Nutrition policies: from 1992 ICN to 2014 ICN2

1. 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

2. 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-regional • technical consultations • 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" Draft World Declaration and Plan of action for Nutrition

3. 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

4. What was pledged: (ICN, Rome, December 1992) • 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

5. "........ 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, WHO • Extract from the ICN Closing Remarks • Rome, 11 December 1992

6. 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."

7. 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.

8. Regional review meetings to evaluate the progress and experiences of countries in developing and implementing national nutrition plans and policies 1996 - 1997 1999 - 2001 Key elements and obstacles in successfully developing and translating national nutrition plans and policies into action

9. Global Nutrition Policy Review • Questionnaire based survey conducted in 2009 – 2010 • 7 modules: • Overview of the nutrition policy and architecture • Infant and young child nutrition • International Code of Marketing of BMS • School-based programmes • Vitamins and minerals • Obesity and diet-related noncommunicable diseases • 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

10. Policy environment and main gaps Source : WHO, 2013. Global Nutrition Policy Review

11. Coordination mechanisms for nutrition Sectors • Most often involved: Health, education, food and agriculture • Least often involved: Finance Location • Most oftenin the Ministry of Health Source : WHO, 2013. Global Nutrition Policy Review

12. Are nutrition problems coherently addressed? Policy content in countries with and without adouble burden of malnutrition Countries with stunting ≥20% and women’s obesity ≥5% Countries with stunting <20% and/or women’s obesity <5% Source : WHO, 2013. Global Nutrition Policy Review

13. Are nutrition problems coherently addressed? Nutrition actions in countries with and without adouble burden of malnutrition 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) Source : WHO, 2013. Global Nutrition Policy Review

14. 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

15. 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