In a major step towards eradicating malnutrition worldwide, over 170 countries on Wednesday made a number of concrete commitments and adopted a series of recommendations on policies and investments aimed at ensuring that all people have access to healthier and more sustainable diets.
Ministers and senior officials responsible for health, food or agriculture and other aspects of nutrition adopted the Rome Declaration on Nutrition and a Framework for Action, which set out recommendations for policies and programs to address nutrition across multiple sectors.
The move came at the opening, in Rome, of the Second International Conference on Nutrition (ICN2), organized by the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO), according to a FAO media release.
The Rome Declaration on Nutrition enshrines the right of everyone to have access to safe, sufficient and nutritious food, and commits governments to preventing malnutrition in all its forms, including hunger, micronutrient deficiencies and obesity.
FAO Director-General José Graziano da Silva said: “We have the knowledge, expertise and resources needed to overcome all forms of malnutrition.”
“Governments must lead the way,” he said. “But the push to improve global nutrition must be a joint effort, involving civil society organizations and the private sector.”
The Rome Declaration and Framework for Action, “are the starting point of our renewed efforts to improve nutrition for all, but they are not the finishing line. Our responsibility is to transform the commitment into concrete results,” Graziano da Silva said.
“We must now redouble our efforts,” United Nations Secretary-General Ban Ki-moon said in a video address to ICN2 participants. “I look forward to learning of the national commitment that each of you will make. In turn the UN system pledges to do all that it can to provide effective support,” he added.
WHO Director-General, Dr Margaret Chan, said: “The world's food system -with its reliance on industrialized production and globalized markets - produces ample supplies, but creates some problems for public health.
“Part of the world has too little to eat, leaving millions vulnerable to death or disease caused by nutrient deficiencies. Another part overeats, with widespread obesity pushing life-expectancy figures backwards and pushing the costs of health care to astronomical heights,” she added.
The Framework lays out effective accountability mechanisms, including monitoring frameworks to track progress as well as nutrition targets and milestones based on internationally agreed indicators. Signatory countries should achieve specific results by 2025, including existing targets for improving maternal, infant and young child nutrition, and for reducing nutrition-related risk factors for non-communicable diseases such as diabetes, heart disease and certain cancers.
Sustainable food systems are key to promoting healthy diets. Governments are called upon to promote nutrition-enhancing agriculture, by integrating nutrition objectives into the design and implementation of agricultural programs, ensure food security and enable healthy diets.
The Declaration and the Framework are the fruits of almost a year of intense negotiations involving representatives of FAO and WHO member countries. Countries recognized that, although important advances have been made in the fight against malnutrition since the first International Conference on Nutrition in 1992, progress has been insufficient and uneven.
While the prevalence of hunger has fallen by 21 percent since 1990-92, over 800 million people in the world still go hungry. Stunting (low height-for-age) and wasting (low weight-for-height) have also declined, yet an estimated 161 million and 51 million children aged under five, respectively, were still affected in 2013. Malnutrition is linked to almost half of all child deaths under five years of age, some 2.8 million per year.
Over two billion people are affected by micronutrient deficiencies, or "hidden hunger", due to inadequate vitamins or minerals. Meanwhile, the burden of obesity is growing rapidly, with around half a billion people now obese, and three times as many overweight. Some 42 million children under the age of five are already overweight. Moreover, different forms of malnutrition often overlap, with people living in the same communities-sometimes even in the same household-suffering from hunger, micronutrient deficiencies and obesity. Overall, half the world's population is affected by some sort of malnutrition.
Sustainable food systems for healthy diets
The role of food systems-the way food is produced, processed, distributed, marketed and prepared for human consumption-is crucial in the fight against malnutrition. Many of the recommendations adopted by ministers today focus on ensuring that food systems become more sustainable and promote diverse and healthy diets.
To this end, governments are encouraged to strengthen local food production and processing, especially by smallholder and family farmers, giving special attention to the empowerment of women.
While a food systems approach is important, complementary actions are also called for in other sectors. These include nutrition education and information, health system delivery of direct nutrition interventions (such as breastfeeding counseling and support, managing acute malnutrition in the community, and providing iron and folic acid supplements to women of reproductive age), and other health services to promote nutrition, water, sanitation and hygiene, food safety, social protection, international trade and investment.
Efforts directed at mothers, infants and children
Malnutrition hurts most in the earliest stages of life. Countries need, therefore, to direct special efforts towards addressing the nutritional needs of mothers before and during pregnancy, and of infants during the ‘first 1000 days' from conception to the age of two. A key part of this is promoting and supporting exclusive breastfeeding for six months, and continued breastfeeding until age two or beyond.
Governments are urged to educate and inform their citizens about healthier eating practices, and also to introduce social protection measures, such as school-feeding programs, to provide nutritious diets to the most vulnerable. Initiatives to combat obesity should be reinforced by the creation of healthy environments that also promote physical activity from a young age.
In order to provide universal access to healthy diets, governments should encourage a reduction in trans fats, saturated fats, sugars and salt in foods and drinks, and improve the nutrient content of foods through regulatory and voluntary instruments. The Rome Declaration also calls on governments to regulate the marketing of infant formula and to protect consumers, especially children, from marketing and publicity of unhealthy foods and drinks.
Today, there is a clearer understanding of the complex nature of malnutrition, and measures to address the multiple challenges are known. Global nutrition problems require global solutions, while nutrition deserves much greater attention on the international development agenda.
The ICN2 Framework for Action sets out the strategies, policies and programs that need to be implemented to “end hunger, achieve food security and improve nutrition” in line with the likely post-2015 UN development agenda.
World leaders vow to combat malnutrition