Welcome to the United Nations
1. An assessment of the situation regarding the principle of “ensuring that no one is left behind” at the global level: The United Nations System Standing Committee on Nutrition
Overall the total number of people that are suffering from one or multiple forms of malnutrition has increased, indicating that the right to adequate food is still far from being realized and many people are being left behind. Today, multiple forms of malnutrition are occurring in the same country, the same community, the same household and even the same person. Almost two billion people are overweight or obese - a figure that continues to grow and increases the risk of noncommunicable diseases. Meanwhile, almost 800 million people are undernourished, most of which live in rural areas, including 156 million children under the age of five years who are affected by stunting and 50 million by wasting. One or more forms of malnutrition affect about 1 out of 3 people, a problem that carries a global a price tag of around 3.5 trillion USD per year. The many manifestations of malnutrition derive not just from a lack of sufficient, nutritious and safe food, but also from a host of interacting processes linking health care, education, sanitation and hygiene, inequity, access to resources, women’s position and more. These conditions also pose a major challenge to sustainable development.
Leaving no one behind means not just focusing on ensuring progress for entire countries, reflected by averages, but looking specifically at the people who are not benefitting from development because current strategies have been unsuccessful in reaching them. This includes those who are living in protracted crises situations, those who are displaced internally or externally as a result of conflict or natural disasters, and those who are living in the most extreme income poverty.
The global nutrition targets as agreed by the World Health Assembly in 2012, the global Noncommunicable Diseases targets and the recommendations of the Second International Conference on Nutrition in 2014, provide a clear direction for action to “reach the farthest first”. These have been woven into the fabric of the Sustainable Development Goals, where they should be seen as crosscutting and essential to the achievement of the 2030 Agenda. The UN Decade of Action on Nutrition (2016-2025) proclaimed by the UN General Assembly (UNGA) on April 2016 amplifies this message by calling for ten years of accelerated, coordinated, global action on nutrition so that the above targets can be reached. Progress will be reported to the highest political level at the UN General Assembly so that they can use their political leverage to unlock bottlenecks and ensure that policy development and implementation is steered in the right direction.
2. The identification of gaps, areas requiring urgent attention, risks and challenges
Both the 2030 Agenda and the ICN2 outcome documents acknowledge the need for transformative change to eliminate all forms of malnutrition, ensure well-being, prosperity and sustainable use of natural resources. Food systems have an impact on natural resources in the way we produce, transform, transport and consume food. They also impact people’s health by determining, through the food environment, the quality and quantity of people’ dietary choices. Food systems should urgently be transformed and move away from feeding people to “nourishing people”. Considering that an estimated one third of all food produced for human consumption is lost or wasted on an annual basis, with significant environmental and economic costs (FAO 2011) it is imperative to also address this.
The characteristics of current food systems, including their nutritional outcomes – are directly tied to investment decisions made decades ago. Today’s investment choices similarly will have long-lasting effects, and so they must look forward to the nutrition and health needs of tomorrow, rather than backward to yesterday’s problems and today’s solutions. There is urgency undergirding this perspective shift because food systems don’t change overnight, and current trends are in the wrong direction. In the agriculture and food sectors, investment is intended to increase production, productivity, affordability, and access to agriculture and food. This can include government efforts to attract private sector investment in healthy food systems. Examples of desired actions include creating nutrition-enhancing value chains, supporting smallholder and family farmers, and improving infrastructure. Investments should be made that to raise the nutrition and health values of what is produced, processed, marketed and consumed within a range of food systems, and across the full range of commodities that enter the food system, including aquaculture, crops, livestock, and forestry . Equally important is to design and implement social safety nets (including cash transfers) that are nutrition sensitive.
Food systems are heavily influenced by climate change, aggravating existing problems by increasing the risk of extreme weather-related natural disasters, jeopardizing livelihoods and adversely impacting agricultural activities, access to adequate food, clean water and sanitary conditions, which are all essential for good nutrition. Unless action on climate change is taken, 35 to 122 million people (FAO 2016) could fall into poverty due to its negative impact on incomes in the agricultural sector and 25 million additional children will be malnourished (IFPRI 2009) . Furthermore, the world’s poorest nations and the most vulnerable segments of the population, which contribute least to rising CO2 levels, are also least equipped to deal with the consequences.
While climate change has an impact on nutrition, our diets also affect climate change, specifically through consumption and production patterns. Food production and consumption contribute 19–29% of all anthropogenic greenhouse gas (GHG) emissions, and terrestrial biodiversity loss (60%), as well as being a major user of water (70%). Modeling studies show that by adopting dietary patterns optimized to conform to WHO dietary guidelines, the GHG emissions associated with diets could be substantially reduced . At the global level, it is estimated that shifting to more plant-based diets that are in line with WHO global dietary guidelines on healthy eating (WHO, 2003), human energy requirements (WHO, 2004) and on recommendations of the World Cancer Research Fund (WCRF/AICR, 2007), could reduce global mortality by 6–10% and food-related GHG emissions by 29–70% compared with a reference scenario in 2050 (Springmann et al. 2016b).
There are multiple interlinkages between food systems, the food environment in which products are being marketed, poverty, environmental concerns, diets, nutrition and health that need to be better understood. Investments in multidisciplinary research are essential to obtain the necessary evidence on effective ways to shift towards sustainable and healthy diets for different socio-economic and cultural contexts. Research should support the development of metrics and indicators to review national policies and investments and integrate nutrition objectives into food and agriculture policy, program design and implementation, to enhance nutrition sensitive agriculture, ensure food security and enable healthy diets (Recommendation 8, ICN2 FFA) . FAO and WHO can lend support by developing dietary guidelines with sustainability criteria and increasing their research to better understand what people actually eat, the composition of their current diets. Without this knowledge it is difficult to steer to a healthier and more sustainable solutions.
Gender equality and the empowerment of women deserves special and continual attention as all too often it is these embedded inequalities that lead to hunger and malnutrition and undermine the resilience of communities to shocks.
3. Valuable lessons learned on eradicating poverty and promoting prosperity
Nutrition is a maker and marker of development and an essential accelerator to achieve all SDGs. Good nutrition is associated with mental acuteness and higher individual earnings. These outcomes in turn support macroeconomic and societal growth. Good nutrition during the first 1000 days of a child’s life is critical to achieving full physical, intellectual and human potential in adolescence and adulthood. According to the 2015 Global Nutrition Report, every US $1 spent on high impact nutrition actions such as exclusive breast-feeding yield at least US $16 in return. This support can be catalyzed by foreign assistance but, ultimately, nutrition needs to be a national priority supported by domestic finances to ensure long-term, sovereign growth.
The eradication of poverty does not automatically lead to elimination of malnutrition. In some cases, higher GDP has contributed to lower levels of undernutrition; however, this progress has been modest and uneven across countries, regions, populations groups and gender. Overweight and obesity have increased in all countries, regardless of income levels. In richer countries, poorer populations groups are disproportionally affected, although the effect is less clear for low and middle income countries. The elimination of malnutrition and promotion of well-being is a more complex process than reducing the number of people that live below the poverty line. Integrated policies are needed that combine efforts of multiple sectors and actors, including the engagement with private sector actors, while putting in place robust mechanisms against conflicts of interest.
4. Emerging issues likely to affect the realization of poverty eradication and achieving prosperity
Food systems are changing because of economic development, external factors such as climate change, and also because of emergencies and shocks. These transformations need to be guided towards good nutritional outcomes or protected against worsening nutritional situations. Building resilience to shocks to secure nutrition outcomes will help, and will ensure a continuum between humanitarian response and development.
Currently tens of millions of people who have fled their homes to escape (civil) wars, terrorism, natural disasters, disease outbreaks, and human rights violations are at increased risk of malnutrition.
Rural-urban migration and rural transformation are transforming food systems in another particular way. People migrate between rural and urban settings, affecting the way they produce and access food, and make their livelihoods. These changes also affect life style and dietary choices, often including more highly processed foods and food high in sugar, salt and fats, increasing the risks for the development of non-communicable diseases.
Industrialized food systems are increasingly challenged to provide adequate food requisite to sustainable, diverse and healthy diets. Some of the underlying factors for malfunctioning food systems include unequal access to and control over resources, and unsustainable production and consumption patterns leading to environmental degradation. Food systems that are in transition toward higher levels of industrialization should aim to prevent to develop into food systems that contribute to higher GHG emissions, biodiversity loss and pollution and are characterized by high levels of consumption of highly processed foods that are calorie dense but nutrient poor. Robust policies and legal frameworks are needed to steer food systems and food environment in a direction that is conducive to promote access and consumption of diverse and healthy diets.
5. Areas where political guidance by the high-level political forum is required
In recent years, we have witnessed an unprecedented rise in high-level political attention for nutrition. This can be attributed in part to the greater understanding of the central role that nutrition plays in human development—and indeed sustainable development more broadly.
Yet improving nutrition remains a complex, intersectoral challenge, and one that requires the involvement and alignment of a multitude of actors. This, in turn, creates a governance challenge as well as the challenge of ensuring coherence and coordination amongst diverse stakeholders. Notably, the human rights agenda offers a roadmap to address these challenges; for example, by emphasizing the central role of governments in developing coherent policies in a participatory and transparent way. Policy coherence with other sectors with nutrition objectives and outcomes is key, such as with trade agreements, climate policies and agriculture methods to ensure that they are designed to be nutrition sensitive.
UNSCN works at global level to maximize policy coherence among UN agencies and initiate global guidelines for nutrition policies and programming, in line with global frameworks. This is a challenging and ongoing process but essential if the ambition of the 2030 Agenda is to be realized.
The Nutrition Decade offers a time-bound framework asking Member States to intensify the development of nutrition policies, programmes and action, following the recommendations agreed at the global level and invites all relevant stakeholders to support the elimination of all forms of malnutrition. UNSCN is doing its part to ensure that the UN “delivers as one” in their support to governments, by helping to strengthen policy coherence, enhancing dialogue and identifying linkages to foster joint nutrition programming. As a part of this effort, UNSCN is working on the development of global guidelines to integrate nutrition in UNDAF processes at country level.
As an intergovernmental body, the HLPF should guide country decisions about coherent policies and legal frameworks that maximise nutrition outcomes and thus accelerate progress towards the achievement of the 2030 Agenda. The world set ambitious targets to eliminate all forms of malnutrition. Governments are asked to translate the global targets to country level policies, programmes and actions, which is supported by the UN system. Since this progress is reported to world leaders through the UNGA, ECOSOC and HLPF, this sets the conditions to support good monitoring and accountability.
6. Policy recommendations on ways to accelerate progress in poverty eradication
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Member States must take the lead to strengthen coherent policy and legal frameworks and be explicit about ways in which several actors can contribute with their specific added values and expertise.
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Nutrition should be included in the country plans to address the SDGs, allowing space for inclusion of relevant nutrition indicators. The revision of country UNDAFs would be an excellent opportunity for the UN system to support country processes.
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Member States are strongly encouraged to engage in the Work Programme of the UN Decade of Action on Nutrition, and work in collaboration with others to align their actions to the six action areas: Sustainable resilient food systems for heatlhy diets; Aligned health systems providing universal coverage of essential nutrition actions; social protection and nutrition education; Trade and investment for improved nutrition; Safe and supportive environments for nutrition at all ages; strengthened nutrition governance and accountability .
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Nutrition, food security and poverty need to be addressed simulaneously in order to ensure sustainable progress in poverty reduction. Women empowerment should be central in these strategies.
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Elimination of malnutrition and poverty requires mutli sectoral dialogue among many actors at all levels, knowledge sharing and capacity building.
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All stakeholders should implement CFS policy outcomes and WHA resolutions and promote national monitoring events as part of the efforts for a better use and application. This is one step to ensure that decisions agreed by Members States in Rome, New York and Geneva are translated into concrete action on the ground.
