United Nations Sub-Committee on Nutrition (ACC/SCN)
29th Session 11.-15. March 2002
Sitzung des Sub-Committee on Nutrition
Hunger bekämpfen – die Welternährung sichern
Auf Einladung des BMZ fand die diesjährige Sitzung des Sub-Committee on
Nutrition (SCN) der Vereinten Nationen Mitte März zum ersten Mal in Deutschland
statt. Von deutscher Seite wurde die Konferenz vom Sektorvorhaben Welternährung
in Zusammenarbeit mit dem Fachzentrum für Ernährung, ländliche Entwicklung und
Umwelt der DSE vorbereitet und unterstützt. Ziel war es, Fragen der
Ernährungssicherung stärker in das öffentliche Bewusstsein zu rücken,
Entscheidungsträger für dieses Themenfeld zu sensibilisieren und
Ernährungssicherheit sowie das Recht auf Nahrung stärker in internationalen
Verträgen und Abkommen zu verankern.
Das
Themenspektrum reichte von „Breastfeeding and Complementary Feeding“,
„Micronutrients“ über „Nutrition and HIV/AIDS“ bis zu „Capacity Development in
Food and Nutrition“. Darüber hinaus fand ein zweitägiges Symposium „Nutrition
in the Context of Crisis and Conflict“ statt.
Das SCN hat die Aufgabe, die Aktivitäten der zum Thema Hungerbekämpfung/
Welternährung arbeitenden UN-Organisationen – zu denen die FAO, das
Welternährungsprogramm WFP, die Weltgesundheitsorganisation WHO, UNICEF u.a.
zählen – zu bündeln und die Programme besser abzustimmen. Die
Koordinierungsfunktion erstreckt sich auch auf die Zusammenarbeit mit
bilateralen Gebern und Nichtregierungsorganisationen.
Anbei einen englischen Kurzbericht zur Tagung, der sich wie folgt gliedert:
1. Infos zum 5th World Nutrition Report
2. Zusammenfassung des Symposium on “Nutrition in the context of Crisis and Conflict”
3. Teilbereicht zu den „Working Sessions“ (UN Agencies, Bilaterals, NGO’s and Civil Society)
4. Zusammenfassungen einiger „Working Groups“ die in Berlin getagt haben
- Capacity Development in Food and Nutrition
- Micronutrients
- Nutrition and HIV/AIDS
- Breastfeeding and Complementary Feeding
Die „Working Groups“, die in Berlin nicht getagt haben, stellten den Sachstand der Arbeitsgruppen am Ende der Tagung kurz vor:
- Household Food Security
- Nutrition in Emergencies
- Nutrition, Ethics and Human Rights
- Nutrition of School-Age Children
5. Auswahl von Papieren und Veröffentlichungen die während der Konferenz ausgelegt oder vorgestellt wurden (mit weiteren Links).
Der Bericht erhebt keinen Anspruch auf Vollständigkeit. Es wurden im wesentlichen die Veranstaltungen dokumentiert, die von mir selbst besucht wurden, bzw. zu denen während der Tagung Kurzpapiere erstellt wurden. Die Informationen sind Stichpunktartig festgehalten. Für Rückfragen stehe ich gerne zur Verfügung
Mehr
Informationen zum SCN, den jährlichen Tagungen und den Symposien auf Internet
unter http://acc.unsystem.org/scn/
im Internet abrufbar. Dort finden sich in Kürze die Tagungsdokumente.
United Nations Sub-Committee on Nutrition (ACC/SCN)
The UN Systems Forum for Nutrition
29th Session 11.-15. March 2002
- Capacity Development in Food and
Nutrition
- Breastfeeding and Complementary Feeding
- Micronutrients
- Nutrition and HIV/AIDS
1. 5th WORLD NUTRITION REPORT
Working Title: “Engaging development: new opportunities for nutrition”
The 5th World Nutrition Report is going to be launched in March 2003 and will contain the following four main chapters:
Social Sector Reform (esp. health sector)
- how to improve health sector/services (efficiency, quality, equity)
- Analysis of PRSP process and “new poverty paradigm”
- broader definition of poverty, that includes nutrition as a goal
- strengthen national nutrition capacities
- multi-sectoral and holistic approach
- good governance, accountability, democracy
- focus on basic causes of malnutrition
- pathways, employment,.....
- discussion whether trade liberalisation contributes to nutrition inequities
2. SYMPOSIUM ON NUTRITION IN THE CONTEXT OF CRISIS AND CONFLICT
Agenda:
- Official Opening of the Symposium: Namanga Ngongi, SCN Chairman
- Opening Address: State Secretary of the Federal Ministry for Economic Cooperation and Development (BMZ), Germany
-
Keynote address:
Austen Davis, Médecins Sans Frontières Holland
When is a “System” not a System
-
Frances Mason,
ACF; Anna Taylor, SCF UK
Achievements in
Assessment, Interventions and Coordination
-
Yakob Akilu,
Helen Young, TUFTS University
Nutrition and
Livelihoods in Situations of Crisis and Conflict: Reducing Vulnerability and
Risk
-
Urban
Johnson, ACC/SCN working Group on Nutrition Ethics and Human Rights
The Right to
Nutrition in conflict Situations
-
Keynote address:
Catherine Bertini, World Food Programme
Reaching women: the key to better nutrition in humanitarian crisis
Panel discussion
“Doing the right thing – addressing humanitarian dilemmas”
- MS Swaminathan, Moderator
- Alain Mourey, ICRC
- Susanne Jaspars, Nutrition Works
- Manuel da Silva, WFP
- Wolfgang Henrich, Church Development Service
Dr Abraham Horwitz Memorial Lecture:
Keeping Schools
Open: School feeding in Crisis and Conflict - Soha Moussa, Tufts University
Poster session on examples of coordination amongst UN agencies, bilaterals and NGOs
- Concluding Session: Synthesis of conclusions and next steps
(including the recommendations from the Working group on Nutrition in Emergencies)
Achievements in Assessment, Interventions and Coordination
· many technical and institutional progress and improvements have been made in the context of nutrition in the context of crisis and conflict
· still donors meet only 10-17% of emergency needs
· increased recognition of the social, economic and political determinants of malnutrition in emergencies
· more flexibility should be applied to the use of resources for emergency response and in food aid programming
· specialisation of agency mandates can lead to a gap in intervention capacity => call for more coordination
· food aid is now more considered as a nutrition intervention (more important role of non-food items, locally purchased food, capacity building, etc.)
· NGO’s work in the field of emergency aid has become more professional
keys to better nutrition in humanitarian crisis
· Nutrition needs to be addressed though broad based interventions (multi-sectoral) to ensure livelihoods besides saving lives
· role of women in emergencies was highlighted and controversially discussed, including their specific needs
· more consideration needs to be given to the social role of food (culture and dignity)
· more emphasis is given to the need of capacity building/capacity strengthening/capacity development. Agencies should follow the Red Cross/NGO code of conduct and build disaster response on local capacity
The Right to Nutrition in conflict Situations
· more emphasis on human rights and human dignity
· to expand emergency aid from a humanitarian action (needs based) to a broader concept of human rights (rights based). The rights based concept includes aspects of empowerment
· need for more coordinated action based on common standards (e.g. SPHERE project, minimum standards for a rights based approach in emergency interventions)
· more knowledge and experience needed for the practical application of human rights programming in emergencies
· human rights apply in emergencies as well as in peace (in contrary to the perception, hat in a war situation only the International Humanitarian Law (IHL) applies)
Reducing Vulnerability and Risk
· humanitarian imperative is a tenant of emergency relief interventions but undermined by political interests
· moral dilemma (aid needs to be provided to the population most in need, but access and cooperation needs to be discussed and negotiated with stakeholders who are often corrupt and/or players in the conflict)
· issue of non-food items is critical and needs to be looked into more in-depth (non-food items can be more politicised than food items). Adequate non-food resources needed
· lack of agency presence in low-profile areas (e.g. Sudan, Angola vs. Afghanistan, Kosovo, East-Timor)
· interventions should never apply blank protocols. Vulnerability assessment must consider the multiple risk facing people in conflict and not be pre-occupied with gender, class, race, ethnicity and age
· agencies risk disruption of social structures by inappropriate targeting and blanket protocols, calling for better knowledge and in-depth analysis
· refugee populations are often better off than the host population => Dilemma!
· need to measure cultural impacts of emergency interventions, esp. food aid (typo of food, way of distribution, target group)
·
humanitarian action could potentially cause harm
=> discussion on whether “do no harm” approach might be misleading. Better:
do little harm” or “do any good”?
=> agencies should monitor positive as well as negative effects of
their actions
·
NEXT STEPS
· need for more investment in crisis prevention to avoid conflicts and reduce necessity of emergency interventions
· combining food aid and feeding approaches more with long-term development approaches
· integrate human rights programming into emergency interventions (e.g. SPHERE)
· improve exchange between decision makers and technical people (implementers)
· SCN working group on emergencies conducts an analysis of the politicisation of food aid to provide a background paper for a meeting of politicians and technicians
· need for regional SCN meetings involve more stakeholders closer to field level
3. WORKING SESSIONS
Report on the Working Session of the Bilateral Group
(main points discussed, draft recommendations of the group)
For results of the other Working Sessions (Group of UN Agencies and the Group of the Civil Society see http://acc.unsystem.org/scn/)
Core budget (SCN Secretariat and travel): funded by UN Agencies
Meetings, Publications, RNIS etc.: funded by Bilaterals
Core budget 94/95: 1 Mio US$
2000: 800.000 US$
- big leading agencies (UNDP, UNICEF) cut down their contribution to SCN => Why?
Evaluation of SCN: planned for 2003
Chair of SCN:
- Namanga Nggongi was selected in 2001 for a period of 2 years, but will withdraw from his position, because he is the head of the UN Peacekeeping Mission in DRC (Democratic Republic of Congo)
-
new Chair: Ms. Catherine Bertini
selection process no transparent, selection criteria unnknown
Statement and Recommendations of Bilateral Partners Group (BPG) (main points only!):
· Arne Oshaug (Norway) to be the representative of the BPG in the SCN steering Committee
· thanking Namanga Ngongi for his work as a chair of SCN and offering good cooperation to the new Chair: Catherine Bertini
· the BPG includes donor agencies and people from dev. Countries governments
· participation from Dev. countries to be improved (e.g. through funding for participation)
· new name of SCN: BPG recommends to keep “SCN” and suggests: UN System Coordinating Forum for Nutrition; UN Systems Collaboration/Commitee for Nutrition
· expressed concern regarding the financing of SCN
· coming evaluation of SCN should look into funding issues
· BPG did not have sufficient information on the criteria and process for the selection of the new chair of SCN. In future more transparency is intended
· BPG emphasises the need for advocacy for nutrition and welcomes and supports the initiative “Nutrition, a foundation for Development”
· The Fifth World Nutrition Report should give attention to the role of nutrition in reducing povery
· SCN should advocate for nutrition during WFS+5, AIDS meeting in Barcelone in July, Rio+10 in Sept. etc.
· regarding WFS+5 a voluntary code of conduct is a priority area for Germany and Norway
· SCN working groups should leave more room for discussion, should establish and follow their agendas and encourage more reports from field level experience
· capacity development and HIV/AIDS is considered crucial
4. WORKING GROUPS
Reports from the working groups contain summaries of the main presentations as well as some issues from the discussions!
4.1. WORKING GROUPS who met in Berlin
- Capacity Development in Food and Nutrition
- Micronutrients
- Nutrition and HIV/AIDS
- Breastfeeding and Complementary Feeding
Working group on Capacity Development in Food and
Nutrition
(Chairs: Dr. Cuberto Garza (UNU) and Dr.
Barbara Underwood (IUNS)
IFPRI, FCND Discussion Paper No. 106 (to be downloaded on the WEB)
Promoted the term capacity development rather than capacity building (which implies that little or no capacity is there)
Capacity for what?:
- to analyse and assess the nutrition situation and be able to develop solutions
Capacity why? (in which context)
- human rights, governance, decentralisation, scaling up for impact, capabilities and poverty, sustainability and participation, project performance
“Ingredients”:
- Resources
- system for problem solving, decision making and communicating
- authority/space to act
- Responsibility, leadership, motivation
Flavio
Valente (Brazil): “Civil society, Capacity building and empowerment”
- NGO’s perspective
objective: make capacity building more participatory
- often the capacity development mechanism desroys the capaciy of the local stakeholders, because they loose confidence in their already available capacity
Areas of interest:
- empowerment
- participation
- breastfeeding promotion
- International Trade Liberalisation
- Tenure and agricultural Reform
- appropriate agricultural technologies
Relevant existing experiences in capacity building:
- International Forum for Capacity building (IFCB)
- Population Coalition against hunger and Povery (IFAD)
- Feeding Minds – Fighting Hunger (WB/FAO/NGO’s)
- Human Rights based Food and Nutrition Security (Brasil)
- National Initiatives (thematic)
Focus on project related capacity building has created a gap between “haves” and “have-nots” amongst NGO’s and other partners
Process monitoring of capacity building is highly necessary (long term!! 10-20 years!)
- Training is too much technical oriented, lacking contextual issues
-
significant improvement/success in capacity
building requires:
- knowledge and political will
- capability of human resources
- financial and natural resources
Further
issues discussed:
program success in general highly dependant on
human resources
- lot of technical training, but still lack of programming skills
- nmeed for alliances of UN, NGO’s and bilaterals on regional/country level
- suggestion: UNU to combine all the available training material and provide links on the Web
- need to examine how to retain capacity within the national institutions (brain drain abroad and into international organisations, esp. UN)
- widening gap between academic progress in developing and industrialised countries
- issue of “brain drain”: support countries/regions to develop a long term Human Resource Dev. Plan to encourage local capacities to serve their regions/countries
- need to mainstream nutrition in the PRSP process
- often training is provided according to available resources, not according to actual needs
- capacity building often means to make people in developing countries learn what “Westerners” want them to learn
- Suggestion by SIDA: to spend 2% of the payments for external assistance to a fund for IUNS/UNU for advanced nutrition education/training. Criticism: why only for nutrition training and not other sectors?
Working Group on Micronutrients
Recommendations from 2001:
- food based approach is part of an integrated approach
- complementary approach is more effective
- other micronutrients need to be adressed
J. Mason, Tulane University: Trends in MN Deficiency (see Micronutrient Report)
Vit A: clinical deficiency nearly eliminated
Iron: little progress
Iodine: red. of goiter where iodisation of salt is implemented
25% of children suffer from 2 or more MN Def.
A.Tomkins (UNICEF/MI/CICH): Efficacy Trials on Multiple Micronutrients (MMN) supply
issues:
- common indicators/variables
- bio-markers
- ethical considerations
- analytical issues
- pooling data
Prof. J. Ling (WHO/UNICEF/ICCIDD): Update on IDD
- 2/3 of HH in Dev. Countries use iodised salt (lowest coverage: Eastern Europe and Commonwealth)
- some set-backs (e.g. India removed ban on non-iodised salt)
- global norm for use of iodised salt necessary
- effective public education is hampered , since brain damage is invisible, only goitre is visible
- salt iodisation must be permanent and needs permanent infrastructure and mechanisms
- still cultural, logistical and cultural challenges
Saskia de Pee (HKI): food based approaches
homestead food production (HFP) to increase:
- HH food production and consumption
- HH income
- women’s participation and empowerment
- quality of food
- reduce the risk of MN malnutrition
Publication of HKI: “Homestead food production”
issues mentioned/discussed on Iron:
- increased commitment to a lifecycle approach and an integrated approach
- need to develop approaches to identify groups not currently reached
- need to address the compliance issue of MN interventions
- to build much stronger alliances with NGO’s and public sector
- awareness on consequences of iron deficiency is still low => need to expand the data base, advocacy papers and materials
- solutions to the MN Deficiency problems are still not clear. Perception: complex problem with difficult solutions
-
private sector involvement needed, but risk of
conflicts of interests
=> more guidelines and attention needed
- iron requires a different strategy than other MN Deficiencies
- how to convince policy makers to invest more in programmes against MN Def.
Working Group on HIV/AIDS
Jos
Perriens (WHO) Care and support for people living with HIV/AIDS
Low cost, low complexity:
- psychological and social support
- treatment of pneumonia, TB etc.
- palliative care
- STI treatment
- family planning
- nutrition care and counselling
- cotrimoxazole prophylaxis
- VCT (voluntary counselling and Testing)
Intermediate and high complexity and cost:
- Anti-retroviral (ARV) Therapy
Objective:
- to increase access to comprehensive care and treatment
- to reach agreements between governments and private sector on low-price ARV treatment
Relationship between Nutrition and AIDS and AIDS and Nutrition
- infectivity
- host susceptibility
- natural history, pathogenesis
- resistance to infections
- efficacy of nutrition interventions
Open questions:
- nutrition and susceptibility to HIV/AIDS
- impact of nutritional status on HIV/AIDs natural history
- impact of MN/nutrition on OI’s and their treatment
- impact of nutrition on drug efficacy
- impact of ARV on metabolism, lactation, MN metabolism
- nutrition requirements of HIV infected children and mothers
- difference between children infected in utero and children infected during breastfeeding
children:What do we want to achieve?
- improved survival, hope for thefuture
- improved child development (cognitive, physical etc.)
- realistic management of opportunistic infections (OI’s)
Ways to improve
- care for sick children
- household food technologies (e.g. fortification for better resorption)
- Vitamin A and other MN supplementation
- ARV
mother:What to achieve?
- improve nutrition
- reduce frequency and severity of infections
- lower viral levels in blood and breastmilk
- prevent and treat pregnancy related complications
Ways to improve
- improve maternal nutrition
- decrease toxic exposure and stress
- reduce energy expenditure
orphans: What to achieve?
- improved survival, better child development, adopted strategies
- call for more community based efforts
Working Group on breastfeeding
see http://acc.unsystem.org/scn/
4.2. WORKING GROUPS who did not meet in Berlin, but presented their progress report
- Household Food Security
- Nutrition in Emergencies
- Nutrition, Ethics and Human Rights
- Nutrition of School-Age Children
Working Group on Household Food Security
- insufficient attention has been paid to the importance of HFS in most development efforts
- to share experiences on community-level best practices
- to identify indicators related to HFS
- to define common terminology, concepts and approaches
- approaches must look beyond food and be integrated and multi-sectoral
- focus on community-based nutrition programming
- need to involve NGOs and civil society experiences more actively
- to move from know-how to do-how
-
some specific areas that
need greater attention
- HFS and HIV/AIDS (FAO Paper “Role of Nutrition and Food Security in HIV/AIDS”
is recommended to be a background paper for the WFS+5)
- HFS in emergencies
- HFS in urban areas
Working Group on Nutrition in Emergencies
Recommendations included in the notes on the symposium on “Nutrition in Crisis and Conflict” (see above!)
Thematic groups:
- infant feeding in emergencies
- capacity building
- home-based treatment/community therapeutic feeding
- myths established over food and nutrition programmes
- recommended to improve the function and use of RNIS
- NutritionNET recommended as an interactive platform for nutritional professionals
WEB-Page angeben!!!!!!!!!!!
Working Group on Nutrition, Ethics and Human Rights
- draft document on “Monitoring the realisation of the rights to adequate food, health and care for nutritional well-being”
-
preparation of a manual on
the interpretation of the use of General Comment No. 12 on the right fo
adequate food, issued by the UN Committee on Economic, social and cultural
Rights
– Seminars to be held in South Africa, Brazil, Uganda, Norway, Nepal and Mali
– Synthesis Report will be made to discuss the development of guidelines on
the implementation of GC12
-
to extend the application
of human rights principles to conflict situations (an initiative to promote
the compatibility between human rights law and humanitarian action
Paper: “The right to nutrition in conflict situation”
22.-23 May 2002: International workshop on the right to adequate food in Berlin!!!
Working Group on school-age children
- to support inter-sectoral partnership
- to promote a common vision of school nutrition and health activities
- supports “Education for All” and Gender Equity
School, Nutrition and Health program (www.freshschools.org)
FRESH (Focussing Resources on Effective School Health)
- inter-sectoral initiative; Health related school policies; safe water and
sanitation
– skills based health and nutrition education, access to health and nutrition
services
Food for Education and Deworming
To improve enrolment end
retention, to enhance attention span, to reduce parasitic worm infections, to
enhance parents participation and awareness
HIV/AIDS and school-aged children
- HIV/AIDs is a threat to nutrition and health; nutrition has an adverse effect on HIV/AIDS; HIV/AIDS Prevention ressourdce book was developed; Trainings conducted to plan education sector responses
Knowledge management and info-sharing: see: www.schoolandhealth.org
5. Selection of papers displayed during the conference:
-
Nutrition - A Foundation for Development: Why practitioners in Development should integrate Nutrition
Advocacy papers presenting the contribution of nutrition to the goals of other
sectors and make suggestions for specific co-operative actions
(ACC/SCN, GTZ, Netherlands Ministry Foreign Affairs, IFPRI) http://acc.unsystem.org/scn/
-
SHPERE Project:
minimum standards for a rights based approach in emergency interventions
www.sphereproject.org
-
Infant and young child feeding in emergencies
(Interagency working group on Infant anf young
child feeding in Emergencies.
Operational guidance for Emergency Relief staff and programme managers www.ennonline.net
- IFPRI: Food for Education (www.ifpri.org)
-
The Micronutrient Report: Current Progress and Trends in the control of Vitamin A, Iodine
and Iron Deficiencies (Micronutrien Initiative)
The Micronutrient Initiative 1990-2000: A decade of progress, a lifetime
of hope www.micronutrient.org
-
FANTA (Food and
Nutrition Technical Assistance) Project Publications (www.fantaproject.org)
- HIV/AIDS: A guide for nutrition care support
- Anthropometric Indicators Measurement Guide
-
ADB Nutrition and Development Series (ADB, IFPRI)
No. 2: Manila Forum 2000: Strategies to fortify essential foods in Asia and the
Pacific
No. 3: Improving child nutrition in Asia
No. 4: Attacking the double burden of malnutrition in Asia and the Pacific
No. 6: The nutrition transition and prevention of diet related chronic diseases
in Asia and the Pacific
- Seeds for Health: A newsletter for practitioners in Agriculture and Human nutrition: h.bouis@cigar.org
- Field Exchange (Emergency Nutrition Network) (forelly@tcd.ie)
Training:
Training programme on food and nutrition security; Wageningen University, 1-11 weeks, 16. Sept – 29. Nov 2002; www.iac.wageningen-ur.nl e-mail: training@iac.agro.nl
-
Biblioteca Virtual de Salud para Desasters
(ICRC, UNICEF, UNHCR, Esfera)
www.who.int/eha/disasters
www.paho.org/disasters
-
Gender and Household Food Security (IFAD, JAICA)
genderadvisory@ifad.org