Access the pdf here
Access the pdf of the September editorial here

Last month the WN editorial asked ‘Conferences: What for?’ We are of course referring to conferences concerned with public health nutrition. That said though, some of what applies to our work, also applies to gatherings organised by shakers and movers from other professional disciplines.

This month’s editorial removes the question mark, and we make some assertions and proposals. What’s here is not a blueprint. That will come. Rather, it summarises some of the first agreements so far shared between the Association, and the Brazilian national public health organisation Abrasco, as jointly responsible for our next conference, Rio 2012. (The word ‘conference’ here refers to congresses, workshops, and other formal gatherings and events). The timing seems good. The Porto 2010 congress, with its 1,000+ delegates from over 50 countries, has just ended, amid general acclaim, and with the announcement of Rio 2012, to be held in ‘the marvellous city’ between 27-29 April 2012.

Are they broke?

A sensible saying is: ‘If it ain’t broke, don’t fix it’. Porto 2010 serves as a reminder that much of what has been achieved and sustained, ever since public health nutrition became a feature within general nutrition congresses – which it always has been, though initially not headlined – is remarkable and valuable. The organisers of Barcelona 2006 and Porto 2010, and above all other individuals, Association founder member Lluis Serra-Majem, have good reason to be proud of their work, first with the venue in Spain, then in Portugal.

It is now generally believed that UNESCO next month will announce that the Mediterranean Diet has been awarded the status of a World Heritage. If so, this will be a culmination of the extraordinary enterprise of hundreds of public health nutritionists based in the region, also notably Association founder member Antonia Trichopoulou and Anna Ferro-Luzzi, and others based elsewhere, notably Association founder member Walter Willett. Work like this – and there are many other examples – needs to be and is featured in nutrition congresses, which in this way act as rallying points and as times when energy and purpose dedicated to great enterprises are focused and renewed.

Also, as proved at Porto, public health nutrition as manifest in conferences is increasingly innovative. Just one outstanding example was the series of debates at Porto on urgent and important issues of real controversy, masterminded by Noel Solomons. These sessions included Michael Latham debating with Keith West on global vitamin A supplementation, Carlos Monteiro and John Lupien colliding on ultra-processed food, the duel between David Sanders and Mark Manary on ready to use therapeutic foods (RUTFs), Jaap Seidell taking a different view from Walter Willett on front-labelling, and Geoffrey Cannon and David Pelletier debating what is the right human size.

Issues like these need ventilation and continued debate, because getting the facts and the ideas right is crucial to public policy and practice, which impacts on population health and well-being. This editorial here, is followed by a commentary by Keith West, with colleagues Rolf Klemm and Alfred Sommer from the Johns Hopkins School of Public Health, upholding current vitamin A supplementation policy and practice. Next month’s WN commentary will develop Carlos Monteiro’s views on ultra-processing. Further commentaries with accompanying editorials on RUTFs, and on human size, are planned for publication in WN in coming months.

How they need fixing

So there’s plenty of which to be pleased and proud. That said though, yes, nutrition conferences, other meetings and events, do need fixing. One recurring criticism of nutrition conferences is of their relationship with that sector of the food, drink and associated industries whose policies and products are harmful to public health. We agree that this is a problem that needs solving. That said, we do not think that of itself, the exclusion of conflicted industry would make much of a difference for the better. Indeed, as said in last month’s editorial, most people who attend and participate in nutrition congresses probably enjoy and appreciate the industry presence as exhibitors, while also perhaps agreeing that covert industry infiltration into the actual programme of conference sessions is bad practice. And here is the main issue: the nature, structure and outcome of conference programmes.

It’s also sometimes said: ‘Those that can, do; those that can’t, criticise’. Accordingly, we also think that identifying problems with conferences is valuable only when this is followed by outlining solutions that are practical, feasible, appropriate and attractive.

Interactivity

Currently, most sessions at conferences consist of people identified as experts, talking at people identified as audience (or, to use that hideous word, ‘attendees’). This is plainly the case with plenary lectures. But it is also more or less the case with sessions called ‘symposium’ or ‘round table’. Despite these promising words, such sessions almost always are sequences of presentations, with little time left for interventions, which usually take the form merely of ‘Q&A’ in which the presenter gets the final say. Even ‘workshops’ are not particularly interactive, and indeed could not be, when scheduled as single sessions, maybe followed up by summaries.

We propose that most work in conferences needs to be interactive. One lead here is given by the cover of this month’s WN. This photograph records a moment not in a conventional conference, but during the four-day young leaders’ training and workshop held in a pousada (country inn) in the foothills of the mountains above Santiago, Chile, last November. Senior scientists dedicated to public health nutrition in Latin America, and the local convenors from Chile’s national school of nutrition, worked together all week with outstanding young scientists to develop their capacity. The occasion included presentations, but the chief focus always was interaction.

Another lead was given by the cover of last month’s WN. The picture was also taken in November last year, at the third International Cancer Control Congress, outside the villa in Cernobbio on Lake Como where the Italian movie director Luschino Visconti lived as a child. Again, the point made by the photograph is about ideas and interaction. The 50 people in the picture had just emerged invigorated, from a session in which presentations had been followed by vigorous exchanges of experience, ideas and opinions. The topic was how to shift the teaching and practice of cancer control, so that while medical approaches are preserved, the key focus will be on prevention in the public health sense – stopping cancer before it starts.

So that’s talking the talk. The Association, with our partners Abrasco, will also walk the walk, at Rio 2012 – our world public health nutrition congress to be held in Rio between 27-29 April 2012. Initial information about Rio 2012 is on our website for October 2010 (this issue). As also said in Association President Barrie Margetts’s letter in the same issue, interactivity at Rio 2012 will be reflected in the structure and nature of the programme, and also in its seating arrangements. There will be a place for podiums and lecterns, but the congress will very much be about people with shared training and vision coming together to reason together. The workshops to be held at Rio 2012 will extend through the three days at the congress. They will be pre-prepared, and will have a product – an agreed text to be put to the congress assembly for final revision, approval and publication. Even the formal plenary presentations will be followed by a substantial time reserved for genuinely interactive discussion and debate.

Structure

With no exception known to this editorial team, nutrition congresses do not have beginnings, other than ceremonials and opening ‘keynote’ plenaries, nor do they have endings, other than farewells and awards. They are all ‘middle’. True, they usually have some declared theme, such as ‘Towards Sustainable Nutrition Security For All: New Challenges, New Opportunities, New Commitment. A Vision For The Future’. (You may also see such mottos used by transnational food and drink corporations). True too, a number of sessions may be shaped to fit, and may feature speakers whose presentations tend to explain what a terrific job they are doing. But such professions are patches stuck on what actually are incoherent events.

There is a place in conferences for presentation of new research findings. But the Association and Abrasco agree that their main purpose, particularly in the times we live in now, is to move from knowledge, to agreements, and so in the direction of action, on specific pre-selected themes. One model for this thinking are the Bellagio Centre workshops held at the Rockefeller Serbelloni Center on Lake Como.

Rio 2012 will have a beginning and an end as well as a middle. It will have a concrete theme, to be elaborated into a set of objectives that will guide the programme. The conference will end with a series of agreed statements designed to be made the basis of rational policies and effective programmes. To this end, the conference will have a public aspect. Key electronic and print media journalists will be invited to participate and to report its proceedings.

Time

In the experience of this editorial team, the use of time within nutrition conferences is usually poor and sometimes abyssal. Speakers, whether solo plenary or members of sessions identified as symposiums or round-tables, are given licence to do their thing. More often than not, little or no real attempt is made to engage session chairs or convenors who are willing and able to control sessions. The result is that almost all sessions over-run, discussion is truncated into a few hurried questions and answers, and sometimes participants in following sessions can only hang about outside the room, feeling frustrated. Quite simply, this is disrespectful. .

The sessions of all types in Rio 2012 will be run professionally. All sessions will specify the amount of time for discussion, and that amount of time – often as much as that allocated for presentations – will be protected. Speakers will be asked to rehearse. They will be given support from the conference organisers, but if they over-run significantly they will be cut off. This is the only way to respect the themes they have been asked to present, and participants in the conference sessions, many of whom will already have given deep consideration to these themes in their own work.

Nature

The profession of nutrition has been built up gradually notably since the 1940s, a time when there were almost no university or research posts for scientists who professed to be nutritionists. This period has passed, and now it is public health nutrition academics who are preoccupied with the status of their profession. This sense of fragility has been reflected in the nature of conferences, including Porto 2010. The sub-text of many sessions is ‘please, public health nutrition is important’. Indeed so it is, but the time has come now to stop being defensive.

Rio 2012 will be a scientific congress, in the broad sense of the word, but not merely academic. Its general theme is ‘knowledge – policy – action’. This acknowledges the fact that much authentic knowledge does not derive just from conventional scientific investigation. Sessions in Rio 2102 will of course feature professed public health nutritionists. They will also feature participants for whom food and nutrition policy and practice are crucial, but who are not academically trained nutrition scientists. In Brazil, as in many countries, the move towards improved sustained population nutrition comes mostly from civil society organisations most of whose leaders are not academically trained nutritionists, and indeed who are not academics. They will feature in Rio 2012.

Commitment

Conferences proudly announce the presence of big-shots, who are usually influential academics. They accept invitations to give plenary presentations, and are cosseted in business class and five-star hotels. Too often they turn up on the day, do their thing, maybe answer a few questions, do some business with other big-shots at the conference, lurk for a while in the speakers’ preparation room, and the VIP suite if this is provided, and then shoot off, either on holiday in the vicinity, or back home, with smiles and mock apologies.

This will not happen at Rio 2012. As a rule, invited speakers, however eminent, will be asked to participate in the whole conference. They will have a number of tasks, as speakers whose presentations will be followed by interactive discussion, as members of workshops, as convenors of other sessions – and also as students. Rio 2012 will not have a podium mentality.

Will this be resented, by our most senior and busy colleagues? We think not. An interesting model pointed out by Brazilian colleagues, is the FLIP literary festival held every year in Paraty on the coast of the state of Rio de Janeiro. International stars of the European and North American literary world are delighted to be invited. One reason is the beautiful historic venue. But another reason is the sense of festival, with invited luminaries speaking at one session, sitting in on other sessions, and having informal discussions with participants. They love it! This quality, of reasoning together openly, is much needed in the profession of nutrition.

Senior members of the nutrition profession trained in a different age from now have much to learn, both from the South, and also from young professionals who have grown up in a world that has been transformed in the last two decade. One of the changes Rio 2012 is likely to take into account, in the choice of topics and speakers, is the steadily increasing influence in world affairs of great unaligned nations that have retained substantial resources. These include South Africa, India, China – and Brazil.

Sponsors

As mentioned above, we do not think that the main problem with conferences currently, is declared and explicit funding and support of conferences by those sectors of industry whose interests conflict with those of public health. It is an issue, though. A bigger issue is covert support, resulting in sessions and presentations that are the result of understandings between commercial sponsors and organising committees.

We believe that conferences do not need financial, material and other support from conflicted industry. We think that this is a myth. Indeed, the presence of such sponsors, particularly when they are transnational companies with mind-boggling corporate affairs budgets, will tend to drive away support from non-conflicted potential sponsors and supporters, especially when these are funded with public money. Conference organisers tend to accept sponsorships from transnational food and drink manufacturing companies simply because this is the usual thing to do. Deals are done between scientists inside and outside industry, whose roles may later reverse, and who know one another, shake hands, rub shoulders and hold elbows at industry events. The results are sponsorships – often, we are told, not for great sums of money – that enable deep penetration of conferences.

Rio 2012 is pledged to be funded solely from registration fees, and from non-conflicted sources. Sponsors will include government and its agencies at federal, state and municipal level. The conference is being held at the Federal University of the State of Rio de Janeiro which, fans can note, literally overlooks the fabulous Maracana football stadium. The Rector of UERJ has donated this space, and also many other facilities, including the services of relevant university departments such as those concerned with electronic distance interactive communication.

Sponsorship of Rio 2012 is also open to non-conflicted industry, such as banks, insurance, airlines, tourism. And what about sectors of the food production, manufacturing, distribution, retailing and catering industries whose products are generally agreed to be healthy? Decisions here are not yet taken. (Some of us with long memories will recall the innocent enthusiasm for sponsorships from the margarine industry). The whole process will be open. Details of sponsorship and other material support will be published. The committee responsible for the direction of the conference will publish its accounts.

Barrie Margett’s President’s letter published on the Association’s website in October 2010, at the same time as this WN editorial, concludes as follows. ‘Rio 2012 will be an occasion to clarify the nature of public health nutrition, and to transform its scope, relevance and influence as a major and crucial part of public health. All public health professionals are now confronted with issues as tremendous as those that faced the pioneers of the 19th century. United, we have it in our power to begin the world for which we have responsibility over again, always guided by principles of justice and equity’.

As a result of Rio 2012, nutrition conferences will enter a new age. That’s the commitment. Working together as a profession, we can achieve this.

The editors

Request and acknowledgement 

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: Anon. Conferences: What for. [Editorial] World Nutrition, October 2010, 1, 5: 204-210. Obtainable at www.wphna.org

The opinions expressed in all contributions to the website of the World Public Health Nutrition Association (the Association) including its journal World Nutrition, are those of their authors. They should not be taken to be the view or policy of the Association, or of any of its affiliated or associated bodies, unless this is explicitly stated.
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