Nutrition policies:from 1992 ICN to 2014 ICN2
Chizuru Nishida
Coordinator, Nutrition Policy and Scientific Advice
Department of Nutrition for Health and development
WHO/HQ
PREPARATORY TECHNICAL MEETINGFAO Headquarters, Rome, Italy
13-15 November 2013
The ICN Preparations (1990 – 1992)
Country and Regional level:
Designation of an official country focal point
Country paper --- nutrition problems, past experience in confronting them, plans for future action
Regional / Sub-regionaltechnical consultations
Draft World Declaration and Plan of action for Nutrition
Global level:
Framework paper on Meeting the Nutrition Challenge
8 theme papers
Case studies- Topic approach- Whole country approach
Main background paper on "Assessment and analysis of trends and current problems in nutrition"
The International Conference on Nutrition (ICN)Rome, 5 – 11 December 1992
A Preparatory Committee (PrepCom) held in Geneva, 18 – 24 August 1992:
Reviewed and revised the draft of the World Declaration and Plan of Action for Nutrition
The Conference in Rome, 5 – 11 December 1992:
Adopted the World Declaration and Plan of action for Nutrition
To make all efforts to eliminate before the end of this decade (by 2000):
• famine and famine-related deaths• starvation and nutritional deficiency diseases in communities affected by
natural and man-made disasters• iodine and vitamin A deficiencies
To reduce substantially within this decade (by 2000):
• starvation and widespread chronic hunger• undernutrition, especially among children, women and the aged• other important micronutrient deficiencies, including iron• diet-related communicable and noncommunicable diseases• social and other impediments to optimal breast-feeding• inadequate sanitation and poor hygiene, including unsafe drinking-water
What was pledged:(ICN, Rome, December 1992)
"........ Rome was not built in a day, and our alliance to achieve nutritional well-being will unfortunately take time to reach its objectives. However, with this Declaration and Plan of Action, we are the architects of a new nutrition order…... We must fulfill our responsibility , no our obligation, to lift the burden of malnutrition, in all its forms, from the frail shoulders of our newborn, our young children, our mothers, the coming generation, and indeed all humanity. ... A clarion call for solidarity and concerted action has rung out ….. We must all respond….. We have a mandate for action. Let time not escape, for now is the time to act……."
Dr Hiroshi Nakajima, Director-General, WHOExtract from the ICN Closing RemarksRome, 11 December 1992
Status of NPAN
No. of Countries
Final/draft/preparing NPAN
139
- Final NPAN prepared
72
- Draft NPAN
26
- NPAN in preparation
(plan formulation has been hampered by various causes, including lack of local capacity, inadequate institutional arrangements, lack of resources or political turmoil)
41
World Declaration on Nutrition(adopted by 1992 ICN)
"..... we (the Ministers and the Plenipotentiaries) ... affirm our determination to revise or prepare, before the end of 1994, our national plans of action, including attainable goals and measurable targets, based on the principles and relevant strategies in the Plan of Action for Nutrition. We pledge to implement it."
ICN Plan of Action for Nutrition
Strategies and actions:• incorporating nutritional objectives, considerations and
components into development policies and programmes;• improving household food security;• protecting consumers through improved food quality and safety;• preventing and managing infectious diseases;• promoting breast-feeding;• caring for the socio-economically deprived and nutritionally
vulnerable;• preventing and controlling specific micronutrient deficiencies;• promoting appropriate diets and healthy lifestyles;• assessing, analysing and monitoring nutrition situations.
Regional review meetings to evaluate the progress and experiences of countries in developing and implementing national nutrition plans and policies
1. 1996 - 1997 2. 1999 - 2001
Key elements and obstacles in successfully developing and translatingnational nutrition plans and policies into action
1. Official governmental adoption & political support • not just having nutrition budget line• but specifically allocated
"governmental funds" for nutrition• influential ministry leading the process• having high profile advocate
2. Intersectoral coordinating mechanism• location in the government• specifically allocated budget for their
operation• members from all concerned
stakeholders
3. Ability to translate plans into action• Prioritization of activities & designation
of responsible sectors/ministries
4. Disconnect between national policy priority and regional / provincial level policy priority
5. Lack of human capacity in nutrition
6. Frequent turnover of staff -- Lack of institutional memory and continuity
7. Incorporation of monitoring & evaluation mechanism
8. Unavailability of reliable national food, nutrition and health data
9. Continuously changing international context of macropolicy on food and nutrition
Global Nutrition Policy Review
• Questionnaire based survey conducted in 2009 – 2010• 7 modules:
1. Overview of the nutrition policy and architecture2. Infant and young child nutrition3. International Code of Marketing of BMS4. School-based programmes5. Vitamins and minerals6. Obesity and diet-related noncommunicable diseases7. Food security and agriculture policies
• 123 countries responded
• Report published 2013 – Served as background paper for CIP-MIYCN
• Data available on the WHO Global Database on the Implementation of Nutrition Action (GINA) www.who.int/nutrition/gina
Policies• Most countries have nutrition policies, but they do not:
− Address challenges of the double burden of malnutrition
− Address nutrition challenges throughout lifecourse
− Include evidence-informed actions comprehensively
− Address underlying and basic causes of malnutrition
• Food security strategies seldom include nutrition goals or actions
Coordination• Intersectoral coordination mechanisms exist in
most countries, but they do not:− Address existing challenges
comprehensively− Anchor in high-level policy making
frameworks e.g. PMO
Implementation• Most countries implement some key
interventions at national scale, but they do not:− Implement a comprehensive set of
essential nutrition actions at scale− Address maternal nutrition through
reaching out to girls and reproductive age women before pregnancy
− Address adequately risk factors for obesity and diet-related NCDs
Monitoring and evaluation• Most countries conduct national surveys,
but they do not:− Include relevant indicators− Disaggregate data sufficiently to address
inequities− Conduct surveys routinely in a timely
manner− Use collected data for inform policy
formulation
Policy environment and main gaps
Source : WHO, 2013. Global Nutrition Policy Review
Sectors • Most often involved:
Health, education, food and agriculture
• Least often involved: Finance
Location• Most often in the
Ministry of Health
Coordination mechanisms for nutrition
Source : WHO, 2013. Global Nutrition Policy Review
Are nutrition problems coherently addressed?Policy content in countries with and without a double burden of malnutrition
Source : WHO, 2013. Global Nutrition Policy Review
Countries with stunting ≥20% and women’s obesity ≥5%
Countries with stunting <20% and/or women’s obesity <5%
Are nutrition problems coherently addressed?Nutrition actions in countries with and without a double burden of malnutrition
Source : WHO, 2013. Global Nutrition Policy Review
Countries with stunting ≥20% and women’s obesity
≥5%
Countries with stunting <20% and/or women’s obesity <5%
Note: darker area indicates implementation at national scale, the lighter area indicates implementation at subnational scale, and the full bar implementation at any scale (national or subnational)
Obesity and diet-related NCDs
• Most often implemented and at national scale:
– Promotional interventions, e.g.• Food-based dietary guidelines• Nutrition counselling in PHC• Food labelling• Media promotion of health
nutrition• Fruit an vegetable promotion
• Less often implemented:– control-demanding/legislative
interventions, e.g.• Removal of TFA• Price control
Source : WHO, 2013. Global Nutrition Policy Review
Food security and agriculture
• Policy goals – Most common:
• Increase output and farm incomes
• Improve quality of the products
– Less common:• Combating undernutrition• Reducing obesity and diet-
related NCDs• Promoting healthy diet
Source : WHO, 2013. Global Nutrition Policy Review
Top Related