Here are some comments from Corinna Hawkes at WCRF International, an
organisation concerned with the prevention of cancer through the promotion of
improved nutrition:
http://www.wcrf.org
Twitter: http://www.twitter.com/wcrfint
Facebook: http://www.facebook.com/wcrfint
Research and Policy Blog: http://www.wcrf.org/blog
Theme 1: What are some of the key lessons that have been learned during
the current MDG Framework, 1990-2015?
Many lessons have been learned during this period. Here are some:

Food and nutrition insecurity encompasses a triple burden of poor
nutritional status: underweight; stunting; and overweight/obesity. These
three conditions can co-exist within the same individuals, households,
and communities. They may also exist independently of each other.

All forms of malnutrition are linked with health, including the
development of chronic non-communicable diseases in later life. Evidence
indicates that poor nutritional status is linked with the development of
noncommunicable diseases.

Intervention in early life is critical to prevent stunting and the health
conditions associated with it later in life since malnutrition has a
profound effect on child growth and development during the first two
years of life.

Good nutritional status should therefore be an objective for
development, rather than “hunger” alone.

Moving out of a situation of undernutrition does not necessary lead to
good nutritional status if replaced by overweight and obesity. Healthy
development needs to take a different path to Western nations in this
regard!

Good nutritional status is achieved by a range of actions, including on
food, health and care.

With regard to food, improvement to the total diet is essential. Focusing
on one or two specific foods or nutrients can have perverse effects.

A strong civil society can galvanise and promote action to address
malnutrition.

Good governance, including multi-sectoral mechanisms, is essential for
the effective development and implementation of actions to address
malnutrition in all its forms.

Having clear goals can motivate action.
1
Theme 2: What actions are needed?
Taking into account the triple burden of poor nutritional status, the following
actions are needed for the post-2015 development agenda:

Actions that address all forms of poor nutritional status. Some actions
are needed to address two of three aspects of malnutrition at the same
time; others are needed that target the specific form of malnutrition
alone.

Maintaining and promoting breastfeeding – evidence states that
breastfeeding leads to positive nutritional outcomes in all its forms. UN
recommendations on breastfeeding should be followed, implemented and
monitored by all relevant actors.

Social safety nets are needed to reduce poverty and malnutrition among
poor families, including systems of ensuring adequate food intake, such as
school meal provision and cash. However, it is essential that these
systems include nutrition standards and/or provisions to promote
healthy eating (evidence suggests these otherwise valuable programmes
can be associated with excessive energy intake or unbalanced diets).

Malnutrition should be viewed as a food systems problem, as well as one
of poverty and unbalanced development. This is particularly the case now
that more attention and investment is being placed into agriculture. There
currently exists a considerable opportunity to promote “nutrition
sensitive agri-food systems”. Actions are needed to improve the
nutrition-sensitivity of “short value chains” between farmers and
consumers, focused on specific, and often rural, populations e.g. initiatives
to promote the production of plant-based foods and their movement into
the market throughout the value chain. Given the presence of huge urban
populations who purchase food that has moved through long and complex
value chains, action is also needed to make “long value chains” more
nutrition sensitive. This is needed to bring the triple burden and
vulnerable urban populations into the frame of nutrition-sensitive agrifood systems.

As part of this, policy actions are needed that target entire
populations. For example, national governments and UN bodies should
build the protection and maintenance of good nutritional status into
relevant policies and agreements; the food and drink industries should
make nutrition an explicit priority in all stages of food systems including
product research, development, formulation and reformulation, and
promotion. disincentives to the food and drink industries to mobilise and
create demand for poor quality diets, such as policies to significantly
reduce the marketing of high calorie, nutrient-poor foods to infants,
young children, adolescents, and their caregivers.

Overall, policies and actions will only be effective if they change the 3As
– the availability, affordability and acceptability of healthy diets.
Policies should thus promote a combination of supports changes in the
food environment to address all 3As, plus educational strategies designed
2
to facilitate the acceptability of healthy food choices and other food- and
nutrition-related behaviours conducive to health.

Evidence suggests that school-based approaches can be effective, but
that a “whole school approach” is needed (that is, the integration of
nutrition in several different forms throughout the whole school,
including education on the curriculum, food served in schools, gardening
etc). School gardening interventions are becoming more popular all over
the world as a way of integrating many different aspects of nutrition
education into one.

Multi-sectoral (health, agriculture etc) and multi-stakeholder (civil
society, government etc) action is needed to ensure good governance of
the triple burden of malnutrition. For multi-sectoral and mulitstakeholder action to happen, it is necessary to create the spaces to do so.
This requires a policy spaces and governance spaces, such as national
multi-sectoral councils. There is evidence that these multi-sectoral
governance mechanisms have more power and positive influence when
they report directly to the executive branches of government, preferably
at the prime ministerial or presidential level.

Current civil society mobilisation around nutrition has largely (and
understandably) focused on undernutrition. A stronger “social
movement” around all forms of malnutrition is needed to bridge gaps
and cut across into the health and development agenda. Further focus is
needed from civil society on overweight/obesity and nutrition-related
non-communicable diseases.
Theme 3: Objectives, targets and indicators
The post-2015 development framework should include goals and indicators.
With regard to nutrition, nutrition indicators should be mainstreamed
throughout the entire post-2015 framework given its interlinkages with
other areas, such as health and sustainability.
The Zero Hunger Challenge and the Global Strategic Framework for Food
Security and Nutrition are to be welcomed and have many strengths, but are
limited in how they bring the triple burden of malnutrition together into one
framework. The post 2015-agenda should be more explicit in how it addresses
this triple burden in its actions, goals and indicators for food and nutrition
security.

There should be time-bound targets that take into account the triple
burden of malnutrition.

Reduction of stunting should be a key target, as should zero growth
of obesity, particularly among infants and young children.

There should also be an “indicator” on the development of food
systems relevant to the triple burden of malnutrition.
3