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«Jomo Kwame Sundaram Vikas Rawal Michael T. Clark Tulika Books Published by Food and Agriculture Organization of the United Nations (FAO) Viale delle ...»

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Today, a heated debate surrounds the role of alliances or partnerships with the private sector and other non-state actors in achieving development outcomes. In the area of nutrition, four issues stand out. First, how are these non-state actors to be made accountable to the host or beneficiary nations?

The current vogue is for promoting beneficiary country accountability to international actors – donors, CSOs and NGOs, and private sector entities – but not the other way round. Mutual accountability, the catchphrase of international political correctness, has little practical meaning in these contexts. Too often, the effort is to make the recipient country’s processes and expenditures fully transparent, but reporting by intentional actors, if it exists at all, to host governments is comparatively limited. In such circumstances, the international presence also works to undermine 110 Ending Malnutrition governmental authority and capacity by establishing institutions that operate parallel to local and even national governments, and compete with them for resources and talent.

Secondly, the question of how to engage with the private sector is particularly acute. Given the well-known history of interference in national and international regulatory bodies, there is a need for strong and credible protections against conflicts of interest, but few public–private partnerships take this responsibility seriously, and action on this front is usually limited to a memorandum of understanding without practical or legal effect, and with limited, if any, investment in monitoring and enforcement. In the context of the extreme asymmetries of power, information, and resources that exist between many developing countries and large multinational corporations, there is clear need for a neutral third party to help define – and monitor and enforce – the clear rules of the game. This is in the best interests of both the developing countries and the large corporate entities, who need help with setting the boundaries of acceptable behaviour where individuals from both the private and public sides too easily pursue private ends that undermine public policy and trust in public institutions.

A third area of contention surrounds the need for enabling developing countries’ governments to play a meaningful role in deciding what policy objectives and means of support should be prioritized. The private sector and non-state actors are less likely to offer what developing countries need if decisions are all made on the supply side; intergovernmental processes where donors and beneficiaries meet to assess needs offer the most balanced, if not always satisfying, forums for defining and matching needs and responses, developing appropriate policy guidance, and mobilizing financial and other means of implementation.

Finally, there is the matter of accountability. Developing countries complain that efforts to shift the discussion of development partnership from intergovernmental processes to public–private partnerships lead to much weaker forms of mutual accountability than the admittedly challenged multilateral processes. Intergovernmental forums, and the agreements produced in them, typically lead to institutionalized monitoring and reporting of follow-up actions, unlike pledges, memoranda of understanding, and other such transactions with non-state actors. Private sector investment pledges are seldom followed through, and there is, in any case, rarely any mechanism for follow-up tracking and reporting.

To address these issues, there are at least four important functions and roles that UN institutions are uniquely called on to play at regional and country levels, which cannot be played by other international actors either at all or as well: (1) developing – and monitoring and ensuring compliance with – intergovernmentally agreed norms, including voluntary guidelines and conflict of interest rules; (2) providing a critical but informed forum for discussion of key policy issues and development of internationally Governance 111 agreed guidance, enabling mutual learning, often through South–South cooperation; (3) providing global data standards to enable consistent and comparable monitoring of progress; and (4) serving as a neutral broker for information and expertise. The unique status of UN institutions in their accountability to the member-states is decisive for enabling the UN to fulfil each of these functions.

To be truly effective in enabling action by others, each of these functions must be performed so that they are trusted not only by host governments, but also by the vast array of international partners offering their own services and supports. But here lies a dilemma. For all UN institutions, establishing and maintaining an important ground presence requires reliance not only on the goodwill of host governments, but also on the support of public and, increasingly, private donors. To this extent, multilateral institutions inevitably find themselves in a competitive situation with the other actors whose nutrition actions they hope to regulate through moral suasion, and with one another. To this extent, they stand as one more donor supplicant in the highly competitive “aid industry”.

What can be done to preserve the integrity of multilateral institutions and ensure that their country-level presence is genuinely guided by the

interests of the host government? The answer is disarmingly simple:

ensure accountability through an intergovernmental process. In the end, this is what distinguishes true multilateral partnership from other forms of partnership based principally on like-mindedness, mutual interest or mere convenience. The reason that accountability to an intergovernmental process matters is that it is so far the only reliable guarantee for a developing country to ensure that it can freely decide, albeit in often complex and challenging circumstances, a course for itself. The outcomes of multilateral processes are full of compromises. But they are the most reasonable outcomes attainable for enabling countries to plot their own development pathways. Multilateral processes are time-consuming and difficult precisely because much is at stake, particularly for the developing countries. Put simply, it is in a multilateral system that developing countries have a real say and where they feel an obligation to comply with agreed commitments.

That is why the temptation to bypass such processes will possibly lead to occasional short-term successes, but also, more often than not, to general failure.

An effective system for governance of global nutrition action must be deeply rooted in the norms, member-state agreements, and institutional architecture of the UN system.

Appendix A ICN2: Rome Declaration on Nutrition Second International Conference on Nutrition Rome, 19–21 November 2014 Conference Outcome Document: Rome Declaration on Nutrition Welcoming the participation of Heads of State and Government and other highlevel guests,

1. We, Ministers and Representatives of the Members of the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO), assembled at the Second International Conference on Nutrition in Rome from 19 to 21 November 2014, jointly organized by FAO and WHO, to address the multiple challenges of malnutrition in all its forms and identify opportunities for tackling them in the next decades.

2. Reaffirming the commitments made at the first International Conference on Nutrition in 1992, and the World Food Summits in 1996 and 2002 and the World Summit on Food Security in 2009, as well as in relevant international targets and action plans, including the WHO 2025 Global Nutrition Targets and the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020.

3. Reaffirming the right of everyone to have access to safe, sufficient, and nutritious food, consistent with the right to adequate food and the fundamental right of everyone to be free from hunger consistent with the International Covenant on Economic, Social and Cultural Rights and other relevant United Nations instruments.

ICN2: Rome Declaration on Nutrition 113

Multiple challenges of malnutrition to inclusive and sustainable development and to health

4. Acknowledge that malnutrition, in all its forms, including undernutrition, micronutrient deficiencies, overweight and obesity, not only affects people’s health and wellbeing by impacting negatively on human physical and cognitive development, compromising the immune system, increasing susceptibility to communicable and noncommunicable diseases, restricting the attainment of human potential and reducing productivity, but also poses a high burden in the form of negative social and economic consequences to individuals, families, communities and States.

5. Recognize that the root causes of and factors leading to malnutrition

are complex and multidimensional:

a) poverty, underdevelopment and low socio-economic status are major contributors to malnutrition in both rural and urban areas;

b) the lack of access at all times to sufficient food, which is adequate both in quantity and quality which conforms with the beliefs, culture, traditions, dietary habits and preferences of individuals in accordance with national and international laws and obligations;

c) malnutrition is often aggravated by poor infant and young child feeding and care practices, poor sanitation and hygiene, lack of access to education, quality health systems and safe drinking water, foodborne infections and parasitic infestations, ingestion of harmful levels of contaminants due to unsafe food from production to consumption;

d) epidemics, such as of the Ebola virus disease, pose tremendous challenges to food security and nutrition.

6. Acknowledge that different forms of malnutrition co-exist within most countries; while dietary risk affects all socio-economic groups, large inequalities exist in nutritional status, exposure to risk and adequacy of dietary energy and nutrient intake, between and within countries.

7. Recognize that some socioeconomic and environmental changes can have an impact on dietary and physical activity patterns, leading to higher susceptibility to obesity and noncommunicable diseases through increasing sedentary lifestyles and consumption of food that is high in fat, especially saturated and trans-fats, sugars, and salt/sodium.

114 Ending Malnutrition

8. Recognize the need to address the impacts of climate change and other environmental factors on food security and nutrition, in particular on the quantity, quality and diversity of food produced, taking appropriate action to tackle negative effects.

9. Recognize that conflict and post conflict situations, humanitarian emergencies and protracted crises, including, inter alia, droughts, floods and desertification as well as pandemics, hinder food security and nutrition.

10. Acknowledge that current food systems are being increasingly challenged to provide adequate, safe, diversified and nutrient rich food for all that contribute to healthy diets due to, inter alia, constraints posed by resource scarcity and environmental degradation, as well as by unsustainable production and consumption patterns, food losses and waste, and unbalanced distribution.

11. Acknowledge that trade is a key element in achieving food security and nutrition and that trade policies are to be conducive to fostering food security and nutrition for all, through a fair and market-oriented world trade system, and reaffirm the need to refrain from unilateral measures not in accordance with international law, including the Charter of the United Nations, and which endanger food security and nutrition, as stated in the 1996 Rome Declaration.

12. Note with profound concern that, notwithstanding significant achievements in many countries, recent decades have seen modest and uneven progress in reducing malnutrition and estimated figures show


a) the prevalence of undernourishment has moderately declined, but absolute numbers remain unacceptably high with an estimated 805 million people suffering chronically from hunger in 2012–2014;

b) chronic malnutrition as measured by stunting has declined, but in 2013 still affected 161 million children under five years of age, while acute malnutrition (wasting) affected 51 million children under five years of age;

c) undernutrition was the main underlying cause of death in children under five, causing 45% of all child deaths in the world in 2013;

d) over two billion people suffer from micronutrient deficiencies, in particular vitamin A, iodine, iron and zinc, among others;

ICN2: Rome Declaration on Nutrition 115

e) overweight and obesity among both children and adults have been increasing rapidly in all regions, with 42 million children under five years of age affected by overweight in 2013 and over 500 million adults affected by obesity in 2010;

f) dietary risk factors, together with inadequate physical activity, account for almost 10% of the global burden of disease and disability.

A common vision for global action to end all forms of malnutrition

13. We reaffirm that:

a) the elimination of malnutrition in all its forms is an imperative for health, ethical, political, social and economic reasons, paying particular attention to the special needs of children, women, the elderly, persons with disabilities, other vulnerable groups as well as people in humanitarian emergencies;

b) nutrition policies should promote a diversified, balanced and healthy diet at all stages of life. In particular, special attention should be given to the first 1,000 days, from the start of pregnancy to two years of age, pregnant and lactating women, women of reproductive age, and adolescent girls, by promoting and supporting adequate care and feeding practices, including exclusive breast feeding during the first six months, and continued breastfeeding until two years of age and beyond with appropriate complementary feeding. Healthy diets should be fostered in preschools, schools, public institutions, at the workplace and at home, as well as healthy eating by families;

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