14 March 2014

The ICN2: So far, too food focused

The ICN2 (the second International Conference on Nutrition--the first was in 1992) is currently holding a public web based consultation on the zero draft of the political outcome document that will emerge from the Conference.  

The ICN2 website says:

"The Second International Conference on Nutrition (ICN2) is an inclusive high level inter-governmental meeting on nutrition. It is jointly organized by the Food and Agriculture Organization (FAO) and the World Health Organization (WHO), in cooperation with the High Level Task Force on the Global Food Security Crisis (HLTF), IFAD, IFPRI, UNESCO, UNICEF, World Bank, WFP and the WTO. The ICN2 will be the first global intergovernmental conference to addressing the world’s nutrition problems in the 2lst century. Its overall goal is to improve diets and raise levels of nutrition through policies that more effectively address today's major nutrition challenges. It also aims to enhance international cooperation on these challenges"

My comments:

1. The Zero Draft kicks off by saying "malnutrition poses one of the greatest threat to people’s health and well-being". 

This is true, but it also poses a severe threat to their livelihoods and their ability to escape poverty as well as the economic growth of their nations. This should be stated very clearly up front.

2. Soon after the Draft says we: "recognize that the causes of malnutrition are complex and multidimensional, while food availability, affordability and accessibility remain key determinants."  

So this frames the Draft around food, which is puzzling given that food is just one of 3 sets of underlying factors and one of 2 sets of immediate factors driving bad nutrition. If the focus is to be food (and there may be good reasons) tell us why.  

3. Then it says "Together with inadequate physical activity, dietary risk factors account for almost 10% of the global burden of disease and disability."  

This feels a bit underwhelming, and does it really tally with the data? The table below is from the Lim et. al. GBD paper in the Lancet last year and suggests more than 10% (you can't just add up the risk factors because many of them are co-determined, but a diet low in fruits alone is over 4% of the burden of disease measured by DALYs). (The colours relate to different diseases.)

4. This takes us to points 9-20 in the Draft, "Reshaping the Food System to Improve People's Nutrition."  

This section goes like this. Food systems should focus on quality as well as quantity (paras 9 -11); Food and nutrition require multisectorality, but seen through a food perspective (paras 12-13); consumers need to be protected (para 14) as do people with special needs who are particularly vulnerable (the poorest, pre and antenatal maternal health, child health, school feeding, para 15); development assistance should support nutrition enhancing initiatives at national level (para 16); government leadership is key (paras 17 and 18), civil society, data and accountability are vital for holding governments to account on what they do as well as on outcomes (paras 19-20).

There are a few nods to nutrition outside of food systems, but not much.  

5. Committing to action. Para 21 starts out by recognising the need for a framework for "collective commitment, action and results is needed to reshape the global food system to improve people’s nutrition, particularly that of women and children" and then has 7 action points that are all food systems based. Para 22 says that there will be a Decade of Action on Nutrition guided by this framework and para 23 says it should be integrated into post 2015 global development efforts.

None of the action points relate to anything other than food systems.  


Overall, this would be a superb manifesto for FAO, but as a International Conference on Nutrition it is unbalanced.  It is too food focused. We do need to know how we can make the food system deliver more for nutrition, but we also need to know how to make family planning, social protection, health systems, water and sanitation provision, education, poverty reduction and governance more nutrition sensitive.  

If you feel the same (or not), please comment on the web forum, there is one week to go (March 21).

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