When the SUN casts a shadow The human rights risks of multi-stakeholder partnerships: the case of Scaling up Nutrition (SUN) Authors Laura Michéle (FIAN International), Stefano Prato (SID), Patti Rundall (Baby Milk Action/IBFAN), Flavio Valente (FIAN International) Country Researchers Barbara Nalubanga (Uganda), Maarten Immink and Magali Cano (Guatemala), JP Dadhich and Arun Gupta (India) Reviewers Rehema Bavuma, Angela Carriedo, Mareike Haase, Lida Lhotska, Ann Louise Lie, Victoria Mogollón, Sofía Monsalve, Alejandra Morena, Sarah Schneider, Yifang Slot-Tang, Andrea Sonntag, Ana María Suárez Franco, Bernhard Walter, Ricardo Zepeda Design Jon Rundall Cover Illustration Bill Bragg Print CITY-DRUCK Heidelberg Published by FIAN International, IBFAN and Society for International Development (SID) with the support of Open Society Foundation, Bread for the World, and Misereor. The views and opinions expressed in the publication are the sole responsibility of the authors and do not necessarily reflect those of the reviewers and funders. December 2019 Available at www.fian.org www.ibfan.org www.sidint.net When the SUN casts a shadow The human rights risks of multi-stakeholder partnerships: the case of Scaling up Nutrition (SUN) Laura Michéle, Stefano Prato, Patti Rundall, Flavio Valente Acronyms/Abbreviations 6 Executive Summary 7 Introduction 10 Background 11 Objectives of the study 11 Methodology 12 Limitations and challenges 13 Chapter 1: Conceptual and Analytical Framework 14 The holistic conceptualization of the right to adequate food and nutrition 15 Four-pillar framework for assessing nutrition policies and interventions promoted by SUN 19 Framework for assessing SUN from a governance perspective 21 Chapter 2: The Scaling Up Nutrition ‘Movement’ 23 Vision, objectives, and approach 24 Composition and governance structure 25 Financing structure 27 Rules of engagement, decision making, and conflict resolution 28 Monitoring, evaluation, and accountability 30 Chapter 3: The Evolution of Nutrition Governance and the Emergence of ‘Multi-stakeholderism’ 32 The World Food Summit and the UNSCN Reform 33 The growth of private sector participation in food and nutrition governance 34 How to raise the political profile of nutrition? 34 A political shift of gears in the UNSCN 35 The rise of SUN and its search for an institutional home 36 The private sector sneaks in through the CFS and WHO reform 37 Reclaiming the nutrition agenda: ICN2 and new calls on CFS and SCN 37 Chapter 4: SUN’s Influence on Nutrition Policy at Country Level: The Cases of Uganda, Guatemala and India 38 Conclusions 65 Recommendations 69 Endnotes 72 Acronyms/Abbreviations BMGF Bill & Melinda Gates Foundation NARO National Agricultural Research Office BPNI Breastfeeding Promotion Network of India NCD Non-communicable disease CAC Codex Alimentarius Commission NGO Non-governmental organization CEDAW Convention on the Elimination of All Forms OPM Office of the Prime Minister of Discrimination against Women OWC Operation Wealth Creation CESCR Committee on Economic, Social and POLSAN Guatemala National Policy on Food and Cultural Rights Nutrition Security CFS Committee on World Food Security PPP Public-Private Partnership CMAM Community-based Management of REACH Renewed Efforts Against Child Hunger Acute Malnutrition RtAFN Right to Adequate Food and Nutrition COI Conflict of Interest RUTF Ready to Use Therapeutic Foods CRC Convention on the Rights of the Child / Committee SAM Severe Acute Malnutrition on the Rights of the Child SESAN Guatemala Secretariat for Food Security CSA Civil Society Alliance and Nutrition ECOSOC UN Economic and Social Council SBN SUN Business Network ETO Extraterritorial obligations SID Society for International Development FAO Food and Agriculture Organization SINASAN Guatemala National System for Food and FENSA Framework for Engagement with Nutrition Security Non-State Actors SUN Scaling Up Nutrition GAIN Global Alliance for Improved Nutrition SUN CSN SUN Civil Society Network GAVI Global Alliance for Vaccines and Immunization TNC Transnational Corporation GC General Comment UNAP Uganda National Action Plan 2011-2016 GR General Recommendation UN United Nations GRI Global Redesign Initiative UNDP United Nations Development Programme GSO Global Social Observatory UNDROP UN Declaration on the Rights of Peasants HLTF High-Level Task Force on the Global Food and Other People Working in Rural Areas Security Crisis UFNP Uganda Food and Nutrition Policy IBFAN International Baby Food Action Network UNGA United Nations General Assembly ICN2 Second International Conference on Nutrition UNICEF United Nations Children’s Fund ICESCR International Covenant on Economic, Social and UNSCN/SCN United Nations Standing Committee Cultural Rights on Nutrition IFAD International Fund for Agricultural Development USAID United States Agency for IFPMA International Federation of Pharmaceutical International Development Manufacturers Association WB World Bank IFPRI International Food Policy Research Institute WEF World Economic Forum IMF International Monetary Fund WFP World Food Programme MNPs Micronutrient Powders WHA World Health Assembly MSNTC Multi-Sectoral Nutrition Technical Committee WHO World Health Organization MSP Multi-stakeholder Partnership/Platform 6 | When the SUN casts a shadow Acronyms/Abbreviations Executive Summary When the SUN casts a shadow | 7 The past two decades exposed an increased interest possibly be increased by such approaches; and participation of the private sector, and in particu- ∞ SUN’s so-called ‘nutrition-sensitive’ interventions lar large transnational corporations, in global policy predominantly promote high-input intensive debates on sustainable development and its many agriculture, biofortification and genetically-modified domains. Such stronger corporate engagement has crops that primarily benefit the agro-industrial food generated, and continues to generate, polarizing per- system and contribute to reducing biodiversity; spectives, from the enthusiasm of those that view this ∞ SUN interventions appeared to have limited impact as an opportunity for greater policy effectiveness and on reducing malnutrition while generating negative resource mobilization, to those concerned about corpo- consequences on the realization of the RtAFN; rate capture of the public policy space. Interestingly, this ∞ SUN enhanced private sector influence on policy, phenomenon has also been accompanied by changes in while redefining the legal conflict of interest concept taxonomy, with the emergence of the term ‘stakeholder’ to suit the multi-stakeholder model; and and increased use of ‘multi-stakeholder’ dialogues, ∞ SUN falsely generated the benign illusion of a programmes, platforms and partnerships. broad and inclusive ‘movement’ while failing to include meaningful participation of the most Despite scant evidence of their effectiveness, States and affected communities. United Nations (UN) agencies have been increasingly accepting and actively promoting multi-stakeholder While SUN is not the only force pushing for this techno- models that provide a conduit for the private sector - cratic, silver bullet approach to nutrition it has certainly including large food and agribusiness - to participate as influenced policy trends in this direction. SUN country ‘key stakeholders’ in policy making fora related to food experiences show no strategy in place for fundamentally and nutrition. re-shaping food systems towards better nutritional, envi- ronmental, and social outcomes in line with the RtAFN. This study explores how this shift influences public policy spaces; the framing of agendas; the capacity and The interventions promoted by SUN not only fall short political will of governmental and intergovernmental in addressing the structural causes of malnutrition, institutions (such as the UN) to regulate in the public but they also create additional dependencies and interest; and people’s ability to claim their human rights, reduce confidence in local foods, thereby undermining with special but not exclusive reference to the right to the RtAFN. Finally, and importantly, in the countries adequate food and nutrition (RtAFN). The Scaling-up reviewed, the initiative has contributed to the (further) Nutrition (SUN) initiative was chosen as a prominent institutionalization of private sector influence on public example of a multi-stakeholder initiative in the food food and nutrition policy making and implementation. and nutrition area. The study also examined SUN’s international structure Based on research in two SUN countries (Guatemala and way of working from a governance perspective. and Uganda) and three SUN states (Uttar Pradesh, Contrary to the initiative’s claims of a country-led Maharashtra, and Jharkhand – India), the following movement, decision making structures fail to give a five key findings emerged: strong voice to countries and even less to the communi- ties affected by malnutrition. There are no mechanisms ∞ SUN promotes nutrition approaches that favour in place to balance powers within SUN, hold anyone short-term medicalized and technical solutions, accountable when things go wrong, or deal with claims mostly focused on chronic undernutrition, rather of people affected by SUN-promoted interventions. than addressing the structural causes of malnutrition Moreover, the initiative contributes to an erosion of in all its forms in a sustainable manner. The risks accountability of governments to people by replacing associated with overweight-obesity and related
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