ICN2 Zero Draft Political Outcome Document for 19 November 2014

THE ROME ACCORD

ICN2 zero draft political outcome document for 19 November 2014

We, ...... , assembled at the Second International Conference on Nutrition, on 19-21 November 2014, to address the multiple threats of malnutrition

Multiple threats of malnutrition are a major challenge to global development

1. Acknowledge that malnutrition, including undernutrition and overnutrition poses one of the greatest threat to people’s health and well-being. Malnutrition , undernourishment, micronutrient deficiencies, unbalanced diets and imposes unacceptably high costs on individuals, families and societies.. It restricts the attainment of human potential, negatively impacts human physical and cognitive development, and increases susceptibility to communicable and non-communicable diseases.

2. Note, with profound concern, that recent decades have seen modest and uneven progress in reducing malnutrition, as measured by the targets of the 1992 International Conference on Nutrition, the 1996 World Food Summit and the Millennium Development Goals:

• the prevalence of undernourishment has declined, but absolute numbers remain unacceptably high: at least 842 million in 2011-2013;
• chronic undernutrition (stunting) has declined, but still affected 162 million children under 5 in 2012, while acute undernutrition (wasting) affected 51 million children under 5 in 2012;

 undernutrition is often aggravated, in a vicious cycle, by foodborne infections and ingestion of chemical contaminants due to unsafe food supplies;

• micronutrient deficiencies have not improved;
• about a third of all women suffer from anaemia;
• obesity in children and adults has been going up quickly, as the incidence of non-communicable diseases related to diet has been rising rapidly all over the world.
• Unhealthy diet is among the leading cause of the major non communicable diseases including cardiovascular disease , type 2 diabetes and certain types of cancer , and contributes substantially to the global burden of disease, death and disability.
• Overweight and obesity have been accurately described as un epidemic , as 65% of the world's population live in countries where overweight and obesity kills more people than underweight, with vast impacts in terms of human suffering and economic burden while it is estimated that worldwide the health budgets spent directly on diseases linked to obesity each year hugely rise , with more indirect costs resulting from lost productivity due to health problems and premature death

• different types of malnutrition co-exist in most countries;

• Malnutrition occurs too frequently in children and also among older people who are particularly vulnerable to malnutrition for many reasons.

• large socio-economic differences in nutritional status and exposure to dietary risk factors exist in most populations, while lifestyle-related risk factors as poor diet and physical inactivity, tend to be more prevalent among the less educated or lower income segments of population.

3. Recognize that the causes of malnutrition are complex and multidimensional, while food availability, affordability and , accessibility and quality remain key determinants. The evolution of food (including agricultural) systems -- with innovations in production, manufacturing, storage and distribution -- has led to enhanced dietary diversity, greater consumption of vegetables and fruit, as well as meat and dairy, in developing countries, although benefits have been uneven. The consumption increasing availability and intake of processed foods high in saturated fats, trans fatty acids , simple sugars and fats, particularly saturated and trans-fats, as well as salt and of sweetened beverages in large portions have also increased global, fuelling the global epidemic of NCDs. The food system is still unable to provide safe and nutritious food for all and is increasingly challenged to do so, in view of the constraints posed to food production by resource and ecological sustainability concerns, especially climate change. Moreover food production plays an important role in the environment and is close to exceed environmental limits. Cultivation of local products contribute to a sustainable environment and employment of local people, promoting the balance between the territory and the people.

A vision for global action to end all forms of malnutrition

4. Reaffirm that the elimination of malnutrition in all its forms is an imperative for ethical, political and economic reasons. Malnutrition is still responsible for about half of child deaths and obesity for over three million deaths every year. Together with inadequate physical activity, dietary risk factors account for almost 10% of the global burden of disease and disability.

Nutrition and physical activity are key health determinants and diet –related diseases adversely affect the life expectancy and quality of life of millions of citizens, as well as the efficiency and sustainability of health systems .Obesity and all diet related NCDs are caused by many factors, comprehensive prevention strategies and multi-stakeholders approaches provide best results.

5. Recognize that nutritional needs change over the life cycle, and certain groups, including women and children and the elderly have specific needs, cially during particular phases of life

. Appropriate nutrition during pregnancy and lactation is essential for the wellbeing of both mother and child; eating and physical activity habits are established at an early age and that learning and adopting healthy habits when young substantially increases t he likelihood that such habits will be sustained into adulthood.

The healthy diet and regular physical activity are preventive measures applicable across the lifespan with significant benefits particularly during childhood , when the roots of future health are seeded, and during old age ,when biological risks are inherently maximal and quality of life is most frequently threatened.

6. Renew the commitments made at the first International Conference on Nutrition and at the World Food Summit, and pledge to increase efforts to support initiatives such as the UN Secretary-General’s Zero Hunger Challenge.

7. Renew the commitment to reduce the number of children under 5 who are stunted; reduce anaemia in women of reproductive age; reduce low birth weight; halt the increase in the prevalence of overweight in children under 5; increase the rate of exclusive breastfeeding in the first six months; reduce and maintain the prevalence of wasting in children under 5; as well as reverse the rise in obesity and diabetes, as part of the effort to reduce the overall mortality associated with NCDs.

8. Recall the International Covenant on Economic, Social and Cultural Rights and the Voluntary Guidelines to support the Progressive Realization of the Right to Adequate Food in the Context of National Food Security; the Global Strategic Framework on Food Security and Nutrition of the Committee of Food Security and the commitments of the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases.

Reshaping the food system to improve people’s nutrition

(Ministry of Rural Development and Food)

“Recognize that malnutrition concerning both undernutrition and unbalanced

overnutrition urges for a radical change on food production methods and nutritional models towards a more sustainable manner. Efforts should focus on the adoption of healthy diets that respect the environment, protect biodiversity and ensure availability and affordability. The recognition of the Mediterranean Diet as an element of the intangible Cultural Heritage of Humanity by UNESCO reaffirms its values and attributes, as an effective model of sustainable diet. Characterized as a healthy dietary pattern, rich in olive oil, whole grains, fish, fruits and vegetables, it has high nutrient adequacy and is associated with increased longevity and lower incidence of heart disease, type II diabetes and several types of cancers.

Governments should work nationally and internationally to facilitate the promotion

and dissemination of the Mediterranean Diet or other traditional and/or local

healthy dietary patterns”.

9. Recognize that good nutrition requires more sustainable, equitable and resilient food systems. Food systems – the resources, environment, people, institutions and processes with which food is produced, processed, stored, distributed, prepared and consumed – determine the quantity as well as quality of the food supply in terms of nutritional content, diversity and safety. Agriculture (including livestock), fisheries and potable water are at the basis of food systems.

10. Acknowledge that food systems should produce more nutritious food, not just more food, and guarantee adequate supply of fruit and vegetables, unsaturated fat and animal source foods while avoiding excess of sugars, saturated and trans-fats and salt; food systems should enhance nutrition by providing year-round access to macro and micronutrients, promoting food safety and balanced diets, and avoiding food processing that reduces or adversely affects nutrition.

11. Reaffirm that all systems for food production (soil, seeds, land, water, transport) and processing should be sustainably managed to ensure food and nutrition security for all by adopting ecologically sensitive farming practices. Climate change poses a major threat to sustainable food systems, and hence, to food and nutrition security. Nutrition should be considered in designing policies for inclusive sustainable development, including food systems for sustainable production and consumption. The Climate Smart Agriculture approach promotes improved adaptation and mitigation practices as well as policies that support sustainable food and nutrition security. Efforts to reduce food waste in consumption and storage losses can significantly contribute to reduce food and nutrition insecurity.

12. Recognize that appropriate policy packages are needed to adequately tackle the multiple burdens of malnutrition in different situations. Food and nutrition should be addressed across several sectors: agriculture, industry, health, social welfare, education. Nutrition should be a goal of all development policies. Public policies should deal simultaneously with both food supply and demand while policies on investments and subsidies should be aligned with nutrition goals.

13. Recognize that increased public investment to improve nutrition is needed, including more equitable access to safe food and water, income, education and healthcare – all necessary to ensure universal access to healthy diets. Continued efforts are needed, not only to raise agricultural productivity to meet the dietary energy needs of a growing population, but also to improve access to more nutritious foods to provide other essential nutrients, especially micronutrients, i.e. vitamins and minerals, while curbing the excessive consumption of sugars and saturated fats. With the vast majority of the poor dependent on agriculture for their livelihoods, more viable family farming can help boost local economies, especially with policies for social protection and community well-being, and improve diets as well as ecological and resource sustainability.

14. Recognize that empowering citizens and families to make informed choices on diet, providing information for all ages and socio-economic groups, particularly the most vulnerable such as children and elderly on the impact of life style behaviours on health and on opportunities for improving access to healthy diets consumer to make healthy food choices is essential. Reliable and relevant nutrition information, sensitive to cultural norms and preferences, needs to be effectively disseminated to improve behaviour and practices.  Health education and health promotion on healthy diet should include activities targeted to vulnerable population groups with regard to children and elderly. A thriving market economy requires rules and regulations to keep it fair to all, and to ensure food safety and healthy nutrition Governments must ensure and monitor that consumers ,especially children, are not targeted and misled by advertising ,marketing and promotion of foods high in saturated fats ,trans fatty acids, simple sugars or salt Governments are obliged to protect consumers, especially children, from misleading commercial messages promoting energy-dense, but nutrition-poor foods, which can induce addictions and heighten the risk of disease. Governments should facilitate the establishment of healthy food practices, based on local food cultures The dietary patterns may be more relevant than specific foods in the etiology of diet related diseases ; such dietary patterns, notably the Mediterranean diet and other health promoting traditional diets, merit the attention of public health policy makers.

15. Acknowledge that nutritional protection is provided to people who are food insecure, unable to purchase the nutritious foods they need, have special needs, or are nutritionally vulnerable for other reasons. We will examine the opportunities for enhancing people’s nutrition through programmes, interventions and partnerships for ante-natal and post-natal maternal health, for child health and for feeding school children. We will promote healthy environments, especially in schools and preschool , ensuring the supply of healthy dietary options based on quality standards , restricting access to unhealthy snacks and sugar-sweetened soft drinks. We will promote policies and initiatives aiming at healthy diet throughout the life course , starting from the earlier stages of life, before and during pregnancy, promoting and supporting adequate breast feeding and appropriate complementary feeding, followed by healthy eating in the family ,school environments during childhood ,adolescence ,later during adulthood and older age. Humanitarian interventions in crisis situations pay attention to the nutritional needs of beneficiaries.

16. Recognize that official development assistance, including climate mitigation and adaptation finance, philanthropic transfers and other foreign assistance, should support national nutrition-enhancing initiatives and interventions.

17. Further recognize that nutrition policy and programme implementation is poorly developed, coordinated and monitored at both national and international levels. Government responsibility for and leadership on nutrition is often partial and fragmented, or even non-existent. National nutrition strategies should involve and coordinate all relevant ministries and departments in complementary interventions, supported by the necessary financial, human and other resources.

18. Reaffirm that high-level political commitment and pro-active efforts as well as improved governance for more effective concerted actions by various key stakeholders across sectors are essential for food systems to enhance nutrition and food safety on a sustainable basis. Governments should take responsibility for leadership on nutrition. Institutional capacity should be built, and effective coordination across sectors implemented. Governments’ investment plans should target food systems with the aim of improving the availability, accessibility and acceptability of healthy food.

19. Recognize that eradicating malnutrition in all its forms depends on the active engagement of citizens working with committed, responsible and proactive governments, civil society and the private sector through interaction among stakeholders, often involving new modes. Scientists, educators, the media, community groups, food producers and processors, retailers, farmers, consumer organizations, and faith organizations need to contribute to the common agenda to reshape the food system. The United Nations system must work more effectively together to enhance international cooperation and solidarity to improve nutrition and support national efforts to accelerate progress against malnutrition.

20. Acknowledge that better food and nutrition surveillance will contribute to more effective interventions, policy-making and accountability. Better data can improve nutrition policy interventions and outcomes. Better metrics and indicators would improve policy making. Is important to support and prioritize research on the nutritional status and behaviours of populations groups ,and particularly on the specials needs of the most vulnerable population groups including the elderly.

Essential is also to improve data collection for the assessment of time trends relating to dietary intakes, food availability at the individual or household level. Accountability mechanisms and arrangements with clear objectives and targets can ensure more effective interventions. The accountability framework should include information on the achievements of targets as well as progress in the implementation of programmes and policies.

Committing to action

21. Recognize that a framework for collective commitment, action and results is needed to reshape the global food system to improve people’s nutrition, particularly that of women and children and elderly and agree to the following commitments:

I. aligning our food systems (systems for food production, storage and distribution)to people’s health needs;

II. making our food systems equitable, enabling all to access nutritious foods;

III. making our food systems provide safe and nutritious food in a sustainable and resilient way;

IV. ensuring that nutritious food is accessible, affordable and acceptable through the coherent implementation of public policies throughout food value chains;

V. establishing governments’ leadership for shaping food systems;

VI. encouraging contributions from all actors in society;

VII. implementing a framework through which our progress with achieving the targets and implementing these commitments can be monitored, and through which we will be held accountable

22. Commit to launch a Decade of Action on Nutrition guided by a Framework for Action and to report biennially on its implementation to FAO, WHO and ECOSOC.

23. Commit to integrate the objectives and directions of the Ten Year Framework for Action into the post-2015 global development efforts.