Access the pdf here
Access the pdf of The Association’s position on the
SCN here
Access the pdf of the June editorial on the SCN here
‘Do we have to go on reading about the Standing
Committee on Nutrition?’ asked an Association member
recently. Or even ‘Do we really need to know about
the SCN?’ Others have said more or less the same
things. Fair enough, for our editorial comments on
the SCN
started in June, and our website home news pages
have been and are covering the current SCN crisis in
substantial detail, last
month and this
month. Our answer is yes, please do go on
reading, and yes, we think you do need to know. Only
some of us in the profession have a special interest
in the SCN as an organisation. But all of us are
surely keenly interested in the vision and mission
of the United Nations family, of which the SCN is a
special part. This is illustrated by the picture
above, and the other pictures of happy children on
the cover of
World Nutrition
this month, and
within the
Association’s position paper on the nature and
purpose of the SCN that follows this editorial. With
all its shortcomings, mostly not of its own making,
the United Nations system continues to give hope for
the future of humanity and of the living and
physical world.
Within the UN system, the same is and should be true
of the SCN. This hope is we think well illustrated
by pictures of happy children, and above all,
children from impoverished places. These are within
Latin America and former USSR, also within countries
where average income is high, in many countries in
Asia, and throughout Africa, most of all south of
the Sahara.
Reggie
Annan, who comes from Ghana,
reminds us every
month of the good things that are happening in
sub-Saharan Africa.
Harmonisation
The SCN was founded in 1977, and so has been in
existence for over half the history of the United
Nations itself. Its core purpose has always been to
harmonise UN agencies’ policies and activities
concerning nutrition, and concerning food inasmuch
as these relate to nutrition. This is a hard task.
One reason is that there are 20 or so UN agencies
and entities whose work includes nutrition, all with
their own mandates and responsibilities, which may
clash. One example. The World Health Organization
(WHO), like national governments’ ministries of
health, broadly speaking works within a medical
model of health. By contrast the Food and
Agriculture Organization of the United Nations (FAO),
like national governments’ ministries of
agriculture, fisheries and food, is centrally
concerned with food systems, including production,
manufacture, distribution, sale and consumption.
These two agencies see nutrition through different
lenses.
A further consideration is that individual UN
agencies may have a number of internal departments
concerned with nutrition, but from different
viewpoint. Again one example. The UN Children’s Fund
(UNICEF) has been the lead UN agency championing
breastfeeding. But it is now increasingly taking a
lead in the distribution of vitamin supplements and
of ready to use therapeutic foods (RUTFs) to
impoverished children. These two approaches should
not clash. But increased focus on external nutrition
and food aid for young children may distract
national governments, international aid agencies,
local health professionals, and communities and
families themselves, from the need for exclusive and
continued breastfeeding.
Certainly the UN system needs a nutrition
harmonising body. Only the UN agencies can get their
own acts together, with appropriate expert and
informed advice. This is why it’s so often said ‘if
the SCN did not exist, it would be necessary to
invent it’. Certainly its members need to be senior
executives, with the authority to hammer our
policies some of which may not suit their own
agencies, for the general good.
Policy-making
The SCN has also always been concerned with
discussion, agreement and implementation of new or
revised nutrition policies, as well as with making
existing policies harmonious. An example is the use
of supplements of vitamin A not just to prevent or
treat deficiency states, but in particular as a way
to reduce general mortality in young children. As
readers will know, this policy has been vigorously
attacked (1) and then defended (2) in
World Nutrition
this year.
The current policy on vitamin A supplementation was
developed, in the late 1980s and early 1990s, in
part within the SCN, in partnership in particular
with UNICEF and WHO, and leading academics (3,4). In
more recent years discussion of nutrition policy
within the SCN has become diffuse. There are a
number of reasons for this. One has been an ‘open
door’ style of admitting what eventually turned out
to be large number of people from outside the UN
system, with variable qualifications and abilities,
into the SCN annual open sessions. The point here is
that the SCN has always been engaged in the
formation policies.
The crisis
Any reader of the Association’s website last and
this month will know that the SCN has been in crisis
for almost a decade now. The general decline of the
SCN’s authority emphatically does not indicate
failure of its recent senior and other staff; they
have proved their dedication in frustrating
circumstances, and continue to do so. (We declare an
interest: some of these are Association members). It
certainly does reflect the weakening of the UN
system by external forces notably since 2000. In an
obvious and basic sense, the SCN can only be as good
as the UN itself.
The resolution
Many Association members have been engaged with the
SCN for periods of its history, as senior UN
executives, UN advisors, SCN staff, members of
member state bilateral or civil society organisation
groups, and in other capacities. Collectively these
members of the Association have a deep knowledge of
the SCN and its place in the UN system. The
Association therefore responded to the request of a
number of its members, and also colleagues and
contacts inside and outside the UN system, to agree
our position on the SCN. This we have done. Our
position paper, agreed by our Council, mandated by
our membership in such matters, follows this
editorial.
We gave serious consideration to the option that the
SCN be abolished, and its work given to or subsumed
within another body that might be more competent.
This would be a mistake. The core function of
harmonisation of UN policies has to be carried out
by the UN agencies themselves. Many more UN agencies
should be engaged in this work, which should be
exclusively a UN responsibility. The UN senior
executives that meet together to harmonise policies,
are obviously free to invite advisors with observer
status, to support their work. This way of working
is similar to the original nature of the SCN from
its foundation and into the 1990s.
We decided that the harmonisation function and the
policy development and revision function are
separate, and should be separated. Here we do think
that senior UN executives need to work together with
people of equivalent status and experience from
other actor groups, including representatives of
member states, civil society organisations,
foundations, and industry, and also individual
independent experts. An outline of how this can best
work is contained in our position paper.
The place of industry
The role of industry, also known as ‘the private
sector’, is critical. So far the UN, in attempting
to formulate ‘public-private partnerships’, has
proved to be ignorant and incompetent, to the point
of stupidity. The UN is not alone in this, as this
month’s website home page news story on the pathetic
new UK nutrition policy
shows.
Discussion, agreement, action, monitoring, revision
and improvement of and on public policy of any type,
is possible only with the engagement of industry as
able, willing, and active partners. To give an
analogy relevant to public health and also to
nutrition, the reshaping of cities to make them safe
for walkers and cyclists, and to include secluded
areas for citizens and children, of course must
engage engineers, architects and developers as
partners. They know how to do the business.
But engagement with industry will not work in the
public interest if most of the people round the
table from industry are committed to private
interests that damage public goods, including public
health. So far in our field, the ‘private sector’
has in practice generally meant public relations
people from those sectors of the food, drink and
associated industries whose products, consumed in
typical quantities, damage personal and public
health. This is silly. The responsibility of the UN
system includes being intelligent and informed. This
includes engagement of industry, outside and also
inside the food, drink and associated industries,
prepared to be constructive. This implies thought,
research, understanding of how industry works, and
personal invitations to specific senior executives,
with pressure not to accept deputies.
The first engagement with industry needs to be with
those sectors with no commercial interest in public
health, or whose business may improve as a result of
improved public health. The second engagement needs
to be with sectors within the food, drink and
associated industries whose commercial interests do
not harm public health. Conflicted industries,
including food and drink manufacturers whose profits
depend on products which, consumed in typical or
feasible quantities, are damaging to personal or
public health, cannot be members of any process
designed to protect and improve health. Rational
discussion centres on whether they should be
excluded, or admitted as observers by personal
invitations to senior executives with powers to make
and change policy only. The Association has made the
second choice.
A brief explanation of our policy paper follows.
Our conclusions and recommendations
It is not possible rationally to defend the SCN in
its recent or present form, or in a form that would
amount only to adjustment. First, since its
foundation the SCN has been mainly concerned with
malnutrition in the ‘classic’ sense of
undernutrition, involving deficiencies of nutrients,
food insecurity, and at worst hunger and even
starvation. But now, other UN and other bodies and
initiatives have been set up to address these
issues. These include the intra-governmental
Committee on Food Security (CFS), the UN
Secretary-General’s High Level Task Force (HLTF),
the intra-UN agency REACH initiative, and the
multi-actor Global Action on Nutrition (GAP)
initiative, segueing into the Scaling Up Nutrition
(SUN) initiative.
These have been given impetus by the recent related
finance, fuel and food crises, which have increased
global inequity, poverty and misery. If the SCN
remained a separate body focused on undernutrition,
there would not be much left for it to do.
The gap left by these bodies and initiatives is
nutrition as a whole. This wider scope will justify
the permanent existence of the SCN, especially when
the UN agencies and other bodies are rightly focused
on specific issues such as food insecurity crises.
The scope of the SCN should address nutrition,
and food as this relates to nutrition, as a whole.
It should not be confined to undernutrition and its
prevention, control and relief. A substantial amount
of its work should therefore be strategic.
The SCN has two separate functions
Second, the SCN has two functions. One is to
harmonise the nutrition policies and programmes of
many UN agencies. The other function is deliberative
– in effect, to discuss issues that may take shape
as UN nutrition policies. These two functions have
been mixed together, notably in the SCN’s week-long
annual meetings. This has caused confusion.
Some UN executives have felt that it is not
appropriate for people outside the UN to be members
of meetings that discuss harmonisation of UN
policies. We agree.
The SCN has two separate functions, harmonisation
and deliberative. The harmonisation governing body
is UN business, and all its members, without
exception, should be senior UN officials. The
deliberative forum and its membership should be
multi-actor.
SCN members as representatives
Third, normal UN rules specify that people from
outside the UN who are eligible to participate in UN
meetings, do so not as individuals, but as
representatives, of relevant organisations or
entities.
By contrast, for the last ten years or so, members
of the SCN civil society group, and also some of the
bilateral (government) group, have participated in
SCN business and meetings as individuals, with no
real representative credentials. Anybody identifying
themselves as from civil society, and sometimes also
from a member state, has been able to turn up at SCN
meetings and say what they like.
This has been resented by some UN executives, who
feel that members, and observers, of the SCN process
should, as usual, be representatives, and identified
as such. Exceptions can be made in the case of
individual scholars. We agree.
The SCN should remain a UN body, controlled in
all its work by the UN, and dedicated to the UN
principles that uphold peace, justice, freedom and
human rights. All members of the SCN should be
representatives.
The line between non-conflicted and conflicted
industry
The future of the SCN has been debated for five
years and more. One sticking point has been its
relationship with ‘the private sector’. One change
proposed by critics of the SCN should not take
place. This is that representatives of conflicted
industry be admitted as full members of the SCN.
Members of the harmonising governing body of the SCN
should all be senior executives of relevant UN
agencies. Industry outside and also inside the food,
drink and allies sectors may participate in the
deliberative forum. Non-conflicted and conflicted
industry need to be distinguished, with a small
number of representatives of conflicted industry
invited as observers. It is essential that the UN
agencies make initial invitations, ensure that most
people from industry have no public health
conflicts, ensure that food industry members and
observers altogether represent food systems as a
whole, limit numbers, limit transnationals, control
balance, monitor developments, and accept only main
board executives and not public affairs people.
Similar discipline for the other constituencies is
appropriate
Industry outside and also inside the food, drink
and allied sectors should engage with the SCN’s
deliberative forum. Non-conflicted industry
representatives should be eligible to be members of
the forum. Some representatives from industries with
conflicted interests may be invited as observers.
Some of this editorial was posted as part of the
home page news stories in our November issue.
The editors
References
- West KP Jr, Klemm RDW, Sommer A. Vitamin
A saves lives. Sound
science, sound policy. [Commentary].
World Nutrition 2010; 1, 5:
211-229. Obtainable at:
www.wphna.org.
- Latham M. The great vitamin A fiasco.
[Commentary] World Nutrition May 2010, 1,
1: 12-45. Obtainable at
www.wphna.org.
- West KP Jr, Sommer A. Delivery of oral
doses of vitamin A deficiency and
nutritional blindness: A state of the art
review. SCN Nutrition policy discussion
paper no 2. Geneva: ACC/SCN, 1987. (online
at
http://www.unscn.org/layout/
modules/resources/files/ Policy paper_No
2.pdf).
- Beaton G, Martorell R. L’Abbe K,
Edmonston B, McCabe G, Rossi A, Harvey B.
Effectiveness of Vitamin A Supplementation
in the Control of Young Child Morbidity and
Mortality in Developing Countries.
Nutrition policy discussion paper no 13.
Geneva: ACC/SCN, 1993. (online at
http://www.unscn.org/layout/modules/resources/files/Policy
paper No_13.pdf)
Acknowledgements and request
Readers are invited please to respond. Please use
the response facility below. Readers may make use of
the material in this editorial, provided
acknowledgement is given to the Association, and WN
is cited.
Please cite as: Nourishing our future. [Editorial]
World Nutrition, December 2010, 1, 7:
286-292. Obtainable at www.wphna.org
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World Nutrition,
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