Public interest CSOs vision statement on nutrition
This document emerged from the joint efforts of public interest civil society organizations that have actively engaged in the preparatory process for the Second International Conference on Nutrition (ICN2), an intergovernmental conference organized by the Food and Agricultural Organization (FAO) and the World Health Organization (WHO) to address malnutrition in all its forms. While the group is diverse and positions might differ on specific issues, this vision statement expresses the elements of common concern.
Circumstances have profoundly changed since the 1992 International Conference on Nutrition. Although some uneven progress has been made with regard to the reduction of stunting and underweight rates among children, under-nutrition remains an immediate and dramatic challenge, and the burden of overweight and obesity has significantly expanded, manifesting its profound health consequences in terms of increased incidence of diabetes, cardio-vascular diseases, some types of cancer and other non-communicable diseases.
Although the conclusions of the ICN2 negotiations are a welcome step and include valid recommendations, public interest civil society organizations consider them inadequate to confront the scale of the malnutrition challenge. Furthermore, the negotiations exposed profound differences among governments in both the understanding of the problems and the possible ways forward, casting serious doubts on the real extent and depth of the common political foundation and commitment behind the formal deliberations.
Against such background, this document expresses our agency as public interest civil society organizations. Its purpose is to voice our common concerns and articulate our aspirations and strategies on how to address the complex challenge of malnutrition in all its forms. In the context of the ICN2 follow-up and the proposed Decade of Action on Nutrition, it also aims to inspire, catalyze and direct our common action to scale-up our ambitions, coordinate and synergize our activities, strengthen our advocacy efforts and intensify our monitoring functions.
Lasting solutions to the challenges of malnutrition in all its forms require solid foundations built around the following four strong pillars and domains for action: (I) Human rights and rights-based approach to food and nutrition security; (II) Coherent and coordinated management of nutrition throughout the lifecycle and at all levels; (III) Sovereign local food and agricultural systems based on agro-biodiversity; and (IV) Democratic governance of food and nutrition and global and national regulatory framework.
These foundations can only be laid on a common understanding of the challenge of malnutrition and need to be complemented by coherent strategies, actions and initiatives in closely connected policy domains.
Our common understanding of the challenges of malnutrition in all its forms
Understanding the challenge of malnutrition in all its forms requires a holistic and multidisciplinary analysis, one that combines the political and technical perspectives. Above all, it requires recognizing the need for urgency and justice, the appreciation for diversity and the values of human dignity, equity, sustainability and sovereignty.
It is our common understanding that food is the expression of values, cultures, social relations and people’s self-determination, and that the act of feeding oneself and others embodies our sovereignty, ownership and empowerment. When nourishing oneself and eating with one’s family, friends, and community, we reaffirm our cultural identities, our ownership over our life course and our human dignity. Nutrition is foundational for personal development and essential for overall wellbeing.
In this context, the root causes and factors leading to malnutrition in all its forms are many, complex and multidimensional and cannot be separated from their broader social, political and economic determinants. In our common understanding, the following should be recognized as major causes:
- Lack of access to adequate and diverse food (including healthier food products such as fruits, vegetables, whole grain, etc., as well as breastfeeding), adequate living conditions (water and sanitation, safe food, housing), and social services (education, quality health services, food safety);
- Widespread violations of women’s and girls’ rights, women’s lack of control of economic resources, lack of focus on adolescent girls’ nutrition and reproductive health and the impact these have on breaking the intergenerational cycle of malnutrition;
- Lack of protection, promotion and support of early, exclusive breastfeeding up to 6 months, and continued breastfeeding for 2 years or beyond together with adequate complementary feeding;
- Lack of access to enough nutritious food and hygienic environment during the first 1,000 days of life, from pregnancy to a child’s second birthday, as malnutrition during this critical window for child’s development can cause permanent damage;
- Lack of access to and control over productive resources (among others due to land grabbing, seed patenting, expansion of agribusiness, soil degradation, and production of biofuels);
- Lack of support for local food systems and markets that benefit small-scale food producers, and market distortions by unjust international trade rules and practices, such as dumping and unbalanced/unfair international trade regimes;
- Unemployment and inequitable, precarious and unhealthy working conditions as well as lack of effective social protection schemes;
- Insufficient education on nutrition and its impact on health;
- Hegemony and promotion of non-sustainable food systems based on agro-industrial production methods, which are responsible for dietary monotony and high levels of availability and consumption of ultra-processed food and beverage products, and are major contributors to soil and water contamination as well as climate change;
- Abuses of power by powerful economic actors, in particular large corporations, and absence of clear frameworks comparable to the FCTC for tobacco, to guide engagement with multinational food and beverage companies;
- Increased impunity of those responsible for human rights violations that lead to malnutrition, and lack of global/continental accountability mechanisms and proper national regulation to deal with human rights abuses of large corporations (multinational food and beverage companies for instance);
- Absence or insufficiently established and enforced labeling and nutrient/health claims regulations;
- Abusive food marketing directly to children;
- Abusive marketing of breast milk substitutes to parents of infants and young children;
- Lack of multi-sectorial policies to maximize and leverage nutritional gains and promote increased physical activity;
- Climate change as an increasing factor that is eroding the resilience of agriculture and fisheries, of particular importance in Small Island Developing States, coastal areas and semiarid regions.
The combined outcomes of these closely interrelated causes significantly impair the realization of a wide range of human rights, involve profound consequences in terms of human suffering and premature deaths, reduction of life expectancy and increased incidence of both communicable and non-communicable diseases, impaired physical and cognitive abilities and decreased quality of life, and perpetuate an intergenerational cycle of poverty. Most of these consequences are borne by vulnerable population groups (children, women, landless, urban poor, people living with HIV, people with disabilities, etc.) and contribute to deepening their vulnerability and marginalization and to the intergenerational reproduction of inequalities. The cost of inaction is enormous, first and foremost in human terms but also in economic ones.
It therefore becomes an imperative to end malnutrition in all its forms, including undernourishment, stunting, wasting, micronutrient deficiencies, overweight and obesity, and diet-related non-communicable diseases. A rights-based agenda to address malnutrition in all its forms requires an integrated, coherent and consistent approach across many domains and at all levels. In this context, governments should first and foremost dramatically accelerate progress to achieve the WHA global nutrition targets for 2025 and complement their action with coherent initiatives in closely connected policy domains, such as the broader health agenda, water and sanitation, social protection, gender and climate change, among others. The follow-up of ICN2 should therefore be framed within the broader post-2015 development agenda and integrated with accelerated plans to meet the WHA global nutrition targets for 2025, the WHO Global NCD Action Plan 2013-2020 and the Global Strategy on Infant and Young Child Feeding.
The vision statement was presented and discussed during the CSO Forum on 17-18 November 2014 in Rome, in preparation to the ICN2.