition, food, health

data8. Changing international context of food and

nutrition 9. Frequent staff turnover• Lack of institutional memory, continuity

Policy environment and main gaps 1

– Policies• Most countries have nutrition policies, but do not: − Address double burden of undernutrition− Address changing nutrition challenges over life-courses− Include evidence-informed policies comprehensively− Address underlying causes of malnutrition

• Food security strategies seldom include other nutritiongoals

– Coordination• Inter-sectoral coordination mechanisms exist in most

countries, but do not:− Comprehensively address existing challenges − Influence high-level policy making frameworks

Policy environment and main gaps 2

Implementation• Most countries implement some key interventions at

national scale, but do not:− Implement comprehensive set of essential nutrition actions

at scale− Address maternal nutrition by reaching girls and women of

reproductive age before pregnancy− Adequately address obesity and diet-related NCD risk

factors

Monitoring and evaluation• Most countries conduct national surveys, but do not:− Include all relevant indicators− Disaggregate data sufficiently to address inequities− Conduct surveys routinely in a timely manner− Use data to better inform policy formulation

Why a Decade for Action?The Decade for Action on Nutrition will catalyze the

sustained momentum needed national and global action to address all forms of malnutrition to ensure good nutrition for all

• Governments have committed to take action on addressing all forms of malnutrition

• Requires coordinated , complementary nationaland international, especially UN system efforts

• ICN2 provides common vision, multi-sectoralapproach to address all forms of malnutrition involving all relevant sectors and stakeholders

Programme of Action elements1. Proposed organizational arrangements

2. Financing modalities from both budgetary and

extra-budgetary sources;

3. Procedures for monitoring implementation

4. Public information activities

5. Mechanisms for coordinating UN system activities,

and other IGOs and NGOs concerned

6. Establish national level mechanisms to mobilize

public support, carry out proposed activities

7. FAO-WHO lead agencies for the decade

UN SG Ban Ki-MoonThis Conference marks a new stage in our quest to

banish global hunger and malnutrition for good.

The UN system pledges to do all that it canto provide effective support.

WHO DG Margaret ChanThe future health of this world needs

policy coherence, nationally and also globally. It needs policy coherence across multiple sectors…

…the countries of this world have the creativity to work with civil society and the private sector

to make this happen.

FAO DG Jose Graziano da SilvaWe must recognize that nutrition is a public issue.

And treat it that way.On Rome Declaration on Nutrition and Framework for Action

Together, they are the starting point of our renewed efforts to improve nutrition for all.

But they are not the finishing line. Our responsibility is to transform the commitment into concrete results.

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