SCN NEWS No 39 Late-2011 ISSN 1564 - 3743

SCN NEWS No 39 late-2011 ISSN 1564 - 3743

Nutrition and Business In this issue: Commentary How to engage? Feature papers on nutrition and business Research report Examples of Engagement Frameworks Programme News Speaker’s Corner Publications Bulletin Board

About SCN News SCN NEWS is a publication issued twice a year by the United Nations System Standing Committee on Nutrition. It provides information on issues of importance and sharing of experiences in the field of international nutrition. All manuscripts submitted for consideration are peer-reviewed, although publication is not guaranteed. Every effort is made to ascertain the validity of the information contained in UNSCN publications. Content accountability and responsibility for all articles belong to the individual authors, including accuracy of the references provided. The content of the SCN NEWS does not necessarily represent endorsement or an official position of the UNSCN or its constituencies. All links to websites and online information in this publication were accessed between May and December 2011, unless otherwise indicated.

To contribute to future issues of the SCN NEWS, to be added to or removed from our mailing list, please send an email to [email protected] or register to our mailing list.

Editorial team: Denise C Coitinho Delmuè, Lina Mahy and Sabrina Ionata. Copyright note: Readers are encouraged to review, summarize, reproduce or translate this document as a whole or in part, but please attribute to the UNSCN. CONTENTS CHAIR’S ROUND-UP ...... 3 EDITORIAL ...... 4 COMMENTARY ...... 6 Public-private engagement for diet and health: addressing the governance gap. By Corinna Hawkes & Kent Buse ...... 6 FEATURES ...... 11 The accountability of public-private partnerships with food, beverage and quick-serve restaurant companies to address global hunger and the double burden of malnutrition. By Vivica I. Kraak et al...... 11 The potential of public-private-civil society partnerships in humanitarian emergencies: an NGO perspective drawing from emergency programming in Port-au-Prince, Haiti. Hanna Mattinen & Julien Morel ...... 25 Hybrid public-private delivery of preventative lipid-based nutrient supplement products: key challenges, opportunities and players in an emerging product space. By Travis J. Lybbert ...... 32 Private-public partnerships drive one solution to vitamin and mineral deficiencies: “Fortify West Africa”. By Mawuli Sablah et al...... 40 Social marketing in public-private partnerships as a tool for scaling up nutrition: a case study from Tanzania. By Vir- ginie Claeyssens et al...... 45 Governments should govern, and corporations should follow the rules. By Mike Brady & Patti Rundall ...... 51 Food and beverage transnational corporations and nutrition policy . By Fabio S Gomes & Tim Lobstein ...... 57 RESEARCH REPORT ...... 66 A qualitative study of UNSCN Steering Committee and Working Group facilitators views on engagement with the private industry. By Breda Gavin ...... 66 EXAMPLES OF ENGAGEMENT FRAMEWORKS ...... 73 UNSCN private sector engagement policy ...... 73 IUNS private sector engagement policy ...... 78 SLMA Guidelines for health and nutrition related endorsement of branded commercial products by Professional Asso- ciations / Academic Bodies or any other association ...... 82 IBFAN’s funding policy ...... 84 IAP guidelines on conference organization ...... 85 OBITUARIES ...... 86 PROGRAMME NEWS ...... 88 SPEAKER’S CORNER ...... 95 Developing more effective UN-business partnerships By Melissa Powell ...... 95 The human right to adequate food: reflections on the engagement with the private sector. By Arne Oshaug ...... 98 PUBLICATIONS ...... 101 BULLETIN BOARD ...... 106 www.unscn.org Chair’s round-up 3 CHAIR’S ROUND-UP

Dear SCN News reader,

As the Chair of the UNSCN, a role I assumed on 1 October 2011, I am very pleased to interact with you through our SCN News publication during this exciting time for nutrition. Historic global momentum on nutrition today is galvanizing nations and hundreds of stakeholders around the world to commit to address child undernutrition. New partners and movements are emerging and existing ones are ensuring they are best prepared to support global efforts.

The UNSCN is responding to this dynamic new environment through a comprehensive reform process, initiated under the guidance of my predecessor, Alexander Müller - whom I sincerely thank for his leadership and commitment. The first stage of the reform process established an Executive Committee (ExCom), composed of very senior level officials from FAO, UNICEF, WFP and WHO, and including the UN Secre- tary-General Special Representative on Food Security and Nutrition as a “standing guest”. Guiding the overall UNSCN efforts, the ExCom is a proactive forum for policy development, decision-making and management, and has met several times. As a true fieldworker at heart, my vision for the UNSCN is to evolve into an agile United Nations Nutrition Network focused on:

 Supporting policy and strategic coherence in nutrition across the UN system;

 Ensuring the UN system provides clear and consistent technical guidance in nutrition at the global and country levels;

 Serving as a repository of knowledge/data in nutrition across the UN system.

We are entering a new era of cooperation with new stakeholders working closely with national governments to support better nutrition in effective and innovative ways. Given the immense burden of undernutrition, fostering strong partnerships that capitalize on the unique expertise and capacity of various stakeholders, including the business sector, is essential. Open and constructive dialogues can help pave new paths forward to establish acceptable and sustainable efforts. I am pleased that the UNSCN, through this publication, is looking at how stakeholders can engage the business sector to sustainably address malnutrition.

Looking forward, I am confident that - together - the UN system, national governments and its many important partners can help improve the well-being and nutritional status of millions of the world’s most vulnerable.

Best wishes,

Ramiro Lopes da Silva

UNSCN Chair

Ramiro Lopes da Silva, a Portuguese national, is Deputy Executive Director of the World Food Programme (WFP), and became the eleventh UNSCN Chair on 1 October 2011. Mr. Lopes da Silva began his career with WFP in 1985 as Food Aid Logistics Coordinator during the Great Horn of Africa and Sahel drought emergency. Since then, he has held senior management roles in operations in many countries, including Afghanistan, Angola, Ethiopia, Iraq, Pakistan and Sudan. He has held other senior positions in WFP including Director of Transport and Logistics, Special Envoy of the WFP Executive Director for the Afghanistan Crisis, Director of Emergencies and Deputy Chief Operating Office. In addition to his WFP responsibilities, Mr Lopes da Silva was the UN Assistant Secretary General and Humanitarian Coordinator for Iraq from 2002 to 2004, subsequently becoming in 2004, Senior Advisor to the United Nations Under-Secretary-General for Humanitarian Affairs.

back to contents SCN NEWS #39 4 Editorial www.unscn.org EDITORIAL The numbers of food and nutrition insecure in the world remain unacceptably high. The Food and Agriculture Organization of the United Nations’ estimate for 2010 persisted at 925 million people suffering from hunger. A key indicator of food and nutrition insecurity is stunting - when children fail to grow to their potential and are too short for their age compared to standards. The World Health Or- ganization (WHO) estimates that about 171 million children below the age of five were stunted in 2010. Moreover, 1.5 million children die annually due to wasting - perhaps the most severe acute manifestation of food and nutrition insecurity. At the other end of the spectrum of nutrition problems, overweight and obesity are increasing public health concerns worldwide, affecting people of all ages. As a con- sequence, rates of diabetes, cardiovascular disease and other diet-related conditions are escalating. While undernutrition, obesity and diet-related chronic diseases are often perceived as separate problems, they are closely linked and often rooted in poverty, coexisting in poor communities and at times even within the same household.

Ensuring food and nutrition security to all and realizing the human right to adequate food are moral imperatives, critical challenges and a converging interest and shared responsibility of multiple stakeholders.

High and volatile food prices, climate change and an increased frequency of extreme weather events, increased linkages between financial, energy and agricultural markets due to growing demand for biofuels and the growing and un- controlled financialization of food and agricultural commodities, urbanization, population growth: these are all major contributing factors to food and nutrition insecurity. Coupled with the incidence of disease, decreased household capacity of caring for their most vulnerable members, and food market environments where healthy choices are, recur- rently, not easily accessible and affordable, they can lead to an increase in the prevalence of stunting, wasting and of nutrition-related chronic diseases.

Global efforts to achieve the Millennium Development Goal (MDG) of reducing the proportion of people who suffer from hunger by half in 2015 (MDG1) are being challenged by these factors. But even if this MDG is to be achieved by 2015, some 600 million people in developing countries would still be suffering from hunger on a daily basis. These same people could be the ones also affected by chronic diseases that are on the rise. Much more needs to be done to sustainably achieve food and nutrition security, and it must be done now.

Private initiatives are part of the solution. Millions of farmers and rural entrepreneurs form the bulk of agricultural production and investments. Private businesses, of all sizes, constitute the food supply chain as it evolves from the farm to the fork. Additionally, some of these businesses create foods for special therapeutic uses that can be live-saving. Other private initiatives, from a large variety of industrial sectors create employment, generate income, produce a vast array of goods and services, and, in this way, are also critical to sustainable, long term food and nutrition security.

The United Nations (UN) Secretary-General Ban Ki-moon acknowledged the business community as an essential partner for reaching the MDG goals in his 2010 report for the General Assembly (Report A/64/665). Furthermore, in his report to the UN General Assembly in 2011 (Report A/66/320), he recognized that the relationship between the United Nations and the private sector has entered a phase of maturation and that transformational partnerships are a tool to help achieving development objectives. However, he called attention to the remaining challenges for the UN to more fully take advantage of collaborations with the private sector. He requested that more long term and strategic considerations are taken into account that include "further building up measures to protect the Organization's integrity, promote a culture of transparency and ensure alignment with the priorities set by Member States".

back to contents SCN NEWS #39 www.unscn.org Editorial 5 Nutrition and business interests are overlapping more and more. Businesses are increasingly including product and social innovation as well as sustainability into their core corporate strategies and supply chains. Business is also continuously reaching out to new consumers, including the urban and rural poor, exploring emerging markets and engaging with other nutrition stakeholders. While these overlaps create opportunities for cooperation and convergence of interests for achieving food and nutrition security, they also carry controversy, and sometimes cause heated debate, especially on transparency and accountability issues. There are cases of actual or perceived conflicts of interest that undermine such convergence and diminish trust, jeopardizing potentially fruitful initiatives.

Low- and middle-income countries, engaged in scaling up nutrition, request ideas and examples on how to work with the business sector in ways that assure convergence of interest and manage potential conflicts, minimizing risks and maximizing benefits. Specifically, they are keen to see answers to the following questions:

1. Are there opportunities for a positive engagement with the business sector to improve nutrition? In which in- stances are the agendas of the public and the private sector compatible?

2. Is it possible to achieve convergence of interest by managing conflicts and thus for opening up more opportunities for development? What are the unexplored potentials and gaps?

3. What are the innovative approaches for engaging with the business sector in nutrition that have high potential to sustainably improve livelihoods?

4. What kind of issues should be considered when entering into a partnership agreement with the business sector?

The UNSCN, in 2006, developed a Private Sector Engagement Policy that lays out a series of principles and mechanisms that can help to manage and minimize the possible risk of conflicting interests. This SCN News 39 follows up and aims at adding to this long overdue and necessary debate by offering space for interested authors to not only showcase examples of public-private engagement where interests converged and generated positive results but also examine and present their insights on the potential risks, challenges and opportunities that such engagement brings. We invite the interested reader of the SCN News 39 to engage in this balanced and constructive dialogue on nutrition-business cooperation in ways that contribute to our collective endeavours of ensuring food and nutrition security for all while serving the purposes and principles embodied in the Charter of the United Nations. Denise Costa Coitinho Delmuè

UNSCN Executive Secretary

on behalf of the editorial team

Denise C Coitinho Delmuè has been assigned to the UNSCN as Executive Secretary in May 2010. She has a diverse work experience in food security and nutrition having worked at country as well as global levels, in governmental policy and programming development and implementation as well as in the academic setting. As Director of Nutrition of the Ministry of Health of Brazil, her home country, she has developed, implemented and evaluated the Brazilian rights-based National Nutrition Policy and derived programming with measurable impact on child stunting reduction. At the international level, Dr. Coitinho held senior positions in UN agencies and worked as a consultant for International Financial Institutions and international nongovernmental organizations (NGOs). Dr. Coitinho worked as Director of the Nutrition for Health and Development Department of the World Health Organization based in Geneva and, successfully developed and was the first coordinator of REACH: Ending Child Hunger and Undernutrition Initiative, hosted by the World Food Programme in Rome. Dr. Coitinho has academic training in public health at the doctoral level and is also a researcher and senior lecturer in public health nutrition. At the University of Brasilia, she has conceptualized and implemented the first Food Security and Nutrition Policies Observatory of the American Region. In all positions held, Dr. Coitinho contributed to facilitate the dialogue and collaboration across partners, including from Governments, UN system agencies, NGOs and civil society organizations (CSOs) and has engaged productively with private sector partners to advance nutrition. back to contents SCN NEWS #39 6 Commentary www.unscn.org COMMENTARY PUBLIC-PRIVATE ENGAGEMENT FOR DIET AND HEALTH: ADDRESSING THE GOVERNANCE GAP Corinna Hawkes§, PhD, Fellow, Centre for Food Policy, City University, London Kent Buse, PhD, Senior Advisor, UNAIDS, Geneva

§ Corresponding author. Email: [email protected]

Author statement: The opinions expressed in this document do not necessarily reflect the views of the authors’ affiliated institutions. The authors confirm having no conflict of interest to declare.

THE GOVERNANCE GAP medical groups take funding, or oth- other healthy eating-oriented activi- erwise engage, with the food indus- ties such as food strategy develop- Engagement between the public and try. ment (Finland), fruit and vegetable private sectors in nutrition is pres- and wholegrain promotion ently a topic of hot debate. The arena How to address these controversies (Denmark), nutrition education cam- of healthy eating and non- and risks is highly contested. Listen- paigns (Czech Republic), education communicable diseases (NCD) is no ing to current discussions, it would activities (e.g., EPODE), food labelling exception – as the discussions leading appear that the options are limited to (Romania, the Nordic countries), and up to the 2011 UN High-Level Meet- either developing “partnerships,” or nutrition research (the United King- ing on NCD attest. Indeed, for all the issuing guidelines and conflict of in- dom). In the United States of America risks involved, engagement in some terest statements that appear to aim (USA), the “Healthy Weight Commit- shape or form with the food industry to prevent engagement from hap- ment Foundation” is an industry-led is necessary. After all, it provides the pening at all. Yet there is clearly more initiative that includes nutrition asso- food we eat. – and should be more – to the gov- ciations as partners. Elsewhere, ernance agenda. So how can the nu- Yet a governance gap exists in the Nestlé has formed a series of collabo- trition community better equip itself realm of healthy eating. There is no rations as part of its “Creating Shared to better govern such interaction? clear governance structure that en- Value” programme. These include the ables the World Health Organization “Nutrikid” partnership between the THE CURRENT “ENGAGEMENT” EN- (WHO) to engage effectively and effi- Swiss Society of Nutrition and Nestlé VIRONMENT ciently with the food industry in the Switzerland and Hungary, and area of diet and NCD – that is, for the The first (albeit rather basic) require- “Nutrir” in Brazil through which appropriate objectives, under the ment is to understand that engage- trained Nestlé volunteers promote right terms, and with the right gov- ment takes many different forms. For nutrition to schoolchildren through ernance structure. Local level profes- example, the European Technology games and play. The company also sionals and actors have nothing to Platform Food for Life is hosted by funds the magazine of the profes- follow but their common sense and food companies within a European sional nutrition association in Brazil. economic incentives (which may Commission (EC) framework, and At a global level, examples of formal clash) when faced with a request promotes the development of new engagements between the public and from a private company for collabo- and reformulated foods. The Euro- private sector in the area of nutrition ration. National governments often pean Union (EU) Platform on Diet, are few, particularly as compared want to engage with the food indus- Physical Activity and Health is, in con- with the numerous Global Health try when they think it can help trast, hosted by the EC and aims to Partnerships for infectious diseases achieve political, economic and/or encourage private sector commit- (Buse and Harmer 2009). Some global health goals – but engagement inevi- ments to address obesity. The Cana- advocacy bodies receive funding from tably creates unease among some dian government’s Sodium Working the food or pharmaceutical indus- stakeholders because of concerns Group involved representation from tries, such as the Oxford Health Alli- over real or perceived conflict of in- the public and private sectors on its ance, C3 Collaborating for Health, terest. In other cases, governments Steering Committee and drafted the and The NCD Alliance. The Healthy may want to regulate the industry – country’s recent sodium reduction Eating & Active Living Global Partner- but are swayed by lobbyists to leave strategy. In Europe, too, salt reduc- ship (HEAL), hosted by the Interna- well alone. Similar controversies rear tion strategies have involved public- tional Business Leaders Forum, has a their head when civil society and private sector engagement, as have back to contents SCN NEWS #39 www.unscn.org Commentary 7 range of supporting and partner or- and the private sector (others be- participate but decisions on setting ganizations, largely from the private tween civil society and the private agendas, allocating resources, over- sector but also the public sector, with sector cannot really be termed public seeing and evaluating activities etc. the aim of finding ways that busi- -private partnerships), some are are made by one sector or the other. nesses can be “part of the solution” funded by government, others by The former can be described as a to chronic diseases. In 2009, the In- industry, others jointly; some are “partnership” with the latter describ- ternational Union of Nutritional Sci- hosted by the state, others by indus- ing a looser form of collaboration ences (IUNS) announced a partner- try; some are led by public actors, (Buse and Harmer 2009; Hawkes and ship with Unilever which aims, among others by the food industry; some- Buse 2011). other things, through collaboration times a large transnational company In addition to these significant differ- with the food industry to “translate is involved, other times, a smaller ences between forms of engagement, nutritional recommendations into local business; some involve only in- there are differences in the kinds of food guidelines,” with a donation of stitutions of the state and the private activities they undertake. As shown in funds from Unilever to the IUNS. sector, while others include civil soci- Box 1, these activities include provid- ety as well. This commentary makes no claims to ing information, conducting joint re- assess these interactions as either One particularly important distinction search, increasing access to nutritious positive or negative as far as public is between interactions which are foods and dialogue to develop strate- health is concerned – all these initia- governed by a body with representa- gic responses to nutritional problems. tives have their advocates and (often tives from both sectors, and those These activities require different fierce) critics. Rather, our concern is which are not. In the former, deci- skills, functions and resources – im- to reveal that engagement can take sions about steering and governing plying differences in who should be many forms. While all engagements the initiative are shared between the involved and how. involve participants from the state sectors; in the latter, both sectors

Box 1. Core activities of public-private healthy eating initiatives

1. Health promotion and communication campaigns (e.g., information leaflets and posters) 2. Diet and nutrition education in formal and informal learning venues (e.g., building cooking skills) 3. Communicating information on food products (e.g., nutrition labelling, and “healthy food” logos ) 4. Controlling advertising and marketing of food products (e.g., through advertising codes on marketing) 5. Increasing or decreasing access to food products (e.g., fruits, vegetables, vending ma- chines) 6. Conducting or supporting research (e.g., on development of novel foods) 7. Developing or reformulating food products (e.g., reducing salt) 8. Developing recommendations, guidelines, advice and strategies for governments and industry (e.g., government forum that includes the food industry) 9. Encouraging private sector action in general, such as providing a forum for commitments (e.g., “Platforms”) 10. Funding for above activities connected to healthy eating

Public-private engagement thus in- person’s idea of “engagement” is a should be developed in the first involves different forms of engagement food company providing education stance, and if so, how to govern such as well as differing types of activities. kits in schools and another’s is a re- interactions. Different perspectives This goes some way to explain why search collaboration, it is not surpris- may also be expected between those there are such differing perspectives ing that they may hold different with experience of a formally gov- on public-private engagement: if one views on whether these interactions erned partnership with shared deci-

back to contents SCN NEWS #39 8 Commentary www.unscn.org sion-making, those with experience around the world have allocated the see an urgent need to improve the of engagement that involves funding role of producing, distributing and governance of relations between the alone, and those for whom providing food—as a product essen- food (and pharma) industry and in- “engagement” just means a formally tial for public life and health and a ternational agencies, institutions of agreed place to hold a conversation. means of generating economic activ- the state and civil society in the area ity—to the private sector. Yet this is of diet and NCD. The emphasis to As such, figuring out how to address profoundly different to the state’s date on “partnerships” versus the governance gap should not just role of managing the economy, and “conflict of interest” has muddied the be a discussion about setting up and the responsibility of protecting its waters. What is required is a serious governing “partnerships,” but about citizens, including their health. The discussion of governance more where engagement is needed to second source of risk arises from the broadly and the development of meet objectives (which it may not fact that sectors of the food industry pragmatic mechanisms and meas- always be), and if so, what type of produce and market goods that are ures. Such mechanisms would facili- governance structure is needed to undesirable from a dietary perspec- tate engagement where needed, meet the objectives and undertake tive (such as foods that are high in while recognizing that different inter- the activities involved. This process calories but low in nutrients). This is ests are at stake and need to be met inherently requires some analysis and not the case with the entire sector, if sustained engagement is to be discussion on the potential risks in- the fruit and vegetable industry being achieved. They would also acknowl- volved. the notable example. But even here, edge that different interests mean fresh produce can be transformed that there are circumstances where THE POTENTIAL RISKS OF ENGAGE- and incorporated into high-calorie engagement is not appropriate. MENT food products. Arriving at such mechanisms should Engagement between the public and There are ways to mitigate and man- involve, among other actions, a private sectors inevitably involves age these risks. While statements global process to identify where en- risks – for both sectors. As detailed in about conflicts of interest and gagement with industry would help Box 2, engagement may deflect the “guidelines for engagement” seem achieve defined public health objec- public policy agenda, act to facilitate the most obvious, along with screen- tives faster and more effectively, and negative health outcomes of private ing corporate participants for entry the appropriate governance struc- sector activities, create tensions be- into collaboration, much more funda- tures needed at different scales (not tween public health actors who mental is to design a governance forgetting that different approaches should be collaborating to advance structure that in itself takes account may be needed between the large the healthy eating agenda, damage of and addresses the risks involved. transnationals and smaller local com- the legitimacy of institutions of the So, for example, for some public panies). To do so, the World Health state, and create transaction costs health objectives and activities, the Organization (WHO) should host which may outweigh any public risk profile may be such that the de- some form of expert consultation health benefits. For the private sec- velopment of a formal “partnership” process, in which a broad range of tor, the potential risks take a similar is preferable, with a governance expertise and experience is brought form: negative outcomes for their structure characterized by shared together to think through and make core business; no guarantee that ac- decision-making, accompanied by recommendations on what will work tions by the public sector counter to guidelines for engagement, not least best – at the global, regional, national their core business interests will on conflict of interest. In others, and local levels. More specifically, cease; divisions and tensions within though, the risks – and objectives and the consultation could address the and between companies; and loss of activities – may mean a partnership is legitimacy in the eyes of sharehold- following issues: ill-advised, and a looser, albeit for- ers. mal, form of engagement is required. 1. Clarify why engagement is needed The risks stem from two basic In other cases, there should be no – for what reason, and with what sources. First, the functions of the engagement at all. In all cases, an objectives, would different bodies public and private sectors are funda- honest assessment of the interests need or want to engage with the pri- mentally different. The responsibility involved – for both the private and vate sector. of the private sector is to generate public sectors – must be made. 2. Review evidence of public health profits for its owners and sharehold- impact of different forms of interac- ers. This does not mean that the pri- THE WAY FORWARD tions and of different types of activi- vate sector does not have a public Given rising levels of obesity and non- ties. function: practically all governments communicable diseases (NCD), we

back to contents SCN NEWS #39 www.unscn.org Commentary 9

Box 2. Risks arising from engagement between the public and private sectors in the area of healthy eating and NCD

Risks for the public sector

1) Engagement deflects the public sector from taking potentially effective actions to encourage healthy eating that are against the core business interests of the private sector participants, such as:

 the focus of action is on areas where interests merge rather than on other measures, thus shifting policy agenda away from areas of needed action

 the public sector internally self-censors itself in order not to compromise the engagement

 a culture of the “necessity” of engagement emerges, so leading the public sector to lose sight of the possibility that institutions of the state can take more effective actions in the absence of engagement

2) No guarantee that engagement will stop private industry from engaging in activities counter to public health, with the risk that the engagement will act to further these negative activities, such as:

 engagement becomes a public relations tool for companies that produce products or take actions counter to public health goals as part of their core business, thus facilitating the continuance of these core business activities

 engagement with a single company makes them appear “better” than other companies even though they also produce products or take actions counter to public health goals

3) Engagement, or the potential for engagement, leads to tensions within public bodies, between public bodies, and/or with civil society groups owing to differing perspectives on engagement, so weakening collaboration between bodies with otherwise similar objectives.

4) Loss of legitimacy in the eyes of the general public/media due to perceived cooptation by the private sector .

Risks for the private sector

1) Engagement could lead to negative outcomes on core business interests, such as:

 the outcome of the engagement is reduced sales of core products

 there is pressure to extend the objective/ activities of the engagement beyond the original mandate

 an outcome is a less favourable competitive environment (in the case of sector-wide engagement)

 the costs exceed the benefits

2) No guarantee that engagement will prevent public action counter to private sector interests.

3) Engagement leads to divisions within companies (for example, if departments responsible for reputation management and marketing department disagree about the benefits of engagement) or between them (such as when engagement is with trade groups with members with different perspectives and interests).

4) Loss of legitimacy in the eyes of shareholders if the engagement fails, or if it is perceived as admittance that the company is part of the problem.

back to contents SCN NEWS #39 10 Commentary www.unscn.org 3. Assess the risks posed by interac- any such governance structure itself). ance of public-private sector engage- tions, and review risk mitigation and To do so, the WHO needs a mandate ment? No. On the contrary, we need management approaches and their and a Member State, or group of to start this process. Now. effectiveness. Member States, to provide the References needed resources. It does not need 4. Identify areas to unlock the poten- to be a costly process, but it does Buse K, Harmer A (2009) Global Health tial for further/future engagement on need to be a thorough and thoughtful Partnerships: the mosh pit of global healthy eating and NCD, and areas one, informed by evidence, a review health governance. In: Buse K, Hein W, not amenable to engagement given Drager N (eds.). Making Sense of Global of different possible structures etc., the inability to mitigate risks. Health Governance – A policy perspec- and conducted in full consultation tive. London: Palgrave. 245-267. 5. Propose guidance for interaction at with the private sector. all levels. Hawkes C, Buse K (2011) Public health So, do we need to be cautious about sector and food industry interaction: it's The WHO should host the process in rushing to a “partnership” solution? time to clarify the term 'partnership' and order to ensure it is legitimate, ac- Yes. Do we need to be cautious about be honest about underlying interests. countable and transparent (without a process that places partnerships in European Journal of Public Health 21 in any way implying a priori that the their wider context and provides the (4):400-1. WHO should take a leadership role in framework for more effective govern-

Hosted on the UNSCN website www.unscn.org IASC Global Nutrition Cluster Harmonized Training Package (HTP)

HTP hosted on the UNSCN website The UNSCN website hosts the Harmonized Training Package (HTP) developed under the Global Nutrition Cluster umbrella. The HTP is a unique international training resource and technical reference document bringing together the latest information on Nutrition in Emergencies (NiE). It is increasingly being used by different agencies and institutions in many different countries and in different contexts. The HTP version 2.0 is now fully available. The website allows you to download all modules in either WORD or PDF format. What is the HTP? The HTP is not a ready-to-use training course. It cannot be used as an 'off the shelf' package. Rather it should be used by experienced trainers as a package of materials during the process of developing a training course. The HTP focuses on key nutrition areas in emergencies and protracted crisis situations. Its content is divided into 4 sections: Introduction and concepts (5 modules), Nutrition needs assessment and analysis (5 modules), Interventions to prevent and treat malnutrition (9 modules) and Monitoring, evaluation and accountability (2 modules). The HTP is a unique resource, comprised of 21 modules. Each module contains five parts: i) acknowledgements, ii) a Fact Sheet providing an overview of the module’s topic, iii) Technical Notes for trainers and trainees that provide guidance on current practice, iv) a Trainer’s Guide to help trainers develop a training course, and v) a Resources Document which lists relevant available resources. Nutrition in Emergency Repository Also on the UNSCN website, you will find the Nutrition in Emergency Repository which is a special sub-section of the SCN Food & Nutrition Resource Portal. It contains all relevant key documents referred to in the HTP modules and many more relevant resources and links. Who developed the HTP? The need for the HTP was identified in 2006 by the Global Nutrition Cluster. HTP Version 1 was coordinated and developed by NutritionWorks in 2008 on the basis of a wide-ranging stakeholder consultation, in collaboration with cluster member agencies, individuals and academic experts. The Version 1.0 was funded through the Global Nutrition Cluster. Cluster members decided to periodically update the HTP modules in order to keep abreast with technical developments. The 2011 HTP Version 2 update was undertaken in an Emergency Nutrition Network and NutritionWorks collaboration using the same editorial process and stakeholder involvement. HTP Version 2.0 was funded by the US Of- fice for Disaster Assistance to the ENN. Each module has been written by one expert author and reviewed by at least two other experts in the subject area. The authors and reviewers are from academic institutions, United Nations and nongovernmental organizations and expert consultants. Authors and reviewers of versions 1 and 2 are acknowledged at the beginning of each module.

back to contents SCN NEWS #39 www.unscn.org Features 11 THE ACCOUNTABILITY OF PUBLIC-PRIVATE PARTNERSHIPS WITH FOOD, BEVERAGE AND QUICK-SERVE RES- TAURANT COMPANIES TO ADDRESS GLOBAL HUNGER AND THE DOUBLE BURDEN OF MALNUTRITION Vivica I. Kraak, MS, RD,1§, Boyd Swinburn, MB ChB, MD, FRACP,2 Mark Lawrence, PhD3 and Paul Harrison, PhD4 1 Research Fellow, WHO Collaborating Centre for Obesity Prevention, and PhD Candidate, Deakin Population Health Strategic Re- search Centre, School of Health and Social Development, Deakin University, Australia; 2 Alfred Deakin Professor and Director, WHO Collaborating Centre for Obesity Prevention, Deakin Population Health Strategic Research Centre, Deakin University, Australia; 3 Associate Professor of Public Health Nutrition, WHO Collaborating Centre for Obesity Prevention, Deakin Population Health Strate- gic Research Centre, School of Exercise and Nutrition Sciences, Deakin University, Australia; 4 Senior Lecturer of Marketing, Deakin Graduate School of Business, Deakin University, Australia. §Corresponding author. Email: [email protected] Author statement: The authors confirm having no conflict of interest to declare.

INTRODUCTION tional and regional levels, or world- trust. Partnerships may be fraught wide (World Health Organization with controversy and ideological In recent decades, transformative [WHO] 2008b). Three rationales sup- landmines. Partners may share differ- systems change has been a goal for port pursuing strategic alliances and ent goals, values and understanding diverse groups tackling the most ur- partnerships: to address unmet of problems that lead to disagree- gent public health nutrition chal- needs, to focus on specific under- ments and devaluing others’ pre- lenges affecting billions of people resourced priorities, and to create ferred strategies to address chal- worldwide. Systems change is sought synergy that adds value to target nu- lenges (Austin 2000; Fawcett et al. through new governance structures, trition and health goals (McLachlan 2010). An incompatible and poorly innovative business models and par- and Garrett 2008; WHO 2008b; executed partnership can damage ticipatory approaches that foster Working Group on Global Health public trust, credibility and all part- meaningful public and private sector Partnerships 2005). ners’ brand reputations. Despite stakeholder engagement and action these challenges, diverse groups are (Institute of Medicine 2009; McLach- Strategic alliances and PPP are used engaging in partnerships to improve lan and Garrett 2008; Morris et al. to address emergencies, natural dis- people’s diet quality and nutrition- 2008; Traitler, Watzke and Saguy asters and build disaster resilience related behaviours and health out- 2011; WHO 2004, 2008a). (National Research Council 2010; comes in countries worldwide. Thomas and Fritz 2006); to alleviate Multisectoral collaborations, coali- poverty and mitigate global hunger tions, strategic alliances and public- PURPOSE OF THIS PAPER and food insecurity (Agree 2011; private partnerships (PPP)1 are IBRD/The World Bank 2011; United This paper examines the partner- mechanisms through which stake- Nations [UN] 2009; US Agency for ships, alliances and interactions of 15 holders are pursuing systems change International Development [USAID] transnational food, beverage and fast to address a range of nutrition needs 2 2011); to tackle undernutrition and food or quick-serve restaurant throughout the life course. This ap- micronutrient deficiencies (GAIN (FBQSR) companies with UN System proach entails replacing the “one is- 2009, 2010; Yach et al. 2010b); and to organizations, government agencies sue, one business, and one non- promote healthy lifestyles to prevent and NGOs to address global nutrition governmental organization (NGO) and manage obesity and lifestyle- challenges. These issues have gener- paradigm” with new models that en- related, chronic noncommunicable ated intense controversy, especially courage stakeholders to interact in diseases (NCD) (Hancock, Kingo and in preparation for the United Nations different ways (Global Alliance for Raynaud 2011; Kraak and Story 2010; (UN) Millennium Summit on Prevent- Improved Nutrition [GAIN] 2010). No Sridhar, Morrison and Piot 2011; Yach ing NCD in September 2011 (Cohen single entity has sufficient funding, et al. 2010b). 2011; Lincoln et al. 2011). resources, influence, expertise or reach to tackle the complex nutrition Effective collaboration is difficult, A range of contentious issues have challenges in communities, at na- takes time and involves building been raised, including: power imbal-

1 There are many definitions for a public-private interaction or public-private partnership (PPP). In this paper, a PPP is defined as collaboration between public and private sector actors within diverse arrangements that vary according to participants, legal status, governance, management, policy-setting, contributions and operational roles to achieve specific goals and outcomes (WHO 2011b). 2Fast food represents food, beverages and meals designed for ready availability, use or consumption and sold at eating establish- ments for consumption on the premises or take-out. In this paper, quick-serve restaurant (QSR) companies is the term used because it is used by the restaurant industry sector to describe a specific category of chain restaurants where fast food is sold and consumed, as opposed to full-serve restaurants or catering businesses.

back to contents SCN NEWS #39 12 Features www.unscn.org ances among partners, ineffective partnerships involving transnational that co-branded activities support management of inherent conflicts of FBQSR companies. These examples healthy products and healthy eating interest, failure to establish strong are just a snapshot of existing part- environments, comply with ethical safeguards to protect public health nerships as many of these stake- codes of conduct, undertake due dili- goals from being co-opted by com- holders are engaged in an array of gence to assess partnership compati- mercial interests, inappropriate co- single-agency partnerships and com- bility, and monitor and evaluate part- sponsorship and co-branding ar- plex multi-partner arrangements. nership outcomes. rangements involving unhealthy food We recommend that prospective and beverage products, and a lack of GLOBAL HUNGER AND THE DOUBLE partners use a benefit–risk decision- clear boundaries between public- BURDEN OF MALNUTRITION making pathway tool (see Figure 1) interest NGOs (PINGO) and business- 3 and an accountability lens before Global public health nutrition issues interest NGOs (BINGO) (Brownell and engaging with transnational FBQSR are situated on a continuum of con- Warner 2009; Buse and Harmer 2007; companies to address global nutrition cern. Chronic hunger and food inse- Freedhoff and Hébert 2011; Gilmore, challenges. Accountability means that curity affect an estimated 925 million Savell and Collin 2010; Koplan and some stakeholders have the right to people in low- and middle-income Brownell 2010; Kraak et al. 2011; Lin- hold other stakeholders to a set of countries (LMIC) (FAO 2010). Inade- coln et al. 2011; Ludwig and Nestle performance standards; to evaluate quate food and poor-quality diets 2008; Monteiro, Gomes and Cannon whether they have accomplished contribute to undernutrition and mi- 2010; Oshaug 2009; Richter 2004). their responsibility in meeting these cronutrient deficiencies causing These issues have been extensively standards; and to impose penalties, nearly 8 million child deaths under documented for tobacco, pharma- restrictions or sanctions if they do five years and leading to child and ceutical and infant formula compa- not accomplish these standards adult morbidity (Black et al. 2008; nies (Brownell and Warner 2009; (Grant and Keohane 2005). Two di- Micronutrient Initiative 2009; UNICEF Richter 2004). However, there are mensions of accountability should be 2009). At the other end of the nutri- limited evaluations of PPP involving considered: answerability, involving tion spectrum, poor-quality diets and UN organizations, government agen- organizations and FBQSR companies sedentary lifestyles cause overweight cies, NGOs and global FBQSR compa- that seek to provide an account of and obesity among an estimated 43 nies to address a spectrum of nutri- their decisions and actions to rele- million preschoolers under five years tion-related issues including global vant stakeholders; and enforceabil- (de Onis et al. 2010), 155 to 200 mil- hunger, food insecurity, and the dou- ity, involving government regulation lion schoolaged children (Wang and ble burden of malnutrition (DBM) — or industry self-regulatory mecha- Lobstein 2006), and 1.5 billion adult undernutrition, overweight and obe- nisms to ensure corporate compli- men and women worldwide sity, and lifestyle-related NCD. Global ance with international and national (Finucane et al. 2011). Lifestyle- FBQSR companies want to be recog- laws, established standards, and le- related NCD represent two thirds of nized as legitimate partners who gally binding or voluntary codes of the 57 million global deaths, of which bring unique skills, assets and re- conduct (Newell 2008; Partnership nearly 80% occur in LMIC (Beaglehole sources to address global nutrition Governance and Accountability Initia- et al. 2011; WHO 2011a). tive [PGAI] 2011). challenges, and have requested Further complicating matters are the “clear guidelines that articulate the We describe a six-step benefit–risk intergenerational nature (Delisle domains within which partnerships decision-making pathway tool to 2008; James 2005) and global mani- are appropriate, effective and to be guide partnership engagement deci- festation of the DBM — the co- encouraged” (Mensah, Yach and sions to assess opportunities, com- existence of maternal and child un- Khan 2011). patibilities, and benefits versus risks; dernutrition (i.e. wasting, stunting We describe the scope of global hun- develop objectives and outcomes; and underweight) and micronutrient ger, food insecurity and the DBM be- execute a formal agreement with in- deficiencies (i.e. iron, vitamin A, io- fore examining the resources needed put from legal counsel; and ensure dine and zinc) with child or adult and available (through private sector monitoring, evaluation and account- overweight, obesity and NCD in initiatives, interactions and partner- ability. We suggest that all partners households, communities, and ships) to help governments, UN sys- adopt systematic and transparent among vulnerable populations within tem organizations and NGOs address accountability processes to balance and between countries (FAO 2006; these global nutrition challenges. We private commercial interests with Prentice 2006; Uauy et al. 2008). The discuss the role of the private sector public health interests, manage con- UN System Standing Committee on and examine selected examples of flicts of interest and biases, ensure Nutrition (UNSCN) acknowledged the 3 Accountability is a concept linked to institutional performance and is a driver of governance. Accountability influences why decisions are made and governance influences how decisions are made (PGAI 2011). back to contents SCN NEWS #39 www.unscn.org Features 13

Key Messages

 Multisectoral collaborations, coalitions, strategic alliances and public-private partnerships (PPP) are mechanisms through which stakeholders are pursuing systems change to address a range of nutrition needs throughout the life course.

 PPP take place within a context of governments being publicly accountable for protecting and promoting the nutritional health of their citizens. Since the 1980s, governments have increasingly relied on market-driven solutions to address public health nutrition challenges. The UN System has reinforced this trend by emphasizing private sector engagement through partnerships.

 We examine the alliances, partnerships and interactions of 15 transnational food, beverage and quick -serve restaurant (FBQSR) companies with UN System organizations, governments and nongovernmental organizations (NGOs) to address global nutrition challenges. PPP with global FBQSR companies have raised several contentious issues, including: power imbalances among partners, ineffective management of inherent conflicts of interest, and failure to establish strong safeguards to protect public health goals from being co-opted by commercial interests.

 We examine the signatory status of 15 global FBQSR companies to the UN Global Compact. Seven companies (i.e. Cargill, Danone, General Mills, Nestlé, PepsiCo, The Coca-Cola Company and Unile- ver) are signatories; eight companies (i.e. Burger King, Heinz, Kellogg Company, Mars Inc., McDon- ald’s Corporation, The Hershey Company and Yum! Brands) are not signatories; and although Kraft Foods Mexico was a signatory, it was expelled in 2011 for not communicating progress.

 The UN Global Compact should be amended to contain clear principles that support nutrition, consumer health and wellness. Global FBQSR companies should be held accountable for the products they manufacture and market, as well as their collective policies and actions to prevent and mitigate undernutrition, obesity and the projected noncommunicable diseases (NCD) burden among populations worldwide.

 Prospective partners should use a benefit–risk decision-making pathway tool and an accountability lens before engaging with transnational FBQSR companies to address global nutrition challenges.

 All partners should adopt systematic and transparent accountability processes to balance private commercial interests with public health interests, manage conflicts of interest and biases, ensure that co-branded activities support healthy products and healthy eating environments, comply with ethical codes of conduct, assess partnership compatibility, and monitor and evaluate partnership outcomes. importance of addressing the DBM in ity actions to reduce the risks of obe- dollars through global alliances to a special 2006 issue (UNSCN 2006) sity and NCD (Beaglehole et al. 2011). develop new food and agricultural and more recently in the Sixth Report Coalitions, multisectoral alliances and policies (Agree 2011); to use PPP to on the World Nutrition Situation PPP are a potential way to raise and mitigate global poverty, hunger and 2010 (UNSCN 2010a). administer funds to address global food insecurity targeted by the Mil- hunger and components of the global lennium Development Goals (MDG) Resources needed to address global DBM (GAIN 2009; Sridhar, Morrison (IBRD/The World Bank 2011; UN public health nutrition challenges and Piot 2011). Transnational FBQSR 2009); and also to support comple- companies (see Table 1) and certain mentary initiatives such as the US An estimated US$ 20 billion dollars corporate foundations participate in Government’s Feed the Future annually is required to tackle the several global alliances, coalitions (USAID 2011; US Government 2011). global DBM, which includes US$ 10 to and partnerships to address global Resources have been pledged 12 billion to scale up 13 proven nutri- nutrition challenges (Kraak et al. through the Global Alliance for Im- tion interventions in 36 priority coun- 2011). proved Nutrition (GAIN) to address tries to prevent and treat undernutri- micronutrient deficiencies (GAIN Governments, businesses and private tion (UNSCN 2010b) and at least 2009). Both Feed the Future and GAIN US$ 9 billion to implement five prior- foundations have pledged billions of back to contents SCN NEWS #39 14 Features www.unscn.org partner with several global FBQSR edge tomorrow (Webber and Mer- DBM because of the transnational companies. cure 2010). Businesses are focused nature of interactions among many on several concurrent challenges, stakeholders within and across bor- Transnational FBQSR companies have which include responding to: (1) ders in the globalized food system. also pledged to promote healthy life- global trends of emerging markets; Since the 1980s, governments have styles to prevent obesity and NCD (2) the “global grid”—a highly inte- increasingly relied on market-driven rates through the International Food grated and connected global econ- solutions to address public health & Beverage Alliance (2011); European omy; (3) environmental, social and nutrition challenges. The UN System Platform for Action on Diet, Physical consumer issues; (4) corporate and has reinforced this trend by empha- Activity and Health (The Evaluation public governance issues; (5) the sizing private sector engagement Partnership 2010); US Healthy Weight structure of the industry in which it through partnerships (Richter 2004). Commitment Foundation (2011); and competes; and (6) sustaining cus- five Public Health Responsibility Deal There has also been an emergence of tomer engagement (French, LaBerge Networks in England (Department of social entrepreneurship and cause and Magill 2011; McKinsey and Com- Health 2011). Additionally, the UN marketing to address global poverty pany 2010). Millennium Summit draft resolution (Scott et al. 2011), and a trend to- on the Prevention and Control of Global FBQSR companies are ac- ward voluntary “civil regulation”—a NCD, which was discussed at the High countable to many different stake- type of global economic governance -Level meeting in September 2011, holders: to their board of directors, that relies on socially focused, volun- encouraged multi-sectoral partner- investors and shareholders to make tary codes of conduct or standards to ships with private sector stakeholders profitable return on investments; to govern international businesses, as to address NCD (UN General Assem- governments by adhering to laws and opposed to stronger forms of govern- bly 2011). regulations; and to their employees ment-supported legally-mandated and customers who purchase their standards for businesses (Vogel Role of the private sector in address- products. If companies do not pay 2008). When business standards are ing global nutrition challenges attention to these audiences, they not legalized, accountability operates lose legitimacy. These companies are primarily through reputation and The business sector has an important aware that stakeholder engagement peer pressure, rather than in more impact on health. It provides, man- with all of their relevant audiences is formal ways (Grant and Keohane ages and spends substantial levels of critical to build brand equity and re- 2005). Several of the global FBQSR global health funding (McCoy, Chand main a trusted, legitimate and profit- companies listed in Table 1 are head- and Sridhar 2009). The private sector able business (Bonini, Court and quartered in the United States (US), also develops and markets products Marchi 2009). and are accountable both to US and and services, creates jobs, provides international government laws and employee health benefits, and influ- GLOBAL HEALTH GOVERNANCE, THE regulations, such as Codex Alimen- ences global health governance proc- UN GLOBAL COMPACT AND CORPO- tarius and the World Trade Organiza- esses (Buse and Lee 2005; Hancock, RATE SOCIAL RESPONSIBILITY PRO- tion. Kingo and Raynaud 2011). When GRAMMES appropriately structured and exe- The UN Global Compact cuted, partnerships with businesses Global health governance can potentially address specific cost The UN Global Compact (2011) was Global health governance is a term and investment challenges; improve launched in 1999 by former UN Sec- used to describe the current actors, the efficiency and quality of service retary-General, Kofi Annan, at the actions and agendas used to make delivery through sophisticated distri- World Economic Forum in Davos, progress toward population health bution systems; and provide public Switzerland to stimulate private sec- outcomes. It represents the collective sector stakeholders and NGOs with tor actions to support UN goals and actions adopted by governments, access to financial and in-kind re- serve as an alternative to interna- businesses and civil society to pro- sources, influential networks, com- tional regulatory systems mote and protect population health. munications expertise and technol- (Business.un.org 2009). The UN Governments, UN System organiza- ogy transfer (Conway, Gupta and Global Compact is the largest corpo- tions, NGOs, donors (i.e., private and Prakash 2006; Hancock, Kingo and rate citizenship initiative in the world corporate foundations and bilateral Raynaud 2011; Nikolic and Maikisch that promotes ten voluntary princi- agencies) and businesses are all part 2006). ples of responsible corporate citizen- of the global health governance sys- ship to support human rights, labour, Commercial investment decisions are tem (Dodgson, Lee and Drager 2002). predicated on building a business the environment and anti-corruption case today that will lead to an eco- Global health governance is relevant (Fall and Zahran 2010) (Table 2). By nomic benefit and a competitive to addressing global hunger and the 2007, more than 3000 companies back to contents SCN NEWS #39 www.unscn.org Features 15 from 100 countries, and over 700 civil successful implementation of the vol- Partners must critically evaluate society, international labour organi- untary principles (Fall and Zahran whether and how UN System part- zations and academic institutions 2010). An additional concern raised nerships are formed, and to account were engaged in the Compact to en- is that the UN Global Compact allows for specific PPP contributions, contra- courage businesses to contribute to certain companies to “blue wash” — dictions, transaction costs and trade- solving globalization challenges (UN which means they can improve their offs (Utting and Zammit 2006). We Global Compact Office 2007). reputation by associating with UN suggest that the UN Global Compact System organizations (Ollila 2003; be amended to contain clear princi- Several UN System organizations Utting and Zammit 2006). ples that support nutrition, consumer have acknowledged the important health and wellness. Global FBQSR role of the private sector, and specifi- We examined the signatory status of companies should be held account- cally the food industry, to help 15 global FBQSR companies to the UN able for the products they manufac- achieve nutrition and food security Global Compact (see Table 1). We ture and market, as well as their col- goals (UN 2009; WHO 2004; WHO found that seven companies (i.e. Car- lective policies and actions to prevent 2010a; 2010b). In 2010, UN Secretary gill, Danone, General Mills, Nestlé, and mitigate undernutrition, obesity -General Ban Ki-moon emphasized PepsiCo, The Coca-Cola Company and and the projected NCD burden the important role of the business Unilever) are signatories; eight com- among populations worldwide. community in achieving the MDG by panies (i.e. Burger King, Heinz, Kel- 2015 (UN General Assembly 2010). logg Company, Mars Inc., McDonald’s Corporate Social Responsibility (CSR) Corporation, The Hershey Company However, explicit principles to guide programmes and Yum! Brands) are not signatories; corporate activities that will promote and although Kraft Foods Mexico was CSR programmes are used to address optimal nutrition and health through a signatory in 2006, the company was many issues for which society and sustainability planning are noticeably expelled in 2011 for not communicat- other groups hold businesses ac- absent from the UN Global Compact. ing progress (UN Global Compact Of- countable. CSR is an evolving concept Due to the absence of clear princi- fice 2011). defined in various ways since it ples, certain UN System bodies have emerged in the 1950s (Lee and Car- developed specific private sector en- No QSR company listed in Table 1 is a roll 2011). Carroll (1999) identified gagement guidelines. Between 2000 signatory to the UN Global Compact. four CSR dimensions (i.e. philan- and 2010, WHO released guidelines This finding is especially surprising thropic, ethical, legal and economic) for working with the private sector to given the partnership between Yum! whereas Dahlsrud (2008) identified achieve health outcomes that defined Brands and the World Food Pro- five CSR dimensions (i.e. contributing commercial enterprises and provided gramme (2009) to address global to environmental stewardship, inte- clarification for cash donations, con- hunger; as well as the 2002 partner- grating social concerns into business tributions-in-kind, seconded person- ship between McDonald’s and UNI- operations, contributing to economic nel, product development, meeting CEF (UN News Centre 2002) that used development, interacting with all sponsorship, hosting meetings, and cause-marketing and co-branding relevant stakeholders, and taking vol- using WHO’s name or emblem (WHO strategies to raise funds for World untary actions beyond legal obliga- 2000; 2008b; 2010a; 2010b). Children’s Day to coincide with the tions based on ethical values). anniversary of the UN’s adoption of The UNSCN is a “food and nutrition the Convention of the Rights to the In 2010, the International Organiza- policy harmonization forum that pro- Child in November 1989 (UNICEF tion for Standardization (ISO) devel- motes cooperation among UN agen- 2009). This partnership generated oped a consensus definition for cies and partner organizations in sup- intense controversy among public “social responsibility” using a multi- port of community, national, regional health, child protection and citizen stakeholder consultation process that and international efforts to end mal- groups who expressed that it would involved representatives from 99 nutrition, in all of its forms, in this damage UNICEF’s credibility related countries (ISO 2011). The seven core generation” (UNSCN 2011). In 2007, to its child nutrition and health work areas of “social responsibility” identi- the UNSCN released a proposal for (Butler 2002; Ruskin 2002). UNICEF fied by ISO for businesses include hu- guiding private sector engagement also attracted controversy in 2008 man rights, labour practices, the envi- and PPP interactions (UNSCN 2007). when it partnered with Cadbury ronment, fair operating practices, A 10-year evaluation of the UN Global (acquired by Kraft Foods Global in consumer issues and community in- Compact Office criticized the initia- 2009) to sell co-branded candy and volvement and development tive for lacking a clear focus, failing to chocolate in Canada to raise funds to (Bowens 2011; ISO 2011). develop clear criteria to admit partici- support children’s education pro- CSR programmes are a form of volun- pating companies, and inadequate grammes in Africa (Trick or Treat by tary disclosure used by companies to monitoring of signatory companies’ UNICEF Canada 2010). communicate with relevant stake- back to contents SCN NEWS #39 16 Features www.unscn.org holders to describe how they invest eral Mills, Heinz, Yum! Brands Inc., ties that contribute to obesity and in communities and how well they PepsiCo, The Coca-Cola Company and NCD (Cuganesan, Guthrie and Ward adhere to the UN Global Compact McDonald’s Corporation) on their 2010; Herrick 2009; Lang and Rayner principles. CSR is also used to rescue “Best Corporate Citizens” list (CRO 2010). Certain companies’ CSR pro- or improve a company’s tainted repu- 2009) for actions supporting the envi- grammes can mislead the public into tation, gather information about new ronment, climate change, human believing that more is being done to and emerging markets, and cultivate rights, philanthropy, employee rela- meet public goals than is actually fea- consumer brand loyalty through stra- tions, financial management and gov- sible given these companies’ primary tegic philanthropy (Bonini, Court and ernance (CRO 2009). Actions target- accountability to their shareholders Marchi 2009; Keys, Malnight and van ing nutrition, consumer health and to maximize profits (Reich 2008). wellness goals were not even among der Graaf 2009; McKinsey and Com- Previously secret tobacco company the criteria assessed for the perform- pany 2008; Porter and Kramer 2002). documents show that CSR and corpo- ance of these companies. rate philanthropy have been used as CSR programmes of global FBQSR Only recently have global FBQSR a public relations tool to enhance a companies companies developed more extensive company's image through high- The food system is multifaceted and CSR efforts focused on addressing profile sponsorships (Brownell and has diverse sub-sectors. Global hunger, food insecurity, nutrition, Warner 2009; Tesler and Malone FBQSR companies face a complex set consumer health and wellness. Table 2008); to reframe issues and shift of requirements and societal expecta- 1 provides a list of each company’s attention away from the health risks tions regarding animal welfare, the CSR programme theme (Table 1). of companies’ products and market- environment (i.e. energy, water use, Companies have also developed ing activities (Brownell and Warner and waste management); the quality, pledges, commitments and voluntary 2009; Friedman 2009); to alter public healthfulness and safety of its proc- reporting structures to show that perceptions about companies to essed food and beverage products; they are expanding healthier food, build credibility (McDaniel and and social conditions (Hartmann beverage and meal products; and Malone 2009); and to lobby against 2011). engaging in responsible marketing public health policies (Brownell and practices to promote healthy prod- Warner 2009; Ludwig and Nestle Global FBSQR companies have tradi- ucts to children worldwide (IFBA 2008; Tesler and Malone 2008). tionally addressed social responsibil- 2011). Independent evaluations of Global FBQSR companies could gain ity and environmental sustainability these private sector efforts are the trust of diverse constituencies by identified in the UN Global Compact needed (Kraak et al. 2011). More ex- using CSR programmes in productive using the “triple bottom line” ap- tensive progress should be pursued ways. Companies could show that proach that includes people (social), by global FBQSR companies to ex- they are making meaningful changes planet (environmental), and profits or pand pledges to cover all relevant in food and beverage product refor- prosperity (economic) (Elkington practices that promote nutrition mulation; developing meaningful in- 2004). However, nutrition, consumer goals and healthy lifestyles to prevent dicators and criteria for self- health and wellness were excluded and mitigate hunger, undernutrition, regulation; marketing ethically and both from the “triple bottom line” obesity and the DBM burden (Koplan consistently across national borders; and the Global Reporting Initiative and Brownell 2010; Kraak and Story and creating a long term strategy that (GRI 2011) — a network-based or- 2010; Porter and Kramer 2002). addresses both business and public ganization that developed the widely health nutrition goals that prevent used G3 Sustainability Reporting The conduct and philanthropic activi- and mitigate undernutrition, obesity framework. The GRI framework is a ties of companies influence consum- and NCD. system for companies to mainstream ers’ brand loyalty, purchase intent and voluntarily disclose their per- and product purchases (Hartmann There is also a need to develop ac- formance and progress made toward 2011). Consumers expect companies countability mechanisms that in- specific financial, social, environ- to behave ethically, and a negative crease transparency and hold compa- mental and governance indicators CSR reputation can be more damag- nies accountable for their marketing (GRI 2011; Nikolaeva and Bicho ing for a company than a positive CSR practices. The Access to Nutrition 2010). The GRI system lacks specific profile (Hartmann 2011). Some public Index (ATNI) is a new initiative, jointly indicators for companies to assess health professionals, citizens groups funded by GAIN, the Gates Founda- progress toward achieving nutrition, and legal practitioners are skeptical tion and Wellcome Trust (ATNI 2011) consumer health and wellness out- of and mistrust CSR programmes be- that could potentially serve this func- comes. Indeed, one CSR rating ranked cause they have been used to deflect tion. An Index is being developed to six global FBQSR companies (i.e. Gen- public attention from business activi- rate the performance of global food

back to contents SCN NEWS #39 www.unscn.org Features 17 and beverage companies in providing making pathway tool is available that CONCLUSIONS healthier products to address both can help to promote synergy and ac- Partnerships present both opportuni- undernutrition and obesity. The de- countability for specific outcomes ties and risks to all partners. PPP oc- velopers suggest that publicly sharing (Kraak et al. 2011) (see Figure 1). The cur within a context of governments information about companies’ pro- tool can guide partnership engage- being publicly accountable for production and marketing practices may ment decisions to assess opportuni- tecting and promoting the nutritional potentially develop processes that ties, compatibilities, and benefits ver- health of their citizens. A well de- allow benchmarking of companies’ sus risks; develop objectives and out- signed and executed partnership can performance (ATNI 2011). comes; execute a formal agreement develop good governance structures with input from legal counsel; and to support transformative systems MAXIMIZING BENEFITS AND MINI- ensure monitoring, evaluation and change that is more likely to improve MIZING RISKS OF PARTNERSHIPS accountability. Other partnership as- nutrition and health outcomes. An sessment tools are available (Lasker, An in-depth discussion of partnership incompatible and poorly executed Weiss and Miller 2001; PGAI 2011). challenges is beyond the scope of this partnership can damage public trust, paper but explored elsewhere (Buse Each partner should establish proc- credibility and all partners’ brand and Harmer 2007; Fawcett et al. esses and outcomes that should be reputations. 2010; Koplan and Brownell 2010; independently evaluated to create This paper is intended to stimulate a Kraak and Story 2010; Kraak et al. support for the partnership and dem- dialogue within the global nutrition 2011; Nikolic and Maikisch 2006; onstrate accountability to external and public health community of prac- Working Group on Global Health groups (Bailey 2010). Partnerships titioners regarding the need to de- Partnerships 2005). All partners can be evaluated for infrastructure, velop clear guidelines for partnering should adopt systematic and trans- leadership, function, synergy and with transnational FBQSR companies. parent accountability processes to governance processes. Partnerships We propose that all partners use an navigate and manage six challenges: should also be evaluated for adding accountability lens and adopt system- balance private commercial interests value to achieve nutrition and health atic and transparent processes to with public health interests, manage goals, objectives and outcomes; pro- manage conflicts of interest, develop conflicts of interest and biases, en- duce measurable changes within or- good governance practices, and navi- sure that co-branded activities sup- ganizations, systems, and the com- gate partnership goals and outcomes. port healthy products and healthy munity; reduce health and social in- We offer a benefit–risk decision- eating environments, comply with equities; and achieve sustainability making pathway to help partners ethical codes of conduct, undertake outcomes to build and institutionalize maximize benefits and minimize risks due diligence to assess partnership capacities to address global nutrition when collaborating to address global compatibility, and monitor and evalu- challenges (Barr 2007; Butterfoss hunger, food insecurity and the DBM. ate partnership outcomes (Kraak et 2009; Kraak and Story 2010; Lasker, Doing so will help to achieve nutrition al. 2011). Weiss and Miller 2001; Shortell et al. and health outcomes for populations 2002). A six-step, benefit–risk decision- worldwide.

Table 1. Profiles of global food, beverage and quick-serve restaurant (FBQSR) companies

Company Headquarters Estimated an- Numbers of Fortune Mission state- Company relationship with (source) (city, country) nual revenue* countries 500** or For- ment or CSR UN System in US$ (year) with com- tune Global program theme mercial en- 500*** com- terprises pany ranking (2011)

Burger King Miami, 2.5 billion 74 n/a BK Positive Not a signatory to the UN (2009) Florida, US (2009) Steps Global Compact

Cargill Minnetonka, 108 billion 66 Private, fam- Growing To- Signatory to the UN Global (2010) Minnesota, US (2010) ily-owned gether Compact since 2011 business see footnote

back to contents SCN NEWS #39 18 Features www.unscn.org Table 1. Profiles of global food, beverage and quick-serve restaurant (FBQSR) companies (cont.)

Danone Paris, 21.5 billion 72 433*** Bringing Health Signatory to the UN Global (2010) France (2010) Through Food Compact since 2003 to as Many Peo- ple as Possible General Mills Minneapolis, 16 billion 100 166** Nourishing Lives Signatory to the UN Global (2011) Minnesota, US (2010) Compact since 2008

Heinz Pittsburgh, 10 billion 50 232** The Original Not a signatory to the UN (2009) Pennsylvania, (2009) Pure Food Com- Global Compact US pany

Kellogg Com- Battle Creek, 13 billion 180 199** Bringing Our Not a signatory to the UN pany Michigan, US (2009) Best to You Global Compact (2009)

Kraft Foods Northfield, 48 billion 160 49** Creating a More †Kraft Foods Mexico has been (2010) Illinois, US (2010) 167*** Delicious World a signatory to the UN Global Compact since 2006 but was expelled in 2011 for failure to communicate progress. Kraft Foods acquired Cadbury in 2009. ††In 2008, UNICEF and Cad- bury Canada entered a three- year partnership to raise funds for children’s education in Africa. This partnership was opposed by public health advocates.

Mars Inc. McLean, 30 billion 56 Private, fam- Our Principles in Not a signatory to the UN (2010) Virginia, US (2010) ily- o w n e d Action Global Compact business see footnote

McDonald’s Oak Brook, 24 billion 100 111** The Values We Not a signatory to the UN Corporation Illinois, US (2010) 403*** Bring to the Global Compact (2010) Table ‡McDonald’s announced a partnership with UNICEF in 2002 to raise money for World Children’s Day that coincided with the anniversary of the UN System adoption of the Con- vention of the Rights of the Child in November 1989. ‡‡This partnership was opposed by public health advocates.

back to contents SCN NEWS #39 www.unscn.org Features 19 Table 1. Profiles of global food, beverage and quick-serve restaurant (FBQSR) companies (cont.)

Company Headquarters Estimated an- Numbers of Fortune Mission state- Company relationship with (source) (city, country) nual revenue* countries 500** or For- ment or CSR UN System in $US (year) with com- tune Global program theme mercial en- 500*** com- terprises pany ranking (2011)

Nestlé S.A. Vevey, 111 billion 86 42*** Creating Shared Signatory to the UN Global (2009) Switzerland (2009) Value Compact since 2001 ‡‡‡ In 2009, Baby Milk Ac- tion filed a complaint with the U.N. Global Compact Office alleging that Nestle’s CSR reports were misleading and the company had vio- lated the Compact principles.

PepsiCo Purchase, 57 billion 200 43** Performance ‡‡‡‡Partnership with the (2010) New York, US (2010) 137*** with Purpose WFP to enhance humanitarian relief delivery (2009) Signatory to the UN Global Compact since 2008

The Coca- Atlanta, 32 billion 200 70** Positive Living Signatory to the UN Global Cola Com- Georgia, US (2009) 256*** Compact since 2006 pany (2010) The Hershey Hershey, 5 billion 50 402** Bringing Sweet Not a signatory to the UN Company Pennsylvania, (2009) Moments of Global Compact (2009) US Hershey Happi- ness to the World Every Day

Unilever Rotterdam, 53.9 billion 170 136*** Creating a Bet- Signatory to the UN Global (2010) Netherlands and (2009) ter Future Every Compact since 2000 London, UK Day

Yum! Brands Louisville, 10.8 billion 110 214** Serving the Not a signatory to the UN (2009) Kentucky, US (2009) World Global Compact ‡‡‡‡‡Partnership with the WFP to support Yum! Brands World Hunger Relief Cam- paign and to raise funds to support WFP’s school feeding program for children (2009)

*Estimated annual revenue represents Revenue figures are derived from each annual ranking of America's largest cor- income that a company receives from its company’s annual or corporate social porations. May 23, 2011. (online) normal business activities from the sale responsibility report and/or website. The Fortune 500 is an annual list com- of goods and services to customers. **CNN Money. Fortune 500 2011. Our piled and published by Fortune magazine

back to contents SCN NEWS #39 20 Features www.unscn.org that ranks the top 500 US public corpora- were a public company, it would be ‡‡‡‡Source: PepsiCo. PepsiCo Founda- tions as ranked by their gross revenue ranked among the top 10 companies in tion and United Nations World Food Pro- after adjustments made by Fortune to the Fortune 500 ranking. gramme announce partnership to en- exclude the impact of excise taxes com- Mars, Inc. is a private, family-owned busi- hance humanitarian relief delivery panies collect. ness that is ranked as the fifth largest around the world [press release]. (online) *** CNN Money. Fortune Global 500 privately held company in the United ‡‡‡‡‡Source: World Food Programme 2011. Our annual ranking of America's States. (2009) Yum! Brands, KFC, Pizza Hut, Taco largest corporations. July 25, 2011. †Source: U.N. Global Compact Office Bell Launch World Hunger Relief Effort to (online) (2011) Participants. (online) raise awareness, volunteerism and funds The Fortune Global 500 is a ranking of ††Source: Trick or Treat or UNICEF Can- with Christina Aguilera as campaign’s the top 500 corporations worldwide as ada (2010) Lancet 376:1514. (online) global spokesperson [news release]. (online) measured by revenue. The list is com- ‡Source: UN News Centre (2002) UNICEF piled and published annually by Fortune teams with McDonald’s to raise funds for Source for Table 1: Adapted from Kraak magazine. children. July 19. (online) VI, Harrigan P, Lawrence M, Harrison P, Jackson M, Swinburn B (2011) Balancing ‡‡Source: Butler P (2002) UNICEF in the benefits and risks of public-private NOTE: Cargill Inc. is a private, family- McDonald’s link row. August 3. (online) partnerships to address the global double owned business ranked as the largest ‡‡‡Source: Baby Milk Action (2010) privately held, multinational corporation burden of malnutrition. Pub Health Nutr Nestlé, the UN Global Compact and OECD 2011 (in press). headquartered in the United States. If it Guidelines. 21 May. (online)

Table 2. Ten voluntary principles of the UN Global Compact to support corporate citizenship and sustainability

Issue Area Principles Human Rights 1. Businesses should support and respect the protection of internationally proclaimed human rights. 2. Businesses should make sure that they are not complicit in human rights abuses.

Labour 3. Businesses should uphold the freedom of association and the effective recognition of the right to collective bargaining. 4. Businesses should support the elimination of all forms of forced and compulsory labour. 5. Businesses should support the effective abolition of child labour. 6. Businesses should support the elimination of discrimination in respect of employment and occupation.

Environment 7. Businesses are asked to support a precautionary approach to environmental challenges. 8. Businesses should undertake initiatives to promote greater environmental responsibility. 9. Businesses should encourage the development and diffusion of environmentally-friendly technologies.

Anti-corruption 10. Businesses should work against corruption in all its forms, including extortion and bribery.

Source: Fall PL, Zahran MM (2010) United Nations corporate partnerships: The role and functioning of the Global Compact. United Nations: Geneva. (online)

back to contents SCN NEWS #39 www.unscn.org Features 21 Figure 1. Benefit–risk decision-making pathway for organizations to assess public-private partnerships with transnational food, beverage and quick-serve restaurant companies to address the global double burden of malnutrition

Note: For prospective partners to put this cision-making required to ensure that the Swinburn B (2011) Balancing the benefits decision-making pathway into practice, PPP will optimize benefits and minimize and risks of public-private partnerships to steps 1-5 are non-negotiable and all need risks to all partners and target popula- address the global double burden of mal- to be “yes” before proceeding with a tions. nutrition. Pub Health Nutr 2011 (in potential public-private partnership press). Source: Adapted from Kraak VI, Harrigan (PPP). Step 6 is the ongoing and final de- P, Lawrence M, Harrison P, Jackson M,

References for table 1 Kellogg Company (2009) 2009 Corporate Value Report 2009. Vevey, Switzerland. Responsibility Report: “Bringing Our Best to (online) Burger King (2009) BK Positive Steps: Fiscal You.” (online) 2009 Corporate Responsibility Report. PepsiCo (2010) Performance with Purpose: (online) Kraft Foods (2010) Creating a More Deli- The Promise of PepsiCo. Sustainability Sum- Cargill Inc. (2010) Corporate Responsibility cious World. Our 2010 Report. (online) mary 2010. (online) Report: Growing Together. (online) Mars Inc. (2010) Our Principles in Action. The Coca-Cola Company (2010) Live Posi- (online) tively. Our Commitment to Making a Posi- Danone (2010) Danone 10: Danone Essen- tive Difference in the World. 2008-2009 tials in 2010. Economic and Social Report. McDonald’s Corporation (2010a) McDon- Sustainability Review. (online) (online) ald’s 2009 Worldwide Corporate Responsi- bility Online Report: The Values We Bring to The Hershey Company (2009) Corporate General Mills (2011) Corporate Social Re- the Table. (online) Social Responsibility Report 2009. (online) sponsibility 2011. (online) McDonald’s Corporation (2010b) Annual Unilever (2009) Sustainable Development Heinz (2009) Heinz 2009 Corporate Social Report 2010. (online) Overview 2009: Creating a Better Future Responsibility Report. (online) Every Day. (online) Nestlé S.A. (2009) Nestlé Creating Shared back to contents SCN NEWS #39 22 Features www.unscn.org Yum! Brands (2008) Serving the World. Milbank Q 87(1):259–94. Elkington J (2004) Enter the triple bottom (online) line. In Henriques A, Richardson J (eds.) The Buse K, Harmer AM (2007) Seven habits of Triple Bottom Line. Does It All Add Up? As- highly effective global public-private health sessing the Sustainability of Business and General references partnerships: practice and potential. Social CSR. Earthscan:London. [Anonymous] (2010) Trick or Treat or UNI- Science & Medicine 64(2):259–71. Fall PL, Zahran MM (2010) United Nations CEF Canada. The Lancet 376:1514. (online) Buse K, Lee K (2005) Business and Global corporate partnerships: the role and func- Health Governance. Discussion Paper No. 5. Access to Nutrition Index (ATNI) (2011). tioning of the Global Compact. United Na- London School of Hygiene & Tropical Medi- (online) tions:Geneva. (online) cine:London and World Health Organiza- Agree. New initiative to provide path for- tion:Geneva. Fawcett S, Schultz J, Watson-Thompson J, ward for transforming food and ag policy Fox M, Bremby R (2010) Building multisec- Business.un.org (2009) Guidelines on Coop- [news release]. 3 May 3 2011. (online) toral partnerships for population health eration between the United Nations and the and health equity. Preventing Chronic Dis- Austin JE (2000) Strategic collaboration Business Sector. November 20. (online) between nonprofits and business. Non- ease 7(6):A118. (online) Butler P. Unicef in McDonald’s link row. The profit and Voluntary Sector Quarterly 29 Finucane MM, Stevens GA, Cowan MJ, Dan- Guardian, 3 August 2002. (online) (1):69–97. aei G, Lin JK, Paciorek CJ, Singh GM, Bailey SBC (2010) Focusing on solid partner- Butterfoss FD (2009) Evaluating partner- Gutierrez HR, Lu Y, Bahalim AN, Farzadfar F, ships across multiple sectors for population ships to prevent and manage chronic dis- Riley LM, Ezzati M; Global Burden of Meta- health improvement. Preventing Chronic ease. Preventing Chronic Disease 6(2):A64. bolic Risk Factors of Chronic Diseases Col- Disease 7(6):A115. (online) (online) laborating Group (Body Mass Index) (2011) National, regional, and global trends in Carroll AB (1999) Corporate social responsi- Barr DA (2007) Ethics in public health re- body-mass index since 1980: systematic bility: evolution of a definitional construct. search: a research protocol to evaluate the analysis of health examination surveys and Business and Society 38(3):268–95. effectiveness of public-private partnerships epidemiological studies with 960 country- as a means to improve health and welfare Cohen D (2011) Will industry influence de- years and 9.1 million participants. The Lan- systems worldwide. American Journal of rail UN summit? British Medical Journal cet 377(9765):557–67. Public Health 97(1):19–25 (online) 343:d5328. (online) Food and Agriculture Organization (FAO) Beaglehole R, Bonita R, Horton R, Adams C, Conway MD, Gupta S, Prakash S (2006) (2006) The Double Burden of Malnutrition: Alleyne G, Asaria P, Baugh V, Bekedam H, Building better partnerships for global Case Studies From Six Developing Countries. Billo N, Casswell S, Cecchini M, Colagiuri R, health. McKinsey Q 12:1–8. (online) FAO Food and Nutrition Paper 84. Colagiuri S, Collins T, Ebrahim S, Engelgau FAO:Rome. (online) M, Galea G, Gaziano T, Geneau R, Haines A, Corporate Responsibility Organization Hospedales J, Jha P, Keeling A, Leeder S, (CRO) (2009) CRO’s 100 Best Corporate Food and Agriculture Organization (FAO) Lincoln P, McKee M, Mackay J, Magnusson Citizens 2009. (online) (2010) The State of Food Insecurity in the World: Addressing food insecurity in pro- R, Moodie R, Mwatsama M, Nishtar S, Cuganesan S, Guthrie J, Ward L (2010) Ex- tracted crises. FAO:Rome. (online) Norrving B, Patterson D, Piot P, Ralston J, amining CSR disclosure strategies within Rani M, Reddy KS, Sassi F, Sheron N, Stuck- the Australian food and beverage industry. Freedhoff Y, Hébert PC (2011) Partnerships ler D, Suh I, Torode J, Varghese C, Watt J; Accounting Forum 34:169–83. between health organizations and the food Lancet NCD Action Group; NCD Alliance industry risk derailing public health nutri- Dahlsrud A (2008) How corporate social (2011) Priority actions for the non- tion. Canadian Medical Association Journal responsibility is defined: an analysis of 37 communicable disease crisis. The Lancet 183(3):291–2. (online) 377(9775):1438–47. (online) definitions. Corporate Social Responsibility and Environmental Management 15:1–13. French T, LaBerge L, Magill P (2011) We’re Black RE, Allen LH, Bhutta ZA, Caulfield LE, all marketers now. McKinsey Q. (online) de Onis M, Ezzati M, Mathers C, Rivera J; Delisle HF (2008) The double burden of Maternal and Child Undernutrition Study malnutrition in mothers and the intergen- Friedman LC (2009) Tobacco industry use of Group (2008) Maternal and child undernu- erational impact. Annals of the New York corporate social responsibility tactics as a trition: global and regional exposures and Academy of Sciences 1136:172–84. sword and a shield on secondhand smoke issues. Journal of Law, Medicine & Ethics 37 health consequences. The Lancet 371 de Onis M, Blössner M, Borghi E (2010) (4):819–27. (9626):243–60. Global prevalence and trends of overweight Bonini S, Court D, Marchi A (2009) Rebuild- and obesity among pre-school children. Gilmore AB, Savell E, Collin J (2011) Public ing corporate reputations. McKinsey Q. American Journal of Clinical Nutrition 92 health, corporations and the New Responsi- (online) (5):1257–64. (online) bility Deal: promoting partnerships with vectors of disease? Journal of Public Health Department of Health (2011) The Public Bowens R (2011) Understanding the ISO 33(1):2–4. (online) 26000 Social Responsibility Standard and Health Responsibility Deal. UK Department how it relates to and can be assessed along- of Health : England. (online) Global Alliance for Improved Nutrition (GAIN) (2009) Annual Report 2008-2009. side other standards. SGS SA:Geneva. Dodgson R, Lee K, Drager N (2002) Global (online) (online) Health Governance: A Conceptual Review. Brownell KD, Warner KE (2009) The perils Discussion Paper No. 1. London School of Global Alliance for Improved Nutrition of ignoring history: Big Tobacco played dirty Hygiene & Tropical Medicine:London and (GAIN) (2010) Partnerships and Collabora- and millions died. How similar is Big Food? World Health Organization:Geneva. (online) tion. Summary of the Workshop. Business

back to contents SCN NEWS #39 www.unscn.org Features 23 Seeking Solutions to the Fight Against Mal- sibility in public health. British Medical National Research Council. Committee on nutrition. 4th GAIN Business Alliance Forum, Journal 14:341.(online) Private-Public Sector Collaboration to En- 25-26 May, 2010. GAIN:Geneva. (online) hance Community Disaster Resilience, Geo- Lasker RD, Weiss ES, Miller R (2001) Part- graphical Science Committee (2010) Build- Global Reporting Initiative (GRI) (2011) nership synergy: a practical framework for ing Community Disaster Resilience through Global Reporting Framework. (online) studying and strengthening the collabora- Private-Public Collaboration. The National tive advantage. Millbank Q 79(2):179–205. Grant RW, Keohane RO (2005) Accountabil- Academies Press: Washington DC. ity and abuses of power in world politics. Lee SY, Carroll CE (2011) The emergence, Newell P (2008) Civil society, corporate American Political Science Review 99(1):29– variation, and evolution of corporate social accountability and the politics of climate 43. responsibility in the public sphere, 1980- change. Global Environmental Politics 8:122 2004: The exposure of firms to public de- Hancock C, Kingo L, Raynaud O (2011) The –53. bate. Journal of Business Ethics 104:115– private sector, international development 131. (online) Nikolaeva R, Bicho M (2010) The role of and NCDs. Global Health 7:23. (online) institutional and reputational factors in the Lincoln P, Rundall P, Jeffery B, Kellett G, Hartmann M (2011) Corporate social re- voluntary adoption of corporate social re- Lobstein T, Lhotska L, Allen K, Gupta A sponsibility in the food sector. European sponsibility reporting standards. Journal of (2011) Conflicts of interest and the UN high Review of Agricultural Economics 38(3):297 the Academy of Marketing Science 39:136– -level meeting on non-communicable dis- –324. 47. (online) eases. The Lancet early online publication, Healthy Weight Commitment Foundation 16 September. doi:10.1016/S0140-6736 Nikolic IA, Maikisch H (2006) Public-Private (2011) 2010 Annual Review. January 28. (11)61463–3. Partnerships and Collaboration in the (online) Health Sector. An Overview with Case Stud- Ludwig DS, Nestle M (2008) Can the food ies from Recent European Experience. The Herrick C (2009) Shifting blame/selling industry play a constructive role in the obe- World Bank:Washington DC. (online) health: corporate social responsibility in the sity epidemic? Journal of the American age of obesity. Sociology of Health & Illness Medical Association 300(15):1808–11. Ollila E (2003) Global Health-Related Public- 31(1):51–65. (online) Private Partnerships and the United Na- McCoy D, Chand S, Sridhar D (2009) Global tions. Globalism and Social Policy Pro- Institute of Medicine (2009) The U.S. Com- health funding: how much, where it comes gramme. Policy Brief. No 2. (online) mitment to Global Health: Recommenda- from and where it goes. Health Policy and tions for the Public and Private Sector. The Planning 24(6):407–17. Oshaug A (2009) What is the food and drink National Academies Press:Washington DC. industry doing in nutrition conferences? McDaniel PA, Malone RE (2009) The role of (online) Pub Health Nutrition 12(7):1019–20. corporate credibility in legitimizing disease International Food & Beverage Alliance promotion. American Journal of Public Partnership Governance and Accountability (2011). (online) Health 99(3):452–61. Initiative (PGAI) (2011) The PGA framework: promoting best practice in the manage- International Organization for Standardiza- McKinsey and Company (2010) Global ment of partnerships for sustainable devel- tion (ISO) (2011) ISO 26000 – Social respon- forces shaping the future of business and opment. (online) sibility. Project overview. (online) society. McKinsey Q. (online) Porter ME, Kramer MR (2002) The competi- James WPT (2005) The policy challenge of McKinsey and Company (2008) The state of tive advantage of corporate philanthropy. coexisting undernutrition and nutrition- corporate philanthropy: a McKinsey global Harvard Business Review 80(12):56–68. related chronic diseases. Maternal & Child survey. McKinsey Q. (online) Nutrition 1(3):197–203. Prentice AM (2006) The emerging epidemic McLachlan M, Garrett J (2008) Nutrition of obesity in developing countries. Interna- Keys T, Malnight TW, van der Graaf K change strategies: the new frontier. Public tional Journal of Epidemiology 35(1):93–9. (2009) Making the most of corporate social Health Nutrition 11(10):1063–75. (online) responsibility. McKinsey Q. (online) Mensah GA, Yach D, Khan M (2011) Indus- Reich RB (2008) The Case Against Corporate Koplan JP, Brownell KD (2010) Response of try response to the obesity threat. Journal Social Responsibility. Goldman School the food and beverage industry to the obe- of the American Medical Association 305 Working Paper Series GSPP08-003. August sity threat. Journal of the American Medical (4):361–2. 1. University of California:Berkeley. (online) Association 304(13):1487–88. Micronutrient Initiative (2009) Investing in Richter J (2004) Public-Private Partnerships Kraak VI, Story M (2010) A public health the Future: A United Call to Action on Vita- and International Health Policy-Making: perspective on healthy lifestyles and public- min and Mineral Deficiencies. Global Report How can public interests be safeguarded? private partnerships for global childhood 2009. (online) World Health Organization/P.Virot:Geneva. obesity prevention. Journal of the American Monteiro CA, Gomes FS, Cannon G (2010) (online) Dietetic Association 110(2):192–200. The snack attack. American Journal of Pub- Ruskin G. Commercial Alert Asks UNICEF to Kraak VI, Harrigan P, Lawrence M, Harrison lic Health 100:975–81. drop support for McDonald’s World Chil- P, Jackson M, Swinburn B (2011) Balancing Morris SS, Cogill B, Uauy R; Maternal and dren’s Day, Obesity Lobby [news release]. the benefits and risks of public-private part- Child Undernutrition Study Group (2008) 26 August 26.2002. (online) nerships to address the global double bur- Effective international action against un- den of malnutrition. Public Health Nutrition Scott L, Williams JD, Baker SM, Brace- dernutrition: why has it proven so difficult (in press). Govan J, Downey H, Hakstian AM, Hender- and what can be done to accelerate pro- son GR, Loroz PS, Webb D (2011) Beyond Lang T, Rayner G (2010) Corporate respon- gress? The Lancet 371(9612):608–21.

back to contents SCN NEWS #39 24 Features www.unscn.org poverty: social justice in a global market- tation and follow up. (online) imperative. Preventing Chronic Disease 7 place. Journal of Public Policy & Marketing (6):A121. (online) UN General Assembly (2011) Follow-up to 30(1): 39–46. the outcome of the Millennium Summit Working Group on Global Health Partner- Shortell SM, Zukoski AP, Alexander JA, Baz- Draft resolution submitted by the President ships (2005) Best Practice Principles for zoli GJ, Conrad DA, Hasnain-Wynia R, So- of the General Assembly. Political declara- Global Health Partnership Activities at faer S, Chan BY, Casey E, Margolin FS (2002) tion of the High-level Meeting of the Gen- Country Level: Report of the Working Group Evaluating partnerships for community eral Assembly on the Prevention and Con- on Global Health Partnerships. High-level health improvement: tracking the foot- trol of Non-communicable Diseases. A/66/ Forum on the Health Millennium Develop- prints. Journal of Health Politics, Policy and L.1. 66th session. Agenda item 117. (online) ment Goals, 14–15 November, 2005. High- Law 27(1):49–91. level Forum on the Health Millennium De- UN Global Compact (2011). (online) velopment Goals:Paris. (online) Sridhar D, Morrison JS, Piot P (2011) Expec- UN Global Compact Office (2007) GLN tations for the United Nations high-level World Food Programme. Yum! Brands, KFC, Global Compact implementation tool. meeting on noncommunicable diseases. Pizza Hut, Taco Bell Launch World Hunger United Nations Global Compact Leaders Bulletin of the World Health Organization Relief Effort to raise awareness, volunteer- Summit. (online) 89(7):471. (online) ism and funds with Christina Aguilera as UN Global Compact Office (2011) Partici- campaign’s global spokesperson [news Tesler LE, Malone RE (2008) Corporate phi- pants. (online) release]. 23 September 2009. (online) lanthropy, lobbying, and public health. American Journal of Public Health 98 UN News Centre UNICEF teams with World Health Organization (WHO) (2000) (12):2123–33. McDonald’s to raise funds for children Guidelines on working with the private sec- [press release]. 19 July 2002. (online) tor to achieve health outcomes. Executive The Evaluation Partnership (2010) Evalua- board 107th Session. EB107/20, 30 Novem- tion of the European Platform for Action on UN System Standing Committee on Nutri- ber. WHO:Geneva. (online) Diet, Physical Activity and Health. European tion (UNSCN) (2006) Tackling the Double Commission, Directorate General Health Burden of Malnutrition: A Global Agenda. WHO (2004) Global Strategy on Diet, Physi- and Consumers. Final Report. The Evalua- (online) cal Activity, and Health. Report No. tion Partnership:London. (online) UNSCN (2007) A Draft Proposal for Initiat- WHA57.17. WHO:Geneva. (online) The International Bank for Reconstruction ing SCN Private Sector Engagement. WHO (2008a) 2008-2013 action plan for the and Development (IBRD)/The World Bank (online) global strategy for the prevention and con- (2011) Global Monitoring Report 2011. UNSCN (2010a) Sixth report on the world trol of noncommunicable diseases: prevent Improving the Odds of Achieving the MDGs. nutrition situation: progress in nutrition. and control cardiovascular diseases, can- The World Bank:Washington, DC. (online) UNSCN:Geneva. (online) cers, chronic respiratory diseases and diabetes. WHO:Geneva. (online) Thomas A, Fritz L (2006) Disaster relief, inc. UNSCN (2010b) Scaling Up Nutrition: A Harvard Business Review 84(11):114– Framework for Action. Based on a series of WHO (2008b) Global health partnerships: 22,158. consultations hosted by the Center for progress on developing draft policy guidelines for WHO’s involvement. Report by the Traitler H, Watzke HJ, Saguy S (2011) Rein- Global Development, the International Con- Secretariat. Executive Board. 123rd Session. venting R&D in an open innovation ecosys- ference on Nutrition, USAID, UNICEF and EB 123/6. WHO:Geneva. (online) tem. Journal of Food Science 76(2):R62–8. the World Bank. (online) WHO (2010a) Engaging and Working with Uauy R, Kain J, Mericq V Rojas J, Corvalán C UNSCN (2011). UNSCN Homepage. (online) the Commercial Private Sector. WHO Policy (2008) Nutrition, child growth, and chronic US Agency for International Development Framework. Department of Partnerships disease prevention. Annals of Medicine 40 (USAID) (2011) USAID Administrator high- and United Nations Reform. (1):11–20. lights private sector partnerships to reduce WHO (2010b) Partnerships. WHA63.10 United Nations (UN) (2009) Strengthening hunger and poverty at the World Economic Agenda item 18.1. 21 May. (online) the Global Partnership for Development in a Forum [press release]. 28 January 2011. Time of Crisis: Millennium Development (online) WHO (2011a) Global status report on non- Gap Task Force Report. UN:New York. US Government (2011) Feed the Future communicable diseases 2010. WHO: Ge- (online) Guide: A Summary. (last access 07/2011). neva. (online) UN Children’s Fund (UNICEF) (2009) The (online) WHO (2011b) Public–Private Partnerships State of the World’s Children. Special edi- Utting P, Zammit A (2006) Beyond Pragma- for Health. WHO:Geneva. (online) tion. Celebrating 20 Years of the Convention tism: Appraising UN-Business Partnerships. Yach D, Feldman ZA, Bradley DG, Khan M on the Rights of the Child. UNICEF:New Paper No. 1. PP-MBR-1. Research Institute (2010a) Can the food industry help tackle York. (online) for Social Development, United Na- the growing global burden of undernutri- UN General Assembly (2009) Report of the tions:Geneva. (online) tion? American Journal of Public Health 100 Special Rapporteur on the right to food, Vogel D (2008) Private business regulation. (6):974–80. (online) Olivier De Schutter. Agribusiness and the Annual Review of Political Science 11:261– Yach D, Khan M, Bradley D, Hargrove R, right to food. Human Rights Council. 13th 82. Kehoe S, Mensah G (2010b) The role and Session. (online) Wang Y, Lobstein T (2006) Worldwide challenges of the food industry in address- UN General Assembly (2010) Keeping the trends in childhood overweight and obe- ing chronic disease. Global Health 6:10. promise: a forward-looking review to pro- sity. International Journal of Pediatric Obe- (online) mote an agreed action agenda to achieve sity 1(1):11–25. Yum! Brands Inc. (2010) World Hunger Re- the MDGs by 2015. Report of the Secretary- lief 2011: From Hunger to Hope. (online) General. 64th session. Agenda items 48 and Webber A, Mercure S (2010) Improving 114. Integrated and coordinated implemen- population health: the business community back to contents SCN NEWS #39 www.unscn.org Features 25 THE POTENTIAL OF PUBLIC-PRIVATE-CIVIL SOCIETY PARTNERSHIPS IN HUMANITARIAN EMERGENCIES: AN NGO PERSPECTIVE DRAWING FROM EMERGENCY PROGRAMMING IN PORT-AU-PRINCE, HAITI Hanna Mattinen1, Julien Morel2§ 1Senior Food Security and Livelihoods Advisor, Action contre la Faim, 2Senior Food Assistance Advisor, Action contre la Faim

§Corresponding author. Email: [email protected]

Author statement: The authors declared not having any conflict of interest.

ensuring global food and nutrition security. By 2030, 60% of the world’s population is expected to live in cities, with up to 2 billion people living in slums and in informal settlements2. Up to 1.4 billion people could be affected by urban disasters by 2020 (IFRC 2010). In addition, humanitarian actors are confronted with exac- erbated state fragility (Feinstein In- ternational Centre and Humanitarian Futures Programme 2010) as well as the emergence of new players in the humanitarian arena, such as the mili- tary, an increasingly complex dias- pora and the private sector, whose motives for engaging in humanitarian assistance are fundamentally different. Not surprisingly, humanitarian agen- Fruit vendor, partner of the project, in one of the 4 markets of inter- cies are faced with questions about vention in Port-au-Prince, Haiti their ability to help the increasing number of people affected by emer- the United Nations (FAO) estimates INTRODUCTION: URGENCY, UNCER- gencies. They are looking for creative that 925 million people are under- TAINTY AND INCREASED NEED and efficient solutions to tackle fu- nourished worldwide in 2010 (FAO The world faces today one of the big- ture vulnerability, without compro- 2010). Of these, 55 million suffer gest challenges ever: how to feed 9 mising the humanitarian principles of from the most severe form of hunger, billion people in 2050, in the face of humanity, neutrality and impartiality. acute malnutrition (ACF 2010a). climate change, increased market In the food and nutrition sector, busi- instability and the growing competi- The sheer scale of human vulnerabil- ness as usual is becoming less com- tion for the use of natural resources. ity will grow ever greater1. Greater mon. The proportion of “traditional” This challenge becomes even more vulnerability means greater need and in-kind assistance, such as donor- pertinent considering that the pro- an increased number of affected peo- sourced in-kind food aid, is decreas- gress towards the Millennium Devel- ple. The total number of people af- ing even in emergencies (WFP 2010, opment Goals over the start of the fected by natural disasters has tripled Harvey et al. 2010). Other types of 21st century has slowed and, in some over the past decade to 2 billion (ACF programming, such as cash- and mar- of the most affected countries, even 2010b), with climate change being a ket-based interventions3, are gaining regressed. In addition, before the major determinant of nutritional vul- ground and present opportunities food and economic crisis even started nerability (Crahay et al. 2010). The beyond the traditional boundaries of in 2007, hunger was on the rise. The- rapidly increasing urban population humanitarian response, including Food and Agricultural Organization of further increases the complexity of collaboration with the private sector.

1See e.g. Feinstein International Centre and the Humanitarian Futures Programme (2010) 2See e.g. Food for the Cities at www.fao.org/fcit 3Cash-based programming includes Cash for Work (CFW), cash transfers and vouchers.

back to contents SCN NEWS #39 26 Features www.unscn.org At the same time, technical innova- cess to, and availability of, adequate age were affected by anaemia and tion and information have reached food was compromised as traditional almost 30 000 babies suffered from most parts of the world, and for ex- supply channels were severely dis- mental deficiencies due to maternal ample mobile networks can now be rupted and income sources drasti- iodine deficiency during pregnancy found in exceedingly remote areas. cally reduced. Of the population, 52% (Cayemittes et al. 2007). The continuing developments in tech- was categorized as food insecure The negative effects of undernutri- nology may have significant impacts (CNSA et al. 2010), and an ACF nutrition are all too well known: it per- on humanitarian action, provided tional screening5 showed a significant petuates itself in a vicious intergen- that agencies find ways to harness increase in the number of children at erational cycle, leading to higher and keep abreast of the new develop- risk of acute malnutrition (ACF mortality and morbidity, as well as ments. 2010c). The prevalence of undernu- impaired physical and cognitive de- trition in Port-au-Prince was relatively This article looks at how humanitar- velopment. Undernutrition also has limited prior to the earthquake, even ian organizations can collaborate global repercussions in that it nega- if micronutrient deficiencies were with the private sector in emergen- tively affects economic development, common. A nutrition survey con- cies, drawing from Action contre la costing an estimated 2-3% of the ducted in Port-au-Prince in March Faim’s (ACF) cash-based program- gross domestic product (GDP) in most 20096 showed that 3.9% of the chil- ming in Port-au-Prince, Haiti, after affected countries (World Bank 2006 dren were acutely malnourished the January 2010 earthquake. The in ACF 2010a). while 18.1% were stunted (ACF following section describes the fresh 2010d). The Demographic and Health food voucher programme that was Rationale of the project Survey conducted in 2005-2006 con- put in place in the immediate after- cluded that 4% of the babies were To complement the existing humani- math of the earthquake to address born underweight and that micronu- tarian food and nutrition security re- the nutritional needs of the affected trient deficiencies were widespread: sponse, which included the distribu- population. The final section presents 7 50% of pregnant women and around tion of in-kind food aid , ACF set up a conclusions and discusses out- 60% of children under five years of fresh food voucher project, “Koupon standing questions regarding public- private-civil society partnerships in emergencies.

KOUPON MANGÉ FRÉ4: COLLABORA- TION WITH THE PRIVATE SECTOR IN DELIVERING CASH-BASED EMER- GENCY ASSISTANCE Context An earthquake reaching seven on the Richter scale hit Haiti on 12 January 2010 at 16:53 local time. More than 220 000 people died and 1.5 million people were left homeless, with the vast majority living in non-official settlements in the Port-au-Prince region (United Nations Security Council 2010). Assets were virtually entirely destroyed, and sanitary risks related to poor water and sanitation conditions quickly became apparent. Ac- Meat vendor, partner of the project, in one of the 4 markets of intervention in Port-au-Prince

4Fresh food voucher in Haitian Creole. 5 5 401 children from 6 to 59 months and 1,147 pregnant and lactating women were screened, between 13 March and 23 April 2010, using Mid-Upper Arm Circumference (MUAC) measurement and oedema detection in six areas of Port-au-Prince. 6 Anthropometric nutrition survey conducted between in March 2009, using SMART methodology and based on a sample of 982 children. 7 World Food Programme had put in place a general distribution of dry staple foods (wheat) and a blanket distribution of Supplemen- tary Plumpy, BP5 and CSB-oil-sugar mix targeting children under five years of age and pregnant and lactating women.

back to contents SCN NEWS #39 www.unscn.org Features 27 Mangé Fré”, to diversify household produced vegetables, fruits and fish, services, notably the variety of goods. diets8. Fresh foods, such as vegeta- as well as meat in four markets in The fresh-food traders participating bles, fruits and animal-source foods Port-au-Prince. In total, 163 small in the scheme had to comply with the are important sources of essential traders participated in the scheme, following criteria: i) be based in one vitamins and minerals required for which also included nutrition educa- of the selected markets; ii) sell a vari- adequate nutrition and healthy tion. The objective of the interven- ety of fresh food products only; iii) growth. Where households are un- tion was two-fold: commit to the scheme for its entire able to access these nutrient-rich duration; and iv) not increase prices  To mitigate the risk of undernu- foods, micronutrient deficiencies are artificially during the project (but sea- trition, through improved access present, affecting young children and sonal fluctuations were accepted). to diversified foods and nutrition pregnant and lactating women in par- education; ticular. Markets and banks: collaboration  To support and stimulate the with the private sector on two levels The project targeted 15 000 house- local market. holds, or roughly 90 000 individuals, A market-based approach was appro- during an initial period of three Geographical position, based on the priate even in the close aftermath of months. These final beneficiaries location of the final beneficiaries, was the shock. Rapid assessments showed were selected by ACF using geo- the main selection criterion for the that supply in the markets exceeded graphical and needs-based criteria. four participating markets. Other cri- the demand, which was hampered by Each household received monthly teria included beneficiary preference, a general lack of purchasing power. vouchers of a total value of US$ 25 access to the markets and quality of More detailed assessments showed which were exchanged for locally- Figure 1. Emergency-affected fresh food market map, Port-au-Prince, Haiti (ACF, 2010).

8 ACF also set up free cash grants and cash for work for additional 15 000 households in Port-au-Prince. Voucher-approach was chosen for this project given its specific nutritional aim. It was also deemed advantageous for the supply side, as traders and producers were guaranteed a certain degree of demand for fresh foods.

back to contents SCN NEWS #39 28 Features www.unscn.org that the fresh food production areas outside of Port-au-Prince and the network of middlemen (Madam Sara9) were functional, but that the trade was slowed down due to dis- rupted communication networks and limited demand from Port-au-Prince (ACF 2010e)10. Figure 1 shows the impacts of the earthquake on the fresh food market system. In addition, prices remained relatively stable and comparable to pre-earthquake levels. It was hence deemed safe to stimulate the demand within Port-au- Prince through the provision of vouchers when the road network was re-opened11. Once the small traders had signed up for the project, the “traditional” supply chain composed of private actors took over and ensured the service functioned, i.e. the delivery of fresh foods to the final Example of fresh food basket worth 515 Haitian Gourdes (HTG), in beneficiary. Marché Lalue in April 2010 Cash availability in post-earthquake sub-offices all over the city and is actors involved in the scheme. There Port-au-Prince was limited and the widely used by Haitians to send and was an ACF market monitor present security situation was tense. Most receive remittances. They provided a every day in each of the four mar- traders contracted credits in the highly flexible service, allowing trad- kets, who received grievances, as- morning to buy their daily stock, and ers to redeem their vouchers on a sisted traders and beneficiaries and were asked to reimburse these cred- daily basis in any of their sub-offices, ensured that the vouchers were used its in the evening. Consequently, the complied with ACF requirements on correctly. S/he also monitored food voucher redemption system needed monitoring and control12, and their commodity prices. ACF also organized to be extremely flexible, rapid and fee was reasonable13. ACF transferred regular visits to the Sogexpress of- reliable, whilst ensuring the safety of to Sogexpress the amount equalling fices. In addition, Post Distribution all stakeholders. It was clear from the the total value of vouchers to be dis- Monitoring (PDM) was implemented outset that ACF alone could not man- tributed in the beginning of each throughout the project, collecting age the system, even if it had imple- month. Sogexpress then provided a information from final beneficiaries, mented voucher redemption and monthly report of cash disburse- participant and non-participant trad- cash disbursement schemes on a ments to ACF, and where necessary, ers, as well as from Haitian market smaller scale. Several private banks reimbursed the outstanding amount authorities, aiming to measure the and microcredit institutions were as- to ACF. impact of the project as well as col- sessed and finally Sogexpress, a sub- lecting data on beneficiary satisfac- sidiary of the Haitian bank Sogebank, Detailed and thorough monitoring tion on the project implementation. was selected. Sogexpress has several was crucial given the multitude of

9 The national trade of subsistence crops, from the producer to the consumer, goes historically through a network of female middlemen called Madam Sara. These are itinerant traders, travelling from one market to another, buying and selling farming products with small profits. Port-au-Prince wholesalers and retailers get most of their supply through the Madam Sara network. 10 The study followed Emergency Market Mapping Assessment (EMMA) methodology developed by Mike Albu (Albu 2010). 11 Note that the fresh food trade was confronted with issues linked to poor storage and transport infrastructure and overall low structuring of the marketing chain already prior to the earthquake. 12 Sogexpress would systematically control the validity of each voucher, which all had a unique serial number, and check the ID of the trader, while the latter signed a receipt. This procedure took a couple of minutes. 13 ACF paid Sogebank a commission of 2.75% of the total transaction value.

back to contents SCN NEWS #39 www.unscn.org Features 29 PUBLIC-PRIVATE-CIVIL SOCIETY scheme. ACF designed the project of the approaches that provide most PARTNERSHIPS IN HUMANITARIAN based on an assessed need, identified opportunities for public-private-civil EMERGENCIES: CONCLUSIONS AND the project beneficiaries and ensured society collaboration in emergencies. OUTSTANDING QUESTIONS that the relief was effectively chan- The private businesses may be of as- nelled to those in need, using thor- sistance to the humanitarian sector Setting up an entirely agency-run dis- ough monitoring. Overall, monitoring by providing the scale, the expertise tribution of fresh foods of similar results showed that the satisfaction and the reactivity that humanitarian scale within the given time frame was high, with 76% of the traders14 organizations alone cannot ensure would not have been possible due to and 99% of the direct beneficiaries anymore, given the changing face of logistical issues. Such factors included being satisfied with the project mo- emergencies. Partnerships with the transportation and storage; the dis- dalities (ACF 2010f). private sector may also include ac- persed market chain composed of a cess to new sources of funding. Addi- multitude of small producers, traders There are a number of other success- tionally, the private sector may be and middlemen; as well as the time, ful examples where humanitarian well placed to help increase the sus- human resources and security re- organizations have collaborated with tainability and longer term positive quirements of the voucher redemp- the private sector in delivering cash- effects of humanitarian aid. Examples tion system. Partnering with the pri- based programmes, including in include promoting banking literacy vate sector allowed each actor to emergencies. For example, ACF, Con- and inclusion of the poor into the draw on their comparative advantage cern and Oxfam used mobile phone market system, which is becoming as everyone concentrated on their companies to deliver cash in urban increasingly important given the in- core competencies. Sogexpress al- slums in Kenya, during the post- creased occurrence of protracted ready had in place technological and election violence in 2008. World Vi- crises and the efforts needed to bet- security solutions adapted to han- sion International collaborated with ter link relief to longer term develop- dling large amounts of cash and an an international private company to mental goals. Further, partnerships efficient distribution network. Part- deliver cash in Lesotho in 2007-2008. may foster and encourage innovation nering with a well known and trusted The Hunger Safety Net Programme in and ensure better use of technology. company encouraged the involve- Kenya uses smart cards for their cash As seen above, the private sector ment of the traders in the project. On disbursement. may also have a comparative advan- the supply side, private sector col- The potential of public-private-civil tage in delivering assistance to af- laboration contributed to improve society partnerships for food and nu- fected urban populations. the efficiency of the system, given trition security is also highlighted in the knowledge of the actors of their It is, however, important to remem- recent initiatives, such as the Scaling own environment. Their motivation ber that there are fundamental dif- Up Nutrition (SUN) Movement. Cash- to make a profit most likely also conferences in the aims, objectives and based programming is probably one tributed to the efficiency of the operating principles between the pri-

Fresh food vendor and identification card provided by ACF to ease identification of participanting vendors by vouchers recipients

14 Sources of dissatisfaction among the traders included long waiting times at the Sogexpress counter and recurrent breakdown of computer system due to electricity cuts. back to contents SCN NEWS #39 30 Features www.unscn.org

Marché “Canapé Vert”, one of the four markets of intervention in Port-au-Prince vate and the humanitarian sectors. food voucher project. Thanks go also ACF (2010e) Rapport d’étude de marché, General guidance, for instance the to Sogexpress, the traders, the pro- Produits Frais, Port-au-Prince, Printemps “Guiding Principles for Public-Private ducers and the Madam Saras who 2010. Action contre la Faim Haiti:Haiti. Collaboration for Humanitarian Ac- made the project possible, and to ACF (2010f). Rapport de suivi du projet tion”, elaborated by the World Eco- Philippe Crahay, Béatrice Mounier, Coupons Produits Frais – Juillet 2010. nomic Forum and the Office for the Stanislas Morau, Ioana Kornett and Action contre la Faim Haiti:Haiti. Coordination of Humanitarian Affairs Isabelle Moussard-Carlsen for their (OCHA) (2007), is helpful in facilitat- comments on an earlier draft. Finally Albu M (2010) Emergency Market Map- ping and Analysis Toolkit. Practical Action ing a mutual understanding, but will we thank Philip James for proof read- Publishing Ltd:Rugby. not replace a careful context analysis ing and edits. and a thorough positioning, almost Cayemittes M, Placide MF, Mariko S, Bar- rère B, Sévère B, Alexandre C on a case-by-case basis. Safeguards, References such as detailed monitoring systems (2007) Enquête Mortalité, Morbidité et and transparent communication and ACF (2010a) Taking Action. Nutrition for Utilisation des Services, Haïti, 2005-2006. Survival, Growth & Development. Action Ministère de la Santé Publique et de la agreements, will be crucial regardless contre la Faim International:New York, Population:Haiti, Institut Haïtien de l’En- of the situation. They need to ensure Montreal, London, Paris, Madrid. fance:Piéton-Ville et Macro International that the fundamental humanitarian Inc:Calverton. principles of humanity, neutrality and ACF (2010b) Community-based Disaster impartiality are respected, that inter- Risk Management. Policy Document CNSA, WFP, FAO, Oxfam, ACF, FEWSNET ventions are delivered strictly on a (forthcoming). Action contre la Faim In- (2010) Evaluation rapide d’urgence de la needs basis, that the most vulnerable ternational:New York, Montreal, London, sécurité alimentaire post-séisme. Mars Paris, Madrid. 2010. Coordination Nationale de la Sécu- and the destitute are not excluded rité Alimentaire (CNSA):Haiti. and that humanitarian core stan- ACF (2010c) Evaluation rapide de la situa- dards, such as “do no harm”, are ad- tion nutritionnelle sur l’aire métropolitai- Crahay P, Mitchell A, Gomez A, Israël AD, hered to in their broadest sense. ne de Port-au-Prince. Mars-Avril 2010. Salpeteur C, Mattinen H, Deret H, Action contre la Faim Haiti:Haiti. Lapegue J, Grosjean L, Ait Aissa M, Brown Acknowledgements R, Hauenstein Swan S, Pietzsch S, Dufour ACF (2010d) Enquête nutritionnelle et de C (2010) The Threats of Climate Change The authors would like to thank the mortalité enfants de 6 à 59 mois – Port- on Undernutrition — A Neglected Issue food security and livelihoods teams in au-Prince. Action contre la Faim Hai- That Requires Further Analysis And Ur- ti:Haiti. Haiti, who set up and run the fresh gent Actions, SCN News 38:4-10.

back to contents SCN NEWS #39 www.unscn.org Features 31

FAO (2010) The State of Food Insecurity texts: a review of current thinking. Over- Nations Haiti Stabilisation Mission. in the World 2010: Addressing food inse- seas Development Institute:London. S/2010/200. United Nations:New York. curity in protracted crises. FAO:Rome. IFRC (2010) World Disasters Report 2010. WFP (2010) 2009 Food Aid Flows. Feinstein International Centre and the Focus on urban risk. International Federa- WFP:Rome. Humanitarian Futures Programme (2010) tion of Red Cross and Red Crescent Socie- Humanitarian Horizons: A Practitioners’ ties:Geneva. World Economic Forum and OCHA (2007) Guide to the Future. Feinstein Interna- Guiding Principles for Public-Private Col- tional Centre:Medford. Scaling Up Nutrition Road Map Task laboration for Humanitarian Action. Team (2010) A Road Map for Scaling-Up (online) Harvey P, Proudlock K, Clay E, Riley B, Nutrition (SUN). Jaspars S (2010) Food aid and food assistance in emergency and transitional con- United Nations Security Council (2010) Secretary General’s Report on the United

Agriculture—Nutrition Community of Practice (CoP)

Recently, attention to the agricultural sector is growing, with a focus on leveraging agriculture to improve nutrition and health. Agricultural investments and programs can lead not only to increased production and reduced poverty, but also improved nutrition. As agriculture affects everyone, and many of those most at risk of undernutrition are directly engaged in agriculture, nutrition-sensitive agricultural policies and interventions are needed to reduce malnutrition globally.

Who are we? We are a global network of professionals working on issues pertaining to the intersection of agriculture and nutrition. The group is informal, and designed to facilitate information sharing and networking.

How did we start? This Community of Practice (CoP) arose in June 2010 because a number of experts from different institutions in Wash- ington DC were asked to write policy briefs on how to link agriculture and nutrition. Six experts agreed to work together to harmonize their recommendations. In the process, it became apparent that an increasing number of people are working in this area, and there was a felt need to bridge with others who had some area of relevant specialization. The group continued to grow, and by the end of 2011 it has reached more than 240 members. It includes members of developing country governments, national and international NGOs, UN organizations, universities, independent professionals, bilateral institutions and donor organizations. The UNSCN has offered to provide a space on the UNSCN website for interested individuals to come together and join the Nutrition-Agriculture CoP.

What are the objectives of the CoP? The CoP is designed to be a virtual space for sharing resources to build a common evidence pool, facilitating communication across sectors, and developing key messages to communicate to the broader development community. We wish to break down the silos that separate agriculture from nutrition through creating opportunities for cross-sectoral dialogue on issues of mutual interest. The group has facilitated face-to-face meetings at various conferences and events since mid-2010, held periodic thematic discussions by conference call, and disseminated research findings/ tools/guidance materials. The outcomes of the group evolve with the needs of the members.

This CoP promotes thematic conference calls on topics proposed by group members, and an announcement-only email list. It also envisages to develop a human resource database of specialists working on issues linking Agriculture to Nutrition.

Join the Agriculture-Nutrition CoP! You can subscribe by clicking here.

back to contents SCN NEWS #39 32 Features www.unscn.org HYBRID PUBLIC-PRIVATE DELIVERY OF PREVENTATIVE LIPID-BASED NUTRIENT SUPPLEMENT PRODUCTS: KEY CHALLENGES, OPPORTUNITIES AND PLAYERS IN AN EMERGING PRODUCT SPACE Travis J. Lybbert, Associate Professor, Agricultural & Resource Economics, University of California, Davis & Member, Giannini Foun- dation of Agricultural Economics, [email protected]

Author statement: The author declared not having any conflict of interest. INTRODUCTION to supply all of an individual’s daily the LNS continuum. While RUTFs are food energy requirements and treat designed as a short-term emergency In the past decade, Plumpy’Nut® has SAM anchor one end of this contin- treatment to be consumed inten- seen remarkable success as a means uum. Medium-quantity LNS products sively as part of a short-term treat- of treating severe acute malnutrition (e.g., Plumpy’Doz®, Plumpy’Sup®) – ment regimen, LNS-P products are (SAM) among young children. This often called Ready-to-Use Supple- designed to be consumed daily (or at product triggered a revolution in the mentary Foods (RUSFs) – designed to least regularly) to compensate for the treatment of SAM by (i) inspiring a supply more than half of daily food lack of essential micronutrients and range of Ready-to-Use Therapeutic energy requirements and treat Mod- fatty acids, and thereby protect Foods (RUTFs) and (ii) enabling com- erate Acute Malnutrition (MAM) or against malnutrition. munities and even households in- prevent seasonal wasting occupy the stead of clinics or hospitals to treat Differences between RUTFs, RUSFs middle of the LNS continuum. Small- SAM. Because of this widespread suc- and LNS-P products have important quantity LNS products (e.g., Nutribut- cess and the interest it attracted implications for their respective sup- ter®) designed to supply less than from the humanitarian community, ply and distribution chains. The es- half of daily food energy require- the structure of the RUTF product sential nutritional, legal and eco- ments and prevent undernutrition space emerged quickly and quite or- nomic aspects of these products, anchor the other end of the contin- ganically. Specifically, the structuring while similar on the surface, are dis- uum. These preventative LNS (LNS-P) of this product space – which in- tinct in ways that raise unique chal- products specifically aim to prevent cludes legal, regulatory, commercial, lenges (and possibly opportunities) undernutrition among pregnant/ and distributional dimensions – was for the development, production and lactating women and young children led primarily by the three major dis- distribution of products along the LNS who have access to sufficient calo- tributors: United Nations Children's continuum, including how public, ries, but lack essential micronutrients Fund (UNICEF), Médecins Sans Fron- non-profit and private stakeholders and fatty acids. tières (MSF) and the World Food Pro- interact. While the effectiveness of RUTFs is gramme (WFP). This structure now In this paper, I explore how seem- well established, RUSFs and LNS-P provides a valuable framework within ingly minor differences along this products are still under clinical trial. which RUTF supply chains can con- continuum of LNS products may As a technical matter, starting with tinue to evolve in response to chang- translate into major differences in RUTFs on one end and sliding across ing producers, purchasers and prod- the structure of these “product this LNS continuum implies modified ucts. It also illustrates effective inter- spaces” – that is, in how RUSF and micronutrient levels and formula- action between key nutrition stake- LNS-P products are likely to be pro- tions, calorie content and dosage holders in the public, non-profit and duced, regulated, distributed and rates. As a practical matter, however, private sectors united by a shared consumed differently than their RUTF sliding across this continuum also nutrition priority. cousins. These differences imply new involves major changes to their deliv- The recent success of RUTFs in treat- challenges for effectively engaging ery, consumption and prospective ing SAM has sparked the develop- and coordinating the interests and benefits. Many of these important ment of an ever-expanding contin- actions of different stakeholders. To changes and challenges stem from uum of LNS products1. Large-quantity simplify this exploration, I specifically differences in intended usage across RUTFs (e.g., Plumpy’Nut®) designed contrast the established RUTF prod-

1 The products listed as examples of these different LNS-type products are produced by Nutriset – the company that created Plumpy’Nut®. For a complete description of Nutriset’s LNS product line, click here. While other producers are now competing in this product space, it is perhaps easi- est to see the continuum using a single producer’s product line.

back to contents SCN NEWS #39 www.unscn.org Features 33 uct space with the emerging LNS-P While private market involvement in households regularly buy products product space and acknowledge that LNS-P product distribution3 can help such as soaps, shampoos and snacks the RUSF product space shares some close the gap between the vast need that are actively marketed by the pri- features of both2. for malnutrition prevention and the vate sector. We certainly have more limited public funds available to fi- to learn about effectively marketing LNS-P PRODUCTS WILL REQUIRE DIS- nance programmatic distribution, a nutritional and health products, but it TRIBUTION THROUGH BOTH PUBLIC few observations may shed additional is important at this stage to realize CHANNELS AND PRIVATE MARKETS light on the potential role of private that distribution through private mar- Many important differences between market distribution. First, in many kets involves much more than charg- RUTFs and LNS-P products stem from developing countries, the need for ing a price for goods. The private sec- the fact that the former are thera- nutritional supplementation of preg- tor’s real comparative advantage peutic while the latter are preventa- nant/lactating women and young comes in the rewards it provides to tive. The donor community - always children may extend well beyond those who understand and effectively more reactive than proactive - has households below the poverty line shape and meet consumer prefer- long prioritized the treatment of SAM since the provision of public invest- ences, in the incentives provided to over the prevention of malnutrition. ments in public health typically lag each participant in efficient and func- Although some new initiatives allo- behind increases in private incomes. tional supply chains, and in the inno- cate public funds to preventative in- This means that a seemingly small vation it spurs among competitors to terventions (e.g., the Scaling Up Nu- move along the LNS continuum to- devise new and better ways of deliv- trition (SUN) Movement, some recent wards LNS-P may dramatically ex- ering products (e.g. in new packages Maternal Child Health and Nutrition pand the pool of potential beneficiar- or sizes, bundled with complemen- (MCHN) programs at the United ies. International organizations will tary products, etc.). Obviously, the States Agency for International De- likely take the lead in setting stan- private sector brings its own limita- velopment (USAID) that distribute dards, financing and distributing LNS- tions, but it is important to keep in fortified corn soya blends to prevent P to a vulnerable core of this pool, mind that it differs from public chan- malnutrition, etc.), widespread distri- the rest – perhaps the majority – will nel distribution in more ways than bution of LNS-P products in the urban depend on private market access. just putting a price on goods and services. and rural communities that face mal- Second, involving private markets in nutrition risks will require a depar- RUSF distribution means more than Lastly, we still do not know how ef- ture from business as usual. Specifi- requiring people to pay for these fectively LNS-P products prevent un- cally, if LNS-P products are shown to products. While the undernutrition dernutrition, and what we learn from be efficacious, providing vulnerable problem is unique in its complexity, ongoing efficacy trials such as those populations with consistent and sus- experiences from other health prod- in the International Lipid-Based Nutri- tainable access to these complemen- ucts illustrate this point. A decade of tional Supplements (iLiNS) project tary feeding supplements, while con- research into the private demand for (iLiNS 2011) and concurrent effective- tinuing to address the underlying health products such as bed nets, ness studies will shape both public causes of these malnutrition risks, deworming medicines and water dis- and private distribution of these will require either an unprecedented infectant has shown that charging products. In the case of RUTFs, the and unlikely expansion in donor fund- even small prices for these goods can early Plumpy’Nut® evidence was ing or an alternative distribution quickly eliminate any private demand stunning enough to induce both a model that includes both program- for them (Abdul Latif Jameel Poverty reallocation of budgets towards matic and private market channels. Action Lab 2011). Yet, many poor RUTFs and a general expansion of

2 While I do not explicitly discuss micronutrient powders (MNPs; e.g., Sprinkles), I acknowledge that these products are often classified along with LNS-P products as Food Supplementation Products (see for example the draft UNHCR Operational Guidance on the Use of Special Nutritional Products to Reduce Micronutrient Deficiencies and Malnutrition in Refugee Populations. Some dimensions of the contrast between RUTFs and LNS-P products may transfer cleanly to the contrast between RUTFs and MNPs, but there are also differences between LNS-P products and MNPs that imply that the implications for MNPs may differ in important ways. There are other nutritionally fortified products beyond MNPs that may compete with some LNS-P products, which I similarly do not discuss in this paper. 3 Essentially all the products along the LNS continuum are produced by private firms, but these products have been distributed almost exclusively through public procurement and programmatic channels. Thus, private market distribution of LNS-P products will represent a significant departure from business as usual. back to contents SCN NEWS #39 34 Features www.unscn.org support for nutrition interventions. (NGOs) stand between the private With these observations in mind, five Dramatic evidence of long-run bene- producers and the beneficiaries, dimensions of the potential structure fits in the case of LNS-P products which dilutes the incentive for proof the LNS-P space merit careful con- could similarly encourage the donor ducers to treat beneficiaries as consideration. While each dimension is community to expand their funding sumers. As an example of this effect, unique in important ways and sheds of preventative supplementation for when recipient mothers recently ex- a different light on how the public, young children. Note, however, that pressed dissatisfaction with the taste non-profit and private sectors inter- any evidence that impresses UNICEF of a particular RUTF product and react, they are clearly interrelated. will also impress multinational firms quested a brand with a better taste, like Pepsico and Nestlé. These firms UNICEF considered requiring their Regulatory Status clearly have an interest in this mar- suppliers to remove branded labels What legal options exist for regulat- ket. For example, Pepsico recently from the RUTF products they procure ing the production, distribution and announced Enterprise EthioPEA, a in an attempt to eliminate this prob- marketing of LNS-P products? The major public-private venture with lem by making different RUTF prod- Codex Alimentarius presents con- WFP and USAID to build domestic ucts indistinguishable from each cerns, threats and (possibly) opportu- 4 RUSF production capacity in Ethiopia other – a move that treats clinical nities related to the structure of this that includes production contracts and other field staff rather than product space, but changes in this and technical training of farmers to mothers as the consumers whose domain move at a glacial pace. In a expand chickpea production (PepsiCo consumption ‘experience’ matters. In more rapid, recent development, the 2011). With decades of experience the case of private market distribu- 2010 World Health Assembly (WHA) marketing products in Africa and tion, private producers must carefully issued a resolution that totally pre- Asia, these multinational firms will incorporate these consumers’ per- cludes health or nutrition claims for heavily shape private markets for LNS spectives into the design of both their products designed for infants and -P products – if they decide this is a products and supply chains. young children, except “where spe- viable market. The importance of the consumer per- cifically provided for, in relevant Co- spective in the development of pri- dex Alimentarius standards or na- MIXED PUBLIC-PRIVATE DISTRIBU- vate markets for LNS-P products tional legislation” (WHO 2010). If this TION OF LNS-P PRODUCTS WILL raises a critical feature of the use of resolution were accepted and en- STRONGLY INFLUENCE THE STRUC- these products: LNS-P products must forced strictly, it would dramatically TURE OF THIS PRODUCT SPACE be consumed consistently – perhaps, impair the development of any pri- 5 The mix of public channels and pri- daily – to provide potential physical vate markets for LNS-P products . vate markets that is likely to emerge or cognitive benefits to children, but in the coming years has profound any such benefits are only apparent Producer & Supply Chain Coordina- implications for the legal and eco- years after these investments are tion nomic structure of the LNS-P product made when the child grows to be International organizations will likely space and for the interaction be- stronger and more able both physi- coordinate the production and distri- tween public and private players. cally and cognitively. Furthermore, as bution of LNS-P products through This mix of distribution approaches with many health investments, even public channels. While private firms will force players to seriously con- if such benefits ultimately come, it will be responsible for building and sider consumers’ perspectives, often may be very difficult for caregivers, maintaining their own supply chains neglected, and truly engage them as family members and neighbors to in private markets, these private sup- key stakeholders. Who is the con- identify these as LNS-P benefits, as ply chains will likely be influenced by sumer? What do they want? How opposed to the benefits associated the structure of public distribution much are they willing to pay? In the with a host of possible educational, channels. Precisely how the public case of programmatic distribution of healthcare or other investments or and private channels influence each RUTFs, international organizations or explanations. other will depend largely on which nongovernmental organizations

4 Personal communication. 5 Issue 41 (August 2011) of the ENN Field Exchange contains a useful exchange on the implications of the WHA draft guidelines for LNS-P products (pp.48-51).

back to contents SCN NEWS #39 www.unscn.org Features 35 and how private firms decide to enter certification efforts, large organiza- ers could be significantly constrained the fray. tions are understandably resistant to by the 2010 World Health Assembly assuming the role of third party certi- resolution mentioned above. If the composition of firms involved fiers. in LNS-P production mirrors the cur- Branding alone will not, however, be rent industrial structure for RUTFs, These experiences with RUTF quality sufficient. If private demand for LNS- these specialized and relatively small control will shape quality control op- P products emerges, the threat of producers will continue to be influ- tions in the case of LNS-P products. low quality and cheaper knock-off enced directly by the public channel The existing “in house” RUTF auditing products with less or no nutritional organizations. With such an industrial procedures that certify production value may present a real threat. Con- structure, there will also be good rea- facilities could quite easily extend to sumers may be unable to discern any sons for producers to coordinate LNS-P products since many current differences between these knock-off amongst themselves – perhaps by RUTF producers will likely produce products and high quality LNS-P prod- forming a producers’ association. If LNS-P products as well. While extend- ucts because long-term preventative instead a few large multinational ing the RUTF certification in this way benefits are extremely difficult for firms such as Nestlé and Pepsico may occur to some extent, the audit- consumers to see and to attribute. ramp up and dominate LNS-P producing organizations will almost surely Proper certification of LNS-P product tion and marketing, the private mar- insist that their certification not be quality, though complicated, may ket may be less influenced by public used in private markets. therefore be critical to these markets. channels. These firms would inde- Again the industrial structure matters In many ways, certification in private pendently create and coordinate in this regard. If major multinationals markets will be more challenging and their supply chains based on their with established brands begin pro- more important than in public chan- extensive experience distributing and ducing and distributing LNS-P prod- nels. Private supply chains will have marketing consumer goods to poor ucts, third party certification may not to find a way to ensure product qual- consumers in places near and far. be essential. If many specialized pro- ity and to transmit this information ducers wish to survive in private mar- effectively to consumers. This will Product Safety, Quality Control & kets, however, they will likely have to require effective branding on the part Marketing collaborate as a producers’ associa- of LNS-P distributors as a way to build tion and rely on third party certifica- In the past decade, the international trust and provide quality information tion based on standards set by an organizations have developed their to consumers. Given the nature of authoritative institution (e.g. the own auditing and certification proc- LNS-P products, any branding and World Health Organization (WHO)). esses to ensure the safety (e.g. sani- marketing effort must be based on While such a certification for high tation, input quality) and quality (e.g. credible and verifiable commitments quality and “recommended” LNS-P formulation, shelf life) of RUTFs they to social responsibility. If multination- products could be pivotal to private procure through public channels. als choose to enter the LNS-P market, markets in such a case, it would also These processes assess both facilities they will no doubt leverage their es- entail additional costs. If borne by the and products based on International tablished brands in this effort. While private sector, these costs would Organization for Standardization smaller, specialized RUTF producers squeeze inevitably tight profit mar- (ISO) and other standards. While this such as Nutriset may have recognized gins for LNS-P products. If borne by quality control continues to be done brands in some locations (e.g., Plum- the public sector as part of a general internally and separately by UNICEF, py’Nut®), developing the necessary campaign to ensure food quality and WFP and MSF, a set of shared stan- marketing expertise to effectively safety, these costs may make public dards and protocols have emerged as and broadly connect with consumers health trade-offs yet more difficult. a de facto certification process. To will require massive new invest- date, these organizations have coor- ments, a departure from business as Product Space “Neighbors” dinated their audits somewhat, but usual and great care to avoid mis- have not integrated their efforts as haps. Whether multinational firms or Even if LNS-P products are novel in collaborating procurement players. specialized producers enter this fray, their formulation, have important Even though smaller NGOs would like any campaign to brand LNS-P prod- impacts on early childhood nutrition, to piggyback on these auditing and ucts and communicate with consum- and are cost effective, consumers will

back to contents SCN NEWS #39 36 Features www.unscn.org not see them as unique. In many con- tion will demand an effective com- reasonably wonder how the benefits texts they will be surrounded by munications campaign to succeed of mixing LNS-P in her young child’s neighboring products that similarly where many similar efforts have food compare to instead giving her aim to improve childhood nutrition failed. Compared to handwashing an egg and a mango each day. While such as micronutrient powders6 campaigns that use ultraviolet light to it may be challenging or impossible (recently recommended by WHO show the immediate effect of wash- and expensive7 for even an ambitious [WHO 2011]) and fortified cereals ing hands, for example, campaigns to and informed mother to perfectly and blends. Nutritionally, these motivate mothers to use LNS-P prod- replicate the nutritional profile of LNS neighboring products may not substi- ucts in complementary feeding may -P products using local foods alone, it tute for LNS-P products, but they may be more challenging since inherently is not hard to see how she might see appear to be near-perfect substitutes long-run benefits are difficult to cheaper alternatives as close enough to consumers faced with a growing showcase in the short-run. The 2010 – particularly given the competing variety of supplements and other nu- World Health Assembly resolution demands for her attention and re- tritional products. These competing charges governments with the resources. Clearly, nutritional cam- products and their regulatory, legal sponsibility to provide this training paigns should strive to provide such a and commercial structure will shape and education and virtually bans any mother with adequate and accurate the evolution of private markets for private sector involvement. Such re- information to improve these dietary LNS-P products. strictions would require genuine pub- decisions, but the broader set of con- lic-private partnerships: instead of straints she faces fundamentally Consumer Behaviour public channels and private markets shapes the value of this information In programmatic distribution, inter- operating in parallel, they would have to her. To wit, this mother faces national organizations try to select to be carefully integrated, which can other important tradeoffs between the most cost-effective and sustain- be challenging in practice. any of these nutritional investments in her child’s health and educational able intervention to treat or prevent In most settings, even relatively poor or other investments in her child’s malnutrition given local preferences households have some discretionary future. These broader investment and then work through local partners income, which is often spent on small alternatives may influence (and be to implement this intervention. Al- candies or other snacks. This may influenced by) households’ responses though compliance of recipients can mean that purchasing power per se to LNS-P products appearing in pri- be a concern in such a programmatic will not be a major constraint on LNS- vate markets. approach, consumers in private LNS-P P markets, but consistent or daily markets will have substantially consumption of LNS-P products could Table 1 summarizes each of these greater latitude in deciding whether, nonetheless strain many households five dimensions of the LNS-P product when and how frequently to use LNS- in poor areas. For those choosing to space with several key questions. This P products in complementary feed- purchase a steady supply of LNS-P, it is by no means an exhaustive list of ing. We do not know whether daily is important to understand how they considerations. Instead, these ques- supplementation is necessary to reap would finance these purchases. tions aim to illustrate each dimension the full benefits of LNS-P products, Would they purchase and consume and initiate useful dialogue. but periodic or infrequent usage may less of other foods? If so, what is the deliver far fewer benefits. net nutritional effect of these reallo- THE STRUCTURE OF OTHER NUTRI- TIONAL AND HEALTH PRODUCT LNS-P distribution, whether through cated household budgets? SPACES CAN PROVIDE A USEFUL public or private channels, must Similarly, it will be important to con- COMPARISON therefore include careful training and sider what households perceive as education to ensure it is used prop- viable alternative investments to LNS- A similar intriguing mix of direct and erly as a complementary feeding sup- P products. For example, an informed indirect influences of public channels plement. Ensuring proper consump- mother in a poor household might and nascent private markets is appar-

6 See footnote 2. 7 When a child is 6-11 months old it is challenging to meet all micronutrient needs without the use of fortified products in many contexts. Beyond 12 months of age, it gradually becomes more feasible to provide similar nutritional benefits with local foods, but cost – particularly of animal- source foods – and seasonal fluctuations in local food sources may continue to constrain these local alternatives.

back to contents SCN NEWS #39 www.unscn.org Features 37 Table 1. Key questions for each of the five key dimensions of the LNS-P product space

LNS-P product space di- Key questions mensions Regulatory status What legal options exist for regulating the production, distribution and marketing of LNS-P products? How will the Codex Alimentarius and 2010 WHA resolution shape these regulatory options?

Producer & supply chain How much direct and indirect influence will UNICEF, WFP, MSF, and other inter- coordination national organizations have on LNS-P supply chains? What mix of large multination and specialized private sector firms will emerge in the LNS-P product space? What effect will different private sector composi- tions have on how the LNS-P product space is coordinated? Product safety, quality How will existing quality control processes developed by international organiza- control & marketing tions for RUTF production and products shape safety and quality controls for LNS-P products? How will private sector firms brand and market LNS-P products to convey product safety and quality? Will multinational firms be able to effectively leverage their expertise and existing brands to market LNS-P products? Will an LNS-P producers’ association or other third party organization be required to establish and enforce certification of LNS-P products? In any certification process, what role will the WHO or ISO standards play? Product space What products will compete with LNS-P products for consumers’ attention? “neighbors” Should LNS-P distributors see legitimate neighboring products such as micronutrient powders as threat or opportunity to bundle or build multi-product marketing campaigns?

Consumer behaviour How and how frequently will consumers choose to use LNS-P products? How will intentional deviations from prescribed usage affect the long-run impact of these products on health outcomes? How effectively will information campaigns – whether led by public or private players – convey long-run benefits and thereby affect consumer behaviour? How will broader constraints, concerns and trade-offs faced by mothers affect their procurement and consumption of LNS-P products among other competing investments in the future of their children? ent with other products that aim to which share some features with LNS- chased for daily consumption like LNS improve health and nutritional out- P products. Concerns about the vi- -P products. In the absence of sub- comes. Contrasting the structure of ability of pure public channel distri- scription-type service, the fact that these product spaces with the emerg- bution of ITNs have motivated efforts LNS-P products are supposed to be ing LNS-P product space yields sev- to expand private markets. As with consumed regularly poses a real chal- eral insights. Based on similarities, LNS-P products, the benefits of ITN lenge to private market develop- parallels can suggest lessons for navi- usage are not always immediately ment. gating the challenges described apparent, and the quality of the in- Through the Bed Net Dialogue, coor- above. Differences indicate unique secticide treatment is often unob- dinated by GBCHealth, several pri- features of LNS-P products. First, con- servable. Although ITNs are intended vate companies coordinate the pro- sider Insecticide-Treated Nets (ITNs), to be used nightly, they are not pur-

back to contents SCN NEWS #39 38 Features www.unscn.org duction and distribution of quality or even daily, the farmer purchases CONCLUSIONS bed nets and rely on a certification or otherwise procures seeds or vines In the past decade, the success of process to streamline public procure- as they always have and does so rela- Plumpy’Nut® in treating SAM has trig- ment processes (GBCHealth 2009). tively infrequently. Whereas the LNS- gered widespread changes in public The coordination of private suppliers P decision is akin to establishing a programmatic delivery of emergency around a set of WHO standards could good habit, which can be challenging, food aid and has unleashed a produc- be a useful model for LNS-P produc- the biofortified crop decision involves tive public-private interaction that ers. Given the challenges outlined a slight modification to an existing lead to the development of dozens of above, however, such a coordinated decision, which – although easier – other RUTFs and, more recently, a effort may need to reach further than may still constrain adoption in some range of other LNS-type products. the Bed Net Dialogue currently does contexts. Whereas the structure of the RUTF and include the coordination of pri- As for the integration of public and product space – including various vate marketing activities. Moreover, private channels, the fact that biofor- legal and economic aspects – establishing standards may be more tification adds micronutrients directly emerged quickly due to the direct difficult in the case of LNS-P products. into a staple crop simplifies the de- interests of and management by UNI- Next, consider crop biofortification, sign of hybrid distribution channels. CEF, WFP, and MSF, the structuring of which shares product space similari- To the extent that farmers access the preventative LNS (LNS-P) product ties with LNS-P products even if their seeds through private channels, the space is complicated by the fact that respective nutritional approaches small marginal cost of adding a bio- LNS-P products will likely require dis- and target beneficiaries are quite dif- fortified trait could be subsidized as tribution through both public chan- ferent. Crops that are biofortified to part of a public channel. Since LNS-P nels and private markets that, in turn, produce micronutrients can provide products are not bundled with the will lead to new ways of engagement health benefits. Although Golden- foods with which they are ultimately for public, non-profit and private Rice, the highest profile biofortifed mixed, no similar hybrid distribution players. As always, new interactions crop, is genetically modified, Harvest- approach is apparent for LNS-P prod- between the public and private sec- Plus uses primarily conventional plant ucts. tors bring both new opportunities breeding techniques to biofortify and new risks. Finally, regulatory dimensions of bio- crops such as beans, maize, sweet fortified crops may be informative. In This paper highlights five dimensions potato, cassava, millet and wheat cases where crops are biofortified of this emerging product space that with iron, vitamin A, and zinc. As with through genetic modification (e.g. will influence its eventual structure LNS-P products, any health benefits GoldenRice), a host of biosafety regu- and, ultimately, to the success of LNS associated with eating these bioforti- lations obviously apply. Yet the pres- -P products in preventing malnutri- fied crops are unobservable in the ence of biofortified traits alone has tion among vulnerable populations: short term. For some of these crops, not triggered much discussion or con- regulation; producer and supply especially open pollinated varieties, cern about regulation of vitamin con- chain coordination; product safety, private markets may not play much tent because by design the vitamin quality control and marketing; of a role, but for others a mix of pub- concentration is fixed at levels that neighboring products; and consumer lic channels and private markets is make overdoses very unlikely. behaviour. Although the continuum envisioned. Whereas certification and labeling of LNS products – from RUTFs to As a parallel to a mother’s decision to are critical aspects of the LNS-P prod- RUSFs to LNS-P products – shares use LNS-P for complementary feed- uct space as a whole and of some several common features, the spe- ing, consider a farmer’s decision to biofortified crops, these regulatory cific formulations and intended usage grow a biofortified crop. The fact that dimensions are less critical in the of these products are distinct and the biofortification traits are bred into case of biofortified crops that are challenges and opportunities facing existing and familiar crops makes the easy to distinguish from their non- their respective product spaces are farmer’s decision easier. Instead of biofortified cousins by an observable often unique. In this paper, I have confronting a completely new pur- feature such as color (orange in the focused on considerations that are chasing decision and facing the pros- case of beta-carotene enriched relevant to the LNS-P product space, pect of making the decision regularly crops). while acknowledging that the RUSF

back to contents SCN NEWS #39 www.unscn.org Features 39 product space shares some features ture, the exact structure of these triset in October 2011 in a session but differs in other important ways. product spaces is therefore genuinely entitled, “Quel statut pour les biens uncertain. essentiels de santé publique?” I thank Given the product space dimensions several participants at that event for described above, there is one as-yet- As LNS products shift from pure pub- their insights, including Jean-Hervé unknown feature of the LNS-P prod- lic distribution through programmatic Bradol, Isabelle and Michel Lescanne, uct space that will most influence the channels to hybrid channels with and Omar Taha. I also thank Katie structure it takes on in the coming more private market involvement, Adams, Mary Arimond, Kathryn years. The RUTF product space appreciating and responding to the Dewey, Susan Horton, Jennifer emerged through the direct guidance perspectives of consumers by truly James, and Stephen Vosti for sharing of the major international organiza- considering and engaging consumers their expertise and perspectives on tions that have a direct stake in the in this public-private interaction as these topics and providing feedback public procurement and distribution key stakeholders will be essential. In on early versions of this paper. Three of these products. These organiza- public channels, the preferences of anonymous reviewers provided help- tions are likely to assume a less influ- the mothers who are generally the ful suggestions and comments, for ential role in the emerging RUSF and targeted beneficiaries can be muted which I am also grateful. LNS-P product spaces due to the or muddled by the dominant percep- greater importance private market tion of beneficiaries as patients fol- References production and delivery will play with lowing prescriptions rather than as these products. If large multinational consumers making choices. In private Abdul Latif Jameel Poverty Action Lab corporations see an opportunity with market distribution, understanding (2011) The Price is Wrong: Charging small these LNS products, the structure of the preferences of these mothers and fees dramatically reduces access to important products for the poor. J-PAL Bul- these respective product spaces will the constraints and trade-offs that letin April 2011. (online) inevitably reflect their involvement convert these preferences into ob- and interests. If instead relatively served choices is essential to any vi- GBCHealth (2009) Bed Net Dialogue: Get- small, specialized producers continue able delivery model. As the product ting Life-Saving Nets Where They Need to Be, On Time (online) to develop and market RUSF and LNS- space for RUSF and LNS-P products P products, their influence on these emerges and evolves in the coming iLiNS (2011) The International Lipid- emerging product spaces will hinge years, it will be increasingly impor- Based Nutrient Supplements Project on whether and how well these pro- tant for key players in both the pri- Homepage. (online) ducers organize themselves (e.g. as a vate and public sectors to build their PepsiCo (2011) PepsiCo, World Food Pro- producers’ association) and agree on strategies around the question, “Who gramme and USAID Partner to Increase norms and standards, and on the is the customer here and what does Food Production and Address Malnutri- types and amounts of branding and she want?” tion in Ethiopia. (online) marketing quantities investments. At WHO (2010) Infant and young child nutri- this point, it is unclear which of these Acknowledgements tion. Resolution WHA63.23 . (online) routes is more probable. While im- This paper was inspired by my partici- WHO (2011) Use of multiple micronutrient powders for home fortification of portant legal and economic dimen- pation in the International Lipid- sions to RUSF and LNS-P products will foods consumed by infants and children Based Nutrient (iLiNS) project and at 6–23 months of age. (online) almost surely emerge in the near fu- a roundtable event hosted by Nu-

UNSCN Nutrition and noncommunicable diseases (NCD) eGroup

The UNSCN has created a virtual space dedicated for sharing ideas, knowledge and experience on how to make nutrition considerations more central to NCD action on the ground. The objectives of the Nutrition & NCD discussion are: to raise awareness on the importance of nutrition for combating noncommunicable diseases (NCD); to call for action to scale up nutrition and jointly tackle undernutrition and obesity and diet-related chronic diseases in low- and middle-income countries; and to contribute to building programming and policy development capacities of various groups of stakeholders in these countries and globally.

You can join the eGroup by clicking here. If you have any queries before joining, you are welcome to contact us at [email protected].

back to contents SCN NEWS #39 40 Features www.unscn.org PRIVATE-PUBLIC PARTNERSHIPS DRIVE ONE SOLUTION TO VITAMIN AND MINERAL DEFICIENCIES: “FORTIFY WEST AFRICA” Mawuli Sablah ([email protected])1, Jennifer Klopp ([email protected])2, Douglas Steinberg ([email protected])3, Shawn Baker ([email protected])4

1,2,3,4 Helen Keller International

Author statement: The authors declared not having any conflict of interest.

BACKGROUND including micronutrient deficiencies. (Aaron, Wilson and Brown 2010). In Recent analyses indicate that more West Africa it is projected that only “Give us this day our daily bread”. In than a third of childhood deaths are two countries, Ghana and Guinea- much of West Africa, “our daily attributable to undernutrition (Black Bissau, are on track to meet MDG 1 bread” is now produced from forti- et al. 2008). with no country on track to achieving fied wheat flour enriched with essen- MDG 4. There has been only limited tial micronutrients: iron, zinc, folic Vitamin and mineral deficiencies af- progress in reducing the prevalence acid and other B-group vitamins. In fect a third of sub-Saharan Africa’s of undernutrition and the actual addition, the omelette eaten with the people – impacting physical and cog- number of underweight children has bread may well be fried in vegetable nitive development and disability increased during the past decade oil that is fortified with vitamin A. The among populations, as well as the (Brown et al. 2010). Staple foods such fortification of these two food vehi- economic prospects of nations as rice, wheat, millet, and cassava cles, vegetable oil and wheat flour, (Micronutrient Initiative 2004). In that are regularly consumed by vul- with micronutrients has been realized most countries in West Africa, over nerable populations fail to provide through public-private partnerships 50% of women of reproductive age required levels of essential micronu- that involve the commitment of both and preschool children suffer from trients to meet the recommended local and multinational large-scale degrees of iron deficiency anaemia dietary allowances (RDAs) (Huffman industries, the support of strong poli- with negative consequences on mor- et al. 1998). Countries in the region cies driven by regional ministerial tality, cognitive development, learn- are challenged by economic con- resolutions (ECOWAS 2006; 2008) as ing ability and work capacity (McLean straints, seasonal harvests, limited well as mandatory decrees by na- et al. 2008). It is estimated that production, poor food consumption tional governments within the Eco- 41.2% of preschool age children in patterns, and poor infrastructure, nomic Community of West African West Africa are vitamin A deficient resulting in limited access to micro- States (ECOWAS), financial resources (Aguayo and Baker 2005). Sub- nutrient-rich foods, especially those from a range of public and private Saharan Africa is home to 14% of the of animal origin. funders, and the catalyzing role of world’s micronutrient deficient popu- nongovernmental organizations lation – nearly 170 million people This situation has prompted key nu- (NGOs). Out of fifteen countries in (Bégin and Craig 2002). According to trition partners in both public and ECOWAS, eight form the primarily the 2011 State of the World’s Chil- private sectors to come together in French-speaking West Africa Eco- dren report, 20% of children are un- the past decade to scale up success- nomic and Monetary Union derweight, 9% wasted and 36% ful food fortification programmes (UEMOA), using a common currency, stunted in ECOWAS. Vitamin A sup- that have been known to contribute the CFA franc. plementation coverage is estimated to the control of vitamin and mineral at 77% and iodized salt covers an es- deficiencies, both in industrialized The West Africa region has an esti- timated 44% of households in the and developing countries. These ini- mated population of 295 million peo- region (UNICEF 2011) with an esti- tiatives have focused mainly on forti- ple. The region has some of the poor- mated coverage of 74.9% of the total fying cooking oil and wheat flour for est people in the world, with a population. the large and growing populations in weighted mean annual per capita all socioeconomic classes around the income of US$ 743 in 2007 (World To meet the United Nations’ Millen- region to improve their micronutrient Bank 2009). The underfive mortality nium Development Goals (MDGs) of status. rate is 128 per thousand live births reducing child mortality by two-thirds (though it varies widely between and hunger by half by the year 2015, DEVELOPING THE WEST AFRICA PUB- countries) (UNICEF 2011). The alarm- it is necessary to focus greater atten- LIC-PRIVATE PARTNERSHIP ing underfive mortality rates are at- tion on scaling up nutrition interven- tributable, in part, to undernutrition, tions that are known to be effective In 2000, Helen Keller International (HKI) began catalyzing private-public back to contents SCN NEWS #39 www.unscn.org Features 41 partnerships for food fortification. foods with essential micronutrients. PARTNERSHIP SCALE-UP FOR SUS- HKI started by administering a Fortifi- Food fortification as a policy and TAINABLE FOOD FORTIFICATION IN cation Rapid Assessment Tool (FRAT), strategy began receiving political sup- WEST AFRICA developed by Programs for Assess- port in ECOWAS after the first public- The private-public multisectoral partment of Technology in Health (PATH) private partnership dialogue in 2002 nership was scaled up with the goal Canada and commissioned by the in Accra, leading to the emergence of of sustaining effective food fortifica- Micronutrient Initiative. The FRAT national food fortification initiatives tion in West Africa. Forging a strong survey employs a stratified method in Guinea (wheat flour), Mali (cooking alliance of cooperation among na- to ask women to provide a 24-hour oil) and Côte d’Ivoire (wheat flour tional governments, international recall on the foods they and their and cooking oil). In 2004, at the gen- agencies, the private sector and civil children under five have consumed, eral assembly meeting of the profes- society has been an essential pillar of as well as the frequency of consump- sional association of cooking oil in- the food fortification programme in tion of these food items during the dustries of the West Africa Economic the region (Baker et al. 2009a). The past week. To ensure geographic and Monetary Union (AIFO-UEMOA), partnership was broadened nation- variation, people are selected from Helen Keller International brokered a ally and regionally following the reaf- both urban and rural areas. The sur- win-win strategic negotiation, and firmation of the ECOWAS Assembly of vey allows decision-makers to iden- AIFO-UEMOA adopted a resolution to Health Ministers in 2008 to acceler- tify the best vehicles to achieve the embark on vitamin A fortification of ate their 2006 resolution on manda- greatest coverage, as well as to de- all cooking oil produced by their 15 tory fortification, which comple- termine the appropriate micronutri- member industries. This enabled mented other strategies being pro- ent dose relative to the quantities of them to add value to their products moted to control and reduce vitamin the food vehicle consumed. These against lower quality imports while and mineral deficiencies. surveys identified four potential food improving public health. Food fortification provided industries vehicles (i.e. with large coverage of Regional and national stakeholders with an opportunity to demonstrate target populations): cooking oil, continued to dialogue, plan and im- corporate social responsibility wheat flour, bouillon cubes and sugar plement large-scale food fortification through a value-added process in sta- (Aguayo et al. 2003). A series of programmes in West Africa. A second ple food production. At the same evaluations were undertaken to as- dialogue in 2007 in Bamako followed time, fortification gave industries (at sess the industries’ technical capacity a planning meeting of selected re- least the early adopters) a competi- to fortify, related costs and level of gional nutrition partners in Novem- tive edge. Regular consumption of engagement. ber 2006. The public and private sec- micronutrient fortified foods raises Cooking oil and wheat flour were tors, through the support of civil soci- the threshold of vitamin and mineral identified as the initial focus for rea- ety, NGOs and donors, collaborated intake in micronutrient deficient sons of coverage and technical and to address specific issues to promote populations, and food fortification is financial feasibility. The FRAT con- food fortification as part of the inte- self-sustaining as a business model sumption surveys in West Africa grated strategy to address vitamin under mandatory legislation and ef- show that cooking oil and wheat flour and mineral deficiencies in the re- fective regulatory controls. The roles reach more than 70% of the popula- gion. During the first phase of this of the private sector and govern- tion in most countries. Using current initiative, a focus on vitamin A fortifi- ments are both complementary and World Health Organization (WHO) cation of cooking oil, beginning in critical to success. Strong private- recommendations, it is estimated Côte d’Ivoire and Mali, subsequently public cooperation throughout the that fortifying wheat flour will pro- grew into the regional Faire Tache region has ensured the scale-up and vide between 30-50% of estimated d’Huile en Afrique de l’Ouest1 initia- sustainability of food fortification. micronutrient RDAs for most coun- tive. The accelerated pace of the re- National alliances for food fortifica- tries in the region. Vitamin A fortifica- gional vitamin A fortification of cook- tion have been established (and con- tion of cooking oil will provide an es- ing oil programme catalyzed the re- tinue to function) in Benin, Burkina timated 30% RDA of vitamin A. gional initiative on micronutrient for- Faso, Côte d’Ivoire, Guinea, Guinea- tification of wheat flour, which was Bissau, Mali, Niger, Senegal, Togo Nutrition partners in West Africa be- then launched in September 2007 at and, most recently, in Sierra Leone. gan advocacy in early 2000 with pub- the Clinton Global Initiative under the These alliances provide a forum for lic and private sector stakeholders to Fortify West Africa initiative. national level strategic thinking and collaborate on fortifying these staple

1 Literally “to make an oil stain” – the French equivalent of the “snowball effect”

back to contents SCN NEWS #39 42 Features www.unscn.org oversight of food fortification. Gam- cooperate on a range of issues, both public sector political will. The profes- bia and Liberia will soon be assisted regionally and nationally: sional associations of food industries to join the other Anglophone coun- have ensured that any new member-  Developing and adopting re- tries in ECOWAS, Ghana and Nigeria, ship is pre-conditioned on embarking gional and national standards to establish national fortification alli- on micronutrient fortification. Other and directives on mandatory ances. The membership of the na- strategic private sector partners – fortification of cooking oil and tional alliances includes the ministries such as premix suppliers and equip- wheat flour. for health, commerce and industry, ment manufacturers – engage with finance, and communications; agen-  Building capacity of all large- food industries to provide technical cies responsible for food regulation; scale cooking oil and wheat support. Private television, radio and UN agencies (UNICEF, World Food flour milling industries in the print media play a key role in commu- Programme, World Health Organiza- region, as well as regulatory nicating and sensitizing the population, Food and Agricultural Organiza- agency skills for monitoring tion and consumers on the benefits tion); NGOs; research institutions; compliance. of fortified foods, using the regional industries; food importers; consumer  Developing and implementing logo “ENRICHI” through social mar- associations; and the media. They social marketing campaigns keting. generally meet quarterly to deliber- built around a regional logo, ate on the implementation of na- “ENRICHI”, for branding forti- PROGRESS AND CHALLENGES tional strategic plans on food fortifi- fied foods. Out of the 15 member countries of cation. ECOWAS, twelve are fortifying wheat  Monitoring programme imple- At the regional level, key regional mentation, supporting public flour with micronutrients and ten are partners have committed themselves sector enforcement of stan- fortifying cooking oil with vitamin A. through a memorandum of under- dards, ensuring quality assur- Guinea-Bissau does not have any lo- standing to accelerate food fortifica- ance systems to sustain food cal flour mills or oil refineries but is tion through technical cooperation fortification, and evaluating taking steps to ensure that all im- and resource support to national for- impact. ported cooking oil and wheat flour tification programmes. In addition to are fortified and conform to the re- the donors mentioned in the ac- Fortify West Africa demonstrates gional standards. Gambia and Liberia knowledgement section below, key how effective coordination is re- are now being assisted to implement cooperating partners at the regional quired to manage this multinational strategies on food fortifica- level include: UEMOA, WAHO, re- stakeholder initiative and avoid con- tion. Niger is fortifying cooking oil gional professional industrial associa- flicts of interest while working har- and is working on fortifying wheat tions (for cooking oil producers and moniously to address vitamin and flour, but the only milling industry is wheat flour millers), UN agencies, the mineral deficiencies in a challenging undergoing a change of ownership Flour Fortification Initiative (including context. What has distinguished this and is not currently operating. West through the Smarter Futures Project) initiative is that it has operated both African countries fortifying both and regional communication agencies at the level of individual Member cooking oil and wheat flour include: (such as Africable – a regional franco- States and through two regional bod- Benin, Burkina Faso, Côte d’Ivoire, phone television network). Private ies, with a central focus on building Ghana, Mali, Nigeria, Sierra Leone, sector companies also played a sig- the capacity of local industries to em- Senegal and Togo. Cape Verde, nificant role in providing equipment, bark on fortification while govern- Guinea and Liberia are only fortifying supplies and training and include pre- ment institutions concurrently create wheat flour. mix suppliers (BASF, DSM, Fortitech, the favourable policy environment to Food fortification has witnessed sig- Hexagon Nutrition, and Muhlenche- guarantee sustainability. Synchroniz- nificant progress in West Africa since mie) and manufacturers of fortifica- ing these different processes has 2000, with advances in broadening tion or laboratory equipment. made coordination essential, and HKI took up the challenge of catalyzing partnerships, food technology, ena- This rich network of partnership dem- and managing the process of bringing bling environment, and social com- onstrates the complexity of the task. together the private and public sec- munication. An estimated 55 million Each actor has a unique role to play, tors, donors and not-for-profit stake- people in UEMOA countries are con- and the whole initiative requires each holders to dialogue, collaborate, mo- suming fortified wheat and 55 million one to contribute to the effective bilize resources, strategize and imple- consume fortified oil, of which over 8 realization of the goal of ensuring ment the initiative through a bottom- million are children under five and 70% coverage with fortified cooking up approach, driven by the private over 6 million are pregnant or lactat- oil and wheat flour. These partners sector industries and supported by ing women. Partnership networks are

back to contents SCN NEWS #39 www.unscn.org Features 43 being consolidated both regionally mineral deficiencies in vulnerable Additional technical support to food and at national levels, with continued populations in West Africa. control laboratories so that they are strengthening of industrial capacity. appropriately equipped and staffed Harmonized standards have been Partners have succeeded in equipping to undertake micronutrient analysis is implemented for the UEMOA region industries in the region and have es- also needed; qualitative and quanti- (Baker et al. 2009b). To set regional tablished the regulatory framework tative rapid analytical test kits are standards, the UEMOA secretariat through regional and national stan- being promoted to monitor the qual- coordinated with Member States dards for fortifying cooking oil and ity of micronutrients in fortified foods (Jarvis 2009). Effective control of for- wheat flour. The common “ENRICHI” in West Africa under the second tified foods and inspection carried logo allows consumers to recognize phase of this initiative. Table 1 sum- out at borders and ports of member fortified products throughout the marizes the current status of food countries of the region are required region. Regional and national social fortification, and projections for to ensure that imported fortified marketing of fortified foods has cre- 2013. foods conform to standards while ated awareness and yielded strong facilitating trade in fortified cooking political commitment to food fortifi- oil and wheat flour within the region. SOME LESSONS LEARNED cation. Local industries cover over More countries that are at advanced 70% of the demand for cooking oil Once convinced of the value of fortifi- stages of fortification should follow and wheat flour in the region with cation, business is quick to act, and the example set in passing national strong intra-regional trade. Under many have been eager to be the first policies making fortification manda- mandatory regulations for food forti- in their markets to fortify. However tory, with appropriate labelling. fication, effective control of imported sustainability is only ensured through There is still a need to reinforce the food, and an informed consumer the establishment of mandatory poli- regulatory systems of countries in the population, food fortification effec- cies that create a level playing field region, a top priority for future en- tively complements other nutrition for all industries (including imports). deavours to promote fortification. interventions to control vitamin and Government, however, works at a

Table 1. Table summarizing the current status of food fortification with projections for 2013

back to contents SCN NEWS #39 44 Features www.unscn.org different pace, and many have been up approach to successfully address a Wheat Flour Fortification Initiative. Oral slow in passing regulations for fortifi- critical public health challenge. presentation, November 3, 2009. cation. Policy work at this level re- Copenhagen Consensus Conference on quires attention to detail, mobiliza- Acknowledgements Combating Malnutrition Efficiently:Nairobi. tion of evidence, and painstaking Major funding agencies for this initia- Bégin F, Craig A (2002) Food Fortification construction of alliances within and tive are: Global Alliance for Improved outside government. Such advocacy in West Africa, assessment of opportuni- Nutrition, the Michael & Susan Dell ties and strategies. Micronutrient Initia- efforts are easily derailed by the Foundation, Micronutrient Initiative, tive:Ottawa. (online) rapid turnover of government offi- the Government of Taiwan, United cials. Having an on-the-ground pres- Black RE, Allen LH, Bhutta ZA, Caulfield Nations Children’s Fund, and the LE, de Onis M, Ezzati M, Mathers C, ence to understand the local context United States Agency for Interna- Rivera J (2008) Maternal and child under- is required for nurturing the public- tional Development. nutrition: global and regional exposures private partnerships required to sus- Technical implementation agencies and health consequences. The Lancet 371 tain food fortification. (9608):243-260. (online) include: Helen Keller International, Large-scale food fortification is a West Africa Economic and Monetary Brown KH, McLachlan M, Cardoso P, Tchibindat F, Baker SK (2010) Strengthen- complementary nutrition strategy Union (UEMOA), West Africa Health ing public health nutrition research and Organization (WAHO, an agency of and cannot reach all vulnerable indi- training capacities in West Africa: Report viduals with all required micronutri- ECOWAS), UNICEF, industrial profes- of a planning workshop convened in Da- ents. Other actions that control vita- sional associations for cooking oil and kar, Senegal, 26-28 March 2009. Global min and mineral deficiencies, such as wheat flour (AIFO-UEMOA and AIM– Public Health 5(6):S1-S19. supplementation, dietary diversifica- UEMOA), and technical ministries of ECOWAS Assembly of Health Ministers tion and optimal infant and young West African governments. (2006) 7th General Assembly Resolution child feeding should continue. on Mandatory Fortification of Cooking Oil References and Wheat Flour. Food industries are primarily respon- Aaron GJ, Wilson SE, Brown KH (2010) ECOWAS Assembly of Health Ministers sible for fortification; the other stake- Bibliographic analysis of scientific re- (2008) 9th General Assembly Resolution to holders within the partnership net- search on selected topics in public health Implement Mandatory Fortification of work are facilitators. Effective coordi- nutrition in West Africa: Review of arti- Cooking Oil and Wheat Flour. cles published from 1998 to 2008. Global nation requires open and transparent Huffman SL, Baker J, Schumann J, Zehner Public Health 5(S1):S42-S57. communication with shared values ER (1998) The Case for Promoting Multi- and vision to combat vitamin and Aguayo VM, Zagré NM, Bendech MAG, ple Vitamin/Mineral Supplements for mineral deficiencies. To sustain the Nanema A, Ouedraogo A, Baker SK (2003) Women of Reproductive Age in Develop- programme, however, strong re- Food Fortification Vehicles for the Control ing Countries. The Linkages Project, Acad- gional advocacy must continue to of Vitamin A Deficiency of Children: Find- emy for Educational Develop- translate into national strategic plans ings from a Multi-Country Study in Burk- ment:Washington DC. (online) ina Faso, Guinea, Mali and Niger. Poster that link the health and economic Jarvis M (2009) Fair Tache d’huile : presentation, February 3-5, 2003. XXI Cooking oil fortification in West Africa. sectors. Each partner brings unique International Vitamin A Consultative World Bank:Washington DC and and complementary competencies, Group:Marrakech and together they create a synergy GAIN:Geneva. Aguayo VM, Baker SK (2005) Vitamin A Micronutrient Initiative, UNICEF (2004) that can only be achieved when they Deficiency and Child Mortality in sub- Vitamin and Mineral Deficiency: A Part- all work together. Industries usually Saharan Africa - A Reappraisal of Chal- nership Drive to end Hidden Hunger in consider themselves as competitors; lenges and Opportunities. Food and Nu- Sub-Saharan Africa. Micronutrient Initia- however, when they confront similar trition Bulletin 26(4):348-355. (online) tive:Ottawa and UNICEF:New York. challenges, they recognize the Baker SK, Sablah M, Brown KH, McLean E, Cogswell M, Egli I, Wojdyla D, strength in uniting their efforts. The Belemsigri A, Thiam I, Ladikpo R, Ndiaye de Benoist B (2008) Worldwide preva- public sector must continue to create B, Kupka R, Moench-Pfanner R (2009a) lence of anemia, WHO Vitamin and Min- and maintain the favourable regula- Fortifying West Africa to Control Vitamin eral Nutrition Information System, 1993- tory environment for private food A Deficiency: The Cooking Oil Initiative. 2005. Public Health Nutrition 12(4):444– industries to flourish, while address- Oral Presentation, November 9, 2009. 454. (online) Copenhagen Consensus Conference on ing social and health problems. The UNICEF (2011) The State of the World's Combating Malnutrition Efficiently:New Fortify West Africa initiative demon- Children. UNICEF:New York. (online) York. strates how effective coordination of World Bank (2009) World Development Baker SK, Sablah M, Touaoro Z, Johnson both private and public sector inter- Indicators Database. World Q, Belemsigri A, Thiam I, Gbémou K, ests can converge through a bottom- Bank:Washington DC. (online) Ndiaye B, Diop CD, Kupka R, Moench- Pfanner R (2009b) Fortifying West Africa: back to contents SCN NEWS #39 www.unscn.org Features 45 SOCIAL MARKETING IN PUBLIC-PRIVATE PARTNERSHIPS AS A TOOL FOR SCALING UP NUTRITION: A CASE STUDY FROM TANZANIA Virginie Claeyssens1, Omar Taha2, Svenja Jungjohann3, Leah Richardson4 1Project Manager ACCESS, Nutriset; 2Public Health Development Manager, Nutriset; 3Nutrition leader, Nutriset; 4Independent Pub- lic Health Nutritionist

All inquiries should be sent to [email protected]

Author statement: The authors declared not having any conflict of interest.

INTRODUCTION est and more generally, how exactly the treatment of acute malnutrition to engage with the private sector and and that the threat of malnutrition The recent consensus document benefit from its ability to develop should be addressed from multiple “Scaling Up Nutrition” (SUN 2010) commercially viable business models angles. Through its partnership in the laid out the main elements of an ac- in developing countries. Nutriset’s research consortium “The Interna- tion framework to address undernu- model is atypical in the sense that it tional Lipid-Based Nutrient Supple- trition with relation to the landmark shares its technology and know-how ments Project” (iLiNS), Nutriset was 2008 nutrition series in The Lancet. with its partners, allowing them to engaged in the development of a The SUN Framework calls for in- contribute to responding to needs in complementary food supplement, creased investment in nutrition inter- their respective countries without Evol’Nutributter®. The product was ventions through partnerships be- having to rely on imported solutions. originally designed for infants between key nutrition stakeholders at Further, unlike other private sector tween six and twelve months of age, the global and national levels includ- actors, Nutriset only produces prod- a critical time period for growth and ing the private sector. ucts destined for either the treat- cognitive development. Since then, Nutriset has been answering this call ment or the prevention of the various Nutriset has partnered with various to action for decades; first with its forms of malnutrition affecting young research projects to improve the ef- industrial development of therapeu- children and other vulnerable groups. fectiveness of Evol’Nutributter® for tic milks used in therapeutic feeding children from six months of age and centres; later though the develop- ADDRESSING NUTRITION AT THE at risk of chronic malnutrition. ment of the first Ready-to-Use Thera- COUNTRY LEVEL Evol’Nutributter® was developed in an peutic Food (RUTF) Plumpy’Nut®; and Following the first widespread de- attempt to realize a low cost supple- currently through its continued re- ® mand for Plumpy’Nut during the ment to enrich children’s comple- search and investment in nutrition 2005 famine in Niger, Nutriset cre- mentary food (diets provided to chil- supplements such as the Lipid-based ated and continues to expand a net- dren in addition to breastmilk) with Nutrient Supplements (LNS) Evol’Nu- ® work of local producers of RUTFs. essential vitamins, minerals and fatty tributter for the prevention of ® PlumpyField , as it is now known, is a acids (see Table 1) during the critical chronic malnutrition. Even before network of partners striving to months between the end of exclusive the SUN Framework was drawn up, achieve a common goal of increasing breastfeeding and two years of age. Nutriset has been (and continues) to access to new nutrition solutions for Research has demonstrated that daily contribute to its objectives by devel- at-risk populations while adhering to consumption of Evol’Nutributter® all oping adapted products, establishing international quality standards of along the at-risk period during which a network of local producers and col- production. Currently the eleven the child receives nutritionally inade- laborating with both development ® PlumpyField partners produce nearly quate complementary food (for in- actors and governments alike. ® one third of all Plumpy’Nut used in stance, lack of products of animal There is growing recognition of the humanitarian programming with all origin, fruits and/or vegetables) pro- role the private sector can play in groups working to increase their re- motes the child’s growth and motor addressing issues related to undernu- spective production capacities. cognitive development and prevents trition, especially when it comes to long term nutritional deficiencies innovation and efficiency. In addition WIDENING THE EVIDENCE-BASED (chronic malnutrition) (Adu-Afarwuah to food production, the private sector OPTIONS et al. 2008). Similar to Nutriset’s ® also has a role to play in employment Nutriset realizes that there are many other products, Evol’Nutributter and income generation. However, more challenges and opportunities in does not require any refrigeration or many groups are still concerned addressing undernutrition beyond reconstitution, and can be made pri- about profit motives, conflict of inter- back to contents SCN NEWS #39 46 Features www.unscn.org marily from locally grown or proc- “Public” (external and internal Table 1. Evol’Nutributter® nutrient essed raw ingredients. groups involved in the programme to be addressed by the organiza- content As is the case with Nutriset’s other tion), “Partnership” (the company products, Evol’Nutributter® is a pat- has to team-up with other organiza- ented product and there are plans in tions in order for the programme to place for it to be produced in the be successful), “Policy” (policy United Republic of Tanzania. This is in changes are sometimes needed in reference to the announcement order to implement a favourable made in October 2010 where a pro- environment for the programme) posed Usage Agreement is offered to and “Purse strings” (funding strat- any company or organization (with egy to support the programme). the exception of Europe and North Based on a comprehensive under- America) to manufacture, market and standing of the needs of the target distribute products covered by Nu- population, social marketing pro- triset/IRD patents. grammes place special emphasis on USING MARKET-BASED APPROACHES understanding behaviours and employ communication and awareness Understanding the magnitude of the raising strategies in order to im- global nutritional crisis in terms of prove the health and well-being of both acute and chronic malnutrition, the population in question. and responding to the international Since mid-2006 in Niger, Plumpy- calls for renewed attention to the ® potential of market-based ap- Field network member Société de Transformation Alimentaire (STA), in proaches to enhance the access to a way or planned in three other African partnership with Nutriset distributes range of nutritious food products, countries. especially for mothers during preg- a locally produced ready-to-use nutrition supplement directly through the nancy and very young children ® THE TANZANIA PROGRAMME (Shrimpton 2007), Nutriset is embark- retail market. Grandibien is a ready- In Tanzania undernutrition is an en- ing on research for innovative deliv- to-use supplement for children aged demic problem with 42% of children ery strategies with the objective of 1-5 years which, when consumed under five suffering from chronic continuously striving to improve ac- daily, provides a minimum 50% of the malnutrition and 16% suffering from cess to these nutrient supplements to daily recommended intake of vita- chronic acute malnutrition in 2010. In vulnerable populations through the mins and minerals. Product promo- addition to this, only 50% of children private market. Nutritional supple- tion is based on social marketing ® under six months are being exclu- ments are mostly distributed through methods and Grandibien has been sively breastfed whereas interna- government or nongovernment nutri- tailored (price, name, packaging, dis- tional health organizations recom- tion programmes. The private or re- tribution channels and communica- mend exclusive breastfeeding for the tail market is an option to make prod- tion) to be accessible to vulnerable first six months of life and mixed ucts available in areas not benefiting populations. One of the main lessons feeding for at least 24 months to from these programmes. drawn from the Niger experience is the importance of public information safeguard the nutritional status of To attain this goal, Nutriset’s ap- campaigns and the funds required to young children as well as their gen- proach uses social marketing tech- ensure their continuity. In Niger, it eral health, development and sur- niques in its design and implementa- was noted that sales of Grandibien® vival. Last but not least, when the tion of programmes, which are in- decreased significantly when the Infant and Young Child Feeding (IYCF) spired from traditional marketing public campaigns ceased but quickly practices recommend that breastfed principles but with the objective of picked up again when the informa- children age 6–24 months also be fed addressing a public health need. tion campaign was relaunched three or more other food groups Hence, in addition to the conven- (Beltran Fernandez 2009). daily, only one in four breastfed chil- tional four P’s (Product, Place, Price dren in Tanzania meets this recom- Building on the pioneering work of and Promotion) used in traditional mendation (National Bureau of Statis- Grandibien®, other social marketing marketing, social marketing also in- tics 2011). cludes four more variables: projects are currently either under

back to contents SCN NEWS #39 www.unscn.org Features 47 Lipid-based Nutrient Supplements its ability to forge alliances for com- methodology is to incorporate com- (LNS) targeting children 6-24 months munity-based actions and developing munity participation at all levels in an such as Evol’Nutributter® can be a capacity for nutrition research and effort to ensure the effective integra- convenient way to fill the nutrient action so that even unconventional tion of the product into the local mar- gap of complementary food to en- public health nutrition strategies can ket (Nutriset 2010). Fifty participants hance the child’s growth and devel- succeed at the national level. Involve- took part in the focus group discus- opment and reduce child mortality. ment of the TFNC also ensures con- sions, which included ten in-depth Nutriset is committed to contributing tinuous governmental engagement interviews, ethnographic observa- to the promotion of key nutrition throughout the planning and imple- tions and 315 respondents partici- messages such as exclusive breast- mentation of the programme. pated in the secondary data research feeding and adequate complemen- that led to recommendations for Building on the increasing evidence tary feeding with continued breast- ® product packaging, price, communi- of the efficacy of Evol’Nutributter , feeding and believes that multi- cation and awareness strategies as plans are under way to develop a lo- stakeholder approaches, including well as methods of distribution. The cally produced version of the product both public and private actors, are survey was piloted in Dar es Salaam for introduction into the local market. the most appropriate methods to and subsequently carried out in three A three-phase programme (see Fig- improve these practices. The Global diverse regions (urban: Dar es Sa- ure 1) was initiated in early 2010 with Strategy for IYCF urges countries to laam, Mwananyamala; rural: Mtwara a market study analyzing the target formulate comprehensive policies to – Ziwani; semi-rural: Mwanza – Kis- population – eating habits and food ensure children’s nutritional status esa). An effort was made to ensure purchasing behaviours as well as (WHO/UNICEF 2003) and public- the points of view of both male and other political, environmental, social, private alliances bring scale, effec- female participants were captured technological, economical and legal tiveness and innovation to develop- and ultimately secured feedback (PESTEL) factors that will influence ment efforts thereby accelerating from 76.5% female – 23.5% male re- the programme. The research in- progress towards the Millennium De- spondents. The criteria for selection cluded the assessment of the need velopment Goals (Runde 2006). of interviewees were: primary care- for a supplement for the target popu- These alliances take place at different takers of children 6 - 24 months with lation and support of the programme levels and stages of the programme, a household income less than TZS by nutrition experts in the country, and can take various forms, from a 300 000 per month. including the Tanzanian government. simple interaction to a real partner- In addition, an in-depth study of in- The second and final stage of re- ship, involving shared decision- ternational guidelines and national search focused on empirical field in- making (Hawkes 2011). regulations concerning products tar- vestigation of issues around taste, In 2009, and following lessons geting children from 6 to 24 months usability, packaging and other ele- learned from the Grandibien® experi- of age – such as the International ments of the marketing mix of the ence in Niger, Nutriset partnered Code of Marketing of Breastmilk Sub- proposed supplementary food. As a with Power Foods, a local food pro- stitutes (WHA 1981) - was carried result of these studies, the product ducer in Tanzania, and the locally out. The document review was con- and the programme have been based nongovernmental organization ducted with the help of the Global adapted to the local context to be in (NGO), Industrial Revelation. This Alliance for Improved Nutrition’s compliance with international guide- public-private partnership was made working paper (GAIN 2010) on how lines and national regulations alike. possible thanks to institutional fund- to use this Code, and the National ® Evol’Nutributter is specifically de- ing from the United States Agency for Regulations for Marketing of Breast- signed to meet the needs of children International Development (FANTA-2) milk Substitutes and Designated 6 - 24 months. This approach is in line together with Nutriset’s research and Products (1994) of Tanzania to en- with and supports the exclusive development funds. The partners sure the promotion of appropriate breastfeeding of infants through six work in close coordination with the breastfeeding and complementary months of age. Furthermore, any so- Tanzania Food and Nutrition Centre feeding practices. Simultaneously, a cial and behaviour change communi- (TFNC), a semi-autonomous govern- qualitative study assessed the moth- cation (SBCC) materials will recom- ment institution under the Tanzania ers’/caretakers’ perception of the mend that the LNS be mixed with the Ministry of Health and Social Welfare, product, the associated communica- child’s complementary food and that in order to align development part- tion materials including packaging, the child be fed the supplement only ners’ goals with those of the govern- product name and design. One of the after s/he has been breastfed. This ment. TFNC is known in particular for driving forces of Nutriset’s qualitative approach is being adopted in order to

back to contents SCN NEWS #39 48 Features www.unscn.org Figure 1. Three-phase programme for product development in the United Republic of Tanzania

ensure the introduction of the prod- improve the complementary food of proach allows for increased coverage uct does not displace breastfeeding the child. To overcome this challenge, for a larger target population and and furthermore, in order not to un- Nutriset has undertaken a public- could be the basis for a sustainable dermine traditional feeding practices. private approach to make the prod- model in the long term. The combina- uct accessible to the target population of these different but comple- Due to restrictions on the promotion tions, while emphasizing its appropri- mentary distribution systems can of food products destined for chil- ate use. Evol’Nutributter® will be dis- contribute to a greater impact on dren under five in Tanzania, Nutriset tributed through both the private and preventing malnutrition in Tanzania. will share all available SBCC materials the public sectors concurrently, using with local actors for integration in As alluded to the above, perhaps the a unique packaging design known and their respective programmes. greatest challenge facing Nutriset and recognized by all (see Figure 2). On Power Foods in Tanzania are the Na- Following the infant formula contro- the one hand, NGOs would distribute tional Regulations linked to foods for versy in the 1970s, which has led na- Evol’Nutributter® through their nutri- children under five, which forbid ad- tional authorities to lose confidence tion programmes (provided free of vertising or any form of promotion in private sector players, the Govern- charge or sold at a subsidized price from the producer or the distributor ment of Tanzania has established Na- depending on the type of programme to the general public. As a result, Nu- tional Regulations regarding products being implemented), allowing for triset met several nutrition actors in targeted to young children which are tighter control over the target benefi- Tanzania and in an effort to ensure more restrictive than the World ciary population; and on the other that communication / labelling is Health Organization Code (by extend- hand, Nutriset and Power Foods clear and understood by mothers or ing the prohibition of promotion to would make the product available caregivers, Nutriset and Power Foods all products, even those that are not through the retail sector in areas that is working closely with The Centre for promoted as breastmilk substitutes). are not covered by these pro- Counselling, Nutrition and Health Although these laws are put in place grammes, all the while respecting Care (COUNSENUTH). COUNSENUTH to protect the child’s growth and de- National Regulations and working in is a local NGO with strong ties to the velopment, they also restrict the ac- close concert with local actors. Be- International Baby Food Action Net- cess to LNS that could be an option to sides controlling distribution, this ap- work (IBFAN) that aims to contribute back to contents SCN NEWS #39 www.unscn.org Features 49 to improving the quality of life reau of Statistics 2009). The pro- time before groups find their through strengthening care for vul- gramme evaluation identified the “comfort zone” and engage the pri- nerable groups and promoting pre- need for high initial investment costs vate sector. Despite this reality, sev- ventive healthcare, nutritional care and the preliminary consumer price eral private sector players have suc- and counselling at the community would need to be TZS 150-200 in or- cessfully managed to partner with level. Nutriset and Power Foods will der to cover production and distribu- public sector actors. Specific exam- work in collaboration with COUN- tion in the most effective manner. ples include the longstanding rela- SENUTH whose role would be to en- With this business model, the break- tionship between Cargill and the sure the promotion of appropriate even point for the programme would World Food Programme (WFP). More breastfeeding and complementary be in approximately three years after recent public-private partnerships are feeding practices and the appropriate around 100 MT/year of production is also showing promise, such as the use of the LNS (Evol’Nutributter®) in reached which represents an esti- newly established Partners in Food order to increase its efficacy via their mated 30 000 children in the target Solutions (PFS), a partnership be- existing SBCC channels. population consuming Evol’Nutribut- tween General Mills, Cargill and DSM, ter® every day for six months. This which aims to initiate transfers of Following the studies embarked upon project expects to be supported by technology to producers of fortified in Tanzania, it was determined that institutional grants for the first three blended flours in the developing the target population has the pur- years, specifically in order to finance world. chasing power to include this product part of the extension of the distribu- in their diet if it is priced comparably With the local development of tion network. Once the break-even ® with common snacks already being Evol’Nutributter in Tanzania, Nu- point is reached at the end of the bought for children and assuming triset is proving its commitment to third year, the programme should be there are no other similar or compet- addressing the rampant undernutri- economically viable. Once sustaining products on the market. The price tion facing the Tanzanian population able, Power Foods will be able to re- that was determined to be most af- through supporting the establish- invest profit to permanently reduce fordable for households with total ment of a sustainable system to iden- the price of the product in order to monthly income of less than TZS tify and make accessible the nutrients reach more people and specifically 300 000 (US$ 200) was TZS 150-200 required for the proper development very low-income populations. (US$ 0.09-0.12). Of primary impor- and overall health of vulnerable tance, this price would allow mothers populations. Tackling chronic malnu- INVOLVING THE PRIVATE SECTOR IN to purchase the product in addition trition also serves to address the new THE EFFORTS TO SCALE UP NUTRI- to complementary foods already be- -found support in the world of public TION ing fed to a child 6 - 24 months. health towards addressing noncom- The private sector can contribute to municable diseases, to which chronic All research carried out to date was establishing new and sustainable malnutrition is inextricably linked. considered when establishing the business models for delivering nutri- short and medium term goals. Based The challenges and main lessons tion services or messages and food on the assumption that not all of the learned from the development of products to the target population and target population will purchase, fore- Evol’Nutributter® in Tanzania will be the private sector increases the po- casts for consumption over the next considered and incorporated into tential to bring interventions to scale. five years was estimated based on Nutriset’s future initiatives and part- Unfortunately, many groups still have the target population size (children 6 nerships. One of the most important questions as to how to engage the - 24 months) (Tanzanian National Bu- lessons, and one of the main chal- private sector and it will be some

Figure 2. Evol’Nutributter® packaging design

back to contents SCN NEWS #39 50 Features www.unscn.org lenges, is the development of a policy Home fortification of complementary Nunez MO (2010). Impact of local RUTF environment that incorporates all foods with micronutrient supplements is manufacture on farmers’ incomes in Ma- possible actors that have a stake in well accepted and has positive effects on lawi. The Field Exchange, 38:17-18. improving IYCF practices. Another infant iron status in Ghana. American (online) Journal of Clinical Nutrition 87(4):929-38. main challenge is reaching children 6- Nutriset. Qualitative Research Report: (online) 24 months with a food product and Social Marketing Program. France, Nu- the target population (mothers and Beltran Fernandez A, Sauguet I, Da Costa triset, 2010. F, Claeyssens V, Lescanne A, Lescanne M caregivers) with the right messages Nutriset. Social Marketing Project in Tan- (2009). Social marketing of a nutritional (product use, appropriate breastfeed- zania: Stage 1 Market Study Key Findings. supplement in Niger. The Field Exchange, ing and complementary feeding prac- France, Nutriset, 2010. 35. (online) tices) without direct communication Nutriset. A Nutrition Supplement Social Consensus Report (2010). Scaling Up Nu- to the general public as stipulated by Marketing Project in Tanzania: Stage 2 trition: A Framework for Action. Food and the Tanzanian National Regulations. Definition and Validation of the Offer. Nutrition Bulletin, 31. (online) Nutriset’s experiences in Niger and France, Nutriset, 2010 GAIN (2010). Using the Code of Market- Tanzania highlight the importance of Nutriset website. Nutributter® Comple- ing of Breast-milk Substitutes to Guide mentary food fortifier . (online) engaging with local actors in the pub- the Marketing of Complementary Foods lic sector in order to achieve mutual to Protect Optimal Infant Feeding Prac- Nutriset website. The ACCESS approach, goals. The efficiency and innovation tice. Working Paper Series, 3. (online) a tool for nutritional autonomy. (online) of the private sector coupled with the Hawkes C, Buse K (2011). Public health Runde D. (2006). How to make develop- public sector actor’s intimate knowl- sector and food industry interaction: it’s ment partnerships work. The Organisa- edge of the beneficiary populations is time to clarify the term ‘partnership’ and tion for Economic Cooperation and Devel- essential for ensuring the success of be honest about underlying interests. Eur opment Observer, 255. (online) these types of initiatives. By working Journal of Public Health, 21(4);400-401. Shrimpton R (2007). Private Sector Con- in tandem, goals can be achieved and Food (Control of Quality) (Marketing of tributions to Ending Child Hunger and Nutriset’s experience demonstrates Breast-milk Substitutes and Designated Undernutrition. SCN News, 34: 32-36. that it is indeed possible for the pub- Products) Regulations 1994. Dar es (online) lic sector to engage with the private Salam, Ministry of Health and Social Wel- WHO. International Code of Marketing of sector in an effort to achieve its fare of Tanzania, 1994. Breast Milk Substitutes. Geneva, World stated policy objectives. National Bureau of Statistics . Tanzania Health Organization, 1981. (online) 2010 Demographic and Health Survey – WHO/UNICEF. Global Strategy for Infant References Key Findings. Dar es Salam, National Bu- and Young Child Feeding. Geneva, World reau of Statistics, 2011. (online) Adu-Afarwuah S, Lartey A, Brown KH, Health Organization, 2003. (online) Zlotkin S, Briend A and Dewey KG (2008).

UNSCN Nutrition and Climate Change eGroup The Nutrition and Climate change eGroup is an ad hoc online discussion forum, created with the aims of bringing a nutrition lens into climate change issues and increasing the participation of interested sectors to discuss how this can be done and what the priorities are. This eGroup also intends to identify opportunities for the nutrition agenda and weak- nesses that hinder the participation of nutrition in such debates. It also intends to influence the agendas of the research community, since scientific publications feed the Intergovernmental Panel on Climate Change (IPCC) for the production of their publications, and the IPCC itself shapes the United Nations Frame- work Convention on Climate Change (UNFCCC) agenda. There is also a need of an increasing sensitivity of donors to these issues in order to gather funding for climate change related initiatives.

You are very welcome to join the discussion, and you can subscribe by clicking here. You can also check out some of the results of the eDiscussion here, including the participation in COP 16 and COP 17.

back to contents SCN NEWS #39 www.unscn.org Features 51 GOVERNMENTS SHOULD GOVERN, AND CORPORATIONS SHOULD FOLLOW THE RULES Mike Brady1, Patti Rundall2 1Campaigns and Networking Coordinator, Baby Milk Action, [email protected] 2OBE, Policy Director, Baby Milk Action, [email protected]

Author statement: Mike Brady declared not having any conflict of interest. Patti Rundall declared that, in addition to being Policy Director of Baby Milk Action, she holds several shares in Nestle SA, sufficient to enable her to attend the annual Shareholder meetings. This is the only purpose for her having the shares.

INTRODUCTION der a series of international agree- frequently call for strong regulations ments, including the Convention on in areas that protect their interests Noncommunicable diseases, health Economic, Social and Cultural rights, (such as contract law and protection inequalities and food insecurity are to protect and deliver the right to of intellectual property rights), but all issues that policy-makers at na- health for all: often seem compelled to oppose or tional and international levels are undermine regulations that constrain attempting to address. Sometimes Health is a fundamental human right their freedom to operate. This is par- United Nations bodies, national gov- indispensable for the exercise of other ticularly evident when it comes to ernments and other organizations human rights. Every human being is entitled to the enjoyment of the high- food corporations and the rise of suggest they should enter into part- est attainable standard of health con- noncommunicable diseases (NCD), nerships with the private sector as a ducive to living a life in dignity. The where executives have lobbied way to change problematic corporate realization of the right to health may strongly against, for example, restric- behaviour, to engage corporations as be pursued through numerous, com- tions on advertising, traffic-light la- agents of change and to secure fund- plementary approaches, such as the belling schemes and statutory limits ing for programmes, particularly at a formulation of health policies, or the on unhealthy ingredients. time when public funds are under implementation of health programmes strain. This article suggests that policy developed by the World Health Or- In addressing the role of the private -makers should consider the public ganization (WHO), or the adoption of sector in health issues - and any other interest before considering interact- specific legal instruments (OHCHR issue - it falls to policy-makers to: 2000). ing with the private sector on health 1. Understand the problem and The right to health means that govern- and other issues. When developing the role played by the private ments must generate conditions in health policy at national and interna- sector tional level, this should not involve which everyone can be as healthy as negotiation with the private sector, possible. Such conditions range from 2. Determine the appropriate ensuring availability of health services, though it may be relevant to consult. public-interest response healthy and safe working conditions, If working jointly with the private sec- adequate housing and nutritious food 3. Decide the appropriate rela- tor, organizations should avoid the (WHO/OHCHR 2007). tionship with the private sector term partnership, define relation- in this context ships more clearly and manage con- National governments have a respon- 4. Identify the extent of conflicts flicts of interest that are deemed ac- sibility to govern in the public inter- of interest, minimise them and ceptable or unavoidable. This article est. At times this will involve address- manage those that are consid- supports the call from the Conflicts of ing concerns about the impact of the ered acceptable or unavoid- Interest Coalition, consisting of 147 private sector through national poli- able civil society organizations (CSOs) and cies and programmes, and through networks (including Baby Milk Ac- international bodies, such as WHO. 5. If deciding to work with the tion), for a Code of Conduct and Ethi- Increasingly, the most powerful com- private sector in some way, cal Framework to guide interactions panies, transnational corporations, avoid the language of partner- between policy-makers and the pri- are seeking to set, or at least influ- ship, define the relationship vate sector. ence, the rules that regulate and im- clearly and ensure that your pact on their activities. Company ex- original objectives do not get GOVERNMENTS SHOULD GOVERN ecutives have a fiduciary duty to put subverted. the interests of their shareholders Governments have an obligation un- before all others and consequently back to contents SCN NEWS #39 52 Features www.unscn.org UNDERSTAND THE PROBLEM AND by German researchers tested around ten years ago that for every THE ROLE PLAYED BY THE PRIVATE whether breastfeeding for more than US dollar spent by the World Health SECTOR two months has preventive effects Organization on trying to improve against overweight and adiposity at nutrition of the world’s population, The specific issue of NCD and the role six years of age and found that "early US$ 500 is spent by the food industry played by the private sector in their bottle-feeding brings forward the on promoting processed foods (Lang rise will be considered in this analysis, obesity rebound, predictive of obe- 2004). though the principles are relevant to sity in later life" (Bergmann 2003, many other issues. Government pol- p.162). Many studies have substanti- DETERMINE THE APPROPRIATE PUB- icy-makers face serious problems ated the impact of artificial feeding LIC HEALTH RESPONSE with regards to NCD. According to the (Baby Milk Action 2006). WHO Obesity and Overweight fact While the food industry is not solely sheet (WHO 2011a): The rise in NCD is not restricted to to blame for the NCD epidemic, the industrialized countries. A study in composition and marketing of foods  Worldwide obesity has more than East Africa reported that autopsies are contributory factors that need to doubled since 1980. found no cases of chronic heart dis- be addressed.  In 2008, 1.5 billion adults, 20 ease in the 1930s, but by the 1960s it At national and international level, years and older, were over- was a major health problem (Trowell food companies have promised vol- weight. Of these over 200 million in Lang and Heasman 2004, p.80). untary action in both these areas. men and nearly 300 million According to WHO: Rather than being distracted by offers women were obese. An estimated 17.1 million people died of voluntary action by the food indus-  65% of the world's population from Cardiovascular Diseases (CVDs) in try, policy-makers should first deter- live in countries where over- 2004, representing 29% of all global mine the most appropriate public weight and obesity kills more deaths [...] By 2030, almost 23.6 million health response, looking predomi- people than underweight. people will die from CVDs, mainly from nantly to independent, publicly fi- heart disease and stroke. These are pro- nanced studies that have been sub-  Nearly 43 million children under jected to remain the single leading jected to a rigorous peer review proc- the age of five were overweight causes of death" (WHO 2011b). in 2010. ess. While the potential for bias is Type 2 diabetes is also linked to present in all research, misleading  Obesity is preventable. changing diets and lifestyles. Accord- findings and unintended conse- ing to WHO: The rise in obesity is attributed to quences are reduced if research is various cultural changes, including 346 million people worldwide have commissioned and funded by a disin- changes in living and working condi- diabetes. In 2004, an estimated 3.4 terested party, and where academic tions, with nutrition being central. million people died from conse- rigour can be demonstrated in the The industrialization of food has quences of high blood sugar. More research process. It is also important than 80% of diabetes deaths occur in greatly increased the production of to be aware of publication bias, low- and middle-income countries. food calories, but sometimes at the where trials with negative outcomes WHO projects that diabetes deaths are less likely to be published. expense of food quality. Consump- will double between 2005 and 2030. tion of starchy staples has decreased Healthy diet, regular physical activity, The role of the private sector in pol- and fat consumption has increased. maintaining a normal body weight and icy development has to be consid- Consequently over the past 200 avoiding tobacco use can prevent or ered carefully. The Conflicts of Inter- years, average individual consump- delay the onset of type 2 diabetes est Coalition, consisting of over 147 tion of fat in Western society has in- (WHO 2011c). civil society organizations and net- creased five-fold and of refined sug- The food industry argues that it is works, presented a statement of con- ars 15-fold (Lang and Heasman 2004, responding to consumer demand for cern to the United Nations High-Level p.132). Declines in breastfeeding in foods high in salt, fat and sugar, and Meeting on the Prevention and Con- some cultures is worrying as studies that consumers are also responsible if trol of NCD in September 2011 (Baby have shown the impact of formula- they do insufficient exercise. How- Milk Action 2011). This calls for a feeding on early weight gain, which ever, a key aspect of the change in Code of Conduct and an Ethical has an impact in later life. For exam- diet is the promotional activities of Framework that will guide interac- ple, a longitudinal birth cohort study the food industry. It was noted tions with the private sector at both back to contents SCN NEWS #39 www.unscn.org Features 53 national and international levels Indian Infant Milk Substitutes Act is Denmark until 2003, as in other coun- (including in the current process of one of the most comprehensive ex- tries (Kent 2008). In 2003 the Danish WHO reform) and states: amples and even includes a penalty government enacted legislation for The policy development stage should of imprisonment for Managing Direc- health reasons requiring manufactur- be free from industry involvement to tors who break the rules. As a result, ers to reduce the content of transfats ensure a “health in all policies” ap- the baby-food market in India has in oils and fats to no more than two proach, which is not compromised by remained static, whereas in China it grams per 100 grams. Manufacturers the obvious conflicts of interests as- has grown significantly. Industry ana- were allowed to sell food manufac- sociated with food, alcohol, beverage lysts Euromonitor acknowledge: tured before the law came into force and other industries, that are primar- The huge disparity in the retail value of and were given a period of six ily answerable to shareholders. milk formula sales between China and months when transfats content in These industries should, of course, India is mainly due to the significant food products could be up to five be kept informed about policy devel- differences between their official regu- grams per 100 grams of the product. opment, through stakeholder brief- latory regimes. From December 2003 sanctions of up ings for example, but should not be The Code and subsequent, relevant to two years in prison have applied in an influencing position when it for selling foods with higher-than- comes to setting policy and strategies Resolutions of the World Health As- permitted levels of transfats (Danish for addressing public health issues, sembly are succeeding in protecting Law 2003). such as NCD prevention and control. infant health, despite being labelled (Baby Milk Action 2011) "unacceptable" by the industry. Vigi- Manufacturers appear to have com- lance is required, however, as Euro- plied with the regulations in Denmark DECIDE THE APPROPRIATE RELA- monitor also notes: "The industry is and a similar ban introduced subse- TIONSHIP WITH THE PRIVATE SEC- fighting a rearguard action against quently in New York, whereas ap- TOR IN THIS CONTEXT regulation on a country-by-country peals for voluntary changes and com- Health policies should be developed basis” (Euromonitor 2008). mitments by corporations have had through a process of In some circumstances, government limited impact. An editorial in the “consultation” (defined by the dic- and UN policy-makers may decide it British Medical Journal on transfats tionary as meaning “seek information is not even appropriate to consult notes that: or advice from”) rather than with the private sector: WHO point- Many foods still contain industrial TFAs “negotiation” (defined as meaning edly did not invite representatives of [transfatty acids], especially in restau- “try to reach an agreement or com- the tobacco industry to the 2011 New rants, schools, cafeterias, coffee shops, promise by discussion”) (Oxford York meeting on NCD. WHO Director and bakeries, where food labels are not 2011). General, Dr. Margaret Chan, said in mandatory. Comprehensive education to encourage such businesses in New her opening address: While policy-makers and executives York City to voluntarily reduce the use like to speak of win-win solutions, Full implementation of the WHO of partially hydrogenated fats was un- sometimes necessary policies may Framework Convention on Tobacco successful. Legislative strategies have impact on company sales and profits. Control would bring the single biggest been more successful than labelling or For example, the International Code blow to heart disease, cancer, diabetes, education. In both Denmark and New of Marketing of Breastmilk Substi- and respiratory disease. I call on heads York City, legislation has effectively tutes was adopted by the World of state and heads of government to eliminated industrial TFAs (Mozaffarian stand rock-hard against the despicable and Stampfer 2010). Health Assembly in 1981 despite be- efforts of the tobacco industry to sub- ing described as "unacceptable [...] Although "TFA consumption is associ- vert this treaty. We must stand firm irrelevant and unworkable" (ICIFI against their open and extremely ag- ated with a substantial risk of heart 1981). The Code and subsequent, gressive tactics (WHO 2011d). disease events" and "rare in the natu- relevant World Health Assembly ral human diet", TFAs are favoured In the area of nutrition, there is evi- Resolutions have now been intro- commercially: dence that regulating the food indus- duced into legislation by over 60 try can be far more effective than A high TFA content provides physical countries and lesser measures in encouraging voluntary action. For and chemical properties that are at- many more, in recognition of the im- tractive to food manufacturers, includ- example, transfatty acids (transfats) portance of protecting breastfeeding ing the creation of relatively inexpen- were widely used in foodstuffs in and babies fed on substitutes. The sive (compared with animal derived

back to contents SCN NEWS #39 54 Features www.unscn.org fats) solid or semi-solid fat. The process ist? Company executives have a fidu- tion has thus been a major shaper of also destroys labile omega-3 acids (α- ciary duty to maximize shareholder policy. It has encouraged countries to linolenic acid), and this reduces the value, and so this has to be an under- make their business tax regimes more propensity for fats to become rancid, lying motive in every decision they attractive, particularly through reduc- increases shelf life, and optimises deep tions in statutory corporation tax rates, take about their business. Policy- frying applications. to encourage investment (OECD 2011, makers need to understand what ad- p. 15). These economic benefits appear to vantage is being sought and consider outweigh health benefits for corpora- whether this compromises what they The OECD report notes this is a con- tions - except when '’Transfat Free’' is are aiming to do. For example, if a tinuing trend: used as a marketing gimmick or for company that promotes unhealthy The statutory corporate income tax labelling premium-priced products. food to children gains kudos from rates in OECD member countries sponsoring a healthy eating or exer- dropped on average 7.1 percentage IDENTIFY THE EXTENT OF CONFLICTS cise initiative, this will divert atten- points between 2000 and 2010, from OF INTEREST, MINIMIZE THEM AND tion from its bad practices and per- 32.8% to 25.7%. MANAGE THOSE THAT ARE CONSID- haps lead to reliance on voluntary Rates of income tax for top earners ERED ACCEPTABLE OR UNAVOID- approaches rather than regulation. have also decreased dramatically, ABLE However, a company with no interest whereas, "average effective tax rates When policy-makers from govern- in food, say an electronics or a travel on most individuals have fallen much ment, the United Nations or nongov- company, could offer sponsorship less than top statutory tax rates". ernmental organizations (NGO) speak with the same underlying goal of sell- This means that corporations and of tackling issues such as NCD they ing products without necessarily con- executives are paying less than what are likely to find the company repre- flicting with the specific aims of the some may view as their fair share, sentatives respond in several ways (if initiative (though there may be other and the tax burden has shifted from they have not already taken these matters of policy to consider). the private sector to individuals on steps proactively): The Conflict of Interest Coalition is lower pay.  They want to meet to discuss the encouraging policy-makers to con- As the OECD report commented with proposals. sider these issues when interacting regard to competition for invest- with the private sector. Aside from ment:  They offer to work together to consulting rather than negotiating, develop a voluntary code, or These competitive pressures raise measures could include requiring even legislation. questions about whether more inter- declarations of interest, drawing clear national cooperation on tax policy  They set up a Business Interest distinctions between Public Interest might be desirable to avoid tax com- nongovernmental organization NGOs (PINGOs) and Business Interest petition having pernicious effects. (BINGO) to represent their inter- NGOs (BINGOs), carrying out risk The WHO Commission on the Social ests, either openly or not so analysis and exploring alternatives. Determinants of Health recom- openly. The offer of corporate funding may mended progressive taxation for  They fund or create charities, be attractive to policy-makers, par- funding health in its 2008 report Clos- foundations and events that are ticularly in times of austerity. How- ing the Gap in a Generation and also associated with health. ever, seeking voluntary contributions stated: from the private sector creates de-  They offer funding or other sup- The increasingly globalized nature of pendency and is not the only way to port to government, UN or NGO economic practices, including offshore raise funds. One straightforward way programmes. tax havens, provides a strong argument to avoid conflicts of interest is to fund in favour of the development of a sys-  They present partnerships with programmes through taxation. As tem of global taxation". A concrete the private sector as an essential commerce has globalized there has policy option is "a tax on foreign cur- solution. been a downward pressure on corpo- rency transactions to reduce financial instability (the Tobin Tax) [...] One esti- The first question policy-makers rate taxation. The Organization for mate is that such a tax at a very low should ask themselves when consid- Economic Cooperation and Develop- ment (OECD) states: rate (0.02%) would raise US$ 17-35 ering interacting with the private sec- billion per year, with higher estimates tor is: does a conflict of interest ex- For many OECD countries tax competi- available in the literature (WHO 2008, back to contents SCN NEWS #39 www.unscn.org Features 55 p. 124). -income countries... is estimated... at corporations and other bodies on the Other possibilities are so-called sin an average of US$ 11.4 billion per board of directors and many other taxes on unhealthy foods, tobacco year" (WHO/WEF 2011, p. 8). The types of relationship (Hawkes and and alcohol. proposals seem to favour awareness Buse 2011). raising on diet, but if regulation was Although Commission members were favoured, following the evidence CONCLUSIONS AND RECOMMENDA- present at the WHO World Confer- from the Danish experience on trans- TIONS ence on Social Determinants of fats, this aspect of the package could 1. The role of governments is to Health that met in Brazil from 22 to be both less expensive to deliver, and govern in the public interest. The role 24 October 2011 and spoke in favour if unhealthy foods attracted sin taxes, of executives is to run their corpora- of these proposals, they were not could even be income generating. tions within the rules that society included in the official Rio Political places upon them. Given that com- Declaration. However, they were in- IF DECIDING TO WORK JOINTLY pany executives have a fiduciary duty cluded in an alternative civil society WITH THE PRIVATE SECTOR, AVOID to maximize shareholder value, gov- Rio Declaration that had been devel- THE LANGUAGE OF PARTNERSHIP ernment, UN and NGO policy-makers oped by the People's Health Move- AND DEFINE THE RELATIONSHIP need to be aware that this will some- ment in consultation with other pub- CLEARLY AND ENSURE THAT YOUR times conflict with the public interest, lic interest groups and networks in ORIGINAL OBJECTIVES DO NOT GET and they must put appropriate safe- the lead up to the Conference, being SUBVERTED guards in place. finalised alongside it (WHO 2011e, If government, UN or NGO policy- PHM 2011). Though the official decla- 2. In the context of public health makers decide that it is appropriate ration was a missed opportunity, it and the private sector, policy-makers to work with the private sector, after does at least call for "safeguarding should first understand the problem giving due consideration to the above against conflicts of interest" in inter- being addressed and the role the pri- issues, the term "partnership" should actions with the private sector. vate sector plays within it. They be avoided. "Partnership" has a should decide the appropriate policy The possible US$ 17-35 billion per strong emotional value, and the posi- response, consulting the private sec- year from a 0.02% financial tax would tive image transfer has a major im- tor when it is relevant and in an ap- more than fund proposed interven- pact on the value of any business in- propriate way. This is very different tions on NCD. WHO and the World volved. Partnerships have been de- from negotiation. Having conflicted Economic Forum (WEF) publication scribed as relationships based on industry around the table when poli- From Burden to ‘’Best Buys’’: Reduc- "mutual respect, trust, transparency, cies are decided, encourages small ing the economic impact of noncom- and shared benefits" (ICAP 2011). incremental changes rather than sig- municable diseases in low- and mid- This concept implies that people, in- nificant, effective changes. The legis- dle-income countries gives an eco- cluding the most vulnerable and lation arising from the International nomic justification for tackling NCD, voiceless, should "trust" corporations Code of Marketing of Breastmilk Sub- perhaps not unsurprisingly as WEF to have their best interests at heart stitutes, for example, would not be represents transnational corpora- rather than have the protection of protecting infants and their families tions. The publication identifies popu- independently monitored and en- around the world if the World Health lation-wide strategies as being most forced regulations. Writing in the Assembly had heeded the formula cost effective. Aside from measures European Journal of Public Health, industry complaint that it was tackling tobacco through taxation Corinna Hawkes points out that "unacceptable". The right to food, and regulation, the "best buys" in- "partnership" is too ambiguous a health, and social justice for all must clude enforcing advertising bans and term and the actual relationship surely take precedence over corpo- increased taxation on alcohol, reduc- should be described instead. This rate profits. ing salt intake, replacing transfats in may involve corporations funding food with polyunsaturated fat and government programmes, govern- 3. In terms of funding for health promoting public awareness about ment funding corporate initiatives, programmes, reversing the shift of diet and physical activity. According discussion fora, government setting corporate taxation to personal taxa- to the report, "the total cost of imple- targets for corporations, corporations tion may be a better solution than menting the full set of “best buy” in- making commitments, organizations seeking voluntary corporate contribu- terventions across all low- and middle formed with representatives from tions. Through coordinated action at back to contents SCN NEWS #39 56 Features www.unscn.org the international level funds could be Fatty Acids in Oils and Fats etc., English OHCHR (2000) General Comment on The made available for low and middle- Translation. (online) right to the highest attainable standard of health (article 12 of the International income countries, while instabilities Euromonitor (2008) Global Packaged Covenant on Economic, Social and Cul- in the financial system could be ad- Food: Market Opportunities for Baby tural Rights). Office of the UN High Com- dressed at the same time. Food to 2013. Euromonitor:London missioner for Human Rights:Geneva. 4. If it is decided to work with the Hawkes C, Buse K (2011) Public health (online) sector and food industry interaction: it’s private sector in some way, the na- WHO (2008) Closing the Gap in a Genera- time to clarify the term ‘partnership’ and ture of the relationship should be tion: Health equity through action on the be honest about underlying interests. defined clearly, not lost in the lan- social determinants of health, WHO Com- European Journal of Public Health 21 guage of "partnership". A corporation mission on the Social determinants of (4):400–403. will almost certainly be seeking some Health. World Health Organiza- advantage - otherwise executives are ICAP (2011) International Center for Alco- tion:Geneva. (online) hol Policies - Analysis, Balance, Partner- not fulfilling their duty to sharehold- WHO (2011a) Obesity and Overweight ships. (online) ers. Unless such conflicts of interest Fact Sheet March 2011. World Health are acknowledged, they cannot be ICIFI (1981) Letter from Nestlé Vice Presi- Organization:Geneva. (online) dent, Ernest Saunders to Members States reduced or managed. WHO (2011b) Cardiovascular diseases of the World Health Assembly, May 1981, (CVDs) Fact Sheet. Updated January 5. Formulating a Code of Con- in the name of the International Council 2011. World Health Organiza- duct, requiring inter alia declarations of Infant Food Industries. [Scan of the tion:Geneva. (online) of interest, drawing distinctions be- original letter]. (online) WHO (2011c) Diabetes Fact Sheet August tween Public Interest NGOs (PINGOs) Kent G (2008). Global Obligations for the 2011. World Health Organiza- and Business Interest NGOs Right to Food. Rowman & Littlefield Pub- tion:Geneva. (online) (BINGOs), conducting risk assess- lishers:Lanham. ments and considering alternative WHO (2011d) Speech of WHO Director Lang T, Heasman M (2004) Food Wars: approaches is recommended. General at the NCD Summit, New York, The Global Battle for Mouths, Minds and 19 September 2011. World Health Or- Markets. Earthscan:London. References ganization:Geneva. (online) Mozaffarian D, Stampfer MJ(2010) Re- WHO (2011e) Rio Political Declaration on Baby Milk Action (2006) Infant Feeding moving industrial trans fat from foods. Social Determinants of Health, Rio de and Obesity. Baby Milk Action: Cam- British Medical Journal 340:c1826. Janeiro, Brazil, 21 October 2011. World bridge. (online) Health Organization:Geneva. (online) Baby Milk Action (2011) Statement of OECD (2011) Tax Reform Trends in OECD WHO/OHCHR (2007) Fact sheet: The concern on lack of clarity on role of indus- Countries. Organisation for Economic Right to Health. World Health Organiza- try for June UN interactive hearing and Cooperation and Development, Centre tion and Office of the United Nations September UN High-Level Meeting 2011 for Tax Policy and Administration: Paris. High Commissioner for Human endorsed by 147 health organisations (online) and networks. Baby Milk Ac- Rights:Geneva. (online) Oxford (2011) Oxford Dictionaries. tion:Cambridge. (online) WHO/WEF (2011) From Burden to “Best [Online search of 'consult' and Buys”: Reducing the Economic Impact of Bergmann KE, Bergmann RL, Von Kries R, 'negotiate']. (online1) and (online2) Böhm O, Richter R, Dudenhausen JW, Non-Communicable Diseases in Low- and Wahn U (2003) Early determinants of PHM (2011) Protecting the Right to Middle-Income Countries World Health childhood overweight and adiposity in a Health through action on the Social De- Organization and World Economic Fo- birth cohort study: role of breast-feeding. terminants of Health A Declaration by rum:Geneva. (online) Public Interest Civil Society Organisations International Journal of Obesity 27(2);162 -172 . and Social Movements Rio de Janeiro, Brazil. People's Health Movement. Denmark (2003) Executive Order No. 160 (online) of 11 March 2003 on the Content of Trans

Are you interested in reading WHO’s resolutions and documents on the engagement with the private sector? Check out the following: A63/44, EB122/19, EB123/6, EB123/6 Add.1, EB124/23 and also the WHO Guidelines on working with the private sector to achieve health outcomes.

back to contents SCN NEWS #39 www.unscn.org Features 57 FOOD AND BEVERAGE TRANSNATIONAL CORPORATIONS AND NUTRITION POLICY Fabio S Gomes1§, Tim Lobstein 2,3 1 Senior Analyst of National Cancer Control Programmes, Food, Nutrition and Cancer Division, National Cancer Institute of Brazil, Ministry of Health, Rio de Janeiro, Brazil; 2 Adjunct Professor, Public Health Advocacy Institute of Western Australia, Perth, Austra- lia; 3 Director of Policy, International Obesity TaskForce, London, UK.

§Corresponding author. Emails: [email protected]; [email protected]

Author statement: The opinions expressed in this document do not necessarily reflect the views of the authors’ affiliated institutions. The authors declared not having any conflict of interest.

NUTRITION: PUBLIC HEALTH AND highly processed, non-essential but consumption of highly processed, or COMMERCIAL GOALS strongly promoted, branded foods ultra-processed food and drink prod- and beverages, often eaten between ucts (UPPs) by which we mean energy The rapid rise in nutrition-related or instead of meals. We use “Big dense foods and drinks, often in the chronic disease worldwide is a major Snack” rather than “Big Food” as we form of fast or convenient, ready-to- threat for public health, recognized do not want to imply that the prod- eat or ready-to-heat, fatty, sugary or by the announcement of a High-Level ucts from these companies – primar- salty products, often with long shelf- Meeting of the United Nations Gen- ily foods and beverages high in fat, lives and highly branded packaging – eral Assembly in September 2011. It salt or sugar – are as necessary or and in contrast to fresh and perish- is not only a concern for public health essential to health as traditional able foods, relatively less processed but also a concern for many sectors foods such as staple grains, fruits and and often unbranded (Monteiro involved in shaping economic, envi- vegetables eaten in traditional meal- 2011). ronmental and social policies. In- time contexts. creasingly, food producers, manufac- Secondly it has cast the makers of turers and distributors are being these UPP foods in a poor light, not PRESSURE ON THE BIG SNACK COM- asked to account for the health im- only in the view of consumers and PANIES pact of their activities. In conse- public health experts but also in the quence, there is rising concern about In May 2010 the World Health As- view of investment banks which rec- the control of the global food supply sembly unanimously adopted a reso- ognize the damage that a portfolio of and the governance of commercial lution and set of Recommendations unhealthy products can do to com- food businesses. calling on Member States to restrict pany reputation and the value of the promotion to children of foods stocks and shares (Langlois et al. Underlying the issue of governance is and beverages high in saturated or 2006; EIRIS 2006). the tension between the needs of trans fats, sugars or salt (WHO 2010). commercial operators, especially As a result, the last few years have It follows the 2004 World Health Or- their needs to maintain and expand seen food companies attempting to ganization (WHO) Global Strategy on their markets and provide rising divi- protect their brands with various ac- Diet Physical Activity and Health dends to their shareholders, and the tions. Several of the larger Big Snack which called on companies to refor- needs of consumers for access to a transnational manufacturers have mulate their products, provide more healthy range of foods at an afford- acknowledged the pressure for nutritious and affordable choices, able price. This paper highlights these change and offered a seemingly con- provide understandable nutrition in- tensions and calls for a separation of structive response. Their approach formation and practise responsible policy-making from policy implemen- has three main purposes: (a) to con- marketing. The WHO is also in the tation, and a recognition that the in- vince policy-makers and decision- process of developing guidelines for terests of commercial operators, es- takers that they are not only aware of Member States on how to define pecially the larger food and beverage the problems relating to their prod- foods which are or are not suitable manufacturing transnational corpora- ucts but they are also able to provide for promoting to children. tions – which we refer to here collec- the solution; (b) to pre-empt or un- tively as “Big Snack” – are often in This activity, combined with various dermine statutory measures that are conflict with the interests of public actions taken by Member States to aimed at restricting the demand for health. We adopted “Big Snack” as it restrict advertising to children, has their products and limiting the pro- expresses the characteristics of food had two effects. Firstly it has focused motion of unhealthy eating practices; and beverage transnational corpora- attention on the quality of the foods and (c) to protect their images and tions which are large and well re- being promoted in marketing mes- brands from demonization (Koplan sourced, and which sell or distribute sages, and especially the emphasis on and Brownell 2010; Sharma et al.

back to contents SCN NEWS #39 58 Features www.unscn.org

Key messages

 Policy-makers should recognize the need to pursue sustainable health policies, which may restrict commercial freedoms.  Food and drink transnational corporations will undermine regulatory measures that aim to reduce the demand for their products, because their duty is to increase product share, turnover, profits and shareholder value.  Policy formation must be kept separate from commercial interests. Policy implementation may require action by the private sector, possibly voluntarily but preferably through legislation, but always led by policy-makers.  Voluntary measures should be managed with special caution and legislation should be favoured in emerging economy countries with diets comprising mostly of traditional foods and eating patterns.  Health promotion measures are unlikely to be successful through industry-public health partnerships when the public health aim is to reduce the consumption of products which industry manu- factures or distributes.  Full risk assessments needs to be undertaken before partnerships with private sector interests are considered.

2010). Learning from the tobacco tions, and although they may want processed and minimally processed campaigns of the 1990s, the compa- healthy foods for themselves and foods and culinary ingredients. Peo- nies have been quick to state that, their children, they may accept that ple in such countries, including fami- unlike cigarettes, their products are Big Snack has something to offer and lies with little disposable income, necessary, as “we all have to eat”. can be “part of the solution” (Lachat have actually or potentially a better Whether we need to eat the specific et al. 2009). The prevailing political and greater sense of what they are products they make can be ques- ideology justifies the idea that the eating and giving to their children. tioned, but their control of global market solutions should be helping to However, the producers of these tra- food supply chains puts them in a shape national and global policies, ditional foods do not have large mar- powerful negotiating position. not only on food and nutrition, but keting and promotion budgets, and on environmental change and other as the proportion of UPPs in food sys- THE BIG SNACK OFFER issues of public interest (McCright tems increases, people start to lose and Dunlap 2000). In this context it their direct connection with the Big Snack has been claiming “we are can be hard to challenge the Big sources of their food (Cohen 2008). part of the solution”, and offering Snack companies’ claims that they For such populations, as Big Snack supranational agencies and national should be partners or leaders in set- expands its market, so it increases governments a range of voluntary ting the policy agenda. the population’s potential exposure measures to tackle obesity and other to diet-related chronic disease food and nutrition-related diseases This may not be the case elsewhere. (Monteiro et al. 2011). (Koplan and Brownell 2010; Sharma In contexts where food systems and et al. 2010). These voluntary offers – patterns are still very different from From a food manufacturers’ perspec- including reformulation, nutrition those found in major Northern coun- tive, their duty is to increase product labelling, wider choices of products, tries, the so-called “part of the solu- share, turnover, profits and share- restricted marketing to children – tion” approach could lead to an un- holder value. To get a sense of the should be interpreted according to dermining of good nutritional prac- market potential, we can take Brazil, their context. In countries of the tices and a worsening of public China and India, where in 2009 some North, such as the United States of health. In countries such as Brazil, 48 million children were born (UN America (USA) and the United King- where as little as one fourth of 2011). If all these babies were fed dom (UK), where as much as half or household food purchases are in the with manufactured formula from more of the diet is provided by UPPs form of UPPs (Monteiro 2011), there birth up to six months of age, and if (Monteiro 2011), citizens may accept is still considerable dietary choice the price of an 800 g can of baby for- their national food systems being outside the Big Snack menus. Most of mula is around US$ 25 and lasts one dominated by multinational corpora- the food supply is in the form of un- week, this would add up to around

back to contents SCN NEWS #39 www.unscn.org Features 59 US$ 30 billion sales of baby formula include the regulation of promotional through the Children’s Food and Bev- in one year. This is just for one type marketing (to limit the stimuli for de- erage Advertising Initiative has not of product. The opportunity for in- mand), price (taxation to create a substantially shifted the mix of food creasing the proportion of household financial barrier to unhealthy prod- advertising to children to more nutri- food budgets spent on UPP foods ucts and subsidies for the healthy tious products. In addition, they suggest that many companies are not from say 25-30%, to 50-70%, repre- ones), place (interventions to reduce fully committed to reducing child ex- sents enormous market growth, es- the physical access to products) and posure to advertising for their least pecially in countries such as Brazil product (reformulation of products to nutritious products. (Rudd Center with a population of nearly 200 mil- reduce some unhealthy nutrients). As 2011, p. 2) lion people. Inevitably, Big Snack will we discuss in the sections below, invest extensively in market develop- both private and public sectors have The Quebec advertising ban does not ment, establishing supply and distri- been proposing interventions that appear to be limiting the amount of bution chains, advertising and pro- follow these lines. However, the ap- food/beverage advertising seen by moting their brands, hiring lawyers proaches, and hence the outcomes, children aged 10-12. (Kent et al. 2011, and lobbyists to advance their inter- are quite different. p. e433) ests, funding image-improvement Countries’ official food and nutrition corporate responsibility programmes, guidelines are not the only dietary Children’s exposure to unhealthy fast- and sponsoring nutrition, medical recommendations available. People food advertising has not changed fol- and agriculture congresses to win are daily submitted to a myriad of lowing the introduction of self- influence among professionals. regulation… (Hebden et al. 2011, p. messages, images, sounds and smells 20) It should be noted that while Big that recommend and counter- Snack is propelling the change in eat- recommend them to consume, and Aware of the limitations of self- ing patterns, smaller companies will most people do not even consciously regulation, the role of the State has find that the changing market condi- recognize most of these persuasive been reinforced more recently with tions will lead them to alter their stimuli (Cohen 2008). Big Snack has countries such as the UK and Ireland practices and encourage them to fol- its own dietary ‘‘recommendations’’, introducing statutory restrictions on low the nutritional transition led by which are much more effectively dis- advertising food and beverages to the larger companies. Small traders seminated than countries’ official children (Kelly et al. 2010; Hawkes do not have the purchasing power or guidelines. The evidence consistently and Lobstein 2011; Hebden et al. investment capital to affect the prices shows food advertisements and other 2011). Countries such as Brazil have of commodities and agricultural sup- marketing practices have an influence adopted statutory measures, al- ply patterns which the Big Snack on food choices, food purchases and though the media, the food, the ad- companies have achieved, but they food consumption (Hastings et al. vertising and even the toy industry have exploited the increasing cheap- 2003; Cohen 2008). Cohen (2008) tried to spread the same arguments ness of oils, fats and sugars (Vepa describes neurophysiological stimuli Big Tobacco once used, including the 2004; Traill 2006). Small traders do that promote excessive food con- claimed threat to employment and not brand their own products or pro- sumption, and emphasizes how peo- the unconstitutionality of the propos- mote them in the mass media, but ple unconsciously attend to environ- als (Brownell and Warner 2009; Go- instead small traders are becoming re mental cues and are automatically mes et al. 2010). In Brazil, the adver- -sellers of products, such as soft attracted to food. For this reason, tising regulations were impeded by a drinks, and processed foods, pro- restrictions to food marketing prac- federal judge, who granted the sus- duced by the Big Snack companies tices have been recommended as one pension of the regulations following a (Costa 2011). of the most effective and cost- request by the Brazilian Association effective interventions to tackle un- of Food Industries (Gomes 2010a). MARKETING CONTROLS? healthy eating (Cecchini et al. 2010). Other countries are also facing pressure from the private sector, and Several interventions have been pro- In response, food companies are urg- have been struggling to get their posed to brake and reverse the sharp ing softer (and often inconsistent) statutory measures implemented, increase in the prevalence of diet- self-regulation measures. Big Snack and to resist moves to weaken the related chronic disease. Some of has been successful in persuading already-existing regulations (Hawkes them follow the steps taken by the governments and supranational 2007). tobacco control strategies and aim at agencies to take the voluntary op- reducing the demand for products tion. These have, however, been criti- It is noteworthy that most regulatory that are undermining public health. In cised as insufficient and ineffective: measures, even the statutory ones, the case of food and nutrition they focus on the protection for children. [The] current industry self-regulation back to contents SCN NEWS #39 60 Features www.unscn.org The main reason for that is not so their profitability and will drive com- “healthier” and the timeline for mak- much technical as political, since pany behaviour unless alternative ing changes are established as each there is little political appetite for the drivers, such as regulatory ones, re- company wishes. Furthermore, being protection of adults in a free market place it. The cheapest food commodi- voluntary, any advances can be re- even though adults may be just as ties – fats, oils, refined starches and versed. This has been the case with susceptible to unconscious persua- sugars – will drive the formulation the recent announcement by Camp- sion (Cohen 2008). and quality of food supplies. Refine- bell’s Soup that, after some years of ment and packaging ensures a long salt reduction, the company will be PRICE CONTROLS? shelf-life for the extended distribu- adding more salt to some of their tion chain and allows prolonged sales products to ‘’improve the Another point of action to intervene opportunities. The use of low-cost taste’’ (Campbell Soup Company on the demand for products is pric- additives, such as colourings, flavour ing. This has been proven to be the 2011). boosters and preservatives, gives most cost-effective measure for to- The healthy image of fruits and vege- even greater market advantage to bacco control and alcohol policies tables has been used to mask the un- UPP foods over fresh and perishable (Shibuya et al. 2003; Anderson et al. healthy reality of snack products foods. 2009). Fiscal measures aimed at tack- (Gomes 2011). Freshfel Europe has ling unhealthy diets have been dem- The price of a product is not simply a shown in the Where is the fruit? onstrated to produce the largest function of the cost of its ingredients. study that half of 207 packaged prod- health gains in the shortest time- A large and increasing proportion of ucts with fruit in their name or with frame (Cecchini et al. 2010). Pricing is the price paid by a consumer is used fruit shown on the label had a con- not only useful and effective as a de- by the company to advertise and pro- tent of less than 10% fruit or no fruit mand-reduction strategy for un- mote the product, and develop the at all (Freshfel Europe 2010). By add- healthy foods, but also as a way to next one. In addition, the price paid ing very little fruit to products but improve the access to fresh fruits and helps to fund projects which polish great amounts of fruit imaging on the vegetables through product substitu- the image of the company, such as packages, Big Snack's designers can tion or direct subsidies (Claro and sports promotion and environment transfer consumers’ associations and Monteiro 2010; Andreyeva et al. protection (Millstone and Lobstein imply a health component which is 2010). 2007; Gómez et al. 2011). All these largely absent (Gladwell 2005). projects give the impression of a Big Snack does not support price ma- There is some evidence to show that company taking responsible action to nipulation, even voluntarily, unless voluntary pledges to reduce sodium, promote health but they do not there is a clear advantage for expand- for instance, are less effective com- threaten the market for their prod- ing its markets (Lachat et al. 2009). pared to statutory regulations ucts or the habits and lifestyles which However, the issue of pricing raises (Cobiac et al. 2010). In other cases it accompany their products. And they questions of what the true price of a is possible to predict that voluntary are allowable expenses to offset product really is, and the embedded agreements will probably fail. In Bra- against taxes. subsidies which artificially keep pro- zil, for instance, a voluntary agree- duction costs down and profits high. ment was signed by associations of PRODUCT FORMULATION? Such subsidies include government food manufacturers, including the agriculture support policies, public- One of the leading “solutions” raised major transnationals, on April 2011, funded research into agriculture and by Big Snack companies has been the to achieve an average salt consump- food processing, tax-payer support reformulation of their products’ nu- tion below five grams in 2020. How- for trade and enterprise develop- trient content. The company’s aim is ever, the voluntary agreement ex- ment, and government contracts for to get a brand associated with a pro- pires in 2014. Furthermore, some of food purchases – all of which use health message, even if there is little the goals offer no significant im- public money to assist the market. evidence of nutritional benefit. Occa- provement: the goal for noodles was Furthermore, a company’s own re- sionally, reformulation may be led by set to be at a maximum of search, product development, adver- a government agency, as the salt re- 1920.7mg/100g by 2012, although tising and market promotion activi- duction moves in the UK were led by most noodles already have a sodium ties are all tax-deductible expenses, the Food Standards Agency (FSA concentration below or close to the allowing more of the profit to go to 2006) and the impact can be objec- target (Anon 2011). shareholders. tively evaluated. Most often, refor- Additionally, Big Snack’s promotion mulation is led by companies making Cost is, of course, a primary concern of reformulated and “healthier” their own voluntary arrangements, for food companies, as it determines products, moves attention away from and the definition of what is

back to contents SCN NEWS #39 www.unscn.org Features 61 the continued promotion of their non Besides proposing the reformulation sponsor whose brand is linked to -reformulated products (Gomes of snacks as a solution, and position- salty, sugary, fatty snacks. Does the 2010b). For example, a promise by ing themselves as the guardians of improvement to the brand image PepsiCo to “reduce the average the solution to problems they them- (and the increase in sales) over- amount of added sugar per serving in selves created, food manufacturers shadow the benefits of health educa- key global beverage brands, in key are also pushing snacks and the snack tion? And how does a consumer un- countries, by 25 percent by way of eating further by formulating derstand a mixed message which as- 2020” (PepsiCo 2010) can be new products with a “solution- sociates healthy eating practices with achieved by an absolute increase in appeal” focused on nutrient defi- branded snacks? the sales of both their low-sugar and ciency-related problems (Yach et al. Health education action by compa- their regular drinks, as long as the 2010). Transnational food and drink nies has been one of the main points sales of low-sugar drinks increase manufacturers have been claiming of entry used by Big Snack to become more rapidly than those of the regu- they can help to fight hunger and un- a “partner” of governments and lar sugary drinks. For this reason, a dernutrition in impoverished coun- other public institutions in the area of portfolio of reformulated products tries by marketing “fortified” versions nutrition and physical activity. It not does not solve the problem provoked of their processed snack, drink and only sends a contradictory message by continued sales of non- other highly processed products. to the population (Brownell and War- reformulated products. Effective However, this could result in acceler- ner 2009), but also provides the com- measures to reduce absolute demand ating the obesity pandemic, and obe- panies with access to governments may be proposed, but they will sity-related chronic diseases, as “fast” and allows them to bargain with gov- threaten the core of Big Snack’s busi- and “junk” snacks and other fatty, ernments over actions such as taxa- ness. sugary or salty “fortified” products tion and price disincentives (Gómez take over local food systems and culi- What matters most for Big Snack is et al. 2011). nary traditions (Monteiro et al. 2010). that people continue to consume Health promotion “partnerships”, UPPs, i.e. they continue to snack. It is essential that the solution to nu- with Big Snack companies involved in While debates about reformulation trition deficiency does not increase government-approved health educa- continue, the discussion is moved the risk of chronic disease. There is a tion campaigns, may be tempting for away from recommended nutritious need for secure local food systems policy-makers, especially if resources foods such as fresh fruits and vegeta- and supplies of healthful, perishable from the public sector are insufficient bles, and from healthy ways of pre- foods such as fresh fruit and vegeta- for policy implementation. However, paring and eating such as sharing a bles, fresh fish and lean meat, along caution needs to be urged, and a full meal with family and friends (Chan with access to safe water, sanitation risk assessment may need to be un- and Sobal 2011). Instead of investing and health care, and a cultural appre- dertaken before public-private part- time and money promoting fresh and ciation of food production and of nerships are developed (Ludwig and minimally processed foods and preparation of family meals (Bhutta Nestle 2008; Hawkes and Buse 2011). healthy ways of cooking and eating, et al. 2008). What are being offered Such partnerships are based on a lim- policies are being driven by the trans- are drinks, stock cubes and biscuits ited understanding of the role of formation of unhealthy food snacks with added “magic ingredients” to health education – which should be a into supposedly “healthier” (more solve the deficiencies, and coinciden- strand in a much larger endeavour to accurately “less unhealthy”) products tally to open a new market. That such change social norms – and they deny (Institute of Medicine 2011), keeping a market can be found among poorer the fundamental contradiction at the eating practices locked inside the Big households is surprising, but the ‘two heart of the commercial production Snack world (Gomes 2011). -dollar-a-day consumer’ is now being of food: the tension between the recognized as the next commercial It is also noteworthy that the effec- need for high-quality, low-cost, mini- opportunity for transnational compa- tiveness of product reformulation is mally-processed foods for public nies (Costa 2011). inherently focused on UPPs, and the health, and the need for low-input, effect of a reformulation will vary long shelf-life, highly-processed and HEALTH EDUCATION? according to the share of UPPs in mass-produced products for Big populations’ diet, so that in countries Consider a health education pro- Snack marketing. where only a small share of what is gramme sponsored by a food multi- eaten is in the form of UPPs, the ex- national. This might result in an im- MARKET FAILURE AND THE NEED pected effect of reformulation is provement in knowledge about food FOR GOVERNANCE likely to be small. and healthy eating, but the pro- Interventions and regulatory controls gramme might be associated with a are justifiable even within free mar- back to contents SCN NEWS #39 62 Features www.unscn.org ket ideologies under certain circum- Recent discussions of obesity have termined are cumbersome, the proc- stances. Market interventions are highlighted the need to recognize the esses lack transparency and account- accepted when there is evidence of problems of overconsumption of ability, and the participants are domi- market failure, and economists have food and to set these alongside the nated by institutions which defend accepted that market failure occurs overconsumption of energy and car- the status quo (Volgy and Schwarz in several forms: (a) when there are bon fuels, overconsumption of water 1994). The rules for handling conflicts disproportionate externalities – such and land, and the consequent harms of interest are unclear and need to be as health costs and agricultural poli- to the global physical environment refreshed, especially if “partnerships” cies – so that the purchaser is not (Egger and Dixon 2010; Swinburn et and “civil society” are to include com- bearing the true economic cost of the al. 2011). Overconsumption is argued mercial players. product purchased; (b) when there is to be the expected result of markets inadequate or unequal information dominated by larger corporations CONCLUDING COMMENT given to the consumer about the (Dunn 2011). This paper concludes by calling on likely result of their consumption of Governance bodies at national and policy-makers to recognize the need the product; and (c) when the pur- international levels need to recognize to pursue health policies which may chaser is not acting purely rationally this separation of processes and en- restrict commercial freedoms – in- and consistently (WHO 2007). In the sure that health protection is not un- cluding marketing controls, price in- case of food products there is often dermined by competing interests. At terventions, the protection of tradi- little rationality, poor information times of economic crisis there is a tional products and the setting of and a high level of cost externalities, temptation to allow market growth product formulation standards – and and governments have a duty to in- to dominate the arguments over poli- to recognize the need to handle con- tervene. cies and strategies, and for health flicting interests in a transparent and In reality, 60% the world’s nations governance to be weakened while accountable way. have a smaller Gross Domestic Prod- “economic necessity” takes priority Big food and drink transnational cor- uct (GDP) than the annual turnover of (Fidler 2008). Just such arguments porations need to expand their mar- any of the top five food and beverage have been raised in the discussions kets, potentially increasing the popu- companies (World Bank 2010; For- leading up to the UN High-Level lation’s exposure to diet-related dis- tune 2011). No one doubts that Big Meeting on the Prevention and Con- eases. Their interests can conflict Snack has plenty of money and it is trol of NCD. with public health ones, and for this rare for politicians to stand against These issues put health advocates reason industry-public health part- them. However, the cost of doing and the food corporations into a con- nerships should be treated cautiously nothing is also very high, and global frontational position. It is a confron- by policy-makers. The harms pro- governance issues need to be raised, tation that needs to be recognized duced by the interference of the Big as they have been with banking in- and examined, not avoided or Snack vary by country’s food system dustries and media industries. glossed over. Fidler suggests that the and food patterns. In countries where The public health message, repeated economic crisis has meant that global the major share of diet is comprised in numerous expert reports and pol- health advocacy of traditional foods and ways of eat- icy documents, is to reduce consump- stands better positioned than ever being, a stronger protection for public tion of the sort of foods most fore… in the political, diplomatic, and health and food policies may be re- strongly marketed by Big Snack com- governance spaces where the world quired, since Big Snack companies panies. As noted earlier, strategies will shape the processes of re- may act more aggressively in these need to aim at reducing the demand globalization. contexts to expand their markets. On for these types of products, including He adds a call to arms: the other hand, in countries where the regulation of promotional mar- the major share of what is eaten is keting, the regulation of price, con- This time the global health community already in the form of UPPs, the in- trols on distribution and accessibility will not have the excuse that its neglect dustry’s aim is to protect their mar- and standards for product formula- and marginalization in international kets, and they will resist controls on relations leaves it unprepared to try tion. All of these approaches are re- their marketing and manufacturing influence the course of world affairs sisted by corporations, and for this (Fidler 2008, p. 19). practices. Regardless of a country’s reason it is essential that commercial food system and patterns, policy- interests are kept separate from pol- However it is not a lack of prepara- makers should always lead public policy formation (see Box 1) even if they tion so much as a lack of resources icy formation, implementation and have a role in policy implementation. which restricts health advocacy. The monitoring, and should protect policy structures where global policy is de- formation from being influenced by

back to contents SCN NEWS #39 www.unscn.org Features 63 Big Snack’s corporate interests. ernance bodies able to cut across tee on Nutrition, but we recognize sectors and agencies, and which can that the process of challenging mar- Policy-makers individually are handle the economic, social, environ- ket freedoms in order to improve hu- unlikely to be able to introduce mental and health aspects of food man well-being will need to be con- strong market regulations or insist on supplies. We urge support for sidered systematically across all the transparent processes, and therefore strengthening and enhancing the role bodies which provide the world with we urge a strengthening of UN gov- of the UN System Standing Commit- its global governance.

Box 1. Partners, participants and due process The commercial sector’s self-promotion as “part of the solution” and its desire to be a partner in the de- termining process of change has thrown up some challenging issues for policy-makers. The implication of the word “Partners” and “Partnership” is that it assumes that there is a shared goal, with two or more parties collaborating to reach that goal. Partnerships between commercial interests and public health interests may be successful as a means of delivering specific policy objectives, such as the distribution of emergency relief resources, or the distribution of certain disease prevention measures such as low-cost vaccines, condoms or anti-malarials. However, there are other health promotion measures which are unlikely to be successfully achieved through industry-public health partnerships, especially if the public health aim is to reduce or restrict the consumption of products which industry manu- factures or distributes. This is clearly the case for tobacco products, for alcoholic beverages and for breastmilk substitutes. The lessons from breastmilk substitutes can be used to reflect on the concept of partnerships with the food and beverage industry in general. The modern food industry has objectives which are not identical to those of public health, especially when it comes to diet-related chronic diseases. Food companies have a primary aim of market expansion (this is their duty to shareholders) whereas public health workers urge the restriction of the marketing of certain types of products (those high in sugars, salt, saturated fat and trans fats). In terms of improving population dietary patterns there may be a common alliance for the expansion of some parts of the market (e.g. fruit, vegetables and fish), but for much of the processed food sector there is no shared goal of providing an optimally nutritious food supply. There are also further concerns about the environmental impact of current food production and distribution methods, social inequalities in land use, cash cropping and labour exploitation, and other issues which may set food industry aims against the wider interests of public health. The role of NGOs includes advocacy, and advocacy includes speaking against the role of industry in many of its activities. Partnerships between NGOs and industry may inhibit this advocacy role. Partner- ships may serve industry interests but there should be no assumption that they serve the public health goals of NGOs.

Participation in policy Most governments recognize the need to ensure that policy formation is not unduly influenced by special interests. In good governance, the dialogue with interested parties is separated from the determina- tion of policy need and the selection of policy options: the first should be held in a series of open forums in which stakeholders give their perspectives and arguments, the second requires analysis and recom- mendation from specialists (whose own conflicts of interests are openly declared). In the case of public health it is important to ensure that commercially interested parties are not able to prevent the formation of public health policies or hinder the development of measures to implement the policies. As an example, the WHO took some trouble to ensure separate processes for expert review and for stakeholder comment during the development of the Recommendations on Marketing Foods and Non- alcoholic Beverages to Children (WHO 2010).

back to contents SCN NEWS #39 64 Features www.unscn.org

Box 1. Partners, participants and due process (cont.) Even this separation has some issues that need to be considered. The stakeholders’ consultations may need to be conducted in separate sessions to allow an open dialogue between the host agency (such as WHO) and the stakeholder grouping. This was the case for the issue of marketing to children, where WHO hosted separate meetings with NGOs on the one hand and with the industry sector on the other. Partnerships in policy implementation also need to be carefully examined and a risk analysis undertaken. Hawkes and Buse’s (2011) discussion of the role of food industry “partners” identifies three essential questions which policy-makers need to address, once a policy is decided: (1) Would engaging with the industry help achieve the objective more effectively? (2) Would the interests involved (on both sides) enhance or threaten the likelihood of achieving public health objectives? (3) If interaction is viable, what form of interaction would be most effective? “Platforms” such as the European Platform on Diet, Physical Activity and Health are meetings which encourage a dialogue between different parties (public health, commercial, academic, policy), encourage networking and information exchange, and they can encourage all parties to feel that they are being heard. However, such platforms should not be used to determine policy or to allow commercial operators to appear as unconflicted agents for public health promotion. A Platform is used badly if it delays policy development or deteriorates into a series of public relations exercises by the participants. A good Platform has clear objectives and rules of engagement, is task-focussed and time-limited.

References an Array of Lower-Sodium Choices. Press Egger GJ, Dixon JB (2010) Obesity and release 20 July 2011. (online) global warming: are they similar Anderson P, Chisholm D, Fuhr DC (2009) "canaries" in the same "mineshaft"? Cecchini M, Sassi F, Lauer JA, Lee YY, Effectiveness and cost-effectiveness of Medical Journal of Australia 193:635-637. policies and programmes to reduce the Guajardo-Barron V, Chisholm D (2010) harm caused by alcohol. The Lancet Tackling of unhealthy diets, physical inac- EIRIS (2006) SEE Risk Briefing: Obesity 373:2234-2246. tivity, and obesity: health effects and Concerns in the Food and Beverage Indus- cost-effectiveness. The Lancet 376:1775- try. Ethical Investment Research Services Andreyeva T, Long MW, Brownell KD 1784. Ltd: London. (2010) The impact of food prices on consumption: a systematic review of re- Chan JC, Sobal J (2011) Family meals and Fidler DP (2008) After the revolution: search on the price elasticity of demand body weight. analysis of multiple family global health politics in a time of eco- for food. American Journal of Public members in family units. Appetite 57:517 nomic crisis and threatening future Health 100: 216-222. -524. trends. Global Health Governance 2:1-21. Anon (2011) Termo de Compromisso. nº Claro RM, Monteiro CA (2010) Family Fortune (2011) Global 500 and Food and 004/2011 Diário Oficial da União nº 68, income, food prices, and household pur- Consumer Products Industry. CNN Seção 3. 81pp chases of fruits and vegetables in Brazil. Money. (online) Revista de Saúde Pública 44:1014-1020. Bhutta ZA, Ahmed T, Black RE, Cousens S, Freshfel Europe (2010) Where is the Dewey K, Giugliani E, Haider BA, Cobiac LJ, Vos T, Veerman JL (2010) Cost- fruit? The European Fresh Produce Asso- Kirkwood B, Morris SS, Sachdev HPS, effectiveness of interventions to reduce ciation: Brussels. (online) Shekar M, Maternal and Child dietary salt intake. Heart 96:1920-1925. FSA (2006) New Salt Reduction Targets Undernutrition Study Group (2008) What Cohen DA (2008) Neurophysiological Published as Part of FSA Campaign to works? Interventions for maternal and pathways to obesity: below awareness Reduce Salt in Our Diets. News Release child undernutrition and survival. The and beyond individual control. Diabetes Ref. 2006/0639 Food Standards Agency: Lancet 371:417-440. 57:1768-1773. London. (online) Brownell KD, Warner KE (2009) The perils Costa ML (2011) The $2-a-day consumer. Gladwell M (2005) Blink: The Power of of ignoring history: Big Tobacco played Marketing Week 2 June 2011. (online) Thinking Without Thinking. Back Bay dirty and millions died. How similar is big Books: New York. food? Milbank Q 87:259-294. Dunn S (2011) The modern food industry and public health: a Galbraithian per- Gomes FS (2010a) Six hours of words Campbell Soup Company (2011) Camp- spective. Journal of Post Keynesian Eco- from our sponsor, and other items. bell Continues to Provide Consumers with nomics 33:491-515. [Column] Website of the World Public back to contents SCN NEWS #39 www.unscn.org Features 65 Health Nutrition Association, November man K, Bautista-Castaño I, Berg C, Caroli Update. Rudd Center: New Haven CN. 2010. (online) M, Cook B, Coutinho JG, Effertz T, Gram- (online) matikaki E, Keller K, Leung R, Manios Y, Gomes FS (2010b) Songs to starfruit, and Sharma LL, Teret SP, Brownell KD (2010) Monteiro R, Pedley C, Prell H, Raine K, other items. [Column] Website of the The food industry and self-regulation: Recine E, Serra-Majem L, Singh S, Sum- World Public Health Nutrition Associa- standards to promote success and to merbell C (2010) Television food advertis- tion, July 2010. (online) avoid public health failures. American ing to children: a global perspective. Journal of Public Health 100:240-246. Gomes FS (2011) Snack healthy or un- American Journal of Public Health healthy, but snack: the snack barrier to 100:1730-1736. Shibuya K, Ciecierski C, Guindon E, Bet- increase fruits and vegetables consump- tcher DW, Evans DB, Murray CJL (2003) Kent MP, Dubois L, Wanless A (2011) tion in Latin America. IFAVA Scientific WHO Framework Convention on Tobacco Food marketing on children’s television Newsletter 57:4. Control: development of an evidence in two different policy environments. based global public health treaty. British Gomes FS, Castro IRR, Monteiro CA International Journal of Pediatric Obesity Medical Journal 327:154-157. (2010) Publicidade de alimentos no 6:e433-441. Brasil: avanços e desafios. Ciência e Swinburn BA, Sacks G, Hall KD, McPher- Koplan JP, Brownell KD (2010) Response Cultura 62:48-51. son K, Finegood DT, Moodie ML, Gort- of the food and beverage industry to the maker SL (2011) The global obesity pan- Gómez L, Jacoby E, Ibarra L, Lucumí D, obesity threat. Journal of the American demic: shaped by global drivers and local Hernandez A, Parra D, Florindo A, Hallal P Medical Association 304:1487-1488. (2011) Sponsorship of physical activity environments. The Lancet 378:804-814. Lachat C, Roberfroid D, Huybregts L, Van programs by the sweetened beverages Traill WB (2006) Trends towards over- industry: public health or public rela- Camp J, Kolsteren P (2009) Incorporating weight in lower- and middle-income the catering sector in nutrition policies of tions? Revista de Saúde Pública 45:423- countries: some causes and economic WHO European Region: is there a good 427. policy options. In The double burden of recipe? Public Health Nutrition 12:316- malnutrition: case studies from six devel- Hastings G, Stead M, McDermott L, For- 324. oping countries. Food and Nutrition Pa- syth A, MacKintosh A, Raynor M, Godfrey Langlois A, Zuanic PE, Faucher J, Pannuti C, Caraher M, Angus K (2003) Review of per 84. FAO: Rome. C, Shannon J (2006) Obesity: Re-Shaping the research on the effects of food pro- United Nations, Department of Economic motion to children. Centre for Social Mar- the Food Industry. JP Morgan Securities and Social Affairs, Population Division Ltd Global Equity Research: London. keting: Glasgow. (2011) World Population Prospects: The Ludwig DS, Nestle M (2008) Can the food Hawkes C (2007) Regulating and litigating 2010 Revision. UN: New York. (online) industry play a constructive role in the in the public interest: regulating food Vepa SS (2004) Impact of globalization on obesity epidemic? Journal of the Ameri- marketing to young people worldwide: the food consumption of urban India. In trends and policy drivers. American Jour- can Medical Association 300:1808-1811. Globalization of food systems in develop- nal of Public Health 97:1962-1973. McCright AM, Dunlap RE (2000) Challeng- ing countries: impact on food security Hawkes C, Buse K (2011) Public health ing global warming as a social problem: and nutrition Food and Nutrition Paper an analysis of the conservative move- 83. FAO: Rome. sector and food industry interaction: it's time to clarify the term 'partnership' and ment's counter-claims. Social Problems Volgy TJ, Schwarz JE (1994) Foreign policy 47:499-522. be honest about underlying interests. restructuring and the myriad webs of European Journal of Public Health 21:400 Millstone E, Lobstein T (2007) The Por- restraint. Chapter 2. In Rosati JA, Hagan -401. Grow project: overall cross-national re- JD, Sampson MW III (eds) Foreign policy Hawkes C, Lobstein T (2011) Regulating sults, comparisons and implications. Obe- restructuring: how governments respond the commercial promotion of food to sity Review 8(S2):29-36. to global change. University of South Carolina Press: Columbia SC. children: a survey of actions worldwide. Monteiro CA (2011) The big issue is ultra- International Journal of Pediatric Obesity processing: the price and value of meals. WHO (2007) Obesity policy: the next 6:83-94. World Nutrition 2:271-282. steps. In Branca F, Nicogosian H, Lobstein Hebden LA, King L, Grunseit A, Kelly B, Monteiro CA, Gomes FS, Cannon G T (eds.) The Challenge of Obesity in the WHO European Region and the Strategies Chapman K (2011) Advertising of fast (2010) The snack attack. American Jour- for Response. WHO EURO: Copenhagen. food to children on Australian television: nal of Public Health 100:975-981. the impact of industry self-regulation. WHO (2010) Set of Recommendations on Monteiro CA, Levy RB, Claro RM, Castro Medical Journal of Australia 195:20-24. the Marketing of Foods and Non- IRR, Cannon G (2011) Increasing con- Alcoholic Beverages to Children. WHO: Institute of Medicine (2011) Leveraging sumption of ultra-processed foods and Geneva. (online) Food Technology for Obesity Prevention likely impact on human health: evidence and Reduction Effort: Workshop Sum- from Brazil. Public Health Nutrition 14:5- World Bank (2010) Gross Domestic Prod- mary. Pray L, Pillsbury L (eds.) National 13. uct 2010. (online) Academies Press: Washington DC. PepsiCo (2010) Performance with Pur- Yach D, Feldman ZA, Bradley DG, Khan M (online) pose: The Promise of PepsiCo. Purchase (2010) Can the food industry help tackle Jack A (2011) Brazil’s unwanted growth. NY: PepsiCo. 4pp. (online) the growing global burden of undernutri- Financial Times (April 8, 2011). London: Rudd Center for Food Policy and Obesity tion? American Journal of Public Health The Financial Times. (online) (2011) Rudd Report. Trends in Television 100:974-980. Kelly B, Halford JCG, Boyland EJ, Chap- Food Advertising to young people: 2010

back to contents SCN NEWS #39 66 Research Report www.unscn.org RESEARCH REPORT A QUALITATIVE STUDY OF UNSCN STEERING COMMITTEE AND WORKING GROUP FACILITATORS VIEWS ON ENGAGEMENT WITH THE PRIVATE INDUSTRY Breda Gavin, MPH, BSc SRD ([email protected]) University of Liverpool Author statement: The author declared not having any conflict of interest.

OVERVIEW Health Organization (WHO) and pow- entities and partner institutes in erful governments (Richter 2004) achieving this goal (UNSCN 2009) The purpose of the study was to ex- there remains much scepticism and with the role of the private sector in plore opinions and insights of the concerns regarding how public health this public health issue well docu- United Nations System Standing Com- organizations with altruistic aims can mented. mittee on Nutrition (UNSCN) Steering successfully partner with private enti- Committee and Working Group facili- Currently engagement with the pri- ties that have an inherent profit men- tators with regards to possible private vate industry does not occur at any tality. As surmised by Majestic, sector engagement and their poten- formal level but a recognition of a tial role in the organization. The study the differences in mission, perspec- possible role has been acknowledged found a broad level of acceptance tives, and priorities create scepticism with a concern on how to protect and regarding a role for the private sector for public health officials about the preserve the credibility and auton- in dealing with complex global health motives of the private sector and the omy of the organization (UNSCN benefits of engaging in partnerships, issues including those relevant to the 2009). Discussion on engagement even when the efforts might have sub- UNSCN. However attached to this with the private sector began at the stantial public health benefits (Majestic st acceptance was a requirement to ef- 2009). 31 annual meeting in 2004 which fectively manage such relationships lead to the drafting of a private sector through defined and restrictive crite- An investigation by Cohen and Carter engagement policy in 2006. Following ria. The success of potential engage- has raised serious questions on con- the establishment of a task force ex- ment was marred by a lack of trust on flicts of interest among those advising amining the issue in 2008 the Steer- the motivations of the private sector WHO and on the transparency of the ing Committee of the UNSCN con- based on incompatibility of goals as science that was part of the decision- cluded that to carry out its remit ef- well as perceived and real conflicts of making process (Cohen and Carter fectively it needed to include a wider interests. A clear consensus that the 2010). What has emerged from this range of partners which should en- responsibility of public health re- controversy is the question as to compass the private sector (UNSCN mains within the realm of the public whether public entities are effectively 2009). Up to the commencement of sector and governments emerged as managing conflicts of interest that are this research however no changes on a key conclusion from the study. A part of public-private partnerships in its structure have occurred and the similar study with private sector rep- the health arena (Cohen and Carter UNSCN is currently engaging in a re- resentatives familiar with the UNSCN 2010) and the potential damage to a form process that will include an ex- would also provide useful insight in public health organization’s credibility amination of private sector engage- supporting informed decisions of the that such partnerships can inflict. ment. recently established UNSCN Execu- The Private Sector and the UNSCN Thus the aim of the study was to ex- tive Committee. plore opinions and insights of the for- The UNSCN is '’the food and nutrition mer UNSCN'S Steering Committee INTRODUCTION AND BACKGROUND policy harmonization forum of the and Working Group facilitators with Public-private partnerships in con- United Nations'’ (UNSCN 2009). Simi- regards to their position on possible text lar to other public health nutrition private sector engagement and their entities it is increasingly exposed to potential role in the organization. The One of the most contentious issues the private sector in areas tradition- objectives of the study were: facing public health is the question of ally associated with the public arena. greater engagement with the private As a UN agency with the remit of  To review the literature on the 1 sector . While being promoted by ending malnutrition, its focus is to potential negative and positive leading organizations such as the encourage cooperation among all UN implications of public-private part- United Nations (UN), the World nerships in health with particular

1The definition of the private sector is adopted from the UNSCN's private sector engagement policy.

back to contents SCN NEWS #39 www.unscn.org Research Report 67 reference to nutrition and experi- Sampling as focus groups were not appropriate ences so far. for the study group due to the wide Purposive sampling was the sampling variation in geographical location and  To examine current private and strategy employed. Maximum varia- busy work schedules that made it public partnerships between tion sampling was also employed as difficult to gather participants in one UNSCN member organizations and part of purposeful sampling ensuring location at a specific venue and time. the private industry in order to representation from all three con- understand the dynamics of how stituencies engaged with the UNSCN. An interview framework was con- such partnerships are currently Participants were chosen from the structed based on the literature re- managed. Steering Committee and Working view and the aims and objectives of Groups within UNSCN as this enabled the study. It provided an important  To conduct in-depth interviews a wide representation of all members guide when undertaking the inter- with members of the Steering to be obtained from a small group views and was developed under three Committee and with the facilita- and provided access to UNSCN mem- main themes: tors of Working Groups of the bers that are actively involved in the UNSCN focusing on the potential  Participant experience in private organization. The UNSCN Secretariat, challenges, benefits and risks to sector engagement as part of their in discussion with the Steering Com- engaging with the private sector. professional work; mittee, provided advice on ways to  To establish criteria for potential reach out to study participants, the  Benefits/challenges and risks in private sector engagement which only inclusion criteria were partici- private sector engagement; will inform a future UNSCN private pants must be members of the Steer-  UNSCN and private sector engage- sector engagement policy. ing Committee and/or facilitate the ment – Is it a possibility for the work of the different Working Groups UNSCN and an insight into neces- METHODOLOGY and voluntarily agree to take part in sary criteria or parameters re- Study design and setting the study. Members not part of the quired. Steering Committee or facilitating A qualitative design incorporating in- Working Groups were excluded. In The researcher conducted ten in- depth interviews was considered the this way, no private sector represen- depth interviews. An interview most appropriate study method. The tatives had seats at the Steering Com- schedule provided a similar format study was conducted in Geneva with mittee or acted as facilitators of a for all interviews, but with variations members of the Steering Committee Working Group and were, therefore, in follow-up questions based on par- and facilitators of Working Groups of not included in the study. ticipant responses. All interviews the UNSCN. As an international nutri- were completed over a six-week pe- tion forum it encompasses different A request for participation in the riod from early July 2010 until mid constituencies: UN agencies, bilateral study was sent to all Steering Com- August 2010. Two interviews were partners and nongovernmental mittee members and all facilitators of undertaken face-to-face with eight (NGO)/civil society organizations Working Groups. Five participants occurring by telephone. The duration (CSO) (UNSCN 2009) with a unique agreed to take part from the Steering of the interviews varied between 45 blend of food and nutrition profes- Committee with the remaining five and 60 minutes. sionals within these constituencies. coming from UNSCN Working At the time of the study, the private Groups. Confidentiality and anonymity sector was not yet an organized con- Subjects were recruited through their stituency of the UNSCN; representa- Data collection methods membership of the UNSCN. A sense tives of the private sector did partici- In-depth interviews provide the most of obligation to participate together pate in UNSCN activities and annual appropriate method to generate indi- with the issue of anonymity were im- sessions as part of the NGO/CSO con- vidual accounts on the phenomena portant to consider thus the process stituency. The organization is an in- being studied and to answer the re- of informed consent was of signifi- ternational UN system forum; thereby search question; a key strength of in- cant importance. An information participants in the study were located depth interviews (Green and sheet and a consent form were devel- in a wide geographical area which Thorogood 2004). There is little docu- oped and provided an important tool included America, Europe and South- mented research examining the views through which participants were in- East Asia. The study setting therefore of public health professionals regard- formed about the background, focus, did not have one defined location for ing this issue and in-depth interviews commitment and confidentiality of participation with location agreed will enable new ideas and insights to the research. based on the most appropriate com- emerge. Equally in-depth interviews munication approach. provided the most practical options To ensure confidentiality, each par-

back to contents SCN NEWS #39 68 Research Report www.unscn.org ticipant was given a code number and manner that welcomed equal part- such a big factor now that we cannot data recorded kept at the researchers nerships between all key stake- close our eyes as if they were not home in a locked cabinet with access holders without any terms or condi- there. ...it is not going to go away’’. only available to the researcher. Data tions attached, it was a pragmatic Within this theme there is a very real entered in the computer were pass- response to concerns on how best to contrast between members who ac- word protected. All data gathered tackle global health problems. cept a stakeholder-like approach will be destroyed within 12 months of Participant 7: ‘’In terms of its pro- while other members view the rela- study submission. Reassurance given grammes that relate to deliver of tionship as a practical benefit and at to participants at the beginning of the food they are part of the answer and the same time also expressing a real- study of complete anonymity seemed so we have to engage they are an ity rather than a choice of public en- to allow subjects to speak freely al- essential stoke in the wheel’’. gagement with the private sector. though one cannot account for politi- Participants expressed the view that cally correct answers that may have the role of the UNSCN was to bring all Relationship management been a factor in some of the re- partners in the nutrition debate to- sponses. The theme of how to effectively man- gether to develop a clear harmonized age engagement was an important approach to addressing key issues. RESULTS consideration. In particular there was There was a sense that the politics of a sense that the public sector needed Through the use of thematic content nutrition should not interfere with to become clearer and more assertive analysis four main themes emerged the unique role of the UNSCN. in achieving public health goals and from the study: Participant 1: ‘’If you are in a position to develop clear criteria for any po-  The role of the private sector to make bridges and bring stake- tential engagement. holders to one dialogue to one joint  Relationship management goal you have to engage all stake- Understand the focus of public health  Private sector funding holders’’. engagement with private industry  Trust. Guarded acceptance of a necessary Participants displayed a view that the role for private sector public sector is often unorganized The role of the private sector and unsure about its goals when en- Participants expressed to varying de- gaging in partnerships and this is of This broad theme on an acceptance grees a realization and acceptance of real concern if public good is to re- of a role for the private sector in pub- a role for the private sector based on main at the core of initiatives. lic health nutrition and within the their technical expertise which was Participant 1: ‘’I think the major chal- UNSCN centres on two varying con- not necessarily available within the lenges know what you want I think you clusions of the relationship; one public sector. which sees a central role for the pri- get lost when you don't have that clarity. You have to be clear why you are vate sector and another that de- Participant 5: ‘’They are important for the nutrition area because they give engaging...again it must be managed scribes a relationship driven, some- indications on trends, consumer be- engagement. It is not done where we what reluctantly, by the new reality haviour and so forth. The govern- don't know where we are going’’. of a changing commercial and nutri- ment agencies don't have the re- Participant 9: ‘’The private industry on tion environment. sources to generate that information one hand with a clear well structured and there is a huge amount of infor- focus …..and a public sector, minis- As key stakeholders mation that they have and that is tries, individuals on the other hand important for us to know so there and that very often makes the whole Despite the study bias towards mem- are opportunities there’’. bers of constituencies that exclude thing not equal so the negotiation private sector representation, the Some participants believed it was a power is often towards the private sector because they are just better majority of respondents were in fa- structurally forced engagement organized’’. vour of an interaction with the pri- rather than one of choice. This was due to many interactions at the vate sector for achieving nutritional Engagement criteria goals. There was no dissent on the global level where the private sector need to engage, the issue being how was part of committees/ As part of potential partnerships par- to engage. organizations linked to public health ticipants believed an understanding together with the power that they on the roles and responsibilities of Four of the ten participants viewed currently yield in the food and nutri- those involved and transparency the private sector as being a key part- tion area. were essential. ner in solving public health nutrition issues. This role was expressed in a Participant 9: ‘’The private industry is Participant 3: ‘’That warrants a very

back to contents SCN NEWS #39 www.unscn.org Research Report 69 strong negotiation process what the Conflict of interest lic health professionals might over- principles of this collaboration should come this concern. be and the responsibilities and free- Conflict of interest might be consid- doms from both sides...but I personally ered to impact many themes that Participant 07: ‘’You have to keep in think that transparency and account- emerged throughout the interviews mind that the private sector has a par- ability is very high on the agenda that but it was expressed to a greater ex- ticular mission of profit... their goal as is very very important people actually tend in the area of funding. Partici- a company is not to end malnutrition see what is going on and under which pants questioned the true motiva- they have to answer to their share- terms so that is essential then the con- holders and so they are very opportun- tions of private entities in providing ist ‘’. flict of interest that they declare‘’. funding in the public arena. The above quote indicates that crite- The question of why private indus- Participant 03: ‘’I think they could pro- tries would thus engage was ques- ria are seen as important and this vide funding definitely but it is a ques- was further developed throughout tion of why do they do it.... do they do tioned. the interview process where a clear it just to make market share these are Participant 10: ‘’As a private company requirement for specific restrictions the issues that are important that you have to think about the sharehold- emerged. whatever they do should be done in a ers and the bottom line in order to transparent way’’. stay in business which is their purpose Participant 10: ‘’There would have to Participants expanded on this, raising and the public sector has to worry be the kind of restrictions that I talked about things like the public good’’. about...it would need to be with com- concerns on the consequences that panies that do not have a direct profit result when accepting financial con- Concerns regarding conflicting goals stake in nutrition, it would have to be tributions. that exist should be considered in the with companies that have a strong context of participants’ previous ex- Participant 07: ‘’And we run into issues record of social and corporate respon- periences of engagement and how sibility and that they abide by regula- all the time where money is given to a very prescriptive project and some- this impacts the potential to build tory regimes and the principles of the trusting relationships. This was ex- global compact and they would have time the rights of the researcher might to be a strong measure of transpar- be limited if the results do not match pressed very clearly by one partici- ency...Transparency is really important what the company would like to see pant; the result be...’’. here’’. Participant 03: ‘’so there is a lot of history that people remember so Trust Private sector funding that has created mistrust so open- The role of private sector funding in The overarching theme emerging ness and transparency on this and public health and in the UNSCN was a throughout all interviews was trust. to learn from experiences will be recurrent theme throughout inter- This was expressed through what absolutely essential...There has views. This centred on perceptions participants believed was the incom- been lots of things done here cre- regarding financial support from the patibility between public good and ating feelings of distrust and that private sector and consequences that business-oriented aims inherent in we have to avoid we must create a need to be considered when money commercial organizations. These lead feeling of trust and that is some- becomes a central theme in public- participants to question the rationale thing that is done by everyone not private partnerships. for private sector engagement and by just one actor alone’’. the impact such partnerships might Stakeholder perception on private thus have on achieving public health UNSCN’S ability to remain independ- sector funding goals. Very specifically breastmilk ent from private sector influence substitute companies were repeat- The strength of an organization like Participants were specifically con- edly mentioned. cerned with the use of funding as an the UNSCN is in its independence to act for public good. Maintaining pub- element in accepting and developing Conflicting goals between the aims of lic trust in this ability was of great a relationship with the private sector. public health (public good) and the importance to the reputation of the It was felt such criteria were inappro- aims of the private sector (profit). priate and not one that created the UNSCN. When discussing conflicting goals correct environment from which to Participant 4: ‘’If we have very close that exist, participants continually conduct a relationship of such signifi- collaboration on a specific project cance to public health. mentioned the financial oriented bot- there is a risk that this can be misun- tom line approach of private entities. derstood. I would say there should Participant 02: ‘’Well you just don't This was very much seen as a stum- always be some kind of filter and space take their money then you can engage bling block to building trusting rela- between an organization like ours do- in a completely different way. It’s very ing normative work and the private simple’’. tionships and it was unclear how pub- back to contents SCN NEWS #39 70 Research Report www.unscn.org sector...Creditability risk really and so dren will die if they use the products... public health being left with little it depends on how this engagement is but I know that they are very much choice on private sector engagement. done’’. preoccupied with the market position and have used different strategies... to The study demanded a consideration As members of the UNSCN trust in me they do this to make money. So on factors influencing the UNSCN's this independence, it is believed to be private companies working with for- decision to include the private sector essential. mula is a problem that ...is against and for many commercial and techni- Participant 4: ‘’I believe public health public health’’. cal aspects are a central deciding fac- policy should be led by the public sector. The commercial aspect was tor and wherever there is a larger en- DISCUSSION noted in a study by Kraak and Story gagement by the private sector actors What are the implications of these acknowledging a role for public– you run the risk to at least dilute effec- findings within the current context of private partnerships in delivering tiveness of these policies’’. increasing private sector presence, healthy lifestyle initiatives due to the The growing influence of the private collaboration and engagement in the high costs associated with chronic sector was believed to impact the area of public health? diseases and reduced government independence of decisions taken by financing to effectively address them public bodies and was not necessarily The role of the private sector (Kraak and Story 2010). Thus the for public good. unique practical and technical exper- Participants accepted a role for the tise of the private sector is a key fac- Participant 5: ‘’...and that are involved private sector in public health; albeit in the national activities of nutrition, tors influencing the decision to en- this varied from viewing the private gage. we feel there is a direct conflict of in- sector as stakeholders with others terest there to sell these products and seeing a role driven by the commer- even when they work at the country Relationship management cial realities of health and the often levels all their interest is to change the Central to study objectives was de- food regulations so that the fortifica- superior technical expertise within a veloping an understanding on man- tion becomes mandatory’’. better financed private sector. There is however a conflict between mem- aging engagement while ensuring the Maintaining public trust in the bers seeing a partnership-like ap- best interest of the organization, its UNSCN and concern on the expand- proach with others comfortable only members and public health. A key ing power of the private sector led with engaging from a practical per- issue that emerged was a need for participants to display a real sense of spective. Indeed many links between public health organizations and pro- caution on interactions. both sectors were perceived as a fessionals to become more confident, Participant 5: ‘’I do think they have a forced scenario based on the increas- assertive and sure about its goals. role as long as the role is exercised in ing presence of the private sector in Public health professionals often are an independent way and there is no public health and government discus- intimidated when faced with such conflict of interest because some com- sions. The commercial and practical clarity and this is where the interests panies would like to be involved in realities of health have been dis- of public health may be influenced international activities because they cussed in previous studies particularly negatively. In a review by the Na- think it gives them visibility and from in the context of globalization and tional Public Health Network in the there they can get access to more busi- United Kingdom it was affirmed that ness in the countries concerned”. health. Waitzkin and colleagues believe the ‘‘neoliberal’’ policies implied many individuals were unsure of the role of public health medicine, in- Industry-specific concerns with globalization have resulted in a ‘'reduction and privatization of ser- cluding public health professionals Throughout all interviews there was a vices previously provided in the pub- (National Public Health Network in clear concern regarding breastmilk lic sector’' (Waitzkin et al. 2005). Kisley and Jones 1995). A study by substitute companies. The history Global trade policies that have oc- Buse and Harmer suggests the rise of attached to these companies and curred created opposition from or- organizations such as the World Bank how they are perceived to inappro- ganizations such as consumer groups with its increasing influence on global priately use power as well as the in- and health care professionals health policy and its aim of involving compatibility of their goals with pub- (Waitzking et al. 2005), some of the private sector. At the same time lic health was expressed as an un- which are members of the UNSCN. the reducing influence of the WHO workable alliance. Understanding how partnerships may has played a role in creating uncer- Participant 3: ‘’...but companies mak- be managed was a key aim of the tainty within public health (Buse and ing formula where they try use poor study and it became apparent that Harmer 2007). What is required mothers in need of a job to sell their public health professionals seemed within the UNSCN is a focused products are better knowing that chil- disenfranchised from the debate on agenda and operational plan that

back to contents SCN NEWS #39 www.unscn.org Research Report 71 enables members to have confidence ceptions of stakeholders and the pub- formation was altered to meet rein its work and certainty in what it lic regarding financial interactions. It ward-related goals (WHO 2001 in wants to achieve. A key point that is apparent that the UNSCN needs to Brugha, Starling and Walt 2002) also emerged was the requirement address what is a key issue in main- makes this finding unsurprising with for clearly defined roles and responsi- taining its integrity and the interests participants conscious of the negative bilities for each partner. This has of public health. history attached to private sector been identified in other studies with partnerships. complex and diverse resources, cul- Trust All the key points of concern dis- tures and practices of each partner Many of the discussions throughout cussed on private sector involvement surmising the need for an agreed un- the interviews returned to the issue are manifested with great intensity derstanding on roles and responsibili- of trust. This concept is important and without compromise with re- ties if such initiatives are to be suc- when developing, building and main- gards to opposition to breastmilk cessful (Reich 2000). taining partnerships for public health substitute company involvement in (WEF 2005). The research question the UNSCN. Breastfeeding is the gold Private sector funding and aim both seek to understand fac- standard in infant health and infant Private sector funding, as a rationale tors that may impact any future deci- feeding companies have '’reversed for engagement, was seen as inap- sion on engagement, and one key feeding trends from primarily breast- propriate. Participants believed it issue that emerged was trust. As- feeding to formula feeding through resulted in an environment not con- pects that impacted the building of pervasive marketing strategies tar- junctive to the best interest of public trust were the conflicting goals of a geting hospitals, health providers, health and created questions on the profit-oriented private company with and the general public'’ (Kaplan and independence of decisions from key the public good aims of public health Graff 2008). Such practices have stakeholders and the general public. organizations. The financial-oriented eroded the trust of public health pro- Korn recognized the challenges in- aim inherent to the private sector fessionals in this sector and it re- volved in maintaining public trust created scepticism on the real moti- mains a key stumbling block to any when funding becomes part of the vations behind any potential mem- engagement (Singh, Daar and Singer relationship with an '’unwillingness to bership or partnership building. This 2010). UNSCN members currently see tolerate even a tinge of suspi- has been documented by Grace when no rationale to fully engage with such cion’' (Korn 2000). she concluded that although compa- companies. nies may have philanthropic con- Financial contributions created real cerns, the company assesses the ini- RECOMMENDATIONS and perceived conflict of interest tiative as a commercial opportunity concerns. Participants question the The following are specific recommen- i.e. has it the potential to return a motivations of the private sector and dations that could be considered by good profit for the company (Grace the consequences of financial en- the recently formed UNSCN Executive 2004). What is concerning for partici- gagement are a complex subject de- Committee as part of the current dis- pants is the fact that public good be- bated in other studies. Boyd and cussions on how best to engage with comes secondary to private sector Bero, when undertaking a study for the private sector. objectives. A study by Nishtar found WHO on integrity of scientific re- similar concerns questioning the abil- 1. Develop a clear understanding of search, found “evidence demonstrat- ity of public health to maintain nor- the goals of the UNSCN and its initia- ing the association of financial ties mal regulations (Nishtar 2004). He tives before actively opening discus- with a breakdown in research integ- concluded that motivations of pri- sions with the private sector. This rity” (Boyd and Bero 2006). A study vate sector engagement included im- ensures that the leadership role is by Chren and Landefeld also found proving company image and provid- owned by the UNSCN and that the health professionals decisions were ing access to key policy personnel goals of public health nutrition re- influenced by financial interactions (Nishtar 2004). Despite such concerns main the key priority. with pharmaceutical companies there is recognition of the benefits of (Chren and Landefeld 1994). Prob- 2. Discuss, develop and agree on the such partnerships in meeting public lems could emerge for the UNSCN nature and extent of the relationship health aims (Nishtar 2004). from the conflicts of interest that are that the majority of UNSCN Executive present in such relationship; not nec- The question of independence in de- Committee members are at ease with essarily because these conflicts influ- cisions made was again raised under in relation to the private sector. An ence the public organization in ques- the theme of trust. Findings in studies important first step is a review of the tion but that they have the potential and reviews such as that by WHO on current private sector engagement to (Angelis 2000). This impacts per- the GAVI Initiative in 2001 where in- policy and its ultimate adoption. It is also important to acknowledge that back to contents SCN NEWS #39 72 Research Report www.unscn.org consensus among all members may A similar study with private sector don be difficult to reach. Thus leadership representatives familiar with the Kaplan DL, Graff M (2008) Marketing from the Chair in bringing all mem- UNSCN would also provide useful Breastfeeding—Reversing Corporate In- bers together in the process is essen- insights in supporting informed deci- fluence on Infant Feeding Practices. Jour- tial. sions of the UNSCN Executive Com- nal of Urban Health 85(4): 486–504 doi: mittee. The governance and responsi- 10.1007/s11524-008-9279-6. 3. The dynamics and complexities of bility of public health nutrition how- financial interactions require careful Kisley S, Jones J (1995) A hive of activity: ever remains within the realm of the thought and thus alternative avenues the future of public health. Public Health public sector and governments 109: 227-233. to direct funding must be examined. (Widdus 2001) and this research em- The development of a “pool” fund Korn D (2000) Conflicts of Interest in Bio- phasizes this important distinction for with contributions from the private medical Research. Journal of the Ameri- all public health professionals. This sector pooled together with those of can Medical Association 284: 2234-2237. could and should be further dis- (online) UN agencies and bilateral partners cussed through a public consultation may be an important consideration Kraak VI, Story M (2010) A Public Health process managed by the UNSCN Se- for an organization such as the Perspective on Healthy Lifestyles and cretariat. UNSCN. Public–Private Partnerships for Global Childhood Obesity Prevention. Journal of References the American Dietetic Association 110(2): CONCLUSION 192-200. (online) Angelis CD (2000) Conflict of Interest and In conclusion the study provides the the Public Trust. Journal of the American Majestic E (2009) Public health’s incon- recently established UNSCN Execu- Medical Association 284: 2237-2238 venient truth: the need to create partner- tive Committee further insight into (online) ships with the business sector. Preventing the views of members of its former Chronic Disease 6(2). (online) Boyd EA, Bero LA (2006) Improving the Steering Committee and facilitators use of research evidence in guideline Nishtar S (2004) Public – private of Working Groups on potential pri- development: 4. Managing conflicts of 'partnerships' in health – a global call to vate sector engagement. This is interests. Research Policy and Systems; 4 action. Health Research Policy and Sys- timely since the UNSCN is under re- (16) doi:10.1186/1478-4505-4-16 tems 2(5) doi:10.1186/1478-4505-2-5 form and there is an opportunity for Brugha R, Starling M, Walt G (2002) GAVI: Reich MR (2000) Public−private partner- change. the first steps: lessons for the Global ships for public health. Nature Medicine There is a general acceptance of a Fund. The Lancet, 359(9304): 435-438 . 6: 617-620 doi:10.1038/76176 role for the private sector in dealing (online) Richter J (2004) Public-Private Partner- with global nutrition and health is- Buse K, Harmer AM (2007) Seven habits ships and International Health Policy sues. This represents a trend appar- of highly effective global public–private Making. A GASPP Policy Brief. GASPP ent in many public health entities health partnerships: Practice and poten- Publications. where involvement of the commer- tial. Social Science & Medicine 64: 259– Singh JA, Daar AS, Singer PA (2010) 271. (online) cial sector has become more com- Shared Principles of Ethics for Infant and mon place (Buse and Walt 2000). Un- Buse K, Walt G (2000) Global public– Young Child Nutrition in the Developing derscoring this acceptance lies com- private partnerships: part I – a new devel- World. BMC Public Health 10(321). doi:10.1186/1471-2458-10-321. plex issues that require careful con- opment in health? (online) sideration to ensure members remain Cohen D, Carter P (2010) WHO and the UNSCN (2009) SCN Structure (online) engaged with and supportive of the pandemic flu "conspiracies.. British Medi- Waitzkin H, Jasso-Aguilar R, Landwehr UNSCN as a global nutrition harmo- cal Journal 340: c2912. Aand Mountain C (2005) Global trade, nizing organization. On whether the Chren MM, Landefeld CS (1994) public health, and health services: Stake- engagement with the private sector Physicians' Behavior and Their Interac- holders’ constructions of the key issues. needs to be regulated, there is no tions With Drug Companies. Journal of Social Science & Medicine (61) 5: 893-906 common view. Other issues need the American Medical Association 271(9): Widdus R (2001) Public–private partner- more consultation as well: how to 684-689 ships for health: their main targets, their build and sustain trust, definition of Grace C (2004) Leveraging the Private diversity, and their future directions. Bul- engagement criteria, definition and Sector for Public Health Objectives. DFID letin of the World Health Organization 79 criteria on private sector funding, Health Systems Resource Centre. (online) (8) (online) processes of monitoring and account- Green J, Thorgood N (2004) Qualitative WEF (2005) Development-Driven Public ability, among others. Methods for Health Research. Sage: Lon- Private Partnerships in Health. World Economic Forum: Geneva (online) Editors’ note: This is an independent study which does not necessarily represent the views of the UNSCN. Queries, comments and requests should be sent to the author, who informed the complete study is available by request.

back to contents SCN NEWS #39 www.unscn.org Examples of Engagement Frameworks 73 EXAMPLES OF ENGAGEMENT FRAMEWORKS UNITED NATIONS SYSTEM Standing Committee on Nutrition

UNSCN Private Sector Engagement Policy Interim document agreed at the 33rd SCN Annual Session in Geneva, March 2006 (with minor revisions made 19 June 2006)

Introduction over public policy making 5. Many of the constituent mem- processes of governmental bers of the SCN have their own pri- 1. The Standing Committee on and intergovernmental institu- vate sector engagement policies and Nutrition (SCN) is the food and nutri- tions, at the expense of the guidelines that guide their own tion policy harmonization forum of public good agency private sector interactions1. the UN System. The work of the SCN This SCN private sector engagement is based on the principle of consensus  the opportunity costs of dis- policy only relates to actions and ac- -building and inclusiveness among its traction from or less interest in tivities that are sponsored by and/or members. activities which are not of in- carried out under the umbrella of, terest to the private sector but 2. The SCN acknowledges the pri- and in the name of the SCN. which may be important for vate commercial sector, and espe- nutrition goals cially the food and drink industries, as Defining Private Sector important actors among those en-  regarding private sector en- 6. The ‘private sector’ is recog- gaged in food and nutrition related gagements as ends in them- nized by SCN to be ‘for-profit’ enter- activities. The need for greater pri- selves, thereby undermining prises or companies, whether large or vate sector engagement in efforts to strategic direction small, privately owned, employee achieve the SCN vision and mandate  loss of legitimacy with key con- owned, state owned or stock-market (see Annex 1, attached) are recog- stituencies and funders due to listed, legally registered (formal) or nized. However it is also recognized perceived co-optation by com- unregistered (informal). that such interaction needs to be fa- mercial interests 2 cilitated by special arrangements in 7. Business interest NGOs order to ensure that the integrity of  funding driven shifts in priori- (BINGOs) also comprise the ‘private the SCN is maintained. ties at both international and sector’. These are organizations that national level, with fragmenta- are funded to service ‘for-profit’ en- 3. Private sector engagement pre- tion of public health/nutrition terprises or advocate their interests, sents both opportunities and risks for policies and programming and include trade associations and the SCN and its aims, especially in this charitable foundations that are not increasingly globalized world, and 4. The purpose of this document separate legal entities with an ‘arms- therefore requires a proactive strat- is to serve as a guideline for interac- length’ relationship to the ‘for-profit’ egy and policy and learning through tion of the SCN with commercial sec- enterprise or enterprises that provide experience. SCN recognizes and will tor actors, with the intention above (s) their funding. Such organizations seek to manage the potential risks of all of being open and clear about po- may or may not be registered as not- any private sector engagement, such tential conflicts of interest, and en- for-profit, with or without charitable as: suring that these aspects are adequately managed. status, may or may not express an  greater corporate influence explicit public purpose, but report

1 SCN 2004. SCN Private Sector Engagement Report. Geneva: SCN. 2WHO 2002. Understanding Civil Society: Issues for WHO. External Relations and Governing Bodies Civil Societies Initiative. Geneva: World Health Organization.

back to contents SCN NEWS #39 74 Examples of Engagement Frameworks www.unscn.org over half of their income in the past tion of food and drink supply vention on the Elimination of all year coming from the private sector globally forms of Discrimination Against (as donors, members or clients), or Women (CEDAW), within the sphere  to utilize and shape the growing obviously share a brand with a corpo- of their operations and influence, interest of corporations in volun- ration (determined at the discretion while all other entrepreneurship op- tary responsible practices of SCN). erates in ways that help achieve  to explore new sustainable ap- these rights, whether knowingly or 8. Henceforth all such companies proaches given the limited capac- not. This vision is particularly relevant and BINGOs are referred to as ity of many governments to food-related companies, but is not ‘private sector organizations’ (PSOs). 12. SCN’s engagement with the limited to them, due to the broader 9. PSOs that do not meet the private sector should focus on fulfill- economic influences on both hunger minimum acceptability criteria for ing the SCN mandate and pursuing its and malnutrition. Those aspects of engagement such as human rights, vision, trying where possible to maxi- the right to adequate food that ad- labour rights, environment and good mize the private sector’s potential to dress sustainable development and governance as defined by the UN (see contribute to these efforts. Such ini- food/drink quality issues are particu- paragraph 22 below) are off limits on tiatives should recognize the food larly relevant to SCN’s vision for the all accounts and therefore excluded and nutrition priorities of the UN sys- private sector. from all of the further considerations tem as a whole, including those em- regarding PSOs for the purpose of bodied in the Millennium Declaration Principles of Engagement this policy. and the Millennium Development 14. Collaborative engagement with 10. If a person engaging with SCN Goals, and more specifically the the private sector, beyond mere com- is working on a project that is major- Global Strategy on Infant and Young mercial transactions such as buying ity-funded by PSOs, then even if the Child Feeding and the Global Strategy products and services, is guided by organization does not qualify as a on Diet, Physical Activity and Health. the following principles: PSO, it will be treated as such for the SCN recognizes UN conventions and a) Relevance to Vision and Man- specific engagement concerned. associated documents as the sub- date: Any collaborative activities stantive and authoritative definition with PSOs must have a direct rele- Purpose of Engagement of ‘well-nourishment’ and ‘adequate vance to and be in support of growth and development’, and the 11. The purposes of engagement achieving SCN’s vision and man- rights and responsibilities of various of the SCN with PSOs can be divided date. SCN shall establish and pur- actors to achieve these, including the into two categories: either seeking to sue its own agenda for private sec- private sector. These international receive their support and resources tor engagement, rather than only instruments are particularly relevant and/or seeking to influence their ac- react to proposals. tivities. These two categories are not to companies with international op- b) Effectiveness and Efficiency: Se- necessarily mutually exclusive of each erations. The International Code of curing concrete outcomes in line other. The purpose of engagements Marketing of Breastmilk Substitutes with achieving the goals of the with PSO by the SCN could therefore and subsequent relevant World SCN, as well as the appropriate use potentially include the following: Health Assembly resolutions, provides an excellent example of the sort of the SCN’s resources as com-  to consider new sources of fund- of legislation that states should pared to alternative actions. ing adopt, and practices that companies c) Managing Conflict of Interests:  to harness the skills, experiences, should adhere to, in order for nations Identification of interests of col- resources and networks of the to achieve optimal breastfeeding laborating individuals and institu- private sector, especially for is- practices and the adequate growth tions, assessment of potential con- sues like food fortification and development of their infants. flicts of interest, in keeping with  to increase private sector under- 13. SCN’s vision for the private sec- SCN’s policy on such conflicts (see standing of and support for the tor is a future where international Annex 2, attached) and subsequent work of SCN and its constituen- companies both recognize and ac- management of these or exclusion cies tively support the right to adequate from participation. food and other human rights treaties  to respond to the growing indus- d) Independence from vested inter- including the Convention on the est: Maintaining the credibility of trialization and commercializa- Rights of the Child (CRC) and the Con-

back to contents SCN NEWS #39 www.unscn.org Examples of Engagement Frameworks 75 SCN by ensuring independence tor funding for nutrition-related ac- to Working Groups, in order to help from commercial interests. tivities. in carrying out the work programme of the SCN. e) Transparency: While respecting 16. Direct funding is the provision individual privacy and institutional of cash as a grant. Direct funding of a) Provision of support in the confidentiality, as appropriate, the the SCN by PSOs can either be to sup- form of goods includes travel aim must be for all interested per- port the Action Plan or to support the costs (air fares and hotel bills), sons to easily obtain information work plans of the Working Groups. hosting working breakfast, on the activities, including through lunches or dinner meetings, of a) Direct funding support by posting on websites. providing paper or other con- PSOs of the Action Plan activi- sumables. Such support is easy f) Diversity: Diversifying types of ties involves the provision of to place a cash value on. PSOs, to ensure that no one type funds directly to the SCN (size/origin) dominates engage- through the Secretariat. Such b) Provision of support in the ments, and ensuring that those funding would complement the form of services or access to who have no commercial interests funds provided by the UN resources includes provision of in the issues have preferential par- agencies and other constitu- space for holding events, assis- ticipation. ents for carrying out the Action tance with the printing of re- Plan. ports, and access to informa- g) Differential Safeguards: Dis- tion networks, to communica- tinguishing between activities b) Direct funding of Working tion networks, to data bases, that relate to public policy Group by PSOs should be for to software, and advisory ser- making and should be particu- activities included in the WG vices. Such support is more larly safeguarded from corpo- work plans approved by the difficult to put a cash value on. rate influence, and other activi- Steering Committee and Chair. ties with less relevance to or Such activities could include 18. Dialogues with PSOs by the influence on public policy. Dif- performing studies or reviews SCN are not concerned with receiving ferentiating between PSOs in- of literature to determine ei- PSO resources as such, but with ex- volved in activities that are ther knowledge or practice changing information and/or trying to confluent3 with the interests of gaps for example, and/or for influence PSO practices. Such inter- SCN, and those that are not. realizing symposia and/or actions are likely to involve food re- workshops to discuss such find- lated PSOs in particular and to occur h) Human rights based: pro- ings and make recommenda- within the context of Working Group moting and respecting human tions to the SCN through the activities, or through other specially rights principles, treaties and Chair and the Steering Commit- convened ad hoc task forces. Such covenants. tee. Direct funding of these dialogues could be of relevance to Types of Engagement activities can either be pro- understanding the gaps in implemen- vided through and facilitated tation of knowledge in a particular 15. The types of engagement with by the Secretariat, or be re- field such as food fortification for ex- PSOs by the SCN covered by this pol- ceived through the institutions ample, where the experience of the icy can be categorized into three participating in the Working food related PSOs is particularly per- broad areas, namely direct funding, Group. tinent. Another potential area for contributions in kind including access dialogue concerns business practices 4 17. Contributions in kind by PSOs to resources, and dialogues . Direct and whether these are meeting the are non-cash inputs in the form of funding and in-kind contributions human rights obligations of the food goods or services that can be given a must not be received from food- related PSOs in particular, including cash value. Contributions in kind to related PSOs, consistent with the pol- the issue of voluntary codes of con- the SCN can be provided to the Secre- icy of the World Health Organization, duct versus mandatory codes of con- tariat, or to the SCN Steering Com- as the hosting agency of the SCN Se- duct5. cretariat, with respect to private sec- mittee and/or its task forces, and/or

3 Confluent here means not only to be ‘not antagonistic’ to SCN vision, mandate and principles, but to have mutually supportive interests. 4 A fourth potential area of interaction with PSOs is the joint delivery projects. These involve collaboration in programme delivery of a food and nutrition intervention. These are not of relevance to the SCN, since the SCN is not itself involved in programme or service delivery. Such activities are carried out by the various constituents of the SCN. 5 Utting, P. 2005. Corporate Responsibility and the movement of business. Development in Practice 15 (3-4) 375-388. back to contents SCN NEWS #39 76 Examples of Engagement Frameworks www.unscn.org Management of engagements comes7, which therefore serve as a Monitoring and evaluation 19. The SCN Steering Committee is baseline or minimum requirement. 27. The Secretariat will maintain charged with implementing this pri- 23. The Secretariat, in developing the records all of the conflict of inter- vate sector engagement policy, under any fund raising proposals for the est forms of SCN affiliates updated the guidance of the Chair and with SCN programme of work, will take annually, and they shall be available the support of the Secretariat. Each this private sector engagement policy for public inspection on request. type of engagement with a PSO, and into consideration, and any proposal 28. The Steering Committee will especially food related PSOs, has dif- will require approval of the Steering provide information concerning inter- ferent sorts of risks for the SCN and Committee and Chair before seeking actions of the SCN with PSOs, in its consequently has different sorts of such funding. Annual Report, which will be pub- management requirements 24. In order to protect against indi- lished on the website of the SCN. 20. In order to protect against in- vidual conflict of interest, affiliates of 29. In order to ensure it maintains stitutional conflict of interest, the the SCN that are actively involved in and utilizes its unique competencies Steering Committee will ensure that the work programme of the SCN the SCN does not accept financial or should all sign standard World Health and resources, the SCN will periodi- in-kind contributions from food- Organization conflict of interest cally review and revise as appropriate related PSOs for any of its activities, forms8. All officials (Chairs and rap- this policy. whether they are developed through porteurs) of working groups as well Working Groups or through the as the core members of working ANNEX 1 Steering Committee/Secretariat groups should sign the conflict of in- based work plans. terest form. Similarly all officials SCN Vision, Mandate, Membership and Activities (summary) 21. Annual work plans presented (Chairs and rapporteurs) of the three constituencies should also sign the by Task Forces of the Steering Com- The SCN vision is a world where hun- conflict of interest form. These con- mittee and the Working Groups to ger and malnutrition are no longer flict of interest forms will be kept by the Steering Committee and Chair for impediments to human development. the Secretariat. approval should clearly specify Its mandate is to promote co- whether any direct funding or in kind 25. The Secretariat will keep the operation among UN agencies and contributions will be sought from updated lists of the “active” mem- partner organizations in support of and/or contributed by PSOs. bers and officials of the UN agencies, community, national, regional, and 22. Direct funding and in kind con- NGO/CSO and the Bilateral Partners international efforts to end hunger tributions for the SCN programme of constituencies, as well as the Work- and malnutrition in this generation. ing Groups. Active here means those work (Action Plan and Working The SCN is not in itself another actively taking part in the ongoing Groups work plans) can only be re- agency. It was conceived to serve as a work of the Working Groups and the ceived from non food related PSOs point of convergence for the UN sys- Constituent groupings, as opposed to with satisfactory assessment ratings tem in the area of food and nutrition, those less active ones who just par- with regard to their performance on to ensure that the system-wide re- ticipated at the Annual Session, or human rights, labour rights, environ- sponse to tackling hunger and malnu- 6 are members of a list serve. ment and good governance criteria . trition is greater than the sum of the Direct funding of the SCN Action Plan 26. The Steering Committee will individual agency efforts. through the Secretariat has to be periodically review the way in which managed in accordance with financial the SCN is engaged with PSOs and SCN membership is primarily deter- rules and regulations of the hosting decide and inform the SCN on how mined by institutional affiliation 9 agency, currently WHO. Such funding and whether the balance or emphasis among its three constituencies , therefore needs to satisfy the WHO of such engagements was maintained namely the UN organizations, the Guidelines on working with the pri- or modified. bilateral partners (donor and recipi- vate sector to achieve health out- ent countries together representing

6 The Innovest Global Compact PLUS Screening Tool is an example (www.innovestgroup.com). Such a tool should also exclude tobacco and arma- ments PSOs. 7 WHO 2002. WHO Guidelines on working with the private sector to achieve health outcomes 8All UN agency employees already sign such forms. 9 SCN Strategic Framework back to contents SCN NEWS #39 www.unscn.org Examples of Engagement Frameworks 77 their governments) and the Non Gov- work plans. These include the work tor12. ernment and Civil Society Organiza- plans of the Working Groups and The SCN recognizes that conflict of tions (NGO/CSO). Those that belong Working Group Task Forces, the interest can occur at both the individ- to the UN agencies and/or the bilat- Steering Committee Task Forces, all ual level and the institutional level. eral partners are easily categorized. of which are approved by the Chair SCN understands that conflicts of in- Those that are not in these two cate- and the Steering Committee, with terest can exist when a secondary gories are considered to be in the facilitation and support by the SCN interest influences an organization’s NGO/CSO constituency, which in- Secretariat. or individual’s pursuit of the primary cludes representatives of “not for In order to pursue the SCN vision and or official interest. SCN’s primary in- profit” non-governmental humanitar- 10 realize its mandate an Action Plan terest is in pursuing its vision and ian and developmental aid agencies has been developed (2006- 2010), mandate to achieve a world free active in food and nutrition; repre- with five broad cross-cutting areas of from hunger and malnutrition, and sentatives of academic, research and inter-agency activity including 1) ad- where malnutrition is no longer an civil society organizations; and inter- vocacy, communication and partner- impediment to development. ested academicians and researchers. ship building; 2) assessment, moni- Private Sector organizations are not Individual conflict of interest arises toring and evaluation; 3) develop- seen as members of the SCN per se. when a person affiliated with the ment of integrated approaches; 4) SCN (be they employed by the Se- The SCN is a forum in which the UN identifying key scientific and opera- cretariat, or be a member of the agencies, bilateral partners, and tional gaps; 5) the mainstreaming of Steering Committee, be the repre- NGO/CSO constituents come to- human rights. The first three of these sentatives of the Bilateral Partners gether to harmonize food and nutri- cross-cutting areas of work will be and CSO/NGOs, or be one of the tion policies and programmes, coor- developed by three Task forces linked Chairs of the Working Groups, or a dinate activities and act together to to the Steering Committee. The registered member of a Working achieve global nutritional aims. fourth area of work will be carried Group), uses his/her professional out by the Working Groups. The The SCN holds Annual Sessions which position to influence SCN decisions mainstreaming of human rights will include parallel meetings for each of and activities in ways that could be integrated into all of these other the three constituencies, a public lead directly or indirectly to finan- areas of work of the SCN. symposium, as well as Working cial gain and/or other benefits for Group and business meetings, and the SCN affiliated person or his/her are in most part open to all partici- family (secondary interest), to the ANNEX 2 pants. The SCN is directed by a Chair detriment of the SCN and its inter- 11 and a Steering Committee, with the Conflict of Interest ests. support of a Secretariat. There are While recognizing that defining con- Institutional conflict of interest also Working Groups, each with a flict of interest is not a simple affair, arises when an SCN affiliated or- Chair and two Co-Chairs, which meet through this policy document the SCN ganization through the actions of at the Annual Session and report to is defining what it considers conflict its representative to the SCN, cre- the SCN Chair. The Chair of the SCN of interest. No single document lists ates a situation in which SCN en- reports to the Chief Executive Board generally accepted principles for ters into a collaborative interaction (CEB) of the UN System. avoiding conflict of interests in the with a private sector organization The ways in which the SCN can en- field of public health and nutrition. (PSO) in a manner that puts the gage with the private sector are lim- Nor is there a coherent, comprehen- interests of the PSO (secondary ited to the activities developed sive framework within the United interests) above the interests of through the various structures of the Nations System for identifying and the SCN. SCN, and approved as part of annual addressing conflict-of-interest issues

in interactions with the private sec-

10 SCN Action Plan 11 If accepted, this statement should be incorporated into the SCN Strategic Framework; it currently is part of the interim policy document on private sector engagement. 12 Richter J. 2005. Conflict of interest and infant and young child feeding. Geneva: IBFAN-GIFA

back to contents SCN NEWS #39 78 Examples of Engagement Frameworks www.unscn.org

International Union of Nutritional Sciences (IUNS)

IUNS Private Sector Engagement Policy

Introduction munication technology (see also IUNS  greater corporate influence homepage where the objectives are The purpose of this document is to over public policy making proc- spelled out). All this in pursuing the provide rules for cooperation of IUNS esses of higher training and vision widely shared with countries, with external actors particularly the research, of governmental and the UN, regional organisations, and private sector, to serve as a guideline intergovernmental institutions, other professional organisations, of a for interaction, including sponsoring, at the expense of the public world free of malnutrition (over- and of the IUNS with commercial sector good, such as services for im- undernutrition), including by the pri- actors, with the intention above all of proving nutritional health; vate sector where that is relevant being open and clear about potential  the opportunity costs of dis- and otherwise possible. All agree- conflicts of interest, and ensuring traction from or less interest in ments spelled out in MoU’s or similar that these aspects are adequately activities which are not of in- documents must be in accordance managed. terest to the private sector but with the policy for collaboration and which may be important for IUNS recognize the Private Sector, as sponsoring spelled out in this docu- nutrition goals and activities; important actors among those en- ment. gaged in food and nutrition related Private sector engagement in IUNS  regarding private sector en- activities; the need for sponsoring of presents both opportunities and gagements as ends in them- various scientific meetings is also rec- risks. IUNS recognizes this and will selves, thereby undermining ognized. IUNS is basing its sponsoring seek to minimise the potential risks strategic direction and long policy on internationally accepted of any private sector engagement, term strategies; principles and rules, such as the ones such as: used by UN organisations1, World  funding driven shifts in priori- Economic Forum, governments and  greater corporate influence ties at both international and others. over IUNS conferences, nutri- national level, with fragmenta- tion research2, academic train- tion of public health/nutrition Any IUNS engagement with the pri- research, higher education, vate sector should fulfil its objectives: ing and public nutrition work, particularly as related to using food and nutrition policies and To promote advancement in nutrition programming. science, research and development such influences for the purpose through international cooperation at to gaining ever increasing mar- Many of the constituent members of the global level; and to encourage ket shares; the IUNS have their own private sector engagement policies and guide- communication and collaboration  loss of legitimacy with key con- lines that lead their own private sec- among nutrition scientists as well as stituencies and funders due to tor interactions. This policy only re- to disseminate information in nutri- negative perceived co-optation lates to actions and activities that are tional sciences through modern com- by commercial interests;

1 See one example in the Bulletin of the World Health Organization. vol.79 no.8, Geneva 2001. 2 There are reports on business influences on nutrition research in specific ways that don’t foster credibility of evidence provided by the projects

back to contents SCN NEWS #39 www.unscn.org Examples of Engagement Frameworks 79 sponsored by, carried out under the categories: either seeking to receive and programmes. umbrella of, and/or in the name of their support and resources, and/or IUNS’s engagement with the Private the IUNS. seeking to influence their activities. Sector should focus on fulfilling the These two categories are not neces- purpose of nutrition research, higher Defining Sponsorships sarily mutually exclusive. The purpose nutrition education, public nutrition of engagements with private organi- The ‘’private sector’’ is recognized by (including both health and agricul- sations and business by the IUNS IUNS to be ‘’for-profit’’ enterprises or ture) programming and activities, in could therefore potentially include companies, whether large or small, order to prevent nutrition related the following: privately owned, employee owned, health damages and promote the state owned or stock-market listed,  to consider new sources of consumption of nutritionally ade- and legally registered. funding of the IUNS confer- quate diets, where possible to maxi- Business interests organised as NGOs ences and for IUNS initiated mize the Private Sector’s potential to also comprise the ‘private sector’. activities between the sched- contribute to these efforts. Such ini- These are organizations that are uled 4-year conferences; tiatives should recognize the food and nutrition priorities of IUNS and funded to service ‘for-profit’ enter-  to harness the skills, experi- prises or advocate their interests, and related organisations/associations, ences, resources and networks include research foundations, trade including various action plans for im- of the Private Sector, especially associations and charitable founda- proved nutrition, diet, and physical for issues like communication tions that can be but not necessarily activity, and related national and in- and marketing; are separate legal entities with an ternational policies and strategies ‘’arms-length’’ relationship to the  to increase Private Sector un- that can help promote good nutri- ‘‘for-profit’’ enterprise or enterprises derstanding of realise that any tion. that provide(s) their funding. Such type of support for the work of IUNS recognizes UN conventions and organizations may or may not be reg- IUNS and its constituencies associated documents as the sub- istered as not-for-profit, with or with- would have clear rules and stantive and authoritative definition out charitable status, may or may not regulations; that includes MoU of ‘adequate food’ specified in rela- express an explicit public purpose. and similar specification of un- tion to nutrition for adequate human derstanding and other types of Private organisations and business growth and development, and the agreements; that do not meet the minimum ac- rights and responsibilities of various ceptability criteria for engagement  to respond to the growing in- actors to achieve these, including the such as human rights, labour rights, dustrialization and commer- Private Sector. These international environment and good/democratic cialization of food and drink instruments are particularly relevant governance as defined by the UN are supply globally, with consider- to companies with international op- 3 off limits on all accounts and there- able impact on the nutrition erations . fore excluded from all of the further situation; IUNS’ vision for the Private Sector considerations regarding private or-  to utilize and shape the grow- interaction is a future where local, ganisations and business for the pur- ing interest of corporations in national, and international compa- pose of this policy. voluntary responsible prac- nies both recognize and actively sup- tices; port the human right to adequate Purpose of Sponsorships food and other relevant human rights The purposes of engagement of the  to explore new sustainable ap- treaties (such as the Convention on IUNS with private organisations and proaches in order to prevent the Rights of the Child (CRC) and the business (hereafter called the Private any damages of the Private Convention on the Elimination of all Sector) can be divided into two main Sector against public policies forms of Discrimination Against

3 The International Code of Marketing of Breastmilk Substitutes and subsequent relevant World Health Assembly resolutions provides an excellent example of the sort of legislation that states should adopt, and practices that companies should adhere to, in order for nations to achieve optimal breastfeeding practices and the adequate growth and development of infants.

back to contents SCN NEWS #39 80 Examples of Engagement Frameworks www.unscn.org Women (CEDAW)). This is particularly 4. Sharing email lists: IUNS should not fined by the UN in running the IUNS relevant to all companies due to the share emails of any constituency or as an organisation, including sponsor- broader economic influences on both participants of conferences with the ing, collaboration or other types of the level of malnutrition and in cer- Private Sector, unless such permis- engagement with the Private Sector. tain parts of the world also to hunger. sion is grated in writing. Such sharing Those aspects of the human right to should be reported by the President Types of Sponsorships adequate food that address sustain- in the minutes of the General Assem- The types of engagement with the able development and food/drink bly meetings and in reports by the Private Sector by the IUNS can be quality issues are particularly relevant President. categorized into three broad areas, to IUNS. 5. Transparency: While respecting namely direct funding, contributions individual privacy and institutional in kind including access to resources Principles of Sponsorships confidentiality, as appropriate, the and organisational skills, and dia- Collaborative engagement with the aim must be for all interested per- logues. Private Sector, beyond mere com- sons to easily obtain information on a. Direct funding support by the Pri- mercial transactions such as buying the activities, including through post- vate Sector of the IUNS involves the products and services, arrange sym- ing on websites. Transparency is es- provision of funds directly to the posiums, seminars, satellite meet- sential for an organisation like IUNS, IUNS. Such funding would comple- ings, conferences and workshops, is particular towards its member con- ment the funds provided by IUNS guided by the following principles: stituency. member ship fees and other constitu- 1. Relevance: Any collaborative activi- 6. Diversity: Diversifying types of the ents for carrying out the work of ties with the Private Sector must Private Sector, to ensure that no one IUNS. have a direct relevance to and be in type dominates engagements. Direct funding of any type of work in- support of achieving IUNS’ objectives. 7. Differential Safeguards: Distin- between the conferences organised IUNS shall establish and pursue its guishing between activities that re- by and in the name of IUNS by the own agenda for Private Sector en- late to public policy making (including Private Sector should be for activities gagement, rather than only react to higher nutrition training and nutrition included in a work plan approved by proposals. related research) and other activities the General Assembly of IUNS. Such 2. Effectiveness and efficiency: Secur- with less relevance to or influence on activities could include performing ing concrete outcomes in line with public policy. Differentiating between studies or reviews of literature to achieving the goals of the IUNS, as the Private Sector involved in activi- determine either knowledge or prac- well as the appropriate use of the ties that are confluent4 with the in- tice gaps for example, and/or for re- IUNS’ resources as compared to alter- terests of IUNS and those that are alizing symposia and/or workshops to native actions. not. This includes abstaining from discuss such findings and make recommendations to IUNS. Direct fund- 3. Managing conflict of interests and promising or distributing gifts in or- ing of such activities should be pro- independence: Identification of inter- der to ensure participation in activi- vided through and facilitated by the ests of collaborating individuals and ties related to IUNS conferences or President, in full openness and trans- institutions, assessment of potential meetings between such conferences. parency, and reported to the General conflicts of interest, in keeping with 8. Human rights based: promoting Assembly and in information chan- IUNS’ policy on such conflicts and and respecting human rights princi- nels used by IUNS. subsequent management of these or ples, treaties and covenants/ exclusion from participation. For the conventions. b. Contributions in kind in the form of credibility of IUNS it is important to goods includes travel costs (air fares 9. Good/Democratic Governance: Re- show independence from commercial and hotel bills), hosting working respecting and using the principles of or other interests that may not be in lated satellite meeting, breakfast, Good/Democratic Governance as de- line with IUNS rules and regulations. lunches, symposiums in the pro-

4 Confluent here means not only to be ‘not antagonistic’ to IUNS goals and principles, but to have mutually supportive interests.

back to contents SCN NEWS #39 www.unscn.org Examples of Engagement Frameworks 81 gramme of conferences, or dinner ferent sorts of risks for the IUNS and of work in-between the conferences meetings, or providing papers or consequently has different sorts of organised by and in the name of other consumables. Such support is management requirements. IUNS, or in preparing and during the easy to place a cash value on. Contri- IUNS conferences, should sign the The Private Sector engagement policy butions in kind in the form of services conflict of interest form. These con- is presented by President to the ple- or access to resources includes provi- flict of interest forms will be kept by nary of the IUNS and approved. Any sion of space for holding events, as- the IUNS Secretariat and provided to applicants for hosting a IUNS confer- sistance with the printing of reports, those who demand to see them on ence should state that their applica- and access to information networks, request. tion and policy would be in line with to communication networks, to data general ethical rules and with the The Secretariat of the IUNS will peri- bases, to software, and advisory ser- IUNS Private Sector Engagement Pol- odically review the way in which the vices. Such support is more difficult icy. IUNS is engaged with the Private Sec- to put a cash value on. tor and decide and inform the IUNS Direct funding and in kind contribu- c. Dialogues. Interactions such as ex- on how the engagement was main- tions for the IUNS programme with changing information and/or trying to tained or modified. the Private Sector must be in line influence practices are likely to in- with principles of human rights, la- volve food related Private Sector. Monitoring, Evaluation and Report- bour rights, and environment and Such dialogues could be of relevance ing good/democratic governance criteria. to understanding the gaps in imple- Direct funding of the IUNS work has The President of the IUNS will main- mentation of knowledge in a particu- to be managed in accordance with tain the records all of the conflict of lar field such as food fortification, financial rules and regulations. interest forms, of all IUNS regular including the use of different signs reports, and they shall be available The President of the IUNS, in devel- intended to influence consumers for public inspection on request. when buying products. Another po- oping any fund raising proposals for The President of the IUNS will pro- tential area for dialogue concerns the IUNS programme of work, will vide information concerning interac- business practices and whether these take this Private Sector Engagement tions of the IUNS with the Private are meeting the human rights obliga- Policy into consideration, and any Sector, in its regular reports, which tions of the food related Private Sec- proposal will require approval of the will be published on the website of tor in particular, including the issue of IUNS Council before seeking such the IUNS. voluntary codes of conduct versus funding. If urgencies arise approval mandatory codes of conduct. could be achieved by internet com- In order to ensure it maintains and munications, either through e-mails utilize its unique competencies and Management of Sponsorships or by conference calls. resources, the IUNS will periodically The President5 of the IUNS is charged In order to protect IUNS against con- review and revise as appropriate its with the responsibility to implement flict of interest, affiliates of the IUNS rationale and strategy for Private Sec- this Private Sector Engagement Pol- that are actively involved in the work tor engagement. The next review is icy. Each type of engagement with programme of the IUNS should all proposed for 2013. the Private Sector, and especially the sign a specific form of conflict of in- food related Private Sector, has dif- terest. All members of possible type

5 When the President is mentioned in this document it means the selected president plus the secretariat and/or the Council of IUNS.

Do you want to share Nutrition news with the UNSCN network?

If you have interesting nutrition-related news, nutrition vacancies or other announcements, we can help you in spreading the news via our monthly e-letter, our website, our Twitter or the SCN News publication. Contact us by e- mail [email protected] .

back to contents SCN NEWS #39 82 Examples of Engagement Frameworks www.unscn.org

The Sri Lanka Medical Association (SLMA)

Guidelines for health and nutrition related endorsement of branded commercial products by Professional Associations / Academic Bodies or any other association

Editorial proval. Corporate social responsibility Guidelines for health and nutrition necessitates ethical marketing. Link- related endorsement of branded The Sri Lanka Medical Association has ing brand promotion to public educa- commercial products by Professional developed a set of guidelines in re- tion on nutrition, hygiene and sanita- Associations / Academic Bodies or spect of brand endorsement by pro- tion is not corporate social responsi- any other association fessional associations. These guide- bility. Academic and professional as- lines have also been accepted by the Goal – to describe the conditions un- sociations have to be wary of being Food Advisory Council which is the der which professional associations / party to such activity. regulatory body in respect of food academic bodies or any other institu- labelling and advertisements. They Sound science must underlie the de- tion endorse a branded commercial emphasize the need for professional velopment of new products. Scien- product in respect of its nutritional/ associations to independently verify tists have to collaborate with industry health benefits in a manner, which content claims by a detailed chemical in this endeavour. However when will avoid misleading the consumer. these products are marketed regula- analysis in a reference laboratory ap- This is also to be referred to as Third tory oversight is essential to ensure proved by the regulatory authority. party endorsement. the accuracy of the marketing claims Health claims have to be substanti- regarding their efficacy and safety, in ated by clinical trials or other scien- 1. General guidelines order to protect and inform the con- tific evidence which need to be evalu- sumer. Academic and professional 1.1 The request for brand endorse- ated by an independent panel of ex- associations which have partnerships ment would originate from a manu- perts. There is also a moral obligation with industry have a special obliga- facturer/marketer/ advertiser of the on the professional association to tion to ensure that commercial suc- product. ensure that the endorsement is pri- cess is coupled with social good in marily in the wider benefit of the 1.2 Brand endorsement to be product marketing and brand en- consumer. This necessitates a consid- granted only by professional associa- dorsement. eration of the quality and cost of the tions/ academic bodies and endorse- endorsed brand in comparison to Dr. Narada Warnasuriya ment by individual professionals to be considered unethical and unac- other available products. The associa- President, SLMA tion has to be convinced that it offers ceptable a significant advantage to the con- 1.3 The professional associations/ sumer. This editorial is here published in part, academic bodies endorsing the prod- While the professional association is with authorization of the author. The uct should have the capacity to inde- entitled to recover the costs incurred full editorial has been published in to pendently evaluate the nutritional/ in product analysis and evaluation ‘Chemistry in Sri Lanka. The Tri- health claims of the product both the overall financial remuneration annual Publication of to Institute of clinically and technically including should not be unacceptably high as to Chemistry Ceylon Jan 2009 Vol. 26 laboratory assessment. In the ab- constitute an inducement for ap- No. 1’ sence of such analytical capacity the

back to contents SCN NEWS #39 www.unscn.org Examples of Engagement Frameworks 83 organization should seek independ- have been fulfilled a report should be brand name of the product. ent analysis from accredited1 institu- submitted to the FAC stating the in- tions/ laboratories and review their tention to endorse the product. Validity and cancellation reports. The report of the endorsing organisa- The period of validity shall not exceed 1.4 The professional organization/ tion on the product should be avail- three years from the date of endorse- institution should not endorse a able for public perusal. ment. If extension of the endorse- product based only on evidence/ ment id necessary a reviewed report Once the FAC accepts the proposal material provided by the manufac- should be submitted to FAC for fresh for endorsement the institution/ turer/ importer. approval. organisation could endorse the prod- 1.5 The professional organization/ uct within the stated guidelines for The approval for the product shall be institution should consider compara- usage of logo and institutional name. suspended by the DGHS, FAC, or the bility in quality and cost with other endorsing organisation/institution available products and be convinced Logo usage and advertising guide- after informing the manufacturer/ of the advantages rendered to the lines advertiser if they are not satisfied with the product quality, non compli- consumer by granting professional The organisation/institution must ance with regulations, d e v i a t i o n endorsement to the particular brand. approve in writing all proposed re- from its health/nutritional claims or 1.6 The organization/ institution productions of the licensed prop- from any of the above guidelines. should be convinced that the en- erty, including packaging, display ma- dorsement is primarily in the wider terials and print, radio and television Cancellation of the agreement may benefit of the consumer of the prod- advertising as well as recipes associ- be requested from FAC/DGHS by any uct. ated with advertised products. of the parties and on notice of such cancellation the permit shall forth- 1.7 The professional organization/ All references to the organisation/ with become invalid. institution endorsing the product institution must be approved prior to could claim costs incurred for the the distribution and the organisation/institution reserves the right to 1 process of analysis, evaluation and Accredited – Nationally recognized reject any material used as such. administration. institutions such as Medical Research 1.8 The total financial remunera- The logo can only be used with an Institute, Bureau of standards, ITI approved product and must be repro- tion should be proportionate to the costs incurred and should not be un- duced in accordance with specifica- acceptably high. tions given by the endorsing profes- SMLA Food Nutraceuticals Sub- sional association/academic body. committee Once the organisation/institution granting the endorsement is able to The size of the logo may vary but certify that all necessary criteria must always be smaller than the

The UNSCN Food & Nutrition Resource Portal

The UNSCN "One-Stop-Shop" Food & Nutrition Resource Portal aims to provide the platform through which the agencies and organizations participating in the UNSCN can advertise and disseminate their publications and resources to the UNSCN network worldwide. It constitutes an advanced library for food and nutrition resources. Users may identify and access resources added to the Resource Portal through searching for one or more self-defined key words, as well as through browsing in pre- defined categories of themes, resource types, geographical locations or life cycle focus. Linked to each resource, there is a short description and link to the authoring institution. You can also add your organizations' resources to the Portal through a special form where you can describe the resource, upload the document and/or provide a hyperlink to where it has been originally published. You can also access the Nutrition in Emergencies Repository, a special sub-section of the UNSCN Food & Nutrition Resource Portal which is a state-of-the-art resource base for nutrition in emergencies. It contains all relevant key documents referred to in the 21 Harmonized Training Package (HTP) modules under part 4 "training resource list".

back to contents SCN NEWS #39 84 Examples of Engagement Frameworks www.unscn.org

The International Baby Food Action Network (IBFAN)

IBFAN’s Funding Policy

In line with its 7 Principles, IBFAN 2. IBFAN’s integrity and reputa- FAN groups should consult with their does not seek or accept funds, donation: Regional Coordinating Offices on such matters. tions, gifts or sponsorship from Rationale: Funding from any for- manufacturers or distributors (or profit entities can lead to loss of IBFAN’s Policy regarding possible their trusts or foundations) of infant reputation and raise questions about funding, gifts or sponsorship from and young child feeding and related IBFAN’s integrity. the Global Alliance for Improved Nu- products. trition (GAIN): none acceptable. 3. Solidarity with other social Considerations supporting our fund- (Adopted by IBCoCo, October 2010) ing policy: movement partners: IBFAN values its independence and Rationale: IBFAN’s work on breast- groups are required to give a written 1. IBFAN’s independence: feeding and young child feeding is undertaking not to seek or accept just one element in the global action Rationale: Relations with commercial funds, donations or sponsorship from actors and the private sector may to ensure an environment in which the infant feeding and related prod- create conflicts of interest, lead to children can survive and reach the ucts industry. IBFAN groups should highest attainable standard of health. biased judgment and decisions, and aim to include a clause to this effect damage IBFAN's ability to: Advisory note: In addition, IBFAN in their constitution or statutes. groups are encouraged not to accept & advocate for women's right to Many IBFAN groups refuse any kind funding from any other for-profit impartial information on infant and of commercial support as links be- companies, especially food and young child feeding; tween companies are not always ob- drinks, alcohol, tobacco, arms, phar- & advocate for realization of the vious. In addition, our NGO partners maceutical and pesticide companies, child's right to the highest attain- working on other campaigns may and those that employ child labour or able standard of health; have difficulties with a particular & hold corporations accountable use violence against people. If any company and accepting funding from for their actions and demand com- entity is considered for funding, IB- it may undermine their work. We pliance with the International Code FAN groups are expected to thor- cannot be too vigilant in this matter. of Marketing of Breastmilk Substi- oughly check for bad practices and tutes. social implications of its actions. IB- Source: IBFAN homepage (online)

Box 1. IBFAN’s 7 principles (online) 1. Infants everywhere to have the right to the highest attainable standard of health. 2. Families, and in particular women and children, to have the right to access adequate and nutritious food and water. 3. Women have the right to breastfeed and to make informed decisions about infant and young child feeding. 4. Women have the right to full support to breastfeed for two years or more and to exclusively breastfeed for the first six months. 5. All people have the right to access quality health care services and information free of commercial influence. 6. Health workers and consumers have the right to be protected from commercial influence which may distort their judgement and decisions. 7. People have the right to advocate for change which protects, promotes and supports basic health, in international solidarity.

back to contents SCN NEWS #39 www.unscn.org Examples of Engagement Frameworks 85

Indian Academy of Pediatrics (IAP)

IAP Guidelines on Conference Organization

INTRODUCTION September. This may be scrutinized ORGANIZING SECRETARY by a committee selected by the ex- The Indian Academy of Pediatrics has He/she should be duly elected by the ecutive board comprising of National been holding the National Confer- host branch President, Immediate Past President, ence every year during the month of President-elect, Secretary General January/February. It has been the SPONSORSHIP and one senior member with organi- custom so far to organize the confer- zation experience. Total ban on sponsorship from infant ence at different parts of the country food and milk substitute companies so that maximum number of dele- CENTRE FOR THE CONFERENCE should be strictly implemented. gates from in and around the place No banners or posters should be ex- As far as possible the places where could participate in the conference hibited in the scientific halls to main- travel, accommodation and food are with least expenses and inconven- tain the sanctity of conference as ar- expensive and beyond the affordable iences. There is a lot of interaction eas of learning. During a sponsored margin should be avoided. The city and fellowship during conference programme the slides of sponsor where the conference is to be held days and it also provides sample op- should only be projected before and should be well connected with major portunity to the delegates, to know after deliberation. Stalls may be pro- zones of India by easy means of the vivacity of the culture and the vided to the sponsors in the exhibi- transport. The city should have ac- customs of out vast nation. Hence for tion area. Gambling or fun games in commodation facilities for 2000-2500 the smooth organization and func- the stalls should be strictly prohib- delegates at a moderate rate. tioning of the conference following ited. Other recreational activities The venue of the conference should suggestion are submitted. should be curtailed so that it will not have a main hall with a capacity of at hamper the proceedings of the con- least 2000-2500 and 5-7 other halls REQUEST FOR THE CONFERENCE ference. Mike announcements and of varying capacity of 200-750, in the Any branch, which in the past has other sounds should not spill over same premises. The venue should not successfully organized, at least of a into the conference hall. be more than 15 km away from the state level conference shall be eligi- heart of the city. The organizers Source: Indian Academy of Pediatrics ble to request for the conference pro- should try to provide a cosy, pleasant (IAP) homepage. (online) vided they satisfy the following condi- and comfortable atmosphere in the tion mentioned below. The request venue. The audiovisual arrangements should be submitted two years in ad- should be of excellent quality and Editors’ note: The guidelines are re- vance to the National Executive should be checked in advance by the produced here in part. For the full Board with full details regarding the organizers in each hall. version, please refer to the original conduct of the programme, before source, available online.

For other examples of engagement frameworks, go to our Publications Section. It includes:  The International Union for Conservation of Nature (IUCN)’s Operational Guidelines for Private Sector Engage- ment  The Partnership for Maternal, Newborn & Child Health’s Principles for engagement with the private sector  Voluntary Services Overseas’ Guidance for Engagement with the Private Sector  The UN Private Sector Toolkit for working with Youth ... and more!

back to contents SCN NEWS #39 86 Obituaries www.unscn.org OBITUARIES Professor John Conrad Waterlow 13 June 1916— 19tOctober 2010 Tribute from Professor Joe Millward

in the establishment in Jamaica of the which simplified a confused subject by Tropical Metabolism Research Unit in introducing the concept of stunting (low 1954 under his directorship. After its height for age) and wasting (low weight transfer from the UK Medical Research for height). He also identified body mass Council to the University of the West index cut-off points for chronic energy Indies in 1970 he assumed the chair of deficiency in adults. His experimental Human Nutrition at the London School work on protein metabolism and turn- of Tropical Medicine where he estab- over made him pre-eminent as the inter- lished his second research unit, the Clini- national authority on protein, chairing cal Nutrition and Metabolism Unit the 1981 FAO/WHO expert consultation (CNMU). He retired in 1982 although on Energy and Protein Requirements, remaining active and publishing into his and writing most of the subsequent 1985 nineties. report. Waterlow’s honours include the His work was wide-ranging and included order of St Michael and St George for both experimental work on the patho- services abroad, awarded in 1969 and his physiology of malnutrition and protein scientific recognition included election to John Waterlow died on 19 October metabolism and turnover, and public both the UK Royal Society (1982) and the 2010 aged 94. As recently written1 his health nutrition with influential books in US National Academy of Sciences (1992), passing brought an end to a life charac- each category2. Each of his units became and the award of numerous Honorary 1 terised by service to people, some of internationally renowned and scientifi- Degrees and Prizes . He leaves a daugh- whom he would meet and care for and cally influential under his inspirational ter and two sons from his marriage to millions of whom he would never see, leadership. When he left Jamaica, the Angela Gray, who died in 2006. He also but who would benefit from what he did, mortality rate of infants with kwashior- leaves his colleague and later companion who he was and what he left behind. kor had fallen from more than 20% to a Dr Joan Stephen. That service started shortly after qualify- very low level because of the recognition ing in Medicine in Wartime London with of the need for a delay in the introduc- 1 Alleyne Sir George. Obituary: John Conrad a nine-month visit to the British West tion of aggressive feeding. In the public Waterlow CMG, FRS, FRCP, DSc Br J Nutr Indies to investigate why infant mortality health arena he is best known for his 2011;106:1–5. was so high. This experience and a similar work on the classification and definition 2 Millward D Joe and Stephen Joan ML . John visit to the Gambia shortly after, formed of protein-energy malnutrition and use Waterlow CMG, FRS, FRCP, DSc: an apprecia- his interest in the pathophysiology of of heights and weights to compare the tion of his work as a physiologist. Am J Clin severe infantile malnutrition and resulted nutritional status of groups of children, Nutr 2011 (in the press)

Professor Michael Latham 6 May 1928 — 1 April 2011 Tribute from Professor Ted Greiner

Professor Michael Latham, one of the of a district medical officer in the British early pioneers of the field of interna- Colonial Service, in his book Kilimanjaro tional nutrition and one of the first recipi- Tales), for which he was awarded the ents of the SCN Order of Merit in 2008, Order of the British Empire by Queen died at age 82 on April 1, 2011. Dr. Elizabeth II. A physician, he obtained an Latham worked in several rural districts MPH from Harvard before beginning to in his country of birth, Tanzania, as a dis- teach at Cornell in 1969 where he re- trict medical officer before and after in- mained remarkably active, even after dependence. Then he was the first head retirement, until his death. In addition to of the new government’s nutrition de- writing books for FAO, including Human partment (described, along with experi- Nutrition in the Developing World, he ences of his mother years earlier as wife published some 400 papers. His decades

back to contents SCN NEWS #39 www.unscn.org Obituaries 87 of teaching, research and advocacy ef- implementation of human rights ap- bok has said on the website World Alli- forts impacted program and policy orien- proaches aimed at achieving equity and ance for Breastfeeding Action (in which tation related to infant feeding, control justice for the poorest of the poor. Dr. Michael had been active for two dec- of parasitic diseases in humans, and com- Latham was rare among politically moti- ades), “We could always count on him for bating micronutrient malnutrition. His vated activists in the way he put his con- balance and supreme insight. He was not most recent papers, published in the cern for others into practice in his daily just an intellectual, but a humanitarian online journal World Nutrition, strongly life, sharing a rare level of affection with and a good friend.” And as Anwar Fazal called into question some of the more the hundreds of graduate students he added, “He will live on in all those he popular “magic bullet” approaches; he nurtured for 40 years. Dr. Latham was an touched, taught, and inspired.” always advocated that nutrition improve- inspiration to two generations of nutri- ment could best be achieved through the tion practitioners. As Prof. Miriam Lab-

Lois Englberger 23 November 1948 — 29 September 2011 Tribute from Professor Harriet Kuhnlein

advocacy for nutritious local food. Since Health Nutrition Association and served 1997, she had lived in Pohnpei, in the as a Council Member in that organiza- Federated States of Micronesia, where tion. She also participated in the global she co-founded the Island Food Commu- network of McGill University’s Centre for nity of Pohnpei (IFCP), together with local Indigenous Peoples’ Nutrition and Envi- indigenous partners. At that time, people ronment (CINE), through the Indigenous were switching their diet away from local Peoples’ Food Systems for Health pro- crops towards imported processed foods, gram. She was also on the steering com- and IFCP aimed to help reverse this mittee of the Traditional, Indigenous and trend. A brilliant communicator, through Cultural Food and Nutrition Task Force of IFCP Lois was able to develop a “Let’s go the International Union of Nutritional Local!” campaign featuring the revitaliza- Sciences. tion of the Karat banana, a local variety Through their tireless advocacy work and rich in beta-carotene, other carotenoids interventions, particularly in the areas of and nutrients, including riboflavin. She women’s and children’s health and nutri- reported, for the first time, the nutrient tion, she and her IFCP colleagues have composition of Karat banana, other ba- been a positive influence on decision- nana cultivars, and other local foods of makers and policy-makers in both na- Pohnpei, including Pandanus and giant tional and international arenas. The Lois Englberger, nutritionist and public swamp taro. “Let’s Go Local” movement has inspired health advocate, died on 29 September, Born in Missouri, Lois grew up with an other grassroots movements, as well as 2011 at Pasco, Washington, having suc- interest in farming and food production. numerous public and government institu- cumbed to ovarian cancer, which had She completed her bachelor at the Uni- tions. The idea of using postage stamps been diagnosed the previous year. Lois versity of Missouri (1970), her masters (including one with the now famous was widely known in nutrition circles as a degree under the direction of Michael karat banana), slogans and songs to edu- passionate, informed activist promoting Latham at Cornell (1974), and her PhD cate people about the importance of the value of healthy local foods for peo- from the University of Queensland healthy diet and nutritious local food has ple’s cultures, environments, economies (2003), being mentored by Geoff Marks. drawn the attention of communities and and food security. Her academic accom- She was truly a global citizen, having politicians worldwide. plishments were most significant in the lived for significant periods of time in Lois is survived by her two daughters, area of food composition sampling and Australia, India, Pohnpei, Tonga as well Katrina and Tanja, her husband Konrad, analysis, particularly in addressing the as Yemen. She published more than 75 her mother Doris and sister Barbara. Her problem of vitamin A deficiency in chil- peer-reviewed articles, 60 other papers, personal autobiography as well as a trib- dren. She was a regular contributor to more than 100 newspaper articles, and ute by the World Public Health Nutrition the Journal of Food Composition and 20 nutrition education briefs. She also Association (WPHNA) can be viewed Analysis. gave over 45 oral presentations at vari- online. The website of CINE also has a Through her research, Lois developed the ous conferences and venues, including tribute to Lois and her many contribu- scientific credibility for her grassroots United Nations symposia. Lois was a tions. founding member of the World Public

back to contents SCN NEWS #39 88 Programme News www.unscn.org PROGRAMME NEWS

THE WHO ELECTRONIC LIBRARY OF EVIDENCE FOR NUTRITION ACTIONS (eLENA) World Health Organization (WHO)

The Department of Nutrition for Health tions. The site includes biological and to facilitate the use of the information and Development in collaboration with behavioural rationales, invited commen- contained within eLENA and reach the other departments within WHO have taries on recent systematic reviews pre- maximum number of potential users. recently launched a new web-based li- pared by public health experts, and addi- Access to information on the implemen- brary designed to assist Members States tional resources produced by Member tation of nutrition actions, allowing pro- and partners in making informed deci- States and global partners. In addition, gramme planners and project managers sions on the appropriate actions to im- eLENA is linked to the Cochrane Library to contribute and retrieve information prove the health and nutrition of popula- through a collaboration agreement with about different delivery options, is also in tions globally. The WHO e-Library of Evi- John Wiley and Sons Inc. that permits full the planning stages as a complementary dence for Nutrition Actions (eLENA) was access to Cochrane systematic reviews. web-based tool. This feature will be im- launched at the opening of a three-day Cochrane reviews represent the highest plemented in late 2012. regional nutrition meeting that was tak- level of evidence on which clinical treat- The eLENA project has received financial ing place in Colombo, Sri Lanka in August, ment decisions are made. Links to cur- support from the Micronutrient Initiative, 2011. rent clinical trials corresponding to each the International Micronutrient Malnutri- The WHO electronic Library of Nutrition nutrition action profiled are also avail- tion Prevention and Control Program at Actions (eLENA) functions as an easily able within eLENA through the Interna- the Centers for Disease Control and Pre- accessible web-based tool for policy- tional Clinical Trials Registry Platform vention (CDC), the Government of Lux- makers, health workers, international (ICTRP). embourg, and The Bill and Melinda Gates organizations, bilateral agencies, nongov- The first English edition of eLENA is cur- Foundation. Technical support is received ernmental organizations, academicians rently accessible within the WHO web from international experts, partners and and other interested actors to access the site: www.who.int/elena. Translation collaborators. most up-to-date WHO guidance on nutri- into the six WHO official languages tion and the information that has led to (Arabic, Chinese, English, French, Rus- For more information visit the e-Library the development of these recommenda- sian, and Spanish) will also begin in 2012 of Evidence for Nutrition Actions (eLENA)

THE LANDSCAPE ANALYSIS: 2011 UPDATES World Health Organization (WHO)

The Landscape Analysis on countries' Nutrition of 2010 which urged Member assessment, the stakeholders agree on readiness to accelerate action in nutri- States to strengthen and increase their recommendations for how to overcome tion, featured in SCN News 37 in 2009 commitment to prevent and reduce mal- the observed bottlenecks and the next and further described in the Speaker's nutrition in all forms, WHO has proposed steps for developing operational scale-up Corner of SCN News 38, was developed a process to assist countries in develop- plans. as a follow-up to The Lancet Nutrition ing scale-up plans for nutrition. In this By September 2011, 15 countries have Series (2008) in order to link the findings process, the Landscape Analysis country undertaken Landscape Analysis country presented in the Series to information on assessment serves as a tool for initial assessments: Burkina Faso, Comoros, what action would be appropriate in dif- context mapping and assessment of im- Côte d'Ivoire, Egypt, Ethiopia, Ghana, ferent typologies of countries. The Land- plementation challenges in countries. An Guatemala, Indonesia, Madagascar, Mali, scape Analysis has three components: advantage of the Landscape Analysis Mozambique, Peru, South Africa, Sri 1) Desk analysis of secondary data to country assessment is that it uses stan- Lanka and Timor-Leste. Three additional define country typologies at various dardized, field-tested and peer-reviewed countries (Guinea, Namibia and Tanza- stages of readiness to scale up nutrition assessment tools which countries will be nia) are planning for country assess- action able to adopt and adapt in their respec- ments. A handful of other countries have tive context. These country assessment 2) In-depth country assessments per- also expressed their interest in the meth- tools have been further refined and formed in participatory manner by inter- odology as they are planning to scale up elaborated to include specific elements sectoral and interagency country teams nutrition actions. for planning and analysis and has also

3) The online Nutrition Landscape Infor- been translated into French. Further- mation System (NLIS) which presents more, the Landscape Analysis highlights Contact: [email protected] data on nutrition and underlying factors the importance of the participatory ap- For more information: of malnutrition for all countries. proach where stakeholders from all rele- http://www.who.int/nutrition/ As part of the implementation of the vant sectors work together to identify landscape_analysis World Health Assembly resolution bottlenecks for scaling up. During a con- WHA63.23 on Infant and Young Child sensus meeting held at the end of each back to contents SCN NEWS #39 www.unscn.org Programme News 89 PROJECT FOR AN ENRICHED COMPLEMENTARY FOOD IN CÔTE D’IVOIRE (PACE) Helen Keller International (HKI)

The most recent national surveys under- quirements of children 6-59 months are ing practices. The project will strive to taken in Côte d’Ivoire indicate that the met (HKI 2006). ensure access to an enriched grain-soy prevalence of chronic malnutrition (low Nevertheless, while these are crucial blend cereal for at least 3 million children height for age) among children under steps, they do not meet the heightened 6-24 months of age. fine is 33% (MICS, 2006). Deficiencies in nutritional needs of children between the The project has completed formative micronutrients are also widespread: iron ages of 6-24 months, who are also the research to understand current infant deficiency anemia affects an estimated most at-risk population. One promising and young child feeding beliefs and prac- 50% of children under five, while vitamin strategy for meeting the special micronu- tices in the targeted population, as well A deficiency affects 16% (HKI, CSRS, INSP, trient requirements of this age group is as the reach of existing products. The UFR-SPB, 2007); iodine deficiency has the development of an enriched comple- data have been analyzed and used to been detected in approximately 5% of mentary food, a strategy that recently develop a targeted communications school age children. won the approval of a high Ministerial strategy. Concomitantly, HKI has advo- The government has taken a number of Council. cated vigorously for the adoption of na- strategic steps to reduce these nutri- Earlier this year, with the support of the tional laws in Côte d’Ivoire consistent tional deficiencies, including: i) requiring Global Alliance for Improved Nutrition with the International Code of Marketing universal salt iodization such that 84% of (GAIN), Helen Keller International (HKI) of Breastmilk Substitutes, and the gov- households now have access to ade- with its private sector partner Protéin- ernment of Côte d’Ivoire has now ap- quately iodized salt; ii) organizing bi- Kissé Là (PKL) and the Ministry of Health proved a set of commercial codes that annual distribution of vitamin A supple- launched the Project for Enriched Com- comply with these international stan- mentation to children 6-59 months of plementary Foods, or le Projet d’Alimen- dards. Thus the project will be imple- age that have reached over 90% of chil- tation de Complément Enrichi (PACE). mented in the context of commercial dren nationally since 2008; iii) mandatory The project will adapt a locally-produced codes that protect both exclusive breast- fortification of cooking oil with vitamin A commercial product for vulnerable popu- feeding for six months and improved at levels meeting at least 20% of the daily lations by reducing the package size and complementary feeding practices. requirements of children 6-59 months; cost and promoting its purchase through and iv) mandatory fortification of wheat a social marketing and educational cam- For more information: [email protected] flour with iron and folic acid at levels paign aimed at supporting optimal ensuring at least 29% of the daily re- breastfeeding and complementary feed-

INTEGRATING NUTRITION INTO AGRICULTURE AND MARKET SUPPORT PROGRAMMING IN UGANDA World Food Programme (WFP)

WFP has made a strategic shift from be- facing smallholder farmers in Uganda: lection points) to multisectoral nutrition ing a food aid agency to being a food inadequate market infrastructure and stakeholders; 4) Value addition and forti- assistance agency, with a more nuanced poor productivity. Taken together these fication of nutritionally important com- and robust set of tools to respond to activities should help integrate small- modities. Building on the comparative critical hunger needs. Its overarching holder farmers and small to medium- advantage of WFP’s deep field presence goal is to reduce dependency and to sup- scale traders more fully into the dynam- and linking these channels to partners, port governmental and global efforts to ics of the market, allowing them to sell the aim is to boost nutrition efforts in ensure long term solutions to the hunger more of their products at international Uganda. challenge. standards and better prices- including to P4P is a five-year pilot project launched In Uganda, the World Food Programme WFP. P4P in Uganda takes this one step in 21 countries. By 2013, at least half a plays a strong role in strengthening local further, to seize the opportunity to million smallholder farmers- mostly agriculture and markets through local ‘’Nutritionalise’’ agricultural program- women- will have increased and im- purchases, currently spending over US$ ming. Nutrition objectives are outlined in proved their agricultural production and 50 million a year. In making these pur- the Joint Agreement between WFP and earnings. The program is funded by the chases, WFP targets small-holder farming the Ministry of Agriculture, Animal Indus- Bill & Melinda Gates Foundation and households and seeks to help strengthen tries and Fisheries. For P4P, Warren Buffet. In Uganda, additional their food security through its Purchase “Nutritionalisation” is set to take several donors are the governments of Japan, for Progress (P4P) programme. P4P links forms: 1) Integrate nutrition (in the form Saudi Arabia, and the United States of smallholders to quality markets so they of modules, demonstrations and infor- America. mation sharing) during farmer trainings; can gain greater and more direct benefit For more information: Melissa Antal 2) Expand micronutrient-rich biofortified from their produce. This is done by ([email protected]), Purna Wasti crops as a source of income and source working with FAO and other partners to ([email protected]) or Elvis of micronutrients; 3) Share access to P4P address the two principal constraints Odeke ([email protected]) “touch points” (warehouses, maize col-

back to contents SCN NEWS #39 90 Programme News www.unscn.org STRATEGIES AND POLICIES OF NUTRITIONAL HEALTH PROMOTION IN SCHOOLS: CASE OF LEBANON University of Montreal

Poor nutrition in schools seriously com- such as family, community, government, sonnel, children/adolescents, family, promises children’s health and learning private and public sectors, economic and food industry, epidemiologists, anthro- capacity. It also has a disastrous effect politic situation, etc. pologists, media, etc) facing a new com- through damaging dietary patterns which To this end, many national and interna- ing national School Health Strategy plan affects the prevalence of diseases in tional food policies and programs were in Lebanon. Deduced barriers and facili- adults such as diabetes, cardiovascular developed and implemented at different tators will be used to improve and diseases, obesity, and hypertension. levels and in many countries. Thus, there achieve the implementation of this plan There is disturbing evidence that the nu- were few that used a pre- which is a joint effort with the WHO, tritional status among schoolchildren is implementation analysis and tried to Ministry of Health and Ministry of Educa- deteriorating. However, current radical study the different perceptions of the tion in Lebanon. Additional variables, changes in lifestyle among both poorest actors implicated from the beginning of outcomes and international comparisons and richest strata of developing and de- this process. A new approach to food and will be useful for the follow-up phases veloped countries mean that personal physical activity policies at schools will be such as policy design, implementation, preference about food, fashion, physical studied by Sima Hamadeh and Dr Marie monitoring and evaluation. activity, and the media are now driving Marquis at the University of Montreal. the nutritional patterns of schoolchildren An integrated conceptual framework, For more information: Sima Hamadeh more than the availability of the food based on social marketing approach and ( [email protected] , itself. inspired from many social and changing [email protected]), PhD can- Schools have a major role in ameliorating behavioural models and theories, will be didate at University of Montreal under children and adolescent’s lifestyles and used to study in pre-implementation the the supervision of Marie Marquis, PhD, food habits. However, it’s not the only perceptions of various actors RD. setting for intervention; it should be em- (government, ministry of education and phasized via other environments as well health, school administration and per- NEW RESEARCH SHOWS THAT HIGH-PROVITAMIN A (Β-CAROTENE) MAIZE IS A GOOD SOURCE OF BIOAVAILABLE VITAMIN A HarvestPlus

Staple food crops that are rich in micro- A maize was converted at a rate (6.5:1) bia. The changes in the vitamin A status nutrients could significantly reduce mi- that was almost twice as efficient as pre- will be assessed by measuring serum cronutrient malnutrition among malnour- viously assumed for maize (12:1) and retinol before and after a 6-month feed- ished populations. HarvestPlus leads a even higher than from vegetables. ing trial intervention. The study will take global effort to develop and test micro- Another separate study using stable iso- place in districts where the prevalence of nutrient-rich staple food crops to ensure tope tracers (Muzhingi et al. 2011) con- vitamin A deficiency exceeds 50% among that they have a measurable nutritional firmed this favorable bioconversion and children 2–5 years old. We expect to see impact when prepared and consumed showed an even more efficient (3:1) bio- an improvement in the vitamin A status according to the habitual practices and conversion ratio when labeled provita- of those children fed provitamin A maize consumption patterns of target popula- min A maize was consumed by healthy, compared to those eating the white tions. Zimbabwean adult men. maize. Vitamin A deficiency increases the risk of These results indicate that provitamin A disease and death, especially in sub- maize with 15 ppm β-carotene (fresh For more information, visit the Harvest- Saharan Africa. Millions of people in this weight) could provide far more dietary Plus Newsroom online or contact us at region eat large amounts of white maize vitamin A than previously assumed—up [email protected]. daily. A HarvestPlus-supported research to 50% of the daily requirement for chil- study (Li et al. 2010) has shown that a dren 2–6 years old and women of child- SOURCE: provitamin A maize bred to provide high bearing age. Li S, Nugroho A, Rocheford T, White WS levels of β-carotene is a good source of Next, HarvestPlus will conduct a popula- (2010) Vitamin A equivalence of the β- vitamin A. Beta-carotene gives the maize tion-based efficacy trial in Zambia, where carotene in β-carotene–biofortified maize a yellow to orange color. The provitamin provitamin A maize will first be released porridge consumed by women. American Journal of Clinical Nutrition doi:10.3945/ A maize was prepared using traditional in 2012. This study will evaluate the nu- ajcn.2010.29802. (online) African preparation methods into a type tritional impact on the vitamin A status of Muzhingi T, Gadaga TH, Siwela AH, Grusak of porridge, typically made from white vitamin A-deficient children when provi- MA, Russell RM, Tang G (2011) Yellow maize maize. Porridge is a popular food among tamin A maize containing the full target with high b-carotene is an effective source of children and adults. The study, using level of 15 ppm is substituted for white vitamin A in healthy Zimbabwean men. Ameri- healthy adult women subjects, found maize in preparing nshima, a maize por- can Journal of Clinical Nutrition 94(2): 510– that the β-carotene from the provitamin ridge consumed daily throughout Zam- 519. back to contents SCN NEWS #39 www.unscn.org Programme News 91 THE GLOBAL ALLIANCE FOR NUTRITION (GAIN) GAIN

GAIN was established at the 2002 United tor and civil society organizations, GAIN specific challenges that governments and Nations General Assembly’s Special Ses- provides technical assistance to multi- companies face in reliably procuring sion on Children. GAIN seeks to combat national, regional or national manufac- quality micronutrients to fortify a range malnutrition among vulnerable popula- turers, to help them make their products of products. Through this facility a trans- tions around the world through increas- more nutritious. For example Britannia parent and efficient process has been ing the supply, demand and use of high Industries, an Indian company, now forti- created, allowing procurement of high quality nutritious foods and key micronu- fies its biscuits and breads which are be- quality vitamin and mineral premixes at trients, and through improving feeding ing consumed by more than 600 million the best price, combined with a revolving practices. GAIN’s model is to build sus- people. GAIN’s Infant and Young Child fund mechanism which provides the req- tainable, market-based solutions at scale Nutrition programs are on target to reach uisite financing to assist partners to pur- to improve nutrition, by facilitating part- more than 19 million young children in 9 chase premix. The facility also includes a nerships among the public and private countries with fortified complementary grant mechanism that provides premix sectors, and improve the policy and regu- food products and supplements. Its di- for fortification of food vehicles targeted latory environment for evidence-based rect investments in local medium-size to the most vulnerable. nutrition programming. Initially investing enterprises and social mobilization activi- GAIN’s innovative program portfolio cur- ties have increased both access and de- efforts primarily in large-scale staple food rently reaches approximately 400 million fortification, GAIN has gradually ex- mand for these products, and helped people in more than 30 countries with garner the public and political will panded its portfolio to include projects to nutritious foods, indicating that market- needed to focus on the importance of address the nutritional needs of specific based solutions can play an important vulnerable groups. More recently GAIN nutrition during the 1 000 days window role in sustainable improvements in food has also started to evaluate options for from conception through 24 months. quality for low-income populations enhancing nutrition further up the agri- Another example evolving from GAIN’s around the world. cultural value chain. market approach is the GAIN premix fa- For more information please go to: cility, which was designed to address Apart from working with the public sec- www.gainhealth.org

NUTRITION WORKING GROUP FOR WEST AFRICA REACH / Helen Keller International (HKI)

Former Cape Verde President becomes approaches that can help to reduce child- The Nutrition Working Group is a group the Nutrition Advocate for West Africa hood malnutrition. of organizations that closely collaborates Although progress is being made in sev- to actively combat malnutrition in the The Nutrition Working Group for West eral West African countries more needs region and includes: Action Against Hun- Africa has announced that António to be done to prioritize nutrition as a ger, Counterpart International, European Manuel Mascarenhas Gomes Monteiro, building block of development in policy Commission for Humanitarian Aid former President of Cape Verde, has formulation, to increase government (ECHO), the Food and Agriculture Organi- committed to serving as a Nutrition Ad- spending and ensure they meet their zation of the United Nations (FAO), Helen vocate for the region for the next several commitments, and to address some com- Keller International (HKI), Micronutrient years. Every year, approximately 600 000 mon misconceptions such as that food Initiative (MI), Office for the Coordination children under five die in West Africa security alone will ensure adequate nutri- of Humanitarian Affairs (OCHA), Ending from causes related to malnutrition, action. Child Hunger and Undernutrition part- counting for at least 35% of all child “I am extremely happy to be joining this nership (REACH), Save the Children UK, deaths in the region. Moreover, among effort to bring home what this issue the United Nations Children’s Fund the 15 countries in the world with the (UNICEF), the Office of U.S. Foreign Disas- worst underfive mortality rates, seven means to the future of children and our ter Assistance for USAID, The World are located in West Africa, where one out countries,” said Mr Monteiro. “Children who do not receive the right type of food Bank, the World Food Programme (WFP), of four children is underweight. Coun- and nourishment fall sick more often, and the World Health Organization tries in the Sahel have also suffered cy- (WHO). cles of acute deprivation due to drought and may even die. When they survive, they can suffer from irreversible mental and crop failure, exacerbating the issue. and physical impairment. Yet much more For more information: Sergio Teixeira, Mr Monteiro will work directly with lead- can be done at all levels to make sure this REACH Regional Facilitator for the Nutri- ers of West African nations and their gov- does not happen, and to head off food tion Working Group, [email protected] ernments to encourage them to place emergencies that involve thousands of or Shawn Baker, Regional Director for nutrition at the heart of development personal tragedies.” Africa, HKI, [email protected]. strategies and provide advice on policy

back to contents SCN NEWS #39 92 Programme News www.unscn.org THE DOUBLE BURDEN OF MALNUTRITION PROJECT University of Montreal, TRANSNUT and WHO Collaborating Centre on Nutrition Changes and Development

The double burden of malnutrition now and advocacy. As part of the training nutritionists/dietitians, to concur to the represents a dual challenge for develop- component, two new university training prevention and management of diet- ing countries. As highlighted in the recent programs have been developed and are related chronic diseases, as well as un- High-Level Meeting at the United Nations now offered at Université d’Abomey- dernutrition and micronutrient malnutri- in New York, noncommunicable diseases Calavi (UAC) in Benin. The new Master’s tion. While formal university training in are now escalating, and urgent action is program in public health nutrition started dietetics and nutrition has been a long required. Low income countries are con- two years ago at the Regional Institute of tradition in English-speaking countries, it fronted with this double burden, as diet- Public Health and a first cohort of 10 stu- is not so in the French system, at least up related chronic diseases are increasing, dents graduated last July. Applications to recently. The high demand for the while undernutrition persists. for the next cohort, to begin in Novem- bachelor program illustrates the need for ber, are now open. such training: more than 70 applications TRANSNUT has been involved since 2008 were received, while 30 were retained. in a joint project with West African aca- Even more innovative for the region is demic partners on the double burden of the new bachelor program in Nutrition In-service training is also being offered malnutrition. The six-year project (2008- and Dietetics which opened in January on the nutrition transition and chronic 2014) is funded by the Canadian Interna- 2011 at the Faculty of Health Sciences of diseases, as well as on community man- tional Development Agency (CIDA). The UAC, where a school of nutrition was agement of acute malnutrition. The short principal partner is the Regional Institute created. The curriculum is competency- training sessions (one to two weeks) are of Public Health, Benin. There are several based, and it was designed to comply credit granting, and have so far been other academic and research partner with the recent reform of the university offered in Benin and Burkina Faso. institutions in French-speaking West Af- system throughout Africa. The three-year For more information: www.poleDFN.org rica, including in Burkina Faso and Mali. program trains a new category of health and www.IRSP.bj.refer.org The project involves training, research professionals for French-speaking Africa:

WHO'S WORK ON NUTRIENT PROFILING World Health Organization (WHO)

WHO is working with international ex- Health Assembly (WHA63.41). Develop- sity (IASO) technical meeting was con- perts and partners to provide guidance to ing guidance on nutrient profiling conducted to examine this document and Member States in developing or adapting tributes to the implementation of Objec- consider strategies for its field-testing in nutrient profile models. The aim of the tive 3 of the NCD Action Plan countries around the world. Since that work is to harmonize nutrient profile (WHA61.14), and the implementation of meeting, there have been three WHO model development to produce consis- actions recommended at the United Na- field-testing workshops held in South tent and coherent public health nutrition tions High-Level Meeting on Noncommu- Africa, Canada and Thailand. Discussions messages for the consumer and ulti- nicable Disease Prevention and Control are underway with a number of other mately improve nutrition and public held in New York on 19 - 20 September interested countries to conduct addi- health. 2011. tional field-testing. Revisions are being Nutrient profiling is the science of classi- Nutrient profiling has been employed by made to the guiding principles and man- fying or ranking foods according to their governments, food producers, retailers, ual based on the outcomes and lessons nutritional composition for reasons re- researchers and nongovernmental or- learned from the field-testing in coun- lated to preventing disease and promot- ganizations for more than 20 years; how- tries. In the spring of 2012, another tech- ing health. Nutrient profiling can be used ever, until recently there has been little nical workshop is planned to finalize the in conjunction with interventions aimed global coordination in this field which has Guiding Principles and Framework Man- at improving regional or national diets in led to consumer, policy-maker, and in- ual which will support Member States in applications such as health and nutrition dustry confusion. Taking a global leader- this important area. claims, product labelling, education, pro- ship role, in 2009, WHO began develop- vision of food to public institutions, and ing guiding principles for nutrient profile Contact: [email protected] model development. A draft document the use of economic tools to orient food For more information: consumption. Nutrient profiling is one entitled "Guiding Principles and Frame- mechanism through which Member work Manual for the Development or http://www.who.int/nutrition/topics/ States can implement the set of recom- Adaptation of Nutrient Profile Models" profiling mendations on the marketing of foods was prepared and peer-reviewed. In and nonalcoholic beverages to children October 2010, a joint WHO/the Interna- that were endorsed by the 63rd World tional Association for the Study of Obe- back to contents SCN NEWS #39 www.unscn.org Programme News 93 SUNRAY: SUSTAINABLE NUTRITION RESEARCH FOR AFRICA IN THE YEARS TO COME Institute of Tropical Medicine, Belgium

The year 2011 saw the start of the SUN- Saharan Africa is likely to face. main findings of the workshop will be RAY project ‘’Sustainable Nutrition Re- discussed and further developed using This announcement not only serves to search for Africa in the Years to come’’. new input from participants. (Note: Cost inform the readers of SCN News about By the end of 2012, SUNRAY will propose of travel/accommodation to attend the the aims and objectives of the project. a roadmap identifying the priorities and fourth open day for these sectors regret- This is a call for stakeholders involved in implementation of sustainable nutrition fully cannot be reimbursed by SUNRAY). nutrition research in Africa to get in- research in sub-Saharan Africa. The road- Interested individuals are invited to regis- volved and contribute to the workshops map will be developed by African re- ter or contact us for more information at and/or the development of the roadmap. searchers and stakeholders with exper- [email protected]. The SUNRAY project wishes to be inclu- tise in nutrition and is intended to inform sive and therefore strives to collect feed- The project is conducted by nine part- decision-makers, research funding bodies back from all partners working in nutri- ners; four universities from Africa and and donors in general. tion in Africa when developing the road- two research organizations, a university Besides extensive interviewing of key map. and two nongovernmental organizations from Europe. More detailed information African scientists and a stakeholder The workshops will last four days and will analysis, three regional workshops in about the SUNRAY project, consortium, be held in Tanzania (November 13-16, Africa are a key element of the project. aims and activities of the project and 2011), Benin (tentative: January 23-26, During the workshops, information re- organization of the workshops can be 2012) and South Africa (tentative: May garding the nature of doing nutrition found at www.sunrayafrica.co.za. Main 14-17, 2012). The first three days of the research in Africa, priorities for nutrition events or publications will also be an- workshops are ”by invitation only” and research as well as emerging global chal- nounced on Twitter. Follow us intended for scientists from universities lenges, such as climate change, will feed @SUNRAYafrica. and research institutions active in Africa into the development of a research and for African policy-makers. The fourth agenda for the years to come. The work- day of the workshop is open to a broader SUNRAY is a Coordination and Support shops will draw information from a litera- audience: government officials, UN agen- Action of the EU FP7 AFRICA call under ture review, interviews with nutrition cies, national and international NGOs, Grant Agreement nr. 266080 researchers and stakeholders in nutri- bilateral donors, industry and others in- tion, as well as technical background pa- volved in nutrition are invited to partici- Contact: Carl Lachat [email protected] pers that address future environmental pate with regional and/or national nutri- www.itg.be and socioeconomic challenges that sub- tion advisors. During this open day the

REGIONAL CONSULTATIONS ON THE COMPREHENSIVE IMPLEMENTATION PLAN ON MATERNAL, INFANT AND YOUNG CHILD NUTRITION World Health Organization (WHO)

In 2010, the 63rd World Health Assembly velop a Comprehensive Implementation plementation of policies and pro- (WHA) approved resolution 63.23, urging Plan on maternal, infant and young child grammes in nutrition and to establish a Member States to increase the political nutrition which was further discussed at dialogue on nutrition policies and pro- commitment to prevent and reduce mal- the 64th WHA in May 2011, in consulta- grammes involving the health and agri- nutrition in all its forms, to strengthen tion with Member States. The Compre- cultural sectors. and expedite the sustainable implemen- hensive Plan will provide a common vi- The first one was held in Harare, Zim- tation of the global strategy for infant sion on objectives and modalities of scal- babwe, on 3-5 May 2011, the second one and young child feeding, to develop or ing up nutrition and will be a vital ele- in Ouagadougou, Burkina Faso, on 4-6 review current policy frameworks ad- ment to strengthen the Scaling Up Nutri- July 2011, and the third meeting in Co- dressing the double burden of malnutrition (SUN) Movement. lombo, Sri Lanka, on 10-12 August 2011. tion, to scale up interventions that im- Three consultations were held to discuss In each of these meetings representa- prove infant and young child nutrition an outline of the plan prepared by WHO, tives of 19 countries participated, as well and to strengthen nutrition surveillance. to take stock on the current state of im- as donors, UN agencies, regional organi- The resolution requested WHO to de- back to contents SCN NEWS #39 94 Programme News www.unscn.org zations and nongovernmental organiza- decentralised structures that provide of policy documents and strategy, stake- tions. services to implement all the nutrition holder engagement, the existence of interventions at scale, the need to have a monitoring system resources, adequate Many countries indicated they have na- harmonized intervention package, the human resources and community partici- tional policy documents on nutrition, sustainability of financial resources and pation. Some successes have been docu- with more or less pronounced political the development of stronger advocacy mented in promoting breastfeeding commitments for nutrition. However, the with decision-makers to increase aware- rates, in addressing severe acute malnu- funds do not seem to follow these com- ness for better funding in view of nutri- trition, in improving coverage of micro- mitments. In addition, many countries tion as well as an awareness on nutrition nutrient interventions and in the accessi- have reported difficulties in coordinating issues and multi-causality. bility, coverage and quality of care as interventions and a weakness in the im- well as the sustainability of the achieve- plementation of the intersectoral ap- Key factors for success include high level ments. proach. Multisectoral policies and strate- political commitment, public awareness, gies exist, but nutrition is not always good coordination between actors and mainstreamed in development plans. the presence of high level multisectoral For more information: [email protected] Challenges include insufficient capacity of coordination mechanisms, the existence

NUTRITION AND CLIMATE CHANGE AT THE CLIMATE CHANGE CONFERENCES OF THE PARTIES (COP) United Nations System Standing Committee on Nutrition (UNSCN)

Climate change affects food and nutrition Climate Change and Nutrition Security ment of Public Health and Environment. security and further undermines current policy brief including key messages for Video messages were shown from David efforts to reduce hunger and protect and United Nations Framework Convention Nabarro, UN Secretary-General Special promote nutrition. Undernutrition in turn on Climate Change (UNFCCC) negotiators Representative for Food Security and undermines the resilience to shocks and (available in English, French and Spanish Nutrition as well as from Mary Robinson, the coping mechanisms of vulnerable here). In collaboration with key partners Former President of Ireland and Chair of populations, lessening their capacities to Action contre la Faim (ACF), the World the Mary Robinson Foundation - Climate resist and adapt to the consequences of Food Programme (WFP) and the Public Justice. The video messages can be climate change. Health Institute (PHI), the UNSCN has co- watched here. organized a side event during the COP 17 Since 2009, the UN System Standing During the side event Q&A session, some in Durban (South Africa) on Nutrition and Committee on Nutrition (UNSCN) is pro- key activities for the UNSCN have been Climate Change: Making the connection moting the debate and strengthening the identified: (i) to ensure UN agency har- to enhance livelihood resilience, health participation of nutrition on ongoing and monization of nutrition and climate and women's empowerment. For this future climate change discussions. It has change related policies and programmes side event, which was hosted by the published several documents including, to allow that strong, concerted and non- South African Government, a background in 2009, the UNSCN Statement on the conflicting messages can be sent to paper has been published, available for Implications of Climate Change on Nutri- UNFCCC negotiators; (ii) to organize a download here. tion and in 2010 the SCN News 38 on high-level workshop on nutrition and Climate Change - Food and Nutrition Se- The objectives of the side event were to: climate change and bring together a curity Implications, a peer-reviewed pub- (i) Demonstrate why nutrition must rep- group of experts from different sectors lication which examined climate change resent a key pillar of climate-resilient (agriculture, environment, gender, hu- and nutrition across a range of different development; (ii) Highlight how nutrition, man rights, health, etc.) and country rep- sectors, using an underlying multisectoral food security, health, social protection resentatives to reflect together on nutri- perspective. Also a UNSCN Nutrition and and women’s empowerment approaches tion and climate change resulting in the Climate Change e-discussion group was can be integrated to build climate resil- identification of key recommendations set up and an increasing number of inter- ience. Speakers at the event were: Sheila and a set of concrete priority actions; and ested individuals are joining this group Sisulu, WFP Deputy Executive Director, (iii) to contribute to the integration of (you can still join by clicking here). Alexander Müller, FAO Assistant Director agriculture, gender and nutrition security General Natural Resources Management into National Adaptation Programmes of The UNSCN has attended the climate and Environment Department, Robin Action (NAPAs). change conferences of Copenhagen Mearns, Lead Specialist and Cluster (2009) and Cancun (2010) and Durban For further information: go to the UNSCN Leader Social Resilience, World Bank and (2011). For the COP 16 it has published a website or mail to [email protected] Carlos Dora, Coordinator, WHO Depart- back to contents SCN NEWS #39 www.unscn.org Speaker’s Corner 95 SPEAKER’S CORNER

DEVELOPING MORE EFFECTIVE UN-BUSINESS PARTNERSHIPS Melissa Powell, UN Global Compact , [email protected]

Author statement: The author declared not having any conflict of interest.

INTRODUCTION overcoming operational challenges The United Nations and the Private while also protecting the integrity Sector: A Framework for Collabora- Partnerships between the United Na- and reputation of the UN (UN 2008a, tion (UN 2008b) outlines the main tions (UN) and business have become 2010). ways in which the private sector can increasingly common. There is a collaborate with UN agencies, funds growing consensus among companies A key priority of UN Secretary- and programmes to address global that integrating development issues General Ban Ki-moon’s second term challenges. Specifically, it describes such as hunger alleviation, food secu- will be to improve UN-Business col- how business can make a contribu- rity, and equitable access to health laboration. As the Secretary-General tion through their core business op- and education is important for miti- has stated, “the United Nations and erations, through social investments gating risk and gaining competitive business need each other. We need and philanthropy, and through advo- advantage with customers, consum- your innovation, your initiative, your cacy, policy dialogue and institutional ers, investors, and employees. In ad- technological prowess. But business frameworks. dition, in the wake of the food, en- also needs the United Nations. In a ergy and financial crises, there are very real sense, the work of the Financial contributions from the pri- increasing demands by civil society United Nations can be viewed as vate sector have played an important organizations that companies should seeking to create the ideal enabling role in helping advance the imple- take responsibility for the social and environment within which business mentation of various UN programmes ecological effects of their operations. can thrive”. Although there are a over the years - especially in the number of successful UN-business wake of humanitarian crises where At the same time, it is clear that partnerships across the Organization, cash can be critical in mobilizing life- these complex challenges cannot be we need to ensure we learn from ex- saving support. However, it is in- solved by the public sector alone – periences made over the past decade creasingly recognized that the private holistic, multistakeholder partner- and take steps to implement even sector can make an often more sus- ships are required. Across the UN more effective, transformational UN- tainable contribution through their System, partnerships with the private business partnerships which result in core business activities. Companies sector have become an increasingly greater impact on-the-ground. can have a significant positive impact acknowledged tool for UN entities to on development objectives through achieve development goals, particu- WHY PARTNER WITH THE UN? their supply chains and procurement larly the Millennium Development efforts as well as through their sup- Goals. The UN is a unique potential partner for the private sector – no other or- port to small and medium-sized com- On the political side, subsequent ganization has the same convening panies. Although these types of part- General Assembly Resolutions under power, legitimacy and credibility. nerships are quite complex, they the item “Towards Global Partner- Over the past ten years, a wide range have becoming increasingly promi- ships” have demonstrated support of UN entities have increased their nent as they provide the promise of for enhanced UN collaboration with capacity to partner with business, to being sustainable since they draw on the private sector as a mechanism to mitigate the potential risks of part- the specific capacities of business advance the Organization’s objec- nerships and to share best practices. (UN 2010b). tives. Member States have repeatedly Now, most UN agencies, funds and A good example of a core business recognized that the private sector programmes have dedicated private partnership is the International Fund should be an even more engaged sector focal points who work to de- for Agricultural Development (IFAD)'s partner if the Organization is to velop and implement partnerships Vegetable Oil Development Project to achieve its objectives. These Resolu- with the private sector as a way to address the low per capita intake of tions have also outlined recommen- further advance their organization’s vegetable oils and reduce Uganda’s dations for ensuring more effective mission. reliance on imported vegetable oils and transparent partnerships and for back to contents SCN NEWS #39 96 Speaker’s Corner www.unscn.org by promoting domestic production. ten universal principles and its over basis for their collaborative efforts The partnership leveraged foreign 80 local networks around the world with the private sector. The Guide- direct investment (greater than US$ as a platform for engagement with lines now explicitly allow for the UN 120 million) to produce an essential the private sector. to partner with companies for the food commodity domestically, while purpose of changing their core busi- creating factory and plantation jobs OVERCOMING THE BARRIERS TO ness operations (UN 2009). for about 3 000 smallholder produc- PARTNERSHIP – NOTABLE INSTITU- ers. The mutual dependency between TIONAL DEVELOPMENTS 2. Network of UN Private Sector Focal Points/Annual Meeting: On an the palm oil mill and the participating Although a number of partnerships annual basis the UN Global Compact smallholders constitutes the basis of have clearly demonstrated value both Office leads the organization of the this partnership, providing a secure to the UN and to business, many UN- UN Private Sector Focal Points Meet- market for producers and guarantee- business partnerships have not yet ing which brings together UN staff ing a supply of raw material for pri- reached their full potential. There who work with the private sector in mary processing to the palm oil mill remain a number of barriers to more various capacities along with private (IFAD 2011). effective collaboration. For example, sector representatives who have ex- the UN has yet to fully embrace the ADVANCING ORGANIZATIONAL pertise in partnering with the UN in fact that a company needs a viable CHANGE – THE UN GLOBAL COM- order to enhance communication, business case if it is expected to con- PACT strengthen learning, advance coordi- tinue to engage in a partnership. At nation, and improve collaboration The launch of the UN Global Compact the same time, companies need to across the Organization. in 2000 signalled the beginning of a acknowledge that most of the objec- new phase of UN collaboration with tives of the UN related to peace, hu- 3. Collaboration around due dili- the private sector. For more than ten man rights and development are gence procedures: Together with a years now, the UN Global Compact longer term. Although a short term number of interested UN agencies, has worked to embed universal prin- business case may be difficult, com- funds and programmes, the Global ciples into the marketplace and to panies could explore potential long Compact led a process for making encourage the private sector to take term benefits of collaboration such as more widely available across the UN action in support of UN goals. Now reputation, access to new markets System a service and other tools to the world’s largest global responsible and employee retention (UN, Unile- aid in conducting due diligence of business initiative, the UN Global ver, Dalberg Global Development Ad- potential corporate partners. This Compact has over 6 000 business par- visors 2011a). process culminated in a joint service ticipants in over 135 countries who The UN Global Compact Office has for eight UN entities and is thus help- are implementing policies and prac- been working to strengthen the UN ing to advance a more harmonized tices to ensure their operations re- system in its efforts to engage busi- and thorough approach to screening spect human rights, uphold decent ness and a few notable institutional potential private sector partners. workplace conditions, protect the developments which have resulted environment and implement good from these efforts follow: 4. Business.un.org: The UN- corporate governance. The Com- Business partnership gateway was pact’s ten principles are universal 1. Revised Guidelines on Coop- designed to support and facilitate values firmly embedded in the UN’s eration between the United Nations collaboration between the United mission and objectives - providing and the Business Sector (issued on Nations and the private sector. The both a strong moral compass and a 20 November, 2009): As an impor- site provides a wealth of inspiration/ practical framework for action. tant component of the Secretary- information and a useful matching Global Compact participants are also General’s efforts to modernize the function designed to better link UN engaged in partnership projects as a Organization, the revised Guidelines needs with the resources of busi- way to advance the second objective are intended to help UN staff develop nesses around the world. Companies of the initiative “take action in sup- more effective partnerships between and UN organizations alike can use port of broad UN goals” with a view the UN and the business sector while the site to describe their partnership to having even greater impact. In ad- ensuring the integrity and independ- interests and begin the partnership dition, the Global Compact Office en- ence of the UN. They are intended to exploration process. courages all UN agencies, funds and serve as a common framework for all The Global Compact Office has also programmes to use the Compact, its organizations of the UN system as a

back to contents SCN NEWS #39 www.unscn.org Speaker’s Corner 97 spearheaded the development of a The Implementation phase: els; improve partner selection; en- variety of other resources, helpful to hance capacity-building and training  Initiate partnerships with a pi- UN staff working to build partner- of UN staff; and emphasize the bene- lot phase to help build credibil- ships with business. For example, fits of evaluation and impact assess- ity and trust among partners. Partnership Fundamentals: A 10-step ment. After years of experimenta- Creating early milestones can guide for creating effective UN- tion, the UN is becoming much more help demonstrate early suc- Business partnerships provides a step strategic in its approach to partner- cesses that can increase moti- -by-step roadmap for building effec- ships with the private sector and vation, participation and fund- tive partnerships, as well as a method there is great potential to strengthen ing. to diagnose the likely impact of exist- UN-business collaboration such that ing ones (UN, Unilever, Dalberg  Create mechanisms for regular we can co-create the kinds of trans- Global Development Advisors 2011b). re-assessment of impact and formational partnerships needed to The key recommendations include: the suitability of partners to overcome many of the world’s most ensure the mission is still on pressing challenges (UN, Unilever, The Exploration phase: track. Dalberg Global Development Advi- sors 2011a).  Conduct due diligence to iden-  Create a process for knowledge tify the most suitable partners management that can be help- References and exclude any who fail to ful for continued project suc- meet your criteria. cess especially in the case of a IFAD (2011). Republic of Uganda: Vegeta- longer term project with higher ble Oil Development Project. The Interna-  Seek wide organizational buy- personnel turnover. tional Fund for Agricultural Development, in. Projects that rely on a sin- Homepage. (online) gle individual without broad CONCLUSION UN (2008a) Towards global partnerships. organizational support are at The UN is increasingly recognizing United Nations General Assembly Resolu- high risk of losing momentum tion A/RES/62/211. (online) and funding. business can be a great partner, not only a great donor. It is becoming UN (2008b) The United Nations and the The Design and Negotiation phase: clear to most UN entities that unlim- Private Sector: A Framework for Collabo- ited funding from the private sector is ration. New York: UN Global Compact.  Develop a clear governance not sustainable and thus, an initial (online) structure and implementation emphasis on fundraising is being re- UN (2009) Guidelines on Cooperation plan. This often includes a placed by efforts to harness the ex- between the United Nations and the Busi- signed Memorandum of Un- pertise, products, services and supply ness Sector. (online) derstanding (MoU) that out- chains of the private sector towards UN (2010a) Towards global partnerships. lines responsibilities and mile- more strategic partnerships. How- United Nations General Assembly Resolu- stones. ever, there are still significant differ- tion A/RES/64/223. (online)  Create a monitoring and ences in capacity and expertise UN (2010b) Coming of Age: UN-Private evaluation framework focused across the UN system. Sector Collaboration Since 2000. New on partnership impact. In order to ensure that the United York: UN Global Compact. (online)  Forecast future partnership Nations is at the forefront of efforts UN, Unilever, Dalberg Global Develop- resources and conditions and to more effectively leverage the con- ment Advisors (2011a) Catalyzing Trans- plan for sustainable funding tributions of the private sector in formational Partnerships Between the and impact. achieving development objectives, a United Nations and Business. New York: more strategic and harmonized ap- UN Global Compact. (online)  Design partnerships for scale UN, Unilever, Dalberg Global Develop- which may include develop- proach is needed. More specifically, ment Advisors (2011b) Partnership Fun- ment of a proving template additional efforts are needed to: fur- damentals: A 10-step guide for creating that demonstrates “proof-of- ther strengthen the enabling environment for partnerships; identify and effective UN-Business partnerships. New concept” or a model that al- York: UN Global Compact. (online) lows for easy replication. replicate successful partnership mod-

You can find additional resources from the UN Global Compact in the Publications section of this edition of the SCN News and on the Global Compact website.

back to contents SCN NEWS #39 98 Speaker’s Corner www.unscn.org THE HUMAN RIGHT TO ADEQUATE FOOD: REFLECTIONS ON THE ENGAGEMENT WITH THE PRIVATE SECTOR Arne Oshaug, Professor in Public Nutrition, Department of health, nutrition and management, Faculty of Health, Oslo and Akershus University College of Applied Sciences, [email protected]

Author statement: The author declared not having any conflict of interest.

In a speech related to the 50th Anniversary of the Universal Declaration of Human Rights, UN Secretary-General Kofi Annan said: “Human rights are what make us human. They are principles by which we create the sa- cred home for human dignity”. Ten years later, Secretary-General Ban Ki-moon, when celebrating the 60th Anniversary of the Declaration, said: "We must continue until the timeless and universal principles in this Declaration become not just an inspiration or an aspiration, but the foundation of life for all of the world's people." And this is what we should do.

WHAT ARE HUMAN RIGHTS? most important to mention here is nutrition. Many would say that it was the Convention on the Rights of the a very wise decision to establish such By 24 October 1945, when the United Child. All human rights, including civil, a controversial (at that time) working Nations came into existence with the political, economical, social and cul- group (WG). The WG’s efforts have ratification of the UN Charter by a tural rights are interrelated, interde- undoubtedly contributed to the visi- large number of countries, two World pendent and indivisible. bility and to activities for the progres- Wars had been fought in less than 30 sive realization of the human right to years, and cruelty almost beyond be- Human Rights (HR) are a set of moral adequate food, now being taken for- lief had been inflicted. Nations were principles for protecting human dig- ward by the Food and Agriculture willing to ensure that never again nity and improving the well-being of Organization of the United Nations atrocities like those should be al- all people. Furthermore, HR are es- (FAO). lowed. The United Nations Commis- tablished in international law through sion on Human Rights was soon es- legal rules and are there for all peo- The International Covenant on Eco- tablished, in 1946, as one of the very ple, not only some. Such interna- nomic, Social and Cultural Rights ac- few bodies to draw its authority ditional laws are binding and a state knowledges, in its article 11, that rectly from the Charter of the United party has three types of obligations: the States Parties to (the) present Nations, to develop the international to respect, to protect and to fulfil Covenant recognize the right of every- legal frameworks that protect our every human right. one to an adequate standard of living fundamental rights and freedoms. for himself and his family, including Eleanor Roosevelt, widow of Presi- Malnutrition degrades human dig- adequate food, ... (and) the fundamen- dent Franklin Roosevelt of the United nity. Malnutrition violates human tal right of everyone to be free from States of America, chaired the proc- rights. hunger. ess towards the Universal Declaration Several principles have already been The general process of understanding of Human Rights, and is recognized as mentioned here but in addition the and advocating for the right to ade- the driving force for the Declaration’s following principles are also essential quate food started with the World adoption by the General Assembly in to progressively realize human rights, Food Summit in 1996. This summit December 1948. The Declaration is namely human dignity, equality, ac- asked the Office of the High Commis- possibly the single most important countability and transparency. Far sioner for Human Rights (OHCHR), in document created in the twentieth too often we see that malnutrition collaboration with other parties, to century. exists or arises due to discrimination define what the right to adequate The International Bill of Human and inequalities. food was. The UN High Commissioner Rights, consists of the Universal Dec- for Human Rights in Geneva held a laration of Human Rights, the Inter- The right to adequate food Symposium in 1999 entitled “Substance and politics of a human national Covenant on Civil and Politi- UNSCN provided space and opportu- cal Rights (ICCPR), and the Interna- rights approach to food and nutrition nity for establishing a Working Group policies and programming”. The defi- tional Covenant on Economic, Social (WG) called “Nutrition, Ethics and nition of what the human right to and Cultural Rights (ICESCR). Later a Human Rights” already in 1993 that number of conventions have been adequate food means was provided devoted its work to the advocacy for by the High Commissioner for Human developed and maybe one of the a HR-based approach to food and

back to contents SCN NEWS #39 www.unscn.org Speaker’s Corner 99 Rights in the General Comment 12 preventing and addressing the risk of been endorsed or employed by indi- (GC 12) to article 11 of the ICESCR. adverse impacts on human rights vidual Governments, business enter- When the World Food Summit: Five linked to business activity. The Guid- prises and associations, civil society years later (WFS:fyl) took place in ing Principles recommend how gov- and workers’ organizations, national 2002 the GC 12 was considered still ernments should provide greater human rights institutions, and inves- too generic for policy making. The clarity of expectations and consis- tors. Organizations such as the Inter- participants at the WFS:fyl therefore tency of rule for business in relation national Organization for Standardi- asked for policy guidelines for the to human rights. They provide a zation (ISO) and the Organization for implementation of this human right. guideline for companies on how to Economic Cooperation and Develop- Two years later (2004) the "Voluntary know and show that they are respect- ment (OECD) have drawn upon this Guidelines to support the progressive ing human rights, and focus on ensur- framework for developing their own realization of the right to adequate ing that where people are harmed by initiatives in the business and human food in the context of national food business activities, there should both rights domain. Other United Nations security" was adopted by the FAO be adequate accountability and effec- special procedures have invoked it Council in a historical and sensational tive redress, judicial and non-judicial. extensively. act of FAO Member States. FAO es- One can say that a HR Framework Companies can demonstrate that tablished a unit on the HR to ade- rests on several pillars confirmed by they are respecting human rights by quate food. That Unit has driven, and the Human Rights Council in 2011. ensuring their business policies and continues to drive, the work on the Firstly, it is the State's duty to protect practices do not infringe the rights of HR to adequate food a long way1. against human rights abuses by third others (i.e. they must do no harm). In One thing is certain: the HR to ade- parties, including business enter- order to identify, prevent, mitigate quate food has come to stay. The in- prises, through appropriate policies, and account for how they address ternational community is watching regulation, and adjudication. A sec- their adverse human rights impacts, governments which need to focus on ond pillar is the corporate responsi- business enterprises should carry out the development and implementa- bility to respect human rights, which human rights due diligence, as stated tion of policies that will effectively means that business enterprises in the guiding principles. The process improve peoples’ lives. Today HR in should act with due diligence to avoid should include assessing actual and general, and the HR to adequate food infringing on the rights of others and potential human rights impacts, inte- in particular, are addressed in the UN to address adverse impacts with grating and acting upon the findings, General Assembly and in the World which they are involved. A third pillar tracking responses, and communicat- Trade Organization (WTO) just to is the need for greater access by vic- ing how impacts are addressed. The mention two important arenas. Many tims to effective remedy, both judi- Guiding Principles for Business and actors talk about ethics, global gov- cial and non-judicial. All mentioned Human Rights suggest that due dili- ernance and globalization, but too pillars are essential components in an gence can be understood in several few talk about the tools we have but inter-related and dynamic system of ways (the author’s emphasis): hardly have started to use, namely preventative and remedial measures:  Firstly a human rights policy the human right to adequate food,  the State duty to protect be- should be adopted. Context when fighting malnutrition. cause it lies at the very core of will be essential to include, and the international human rights it must be integrated, based on BUSINESS AND HUMAN RIGHTS regime; assessment of the situation. The private sector (PS) is part of the society. It is an important actor now  the corporate responsibility to  Tracking performance would and will continue to be in the future, respect because it is the basic be very important. A company and thus can play an important role expectation society has of busi- should monitor and audit proc- in the achievement of the human ness in relation to human esses to track its performance. rights; and right to adequate food for all. The  Measuring impact is essential. potential for partnerships are consid-  access to remedy because even A company must take proactive erable. The United Nations Human the most concerted efforts steps to understand how exist- Rights Council has endorsed a new cannot prevent all abuse. ing and proposed activities af- set of Guiding Principles for Business fect human rights. and Human Rights, providing, for the Beyond the Human Rights Council, it first time ever, a global standard for states that such a framework has

1 To learn more: the OHCHR, the Right to Food Unit of FAO, the United Nations Special Rapporteur on the Right to Food, the Hu- man rights council, UNDP, FIAN International and OECD. back to contents SCN NEWS #39 100 Speaker’s Corner www.unscn.org The Guiding Principles seem to be gaging the private sector. The Guid- this note, that basically said that very relevant and applicable for en- ing Principles for Business and Hu- without Human Rights we would tering into conversations with busi- man Rights, the General Comments have lacked important tools to guide nesses, of all types and sizes, on their 12 on the right to adequate food us towards an adequate world for role on contributing to realizing the (GC12), the Voluntary Guidelines to everyone. right to adequate food. support the progressive realization of Finally, it is essential to look at what the right to adequate food in the con- Despite these advancements in the countries are doing to change the text of national food security, are all Guiding Principles for Business and reality of their inhabitants and iden- important tools to be used. Human Rights, there still seems to be tify the role of businesses in this a long way to go for business to really Business should act according to na- struggle. Since we see the private incorporate human rights principles tional regulations. However, if there sector as an obvious part of the soci- in their activities and policy develop- appears to be a conflict with national ety, they have an important role to ments, assuring equity and dignity in regulations and HR, HR principles play. To start with, this sector should and through their business transac- should be considered, sometimes do no harm. But above all, businesses tions. Business has to realize that in- more important than national laws; should think of how they can contrib- corporating human rights perspec- national authorities should be called ute positively to the fabric of society, tives is not only the right thing to do, upon to amend weak laws and regu- by respecting, supporting and con- but it is also good for their own busi- lations. tributing to adequate food as a hu- ness. Issues such as unfair trade, child man right. Nutrition practitioners, managers and labour, lack of respect for women's policy-makers should emphasize ade- In such a context one should not for- rights to adequate protection for re- quate food as a human right in all get what former Brazilian President production are still of great concern their relations with businesses. This Lula da Silva, said: and consumers are alerted. In rela- alone, could lead to a substantial re- tion to nutrition, cases of violation of “Hunger is actually the worst of all duction in malnutrition. the Code of Marketing of Breastmilk weapons of mass destruction, claim- Substitutes are still reported. Inviting The UNSCN is the “perfect” forum for ing millions of victims every year. Fighting hunger and poverty, and pro- business to brainstorm and agree on engaging business in human rights, in particular the right to adequate food. moting development are the truly ways to help realizing the human sustainable ways to achieve world right to adequate food could be an The UNSCN can facilitate contact be- peace… There will be no peace with- important way forward. The result tween the businesses and other nu- out development, and there will be may be a better world for all in the trition stakeholders in close collabo- neither peace nor development with- future. ration with the UN Special Rappor- out social justice”. teur on the Right to Food, and the UN Let all sectors of society, including CONCLUSIONS Secretary-General Special Represen- business, in all countries start to use tative on Business and Human Rights. Business-nutrition collaboration the Framework of Human Rights, as a within a human rights perspective Going back to Kofi Annan’s and Ban Ki foundation of life for all of the can provide a solid platform for en- -moon's citations in the beginning of world's people.

Contribute to the UNSCN Nutrition Information in Crisis Situations (NICS) publication!

Nutrition Information in Crisis Situations (NICS) has published information on key outcome indicators from emergency-affected populations since 1993. These publications take the form of quarterly reports, which include narrative situation analyses and recommendations. NICS has also published online databases with survey results from random- sample nutrition and mortality surveys since 2004. The NICS Reports aim to raise awareness and facilitate action to improve the nutritional situation of populations affected by crisis. The title, Nutrition Information in Crisis Situations, has been chosen to reflect the reports' focus on all populations affected by crisis, including refugees, displaced, and resident populations. Currently, the readership of these reports totals 1,600 people - 70% of whom live in developing countries. Share your own survey reports or encourage other organizations to share theirs. Please contact the UNSCN Secre- tariat by e-mail: [email protected] . You can also download previous NICS Reports on our website or subscribe to NICS to ensure that you do not miss any future issues.

back to contents SCN NEWS #39 www.unscn.org Publications 101 PUBLICATIONS

Scaling Up Nutrition (SUN): Private Sector Engagement Global Leadership for Nutrition: The UN’s Standing Toolkit (online) Committee on Nutrition (SCN) and its Contributions (online) Many nutrition stakeholders at Richard Longhurst, Institute for Development Studies (UK) country level have little or no experience in working with the The author presents a history of the UN’s private sector. At the same time, Standing Committee on Nutrition (SCN), there are many documents and which has been written as a contribution guides on Public-Private Partner- to the continuing debate on the interna- ships, but often SUN stake- tional nutrition development landscape. holders do not have the time to The experiences of the SCN have much to study them. Therefore the SUN Task Force E members decided that they wanted to overcome contribute to understanding how to this hurdle first. They developed a toolkit which aims to make achieve better harmonization and coher- information accessible by illustrating how public and private ence across UN agencies and their part- sectors can work together with a number of examples of exist- ners. This paper documents the SCN’s ing partnerships. The toolkit serves as a guide to start a dia- performance, and what we can learn from this, and also looks logue in meetings with SUN stakeholders in early riser coun- forward to the SCN of the future. It shows where the SCN has tries. This is a living document, a WORK IN PROGRESS and it is proceeded with consensus and where it has not. This paper available at http://www.scalingupnutrition.org/task-forces/. also provides an inventory of SCN activities, publications and public events. The author explores the key features of the SCN; Key Concepts in Corporate Social Responsibility its pioneering World Nutrition Situation reports; the Working Suzanne Benn, Dianne Bolton Groups with networks of UN agencies, NGOs and nutrition experts; workshops and publications; its country and programme Introducing the key concepts in corpo- reviews; and SCN News and the Nutrition in Crisis Situation rate social responsibility, the authors bring together the essential issues rele- reports. The impact of the SCN’s actions is analyzed, as one vant to the responsible management of example, in terms of the spin-off effect of promoting and aid- businesses, not-for-profit organizations ing a very strong network of NGOs and others involved in inter- and government. With detailed cover- national nutrition, especially those involved in emergency ac- age and cross-referencing for each con- tivities and in empowering refugees. The paper shows how cept and over 50 concepts introduced, ideas raised in SCN fora have progressed to the wider main- this guide to both the theory and imple- stream over time, with the SCN’s more subtle and indirect mentation of CSR and sustainability, achievements as a UN coordinating body in terms of its impact provides an indispensable reference for on harmonization. The paper ends on a generally positive note, any student of the subject. Key concepts include: accountabil- with more UN agencies, bilaterals and NGOs than ever before ity; business ethics; corporate citizenship; corporate environ- interested in nutrition. mental reporting; definitions of CSR; ethical consumerism; human rights; NGOs; risk management; stakeholder theory and sustainable development. IPA Guidelines for relationships with Industry International Pediatric Association (online) UN Private Sector Toolkit for working with Youth This publication by the International Pediatric Association (IPA) (online) UN Department of Economic and Social Affairs brings their policy for engagement with the business sector, This toolkit explores cooperation between guided by the principle that the vision and values of IPA must youth and the private sector, both in prin- drive any proposed relationships with donors. ciple and in practice, in order to: highlight the role of youth as social actors, and increase general understanding of young Guidelines for Private Sector Engagement in Biodiversity people’s great potential as development Ministry of the Environment, Japan (online) partners; inspire the private sector to partner with youth by showcasing several The Ministry of the Environment (MOE) has formulated the case studies and demonstrating the eco- Guidelines for Private Sector Engagement in Biodiversity which nomic advantage of investing in youth, in contrast to the cost will act as guidance for voluntary actions for the conservation of underinvestment; and provide initial guidance on facilitating of biodiversity and its sustainable use by the private sector, in private sector engagement with young people, and the forma- line with the Third National Biodiversity Strategy of Japan. tion of meaningful partnerships, to better influence develop- Press release available online, original guidelines available in ment processes worldwide. Japanese.

back to contents SCN NEWS #39 102 Publications www.unscn.org

Beyond Pragmatism: Appraising UN-Business Partner- Addressing Integrated Coordination in Food Security ships (online) Crises: A Brief Assessment of the Role, Mandate, and Ann Zammit, Peter Utting (UNRISD) Challenges of the Global Food Security Cluster (online) Daniel Maxwell and John Parker, Feinstein International Center In recent years, the United Nations (UN) has emerged as one of the principal proponents of public-private partnerships (PPP), In May 2011, the Food and considered by many to be a key instrument of development Agriculture Organization of the and an ideal to be emulated. The authors of this paper argue United Nations (FAO) and that idealizing the concept and its normative content, as well World Food Programme (WFP) as the feel-good discourse that infuses much of the mainstream literature, risk diverting attention away from various formally launched the global tensions and contradictions that characterize UN–business Food Security Cluster (FSC) as partnerships (UN–BPs) and that raise questions about their the UN’s global mechanism for contribution to equitable development and democratic gov- coordinating food security re- ernance. Both the theory and practice of partnerships suggest sponses in emergencies. The that thinking and policy need to go beyond evidence and as- creation of the global cluster sumptions about “good governance” and pragmatism. coincides with a period in The paper identifies key ideational, institutional, political and which the number of food se- economic forces that have driven the PPP phenomenon, only curity actors has continued to some of which are recognized in the mainstream literature. grow, the operating environment has become more complex, This analysis reveals the multiple, sometimes contradictory and the range of responses has required greater levels of skill agendas and interests involved. The authors argue that if the in analysis, planning, implementation and monitoring. All of contribution of UN–BPs to equitable development is to be ade- this underscores the need for greater coordination. This paper quately assessed, these diverse logics underpinning partner- summarizes the mandate of the newly formed global FSC, pre- ships need to be identified and addressed. sents an analysis of the major issues and challenges it faces, and provides recommendations to donors and the global FSC Public Health Nutrition in Developing Countries for possible ways to address these issues. Issues addressed Sheila Vir include the leadership of clusters and coordination; coordination linkages and challenges at the global level; transitions, exit These books (in a 2-volume set) provide and the “boundaries” of food security coordination in emer- public health experts, nutritionists, stu- gencies; accountability, effectiveness and funding. dents, scientists, development professionals and policy makers with information on the current global scenario re- Indigenous peoples' food systems: the many dimensions garding well known public health nutri- of culture, diversity and environment for nutrition and tion problems and to update them with health (online) new emerging problems such as nutrition in reference to AIDS, non- Food and Agriculture Organization of the United Nations (FAO) communicable diseases and emerging and Centre for Indigenous Peoples’ Nutrition and Environment situations. (CINE)

Corporate Social Responsibility and Regulatory Govern- Today, globalization and homog- ance: Towards Inclusive Development? (online) enization have replaced local food cultures. The 12 case studies José Carlos Marques, Peter Utting (UNRISD) presented in this book show the The corporate social responsibility (CSR) movement has been wealth of knowledge in indige- instrumental in raising awareness that firms have responsibili- nous communities in diverse eco- ties other than to their owners and “the bottom line”. Yet de- systems, the richness of their spite all the talk about the importance of stakeholders, trans- food resources, the inherent parency, corporate citizenship and sustainability, the develop- strengths of the local traditional mental and regulatory impacts of CSR remain highly question- food systems, how people think able. This book, edited by Peter Utting and José Carlos about and use these foods, the Marques, assesses the global rise of private regulation and CSR from the perspective of social and sustainable development. influx of industrial and purchased food, and the circumstances By adopting a multidisciplinary lens, it examines why the ex- of the nutrition transition in indigenous communities. The perience of CSR pales in comparison with the promise, what unique styles of conceptualizing food systems and writing needs to be done to address “the intellectual crisis” of CSR, about them were preserved. Photographs and tables accom- and forms of corporate accountability and regulation more pany each chapter. conducive to inclusive patterns of development.

back to contents SCN NEWS #39 www.unscn.org Publications 103

Engagement with the private sector – principles for en- Guidance for Engagement with the Private Sector gagement (draft) (online) (online) The Partnership for Maternal, Newborn & Child Health Voluntary Services Overseas (VSO) (PMNCH) This paper provides guidance for VSO in its engagement with In defining the proposals for principles the private sector. It aims to ensure that engagement with the to be adopted by PMNCH, this paper private sector is managed consistently around the organiza- reviews the principles used in other tion, to maximize benefit and minimize risks, through the es- organizations and sets out a proposal for principles to be adopted by tablishment of robust techniques to select companies, and the PMNCH. The paper does not propose creation of expertise to lead on decision-making. This guidance areas for PMNCH engagement with relates to all forms of engagement with the private sector, in the private sector. Although the scope any country, which includes the following types of engage- of this paper is limited to suggesting ment: public alignment, providing resources, collaboration in appropriate principles for possible programmatic work, advocacy, gifts of goods, services and ex- private sector engagement by PMNCH, pertise, procurement and influencing business practices. It is the last section provides some observations on issues that would need to be considered in applying relevant for all sizes of company: sole traders, private limited the principles in practice. These are in addition to the possible companies and public companies. next steps associated with development of a policy in this area.

Private Sector Development and Partnership Strategy (online) International Fund for Agricultural Development Operational Guidelines for Private Sector Engagement (online) International Union for Conservation of Nature (IUCN ) This paper presents IFAD’s strategy on how best to promote private sector development in rural areas. This publication outlines the neces- The paper also looks at how IFAD sary processes for developing, imple- can forge local, national, regional menting and managing engagements and global partnerships with the with private sector entities, with an private sector that will benefit emphasis on ensuring that engage- IFAD’s target groups and enable ment with the private sector includes them to overcome poverty. The risk management, reflects IUCN’s strategy is organized along three Value Proposition and incorporates broad lines of action: policy dialogue the principles of Free Prior Informed for local private sector develop- Consent, transparency and inclusive ment; investment operations to participation. support local private sector development; and partnership with the private sector to leverage additional investments and Philanthrocapitalism: How the Rich Can Save the World bring knowledge to rural areas. Matthew Bishop, Michael Green

GEF Strategy to Enhance Engagement with the Private In this book, the authors examine this new movement and its implica- Sector (online) tions. Proceeding from interviews Global Environment Facility (GEF) with some of the most powerful people on the planet – including Bill This publication is based on a criti- Gates, Bill Clinton, George Soros, cal review of the private sector Richard Branson, Angelina Jolie, and development strategies of the Bono, among others – they show multilateral and regional develop- how a web of motivated givers has ment banks. Generating global set out to change the world. In the environmental benefits through new, updated paperback edition of private sector engagement in the Philanthrocapitalism Bishop and focal areas serves as the founda- Green also describe how new, smart tion for the strategy. The strate- ways of giving that harness the power of social networks can gies focus on: creating an ena- help all of us to become philanthrocapitalists and play a more bling environment/investment effective part in changing the world for the better. climate for the private sector; and supporting eligible private sector activities.

back to contents SCN NEWS #39 104 Publications www.unscn.org

Nutrition and HIV Food Policy for Developing Countries Vivian Pribram Per Pinstrup-Andersen, Derrill D. Watson II

In this book an international team of In this new textbook intended to authors bring together the latest re- be used with the three volumes search to provide the practicing dieti- of Case Studies in Food Policy for tian and nutritionist with a practical Developing Countries, the authors guide to the nutritional care of the HIV analyze international food policies and AIDS patient. Students and other and discuss how such policies can health care professionals working and and must address the many com- studying this area will also find Nutri- plex challenges that lie ahead in tion and HIV an important and valu- view of continued poverty, global- able resource. ization, climate change, food price volatility, natural resource degra- dation, demographic and dietary The Next Billions: Business Strategies to Enhance transitions, and increasing inter- Food Value Chains and Empower the Poor (online) ests in local and organic food production. Calling on a wide World Economic Forum (WEF) variety of disciplines including economics, nutrition, sociology, anthropology, environmental science, medicine, and geogra- This report documents a series of phy, the authors show how all elements in the food system commercially viable business mod- function together. els that have proven effective at strengthening food value chains in Guiding Principles on Business and Human Rights: Im- developing countries, and offers plementing the United Nations “Protect, Respect and recommendations for scaling them Remedy” Framework (online) up. It presents examples of specific United Nations General Assembly business approaches that can engage poor producers, consumers These guiding principles are designed to provide for the first and entrepreneurs along the food time a global standard for preventing and addressing the risk value chain. It outlines design prin- of adverse impacts on human rights linked to business activity. ciples for companies interested in The new standards outline how States and businesses should developing such initiatives, and suggests actions that all stake- implement the UN “Protect, Respect and Remedy” Framework holders can take to facilitate expansion of these business ap- in order to better manage business and human rights chal- proaches. lenges. Under the “State Duty to Protect,” the Guiding Princi- ples recommend how governments should provide greater Nutrition Advocacy: Building Opportunities in Europe clarity of expectations and consistency of rule for business in relation to human rights. The “Corporate Responsibility to Re- (online) London School of Hygiene & Tropical Medicine spect” principles provide a blueprint for companies on how to know and show that they are respecting human rights. The “Access to Remedy” principles focus on ensuring that where In recent years, the combination of people are harmed by business activities, there is both ade- food price rises and economic volatil- quate accountability and effective redress, judicial and non- ity has intensified the challenges in judicial. nutrition security. However, global attention to the issue of undernutrition is starting to rise. New initiatives, The United Nations and the Private Sector: a framework such as the Scaling Up Nutrition road- for collaboration (online) map and the “1,000 Days Partner- United Nations ship”, have increased nutrition’s visibility. Coordinated advocacy efforts A framework outlining different ways will be integral to build on this mo- in which the private sector can collabo- mentum and drive forward sustainable change in global nutri- rate with UN agencies, funds and pro- tion. grammes to address global challenges. Specifically, it describes how business The London School of Hygiene & Tropical Medicine was con- can make an effective contribution tracted by the Bill & Melinda Gates Foundation to conduct a through their core business operations, mapping exercise of the landscape of European organizations through social investments and philan- that have existing or potential involvement in activities ad- thropy, and through advocacy, policy dressing undernutrition in low- and middle-income countries. dialogue and institutional frameworks. This report provides an overview of the European landscape, highlighting potential opportunities to scale up investments

back to contents SCN NEWS #39 www.unscn.org Publications 105

Joining Forces for Change: Demonstrating Innovation Coming of Age: UN-Private Sector Collaboration Since and Impact through UN-Business Partnerships (online) 2000 (online) UN Global Compact UN Global Compact

This publication profiles how compa- Collaboration between the United Na- nies from a variety of industries tions and the private sector has become have partnered with different ingrained in the way the United Nations United Nations agencies, funds and and its agencies, funds and programmes programmes to help address signifi- function; but it was not always this way. cant global issues. The guide illus- The report charts the evolution of UN- trates how different types of UN- business engagement since 2000. Business partnerships can contribute to development objectives, and shows the win-win potential of collaboration. Food, Globalization and Sustainability Peter Oosterveer, David A. Sonnenfeld Guidelines on Cooperation between the United Nations and the Business Sector (online) This book provides an overview of UN Global Compact the principal conceptual frameworks that have been developed for un- As an important component of the Secretary-General’s efforts derstanding the plethora of salient to modernize the United Nations, the Guidelines are intended issues in this topic. It shows how to help UN staff develop more effective partnerships between conventional regulation of food pro- the UN and the business sector while ensuring the integrity vision through national govern- and independence of the United Nations. The purpose of these ments is becoming elusive. At the guidelines is to facilitate the formulation and implementation same time multinational and supra- of partnerships between the United Nations and the business national institutions put serious lim- sector in a manner that ensures the integrity and independ- its on governmental interventions. ence of the UN. The Guidelines are intended to serve as a com- In this context, other social actors mon framework for all organizations of the UN system as a including food retailers and NGOs basis for their collaborative efforts with the business sector. All are shown to take up innovative roles in governing food provi- are encouraged to adopt the Guidelines in accordance with sion. necessary internal processes. Safeguarding Food Security in Volatile Global Markets Enhancing Partnership Value: The Partnership Assess- (online) ment Tool (PAT) (online) Food and Agriculture Organization of the United Nations (FAO) United Nations A timely publication as world lead- A tool for companies and the UN to as- ers deliberate the causes of the sess the impact and sustainability of part- latest bouts of food price volatility nerships for development, jointly devel- and search for solutions that ad- oped by the Global Compact, UNDP, UNI- dress the recent velocity of finan- TAR and the UN Office for Partnerships. cial, economic, political, demographic, and climatic change. As a collection compiled from a diverse group of economists, analysts, traders, institutions and policy for- mulators - comprising multiple Partnership Fundamentals: A 10-step guide for creating methodologies and viewpoints - effective UN-Business partnerships (online) the book exposes the impact of UN Global Compact volatility on global food security, with particular focus on the world's most vulnerable. This volume brings together top ana- The guide serves as a step-by-step roadmap lysts from inside and outside FAO to examine a problem that for maximizing the transformative potential has become increasingly relevant as food prices once again, of partnerships. As transformational part- soar to high levels. It stresses that countries themselves can do nerships cannot exist without a strong foun- a great deal to safeguard food security in the event of turmoil dation in place from the outset, this guide by establishing social safety nets, emergency food reserves and provides a roadmap for building effective other schemes to protect the poor. It also presents guidelines partnerships, as well as a method to diag- on “smart subsidies”, those which provide production incen- nose existing ones. tives and improve supply responses.

back to contents SCN NEWS #39 BULLETIN BOARD ANNOUNCEMENTS Meetings and Conferences

Human Development Report 2011 International Conference on Food UNDP has released the Human Development Report 2011 "Sustainability and Equity. A Science and Nutrition 2012 Better Future for All". The Report argues that the urgent global challenges of 2 - 4 April 2012 sustainability and equity must be addressed together and identifies policies on the Kota Kinabalu, Sabah, Malaysia national and global level that could spur mutually reinforcing progress towards these interlinked goals. http://www.ums.edu.my/ conferences/ICFSN The complete report is available for download here.

Toolkit: For Countries Applying for Funding of Food and Nutrition Programs 9th Annual Nutrition & Health Conference under the Global Fund to Fight AIDS, Tuberculosis and Malaria 16 - 18 April 2012 Elaborated by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Food Westin Boston Waterfront Programme, the World Health Organization, the United States President's Emergency Boston, Massachusetts Plan for AIDS Relief, and FANTA-2, the Toolkit can be used by countries considering http://nutritionandhealthconf.org/ inclusion of food and nutrition activities for the first time and by experienced countries that want to scale up their response or broaden the range of their food and nutrition support activities to address emerging problems. Global Health & Innovation Conference 2012 To download the toolkit click here. 21 - 22 April 2012

Yale University, New Haven, World Development Report 2012: Gender Equality and Development Connecticut, USA This World Bank report argues that closing persistent gender gaps matters. It matters http://www.uniteforsight.org/ because gender equality is a core development objective in its own right. But it is also conference/ smart economics. Greater gender equality can enhance productivity, improve development outcomes for the next generation, and make institutions more representative. Building on a growing body of knowledge on the economics of gender equality and World Nutrition Rio2012 Congress development, the Report identifies the areas where gender gaps are most significant- 27 - 30 April 2012 both intrinsically and in terms of their potential development payoff-and where growth Rio de Janeiro, Brazil alone cannot solve the issues. www.worldnutritionrio2012.com/ The complete report is available for download here. International Conference on Diet and FEWS NET press release: famine continues Activity Methods Recent analysis by Food Security and Nutrition Analysis Unit - Somalia (FSNAU) and the 14 - 17 May 2012 Famine Early Warning Systems Network (FEWS NET) confirms that famine persisted FAO Headquarters, Rome, Italy through December 2011 in agropastoral areas of Middle Shabelle and among Afgoye http://www.icdam8.org/ and Mogadishu IDP populations. Overall, food security outcomes remain the worst in the world, and the worst in Somalia since the 1991/92 famine. In the most-likely scenario, famine is not expected in Somalia during 2012, with the potential exception Vacancies of some IDP populations. Continued, large-scale, multisectoral response is critical to Keep updated about the latest food prevent additional deaths and to support livelihoods, especially for poor agropastoral and nutrition vacancies through the households. Read more. UNSCN website: http://www.unscn.org/en/ New reports on climate change impact in 23 countries announcements/vacancies/ A series of reports examining the impact of climate change in 23 countries has been launched on the sidelines of the UN climate talks in Durban, South Africa. The reports produced by the UK Met Office Hadley Centre assess the latest research and make Follow us on Twitter! projections using a comprehensive range of 21 climate models also used by the Intergovernmental Panel on Climate Change (IPCC). They looked at climate data SCN Email Update recorded from 1960 to 2010, and the projections are for the period 2050 to 2100. Receive news and updates by email! Among the 23 countries under scrutiny are Bangladesh, Brazil, China, Egypt, India, Ask us to add you to our contact list, Indonesia, Kenya, Mexico, Peru and South Africa. at [email protected] or register here To download the reports, click here.

UNITED NATIONS SYSTEM

STANDING COMMITTEE ON NUTRITION

The United Nations System Standing Committee on Nutrition (UNSCN) is the food and nutrition policy harmonization forum of the United Nations. Its vision is a world free from hunger and malnutrition, where there are no longer impediments to human development. Created in 1977 as the ACC Subcommittee on Nutrition, at that time, the UNSCN was accountable to the Administrative Committee on Coordination of the UN (ACC). As a result of the UN Reform of the ACC (which was renamed as the Chief Executives Board CEB), the Subcommittee continued its functions as the United Nations System Standing Committee on Nutrition (UNSCN). The mandate of the UNSCN is to promote cooperation among UN agencies and partner organizations in support of community, national, regional, and international efforts to end malnutrition in all of its forms in this generation. In this way, the Standing Committee on Nutrition of the UN System (UNSCN) is not another agency but it is a UN platform and an extended network where UN agencies come together to exchange information, harmonize and reconcile their strategies, policies and guidelines, agree common action and approaches and take joint initiative in global nutrition issues, while engaging with other key nutrition stakeholders. By leveraging the normative expertise and operational strengths of different UN agencies engaged in nutrition, it aims to ensure that the system-wide response is indeed greater than the sum of the individual efforts. The UNSCN works towards providing consolidated expertise in nutrition to existing Member States entities such as the Committee on World Food Security (CFS), the World Health Assembly (WHA), among others. It also supports the Ending Hunger and Undernutrition Partnership (REACH) and aims at providing UN coordinated support to initiatives such as the Scaling Up Nutrition (SUN) Movement. The UNSCN is governed by a Chair, currently Ramiro Lopes da Silva (Deputy Executive Director of WFP) who is the eleventh Chair of the UNSCN and who heads the UNSCN Executive Committee. UNSCN has undergone organizational changes and has been governed by an Executive Committee of senior executives from FAO, WHO, UNICEF and WFP and the UN Secretary-General Special Representative for Food Security and Nutrition since 2011. At the hub of this UN nutrition network is the UNSCN Secretariat, which is hosted by WHO in Geneva and core funded by the UN agencies. As part of its advocacy and communication efforts, the UNSCN Secretariat produces and disseminates a series of knowledge products, reaching some 10 000 nutrition practitioners, programme managers and development workers around the world. Among its main knowledge products are the SCN News, the NICS Reports (which are linked to the NICS Database), the Reports on the World Nutrition Situation and the Nutrition Policy Papers.

UNSCN Chair: Ramiro Lopes da Silva c/o World Health Organization 20 Avenue Appia, CH 1211 Geneva 27 Switzerland Telephone: +41-22 791 04 56 [email protected] www.unscn.org