public interest civil society organizations vision statement on nutrition

November 13, 2014 logo

13 November 2014




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:


  1. 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); ?


  1. 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; ?


  1. 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; ?


  1. 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;


  1. 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; ?

  1. Unemployment and inequitable, precarious and unhealthy working conditions as well as lack of effective social protection schemes; ?


  1. Insufficient education on nutrition and its impact on health; ?


  1. 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; ?


  1. 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;


  1. 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); ?


  1. Absence or insufficiently established and enforced labeling and nutrient/health claims regulations; ?


m.Abusive food marketing directly to children; ?


  1. Abusive marketing of breast milk substitutes to parents of infants and young children; ?


  1. Lack of multi-sectorial policies to maximize and leverage nutritional gains and promote increased physical activity; ?


  1. 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.


Pillar I – Human Rights and rights-based approach to food and nutrition security


The first foundational pillar is a rights-based approach to food and nutrition security. The entry point of any policy engagement and action programme on food and nutrition should be the unambiguous understanding of the right to adequate food and nutrition as a fundamental human right, which identifies people as rights-holders and states as duty- bearers with an obligation to respect, protect and fulfill this right, and related rights. One of the main implications of this approach is that governments and intergovernmental bodies have the obligation to elaborate, with the direct participation of rights-holders, human rights compliant national and international strategies with clear goals, timelines and budget allocation, capable of tackling the root causes and addressing the prevention and treatment of all forms of malnutrition. These strategies must be associated with participatory mechanisms to ensure development and implementation of policies, informed by the knowledge and experience of rights-holders, and to hold governments accountable to people for their obligations and commitments.


  1. Human Rights as the central pillar of the Decade of Action on Nutrition: The central pillar of the Decade of Action on Nutrition should be the unequivocal affirmation of the human right to adequate food and nutrition, health, clean water, sanitation and hygienic conditions, and women’s rights, including sexual and reproductive rights, among other rights. Such affirmation must highlight the profound interrelation of nutrition, in real life, with women’s and child’s rights and empowerment, and the recognition of adequate, sustainable and culturally acceptable diets as the stepping stones to healthy lives across the lifecycle. In this respect, Member States should ensure that national and international policies are in line and coherent within and across sectors with their human rights obligations. Member States, together with FAO and WHO, must ensure that other intergovernmental organizations and multilateral regional institutions all promote and act in accordance with the realization of the right to adequate food and nutrition. Furthermore, Member States should ensure this same coherence in their participation in all international policy fora as well as in their regulation of and dealings with transnational powerful actors such as multinational corporations; ?


  1. The full realization of women’s human rights: The full realization of women’s human rights is central to the pursuit of the right to adequate food and nutrition for all. Despite some advances, most women in the world today continue to remain subject to several layers of structural discrimination and violence, at societal, community and household levels. Not only does this have negative implications for the full enjoyment of their human potential, but it also contributes to rendering women and their rights invisible in food security policies, leads to programmes that tend to overburden women even more with additional responsibilities, and promotes the intergenerational reproduction of malnutrition. We therefore urge Member States to promote and protect women’s human rights, including the provision of paid maternity benefits, the social recognition of unpaid work – through social and community support mechanisms –and the gendered redistribution of household tasks, as an integral part of an effective strategy for the reduction of malnutrition in all its forms. We also call for the prevention of child, early and forced marriages and the protection of women and girls against all forms of violence; ?


  1. Peasants’ Rights: Small-scale food producers (including, small-scale farmers, pastoralists, fisher-folks, agricultural workers, landless farmers, rural women and youth and others) are the main producers of food around the world and their productive contribution is essential to guarantee healthy diets. Nonetheless, they suffer daily violations of their rights. These include resource grabbing, destruction of livelihoods, dispossession of their territories, interference in the use of native seeds, discrimination in the access to social security and other services, unpaid work, among others. Not only do these violations affect their human dignity, but also the human right to adequate food and nutrition of consumers. The creation of an Open-Ended Intergovernmental Working Group at the UN Human Rights Council shows the awareness of the majority of Member States of the need to give a special recognition to peasants’ rights and strengthen their realization. In this respect, we urge Member States to respect, protect and fulfil the human rights of peasants and small-scale food producers;


  1. Consumer Rights’ and Protection: Consumers have a right to healthy, affordable and accessible food options, and to be protected (particularly children) from aggressive marketing of unhealthy food and beverage that promote diet-related NCDs, as well as from equally aggressive marketing of breast milk substitutes. Ultra- processed food and beverage products which are affordably priced and ubiquitously promoted need to be regulated through economic and legislative measures. Legislative measures should include: advertisement restrictions in all means of communication; the removal of persuasive elements from packaging and labels (e.g. characters of the childhood fantasy world); the establishment of consumer rights to be fully informed on the nutritional and safety aspects of products and the adoption of labeling systems that provide evident (front-of- package), easy-to-understand and accurate information about nutritional content as well as on the inclusion of ingredients from GMO crops; the redesigning of promotional areas at point-of-sale to encourage healthy foods and reduce the offer and stimuli for unhealthy products; and, the development of institutional education campaigns addressed at all population segments to promote healthy eating. Fiscal policies should include those that foster and facilitate access to healthy, fresh, and locally produced foods, such as fruits, vegetables and legumes, reinforcing the nexus between the rights of consumers and those of small-scale local food producers. Furthermore, adequate awareness needs to be urgently raised on the critical importance of optimal breastfeeding as one of the most cost-effective intervention to reduce child illness and death and in all its forms as well as on the role of healthy diets in the prevention of non-communicable diseases.


Pillar II – Coherent and coordinated management of nutrition throughout the lifecycle and at all levels


The second foundational pillar must address malnutrition in all its forms, including undernourishment, stunting, wasting, micronutrient deficiencies as well as overweight and obesity, and promote good nutrition and adequate dietary practices throughout the life-course. Malnutrition must be viewed as an “everyday emergency” which needs to be addressed in both developed and developing countries as well as in humanitarian emergencies. It is therefore necessary to address malnutrition in the broader context of changing lifestyles as a result of economic globalization and modernity.


  1. The urgency of acute child malnutrition: 52 million children under five in the world today – one in twelve children in this age group – are suffering from acute malnutrition. The majority of the children affected, over 90%, are found in South and Southeast Asia and sub-Saharan Africa, and contrary to popular belief, most deaths in under-5 children do not happen in acute emergencies but in relatively stable countries. It is imperative that the ICN2 follow-up address the profound social, economic and political determinants of this situation rather than purely propose treatment approaches that only address the symptoms of the problem. In this context, we urge governments to balance treatment and preventive approaches that empower communities and strengthen health and food systems in order to enable the long-term expansion and affordability of community-based management of acute malnutrition (CMAM) into the essential framework for the management of common childhood illnesses, where applicable using the Integrated Management of Childhood Illness (IMCI) strategy at facility level and Integrated Community Case Management (ICCM);


  1. The 1000-day window of opportunity and the life-cycle approach to nutrition: Nutritional needs change over the life-course, and certain groups, including women and children, have specific needs, especially during particular phases of life, including the 1,000-day window of opportunity from a woman’s pregnancy to her child’s second birthday. Promoting and guaranteeing the full realization of women’s and girls’ rights, including the right to self-determination, to control their life and body, to access economic resources, adequate nutrition information and appropriate sexual and reproductive health services, and preventing child marriage and adolescent pregnancy (including comprehensive sexuality education) are key conditions to effectively take advantage of this window of opportunity. It is of utmost importance to maximize these opportunities and develop policies and initiatives for ensuring healthy diets throughout the life course, including: nutritional quality and safety of foods; promotion of healthy dietary practices, starting with pregnant women, optimal breastfeeding and adequate complementary feeding, and considering diet-related NCDs; prevention and control of nutritional disorders, including micronutrient deficiencies, especially among biologically and socially vulnerable groups; and, promotion of healthy water and sanitation practices that improve nutritional status. In this context, increasing attention should be devoted to the nutritional requirements of a global ageing population;


  1. Breastfeeding: It is also equally important to acknowledge that many barriers remain with regard to the protection, promotion and support of optimal breastfeeding. Early, exclusive and continued breastfeeding play an important role in mitigating malnutrition in all its forms as well as child illnesses and deaths. We therefore call on Member States to put in place comprehensive infant and young child feeding policies to ensure the implementation of existing resolutions and guidelines, and to further strengthen the rights of all working mothers by instituting justiciable maternity protection entitlements such as paid maternity leave policies, support for breastfeeding in the workplace as well as adequate social protection for those working within the informal sector, in the context of the full promotion and protection of all women’s rights. We also urge the widespread adoption into national laws of the International Code of Marketing of Breast-milk Substitutes (including subsequent relevant WHA resolutions) as well as its enforcement and adequate independent monitoring;


  1. The challenge of connected malnutrition burdens: Many countries are facing complex overlays of connected malnutrition burdens. Member States need to recognize the reality of overweight and diet-related non- communicable diseases as severe problems by committing to accelerate progress on the WHO Global NCD Action Plan 2013-2020. Accordingly, policies are needed to encourage breastfeeding and consumption of nutritious foods, discourage, and when necessary effectively regulate, private sector practices that induce the overconsumption of ultra-processed products high in salt, sugar and saturated and trans fats, and promote physical activity; ?


  1. Containment of product based approaches to the treatment of acute malnutrition: We urge Member States to address the underlying causes of malnutrition, so that existing product-based approaches (e.g., vitamin A capsules, ready-to-use therapeutic foods) can be limited and possibly phased-out in favor of human rights- and food-based, local, bottom-up, capacity-building approaches for the prevention of all forms of malnutrition at the community level. ?


Pillar III – Sovereign local food and agricultural systems based on agro-biodiversity


The third foundational pillar is a conception of the “global food system” as being built of local food and agricultural systems based on food sovereignty, small-scale food producers, agro-biodiversity, deep ecological foundations and sustainable use of natural resources, native seeds and traditional knowledge and practices, and local markets and value chains.


  1. The baseline of any agriculture and food policies should be the “do no harm” principle to human health: Governments have a strong role to play in reshaping the food system by ensuring that food and agriculture policies and investment lead to improved nutritional and health outcomes for all. We therefore call on Member States to fully embrace the “do no harm” principle as the baseline of any agricultural and food policy and ensure that these policies at a minimum do not harm people’s nutrition and rather aim at improving people’s nutrition status. As human health can only be realized within a healthy planet, it is also necessary that these policies take in full consideration the urgent need to sustainably realign production and consumption patterns to the planetary boundaries and the need for viable ecosystem services; ?


  1. Centrality of small-scale and family food producers: In this context, it is necessary to reaffirm the centrality of small-scale and family food producers as the key actors and drivers of local food systems and the main investors in agriculture, as internationally celebrated in 2014 in the International Year of Family Farming (IYFF). Their secure access to, and control over, productive assets such as land, water, seeds, technical and financial resources, and social protection, particularly for women, is essential for a diversified diet and adequate nutrition. In this context, it is also important to highlight the crucial role of healthy marine ecosystems, sustainable fisheries and sustainable aquaculture for enhancing food security and access to adequate, safe and nutritious food and in providing for the livelihoods of the people who depend on these ecosystems. It is therefore essential to enhance the resilience of agriculture and fisheries to the adverse impacts of climate change, ocean acidification and natural disasters. This is of particularly vital importance for Small Islands Developing States; ?


  1. Agro-biodiversity and community capacity building as key drivers of dietary diversity and nutritional wellbeing: We are deeply concerned at any approach that promotes food fortification as the main path to address nutritional imbalances and purely technological fixes that do not recognize the social determinants of preventable malnutrition. Biodiversity loss – especially loss of diversity within crops and some animal species – is in itself an important cause of malnutrition. In this respect, agro-biodiversity and the development of new plant varieties need to build on traditional methods and approaches that protect native seeds rather than engaging in forms of genetic modification that may present grave consequences for biodiversity and food sovereignty. Farmers must also be protected against the contamination risks that GM crops might cause to conventional varieties and the associated contamination with agrochemicals, while it is necessary to emphasize policy and research support to a vibrant, public, plant breeding and conservation agenda led by farmer- researchers; ?


  1. Rethinking food systems and promoting local and regional markets: We embrace a definition of agricultural productivity that fully incorporates the agro-ecological, social, cultural and political dimensions of production and consumption, embodies the sustainable livelihoods of families and communities, is capable of providing for nutritious, healthy and diversified diets in line with culturally accepted eating patterns, and contributes to the reduction of the emission of greenhouse gases. In this context, the vibrancy of local and regional markets needs to be strengthened by appropriate infrastructural developments and needs to be protected against the rampant influx of ultra-processed foods, including breast milk substitutes. This should also include the reform of current local food procurement practice for school canteens, homes for the elderly and hospitals as well as social groceries to include clauses that privilege the provision of fresh local produce by small-scale local producers. ?


  1. National Policy coherence and integration: In this context, it would be necessary to review national policies and investments and integrate nutrition objectives into food and agriculture as well as related policies, programme designs and implementation, in order to enhance nutrition-sensitive agriculture, ensure food security and enable healthy diets. At the same time, this approach also requires coherent policies that protect, promote and support breastfeeding, encourage the consumption of nutritious foods, discourage the consumption of trans- fats and the overconsumption of ultra-processed products high in salt, sugar and saturated fats, ensure a hygienic environment, and promote physical activity.


Pillar IV – Democratic governance of food and nutrition and global regulatory framework


The fourth foundational pillar is the democratic governance of food and nutrition and its regulatory framework. A rights- based approach to food and nutrition requires that the governance of food and nutrition is firmly located within government-led normative and regulatory frameworks that are able to democratically devise policies and guidelines and ensure the proper accountability to the people of all actors involved. The global regulatory framework should protect and enhance the national governmental policy space for advancing public health, food and nutrition measures in all phases and at all levels. It should also include effective safeguards against conflicts of interest introduced by inappropriate relationships with powerful economic actors, including transnational corporations.


  1. Governance and regulatory framework: We appreciate the efforts by FAO and WHO to coordinate their work plans in the light of the ICN2 outcomes and welcome the UN General Assembly (UNGA) endorsement and oversight. However, we remain concerned that the governance and accountability mechanisms for the implementation of the ICN2 outcomes appear unclear, fragmented, disconnected and duplicative. It is therefore fundamental that Member States commit to developing a legitimate, coherent, accountable and participatory governance mechanism, safeguarded against undue corporate influence. In this context, we recommend the following:


Members States (MS) leadership and FAO-WHO facilitation: The implementation of the ICN2 outcomes must be led by Member States and facilitated by FAO and WHO under the overall umbrella of the UNGA in order to ensure coherence, coordination and integration with the broader development agenda. In the context of their Member State-led governing bodies, FAO and WHO can serve as normative, standard- setting and regulatory intergovernmental spaces;


Committee on World Food Security (CFS): Member States should request the CFS – reaffirming its role as the foremost inclusive government-led global platform on food security and nutrition with a specific mandate to establish coherence and coordination among all concerned actors – to address nutrition in all its discussions much more prominently than it has done in its past proceedings and build the necessary capacity to perform this enhanced role. This might include, among others, the direct engagement of WHO within the CFS Secretariat. At the same time, it is fundamental to build coherence between the ICN2 follow-up process and the CFS Global Strategic Framework and other relevant CFS policy documents and also to protect CFS policy space from undue corporate influence. It is also important to firmly establish the CFS role in the reporting and accountability mechanism of the food and nutrition components of the post-2015 development agenda;

World Health Assembly (WHA): National governments are encouraged to establish nutrition targets and intermediate milestones, consistent with the timeframe for implementation of the six WHA global nutrition targets (2025) and the global WHA NCD targets (2025), and report on progress towards these targets to the World Health Assembly (WHA) every second year;

UN Coordination: Members States should request that, under the leadership of FAO and WHO, UN agencies and programs harmonize their initiatives on food security and nutrition, at both global and national level, in collaboration with national governments (with inter-sectorial representation), public interest civil society organizations and peoples’ organizations, in particular those most affected by hunger and malnutrition, and draw on independent evidence provided by academia;

Post-2015 Development Framework and Zero Hunger Challenge: Member States should ensure that the post-2015 development framework is consistent with the imperatives of food security and nutrition and includes ambitious, robust measurement and accountability indicators. They should also ensure consistency between the post-2015 framework and the Zero Hunger Challenge, thereby ensuring the overall coherence of the food and nutrition agenda;

  1. Accountability framework: It is equally essential that Member States establish a clear accountability framework – one based on principles of human rights, social justice, transparency, and democracy – that includes mechanisms for citizens’ participation and the direct engagement of the populations and communities which are most affected by different forms of malnutrition. Such framework should also include independent assessment and monitoring of partnerships with the private sector and ensure that transnational corporations and other economic actors act in accordance with the law and do not infringe human rights; ?


  1. Decade of Action on Nutrition and monitoring framework: We welcome the Decade of Action on Nutrition. It is our understanding that this would amplify the impact of the ICN2 outcome by promoting coherence across different policy domains, multiplying spaces for action and broadening the agency of the implementation platform. However, we call on FAO and WHO to clearly articulate how the Decade would interface with the post- 2015 development agenda, the commitments of the United Nations Decade (2011-2020) on Biodiversity (Resolution 65/161), as well as the ongoing work of the Committee on World Food Security (CFS). The Decade of Action on Nutrition should also include a clear timeline and indicators for assessing progress, while providing some flexibility for countries to select priorities and actions based on their population specific needs and national capabilities. Progress review should include publicly available annual reports to the UNGA and CFS, hosting an ICN3 no later than in 10 years, and conduct a 5-yearly review to track implementation, including progress towards the 2025 World Health Assembly global nutrition targets, the 2025 World Health Assembly NCD targets, and all relevant components of the post-2015 development agenda; ?


  1. Strengthening Governments’ policy space on Health, Food and Nutrition: We are deeply concerned that, under current trade and investment regimes (both bi and multilateral), the governmental policy space for advancing public health, food and nutrition related measures is severely limited. An informative example in this regard is the inclusion of investor-state-dispute-settlement (ISDS) mechanisms in free trade agreements (FTAs), which allows private investors to bypass domestic legal systems and sue governments for potential losses in profit caused inter alia by enactment of public health regulation or imbalanced WTO rules, which deter countries from engaging in national food and nutrition security programmes. Such mechanisms severely undermine States’ sovereign rights and obligations to regulate in the public interest. We therefore urge Member States to protect the public policy space for food, nutrition and health by ensuring that trade and investment agreements are compliant with existing international obligations in relation to the right to adequate food and nutrition, the right to health and other human rights. Furthermore, we call on Member States to promote transparency, public participation (particularly of groups most affected) and accountability in relation to trade and investment negotiations. In order to do this, governments will have to secure significant involvement of all relevant civil society actors in these national or regional processes; ensure that all treaties include explicit clauses to respect and protect the human right to adequate food and nutrition and the right to health; encourage societal scrutiny over the development and implementation of such agreements and increase investments that directly and indirectly improve people’s nutritional status; ?


  1. Counteract power imbalances and regulate the actions of powerful economic actors: The realization of the right to food and nutrition, and the right to health, are hampered by economic, social and political inequalities as well as by existing power imbalances. There is an urgent need to ensure proper regulation, transparency and accountability of powerful economic actors, such as transnational corporations. In this respect, we call upon Member States to regulate those initiatives of the corporate sector that might negatively interfere with the enjoyment of the human right to adequate food and nutrition, women ?s rights and the right to health. Among others, these activities may include land and water grabbing; soil, food, water and human contamination with agrochemicals; the commodification of seeds; the marketing of breast milk substitutes; and the production and marketing of ultra-processed and junk food in particular though not exclusively to children. We therefore welcome the establishment of an open-ended intergovernmental working group on a legally binding instrument on transnational corporations and other business enterprises with respect to human rights and stand ready to support governments’ action in this area; ?


  1. Adequately deal with conflicts of Interest: Governments’ policy space must be protected, in all phases and at all levels, against conflicts of interest introduced by inappropriate relationships with powerful economic actors, including transnational corporations. In this respect, Member States and UN agencies are urged to design and implement effective rules and regulations on conflict of interest, and review and potentially terminate or re- design in conformity to these rules and regulations all Public-Private Partnerships (PPP) and multi-stakeholder arrangements. ?


Connected policy domains


The four foundational pillars interface closely with several other policy domains such as the broader health agenda, water and sanitation, and climate change, among others.


  1. Urgent action required on quality health systems: Swift and urgent action to strengthen health systems is needed in order to minimize and avoid the risk of death. In many developing countries, the majority of children who fall ill are never brought to health facilities. Strengthening and investing in health systems – from national to district and community levels – with the aim of achieving quality Universal Health Coverage (UHC) is essential and will help improve the identification, prevention and targeting of malnutrition in all its forms. A focus on identifying the most vulnerable groups is welcome and should stress that improved nutrition services are free at the point of delivery. In this context, we would like to highlight WHO’s six building blocks for strong health systems, which are indispensable for adequate nutrition; ?


  1. Water and sanitation are critical: Ensuring universal access to clean drinking water, basic sanitation and improved hygiene facilities and practices can promote healthy environments, improve absorption of nutrients, and reduce infectious diseases amongst infants and mothers. Repeated bouts of diarrhea, intestinal worms, environmental enteropathy, and faecal contamination – often contracted through open defecation or poor sanitation – can impede nutrient absorption, lead to chronic activation of the immune system, and diminish appetite, resulting in stunting and under-nutrition. Solutions must be prioritized in in line with UNGA strategy to tackle inequalities in access to services, also reflecting the established principles of the human right to water and sanitation, as recognized in Resolution 64/292 of the UN General Assembly in July 2010; ?


  1. Social protection: Social protection initiatives have the potential to positively impact upon hunger and nutrition. Social protection systems can support poor and vulnerable people by countering deprivation and reducing vulnerability to global challenges such as economic shocks, instability in the price of food or other essential commodities, and climate change. Effective social protection can also build strong foundations and help break the intergenerational poverty cycle. Governments should therefore invest in developing social protection systems that address malnutrition. Social protection recommendations also need to target interventions during the 1,000-day window and incorporate empowerment activities for women and girls;


  1. Climate change: Finally, food systems both contribute to greenhouse gas emissions (GHG) and are increasingly vulnerable to climate change and increases in extreme weather events, rising sea levels and changing precipitation levels in high burden countries. With rising environmental uncertainty, the resilience of food systems is becoming crucially important. Food systems and diets are likely to be affected through reduced crop productivity and changing water availability, plus increasing commodity price volatility. The negative impacts of climate change will be felt particularly by poor countries and marginalized farmers in these countries. Greenhouse gas emissions from agriculture can be significantly reduced by moving away from industrial production methods towards small-scale peasant farming based on agro-ecological principles. This shift towards more sustainable and climate resilient production methods needs to be accompanied by changes in other policy fields, such as trade and energy, as well as changes in dietary patterns (e.g., less meat consumption).

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