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UN Decade of Action on Nutrition: Brazil, Ecuador and Italy make commitments

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Trudy Wijnhoven is a Nutrition Officer and the technical focal point for the UN Decade of Action on Nutrition at FAO, Rome, Italy. 

Michele Lessa de Oliveira is the General Coordinator for Food and Nutrition at the Ministry of Health of Brazil.

Angélica D. Tutasi-Lozada, Internal Management Coordinator for Promotion of Nutrition, Safety and Food Sovereignty, Ministry of Public Health of Ecuador.

Giuseppe Ruocco is the Secretary-General at the Ministry of Health of Italy and the President of the National Working Group “Ita Decade”.

Lina Mahy is a Technical Officer at the Department of Nutrition for Health and Development, WHO, Geneva, Switzerland

The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated.

Background

By proclaiming 2016-2025 as the Decade of Action on Nutrition (“Nutrition Decade”), the United Nations (UN) General Assembly in April 2016 committed Member States to ten years of sustained and coherent nutrition action.1 The Nutrition Decade not only gives a unique time-bound justification for countries and their partners to advance the global nutrition agenda (this includes the World Health Assembly global targets on maternal, infant and young child nutrition and the Sustainable Development Goals), but also aims to keep improved nutrition on the agenda of policy-makers at the highest international and national levels. The Nutrition Decade is a vehicle to advocate for policy and programme implementation, increased nutrition investments and reinforcement and alignment of existing efforts to ensure populations have access to healthy diets.

Country commitments for action are key to the Nutrition Decade’s support in leveraging government policy development, investments and actions on the ground. Countries are encouraged to set SMART – specific, measurable, achievable, relevant and time-bound – commitments, which help all stakeholders understand what action is intended and to improve tracking (e.g. the Scaling Up Nutrition (SUN) Movement is engaged to work with the 60 SUN countries on SMARTening their existing commitments). These commitments, formally submitted to the Nutrition Decade’s Secretariat2, are tracked on a regular basis by country self-assessments. During the World Health Assembly in 2017, Brazil and Ecuador were the first two countries that formally made ambitious, concrete commitments for action, followed by the Government of Italy (a number of other governments have made commitments, for example, to increase domestic funding for nutrition, but have yet to send a formal letter of confirmation). The three countries give a summary of how these commitments have been translated into action, as well as some of the challenges they face.

A customer buying fresh vegetables at a vegetable stall in a city market, Italy

Brazil

The Government of Brazil made a set of 38 commitments, grouping them under the six action areas of the Nutrition Decade, and outlined specific policy measures it will undertake to achieve the goals set. These commitments are part of the country’s National Food and Nutrition Security Plan 2016-2019, which has guidelines, targets, resources and tools for evaluation and monitoring, involving different sectors of the government and society, with a common goal for adequate and healthy diets.

Brazil’s multisectoral coordination is carried out by the Inter-Ministerial Chamber of Food and Nutrition Security, formed of 20 ministries and special secretariats, whereas its monitoring is done by the National Council of Food and Nutrition Security, which, by law, is made up of two thirds civil society representatives (including, for example, small farmers and indigenous groups), and one third government stakeholders in order to ensure meaningful social participation.

The Brazilian priority within the Nutrition Decade is to make progress on the reduction of risk factors and health promotion for the prevention and control of noncommunicable diseases (NCDs), as declared in the National Plans for Tackling NCDs and for Food and Nutrition Security. The Nutrition Decade has increased political support for the nutrition agenda in Brazil as evidenced by the creation of a new programme to prevent and control childhood obesity. The budget for nutrition actions (under the Ministry of Health) has also increased by over 40% in the last four years, and the regulatory agenda in obesity prevention is a current public health priority.

Ecuador

For Ecuador, the commitments taken on under the umbrella of the Nutrition Decade have contributed to the Government of Ecuador reaffirming its responsibility to fight all forms of malnutrition throughout the life cycle, and to generate actions that address the determinants of health and nutrition.

The Government worked with a wide range of actors from public and private institutions, civil society organisations and the general public to produce Ecuador’s Multisectoral Food and Nutrition Plan 2018–2025. The process of developing the plan involved identifying the limitations and strengths envisaged for the implementation of the actions by each of the co-responsible actors. After having gone through this process of awareness and recognition of the local context and thanks to the strong political commitment of the highest authorities, the first phase of the plan is currently being implemented. This translates into the delivery of a prioritised service package of interventions in health, education and social welfare, including strengthening regulations and strategies to promote a healthy diet and physical activity, as well as concrete actions to favour health during the first thousand days of life.

Italy

Italy started working on the Nutrition Decade by launching a “National Working Group Tavolo Italia Decade per la nutrizione (NWG – Ita Decade)” in July 2017. The NWG-Ita Decade, with a multisectoral and multistakeholder composition, has implemented a “Meta-Project” with a national and an international dimension.

As a first national action, the country launched a ‘Decade of Nutrition’ platform in July 2018 on the Ministry of Health’s website to share information on nutrition and healthy diets produced by national research institutes and ministries involved in the NWG-Ita Decade. The next steps will focus on developing a new protocol, following the Government’s 2015 agreement3 with the food industry on ‘processed food’, to identify several product categories (baked goods, cereals, sweets, non-alcoholic drinks, etc.) for which the food industry commits to reducing sugar, saturated fat, trans fats and salt, together with a constant effort to modify serving sizes and provide additional information on labels.

As part of international action, the country aims to launch a “Nutritional Diet Template”, as an example of sustainable and local diets that respect the communities and their specific geographical, socio-economic and cultural characteristics. The template will be informed by discussions between different countries, on traditional and sustainable healthy diets, such as the Mediterranean Diet, as a tool to effectively counteract all forms of malnutrition (including obesity and overweight, and micronutrient deficiencies).

Conclusion

The UN Secretary-General, in his first report on the implementation of the Nutrition Decade, stresses the need for implementation to be scaled up, investments for nutrition to be increased, policy coherence to be enhanced and the number of national commitments to be raised (the Decade of Nutrition itself does not have additional funding, but encourages countries themselves to accelerate efforts). Affordable solutions exist to reduce all forms of malnutrition, but they require greater global ambition and action than is being given at present. With only three countries having put forward in a formal way their commitments, it is hoped that more countries will follow, contributing to the achievement of the global nutrition and diet-related NCD targets and the Sustainable Development Goals.


References

Implementation of the United Nations Decade of Action on Nutrition (2016–2025). Report of the Secretary-General  undocs.org/A/72/829.

Strengthening Nutrition Action: A resource guide for countries based on the policy recommendations of the Second International Conference on Nutrition (ICN2) (FAO & WHO) www.fao.org/3/ca1505en/CA1505EN.pdf

 

1Resolution adopted by the General Assembly on 1 April 2016, 70/259, United Nations Decade of Action on Nutrition (2016–2025). A/RES/70/259 - https://undocs.org/A/RES/70/259.

2Through resolution A/RES/70/259, the UN General Assembly mandated FAO and WHO to act as the Secretariat of the Nutrition Decade.

3http://www.salute.gov.it/imgs/C_17_pubblicazioni_2426_ulterioriallegati_ulterioreallegato_0_alleg.pdf

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Trudy Wijnhoven, Michele Lessa de Oliveira, Angélica D. Tutasi-Lozada, Giuseppe Ruocco and Lina Mahy (2019). UN Decade of Action on Nutrition: Brazil, Ecuador and Italy make commitments. Nutrition Exchange 11, January 2019. p28. www.ennonline.net/nex/11/undecadeofaction

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