25 February 2016

The Global Governance of Nutrition: Why it Matters

Recently I was asked to prepare 10 minutes of thoughts on the global governance on nutrition (I did not have much more guidance than this). It was for an influential group and I wanted to push myself to think more about the topic, so I said yes.

The picture in the blog is my attempt to put something down on paper.
Source: me
I did not think of it as a formal governance system.

Rather I thought of functions that make for good governance: (1) normative views that lead us to doing the right things, (2) reality checks on what is feasible politically and what actually works based on capacity, and (3) accountability mechanisms to tell us how well we are doing on improving nutrition outcomes and on implementing actions that we have  committed to, in one way or another.

I then hazarded a guess on where the centre of gravity is for various organisations and entities in nutrition. The placement reflects my own knowledge rather than any political world view.

The questions from the group were interesting:

Q1. Do we need a consensus map of nutrition global governance?

A.  I think we do.  Much like we have a map of the causes and interventions of malnutrition.  It helps locate activities and gives people a common language.

Q2. How do we assess the adequacy of nutrition global governance?

A. I suppose you could say things are better than they were in 2008 when the Lancet series of papers said global governance of nutrition was, essentially, dysfunctional.  Funding is up from donors, we have ICN2, an SDG on nutrition, the CFS is more focused on nutrition, the N4G moments of 2013, 2016 and 2020, governments who have formed a movement (SUN) etc.

But I have two problems with this perspective.

First it seems like a pretty low bar. Surely we want to assess whether our current global governance is good enough to get us to where we want to be?  Is it fit for purpose? The WB/R4D analysis highlighted in Ch 5 of the 2015 GNR suggested a doubling of government funding to nutrition and a quadrupling of donor spending is needed to reach the stunting WHA goal in 2025.  Is our global governance good enough to get us to this place?

Second, what will stop things backsliding to 2008?  Accountability mechanisms are stronger, but donors and governments are distractible and UN agencies are too.  The governance system has to have a set of one way valves that prevent the nutrition "blood" flowing backwards.

Q3. What is the value-added of good global governance?

A. There are lots of opportunities for nutrition in the next 5 years.  Good governance will help us seize them.  First, there are the political and resource alliances that are possible by a framing of nutrition "in all its forms". Second, food systems are big drivers of all forms of malnutrition--we need to engage with people outside of nutrition if we are to influence them. Third, the SDGs represent another big opportunity: there are at least 50 indicators in the 17 SDGs that are highly relevant for nutrition--to influence them we have to form partnerships outside of the nutrition bubble.  Good enough governance can help us get there.

Finally, what is there to push us towards seizing these opportunities? It is not clear to me.  Leadership is diffuse on nutrition and that can be a strength when things are going well, but where is the forcing moment every one or 2 years where everyone gets together and prioritises action step?  We need some kind of apex moment to force this prioritisation.

The nutrition global governance landscape is changing.  We need to shape it as well as be shaped by it. Governance matters.


Lina Mahy said...

Dear Lawrence,

Thanks for these thoughts. With regard to your final thoughts in this blog, I would like to refer to the ICN2 Rome Declaration paragraph 17: I think a Decade of Action on Nutrition, declared by the UN General Assembly, would serve very well as a "forcing moment". Just imagine that for the next 10 years, malnutrition in all its forms will be discussed and progress assessed in this global forum!


Lina Mahy said...

Dear Lawrence,

Thank you for sharing your thoughts on the global nutrition governance. With regard to your last paragraph, on the "forcing moment" for nutrition, I would like to refer to the ICN2 Rome Declaration (para 17) http://www.fao.org/3/a-ml542e.pdf

A Decade of Action on Nutrition, declared by the UN General Assembly, would be a perfect forcing moment! Just imagine, that in the next 10 years, all UN Member States would report on their progress fighting malnutrition in all its forms every 2 years.

Best wishes,

Lawrence Haddad said...

Hi Lina, yes completely agree, but it has to be a serious stocktake and visioning exercise, at least every 2 years and not just blah, blah, blah...