World Health Organization and the UN
The future of nutrition
Barrie Margetts writes: : The Association is now part of an informal alliance of public interest non-government organisations. Our purpose is to protect the interests of public health, including the prevention and control of chronic non-communicable diseases. We have been hard at work. My specific concern as Association president is that we give all the support we possibly can to protect the interests of nutrition, within the World Health Organization, and also other UN agencies and initiatives.
This work has been progressed in the context of the WHO World Health Assembly held in May. Our fellow members are five other international organisations: Consumers International, the International Association for the Study of Obesity (IASO), the World Cancer Research Fund International, the Global Alcohol Policy Alliance, and World Action on Salt and Health; and one UK organisation, the National Heart Forum.
Making our presence felt
In very difficult circumstances, there was much that was good about what happened at this year's World Health Assembly. Thus, the WHA resolution on maternal, infant and young child nutrition, which is attached here, specifies a series of vital safeguards and initiatives. Challenges remain, for instance on the perennial issue of engagement with the baby formula industry.
At the WHA, as reported last month by IASO president Philip James in his As I see it contribution, our alliance made a statement welcomed by many within WHO. Among other things this urged WHO 'to proceed immediately to develop global governance structures and comprehensive food policies which integrate the prevention of non-communicable diseases with the reduction of hunger and the promotion of nutrition security for all. We call on WHO to work with agencies including the Food and Agriculture Organization to support the call for sustainable food production and nutrition security'.
Now we have gone further. One of the tasks of the WHA this year was to agree a resolution on partnerships designed to improve the prospects of preventing and controlling chronic non-communicable diseases. This was part of the response of WHO member states to the Political Declaration of the UN high-level meeting held last September.
Part of our task is to watch WHO, and to advise and warn. One of our concerns, in our response to the resolution, is as follows. 'A unique characteristic of NCDs is that widely promoted consumer products including unhealthy foods, beverages, alcohol and tobacco are among the vectors of these diseases… There are clear conflicts for the corporations which contribute to and profit from the sales of alcohol, unhealthy foods and beverages and tobacco products, with significant externalities to society'. Our whole response is attached here. Other points made in our statement concern the ineffectiveness of voluntary industry agreements, so-called 'public-private partnerships', and the confusion between genuine civil society organisations and not-for profit organisations set up to protect the interests of conflicted industry.
We also state, citing a paper co-authored by Association member Boyd Swinburn, whose commentary on the role of government in preventing obesity is published this month in World Nutrition: 'The production, promotion and consumption of unhealthy foods and beverages, alcohol and tobacco continues to increase globally. The key drivers and conditions underpinning this trend are policies that promote consumption-based growth, and deregulatory approaches that promote market and trade liberalisation'.
WHO reform and nutrition
Just briefly now I want to touch on the very big issue of reform of WHO. There is a lot more to say on this topic. My specific concern here is whether the proposed new structures of WHO, contained in the document accessed here, will serve the needs of nutrition.
The restructuring proposes to locate nutrition within two departments. These concern non-communicable diseases, and the lifecourse. This makes sense. Nutrition is key to both. But in none of the documents I have seen is nutrition explicitly stated, and thus protected, let alone expanded. Will existing nutrition staff and roles be protected? What happens when nutrition staff leave? Will they be replaced by non-nutrition staff? And how well does the new structure support the crucial need to integrate policies and programmes on 'classic' malnutrition with those on chronic non-communicable diseases? How will it strengthen work on the relation between poor maternal and early child nutrition, and obesity, diabetes and other chronic diseases later in life?
Yes, it is our job to defend the interests of nutrition. Yes, this means we advocate that nutrition has a strong clear presence and voice within WHO, FAO, and UNICEF, and indeed all relevant UN agencies. And who would disagree?
A lot of my professional work is done in Africa and India, and now also in the Arab world. In asking these questions about official structures, in my mind's eye I am seeing the communities I work with. Will all these discussions and debates and reforms make any difference to the rural poor in India or Africa? Will their lives become any different if we make some progress to make the UN work better? What single thing could we do that would really make a difference to the lives of those worst off in society?
My colleague and Council member Urban Jonsson , a former head of nutrition at UNICEF, says that above all we must work to ensure and protect the human right to nutrition, most of all of impoverished populations, communities and families. Let's reflect on this broad vision and work towards it.