Global Nutrition: What Should Change?

On 14 December 2010, lowand middle-income country representatives convened by the United Nations System Standing Committee on Nutrition (UNSCN) met to share their experiences and insights on efforts, challenges, and opportunities to scale up nutrition effectively. Representatives from the governments of Brazil, China, India, Lao PDR, Mozambique, Nepal, Tanzania, and Uganda discussed processes and challenges for sustaining high-level political commitment, for institutional strengthening, for building country leadership and management capacity, and for creating multistakeholder platforms at the country level. They proposed how best the global players could support in-country efforts. These discussions are not new, but they were energized by the current momentum built by the Scaling Up Nutrition (SUN) Framework and Road Map and facilitated by David Pelletier and the findings of the Mainstreaming Nutrition Initiative, presented in this Supplement [1–6]. The government representatives agreed on several basic elements that need to be put in place urgently to enable countries to scale up their efforts in implementing specific nutrition interventions and making development policies nutrition-sensitive. Refreshingly, country representatives with their wealth of experience in hands-on nutrition programming brought up new important issues, adding to the usual call for the global players to speak in one voice and to provide additional financial resources. Very encouraging elements mentioned included the following: » There is an urgent need for new and innovative approaches for strategic capacity development, especially in the fields of leadership, management, monitoring, and accountability. Country representatives urged the international assistance community to move beyond training in their capacity-building programs and efforts and to support active learning and learning-by-doing processes. Equally important was found to be institutional capacity development and the capitalization of local cultural, social, and political resources. » There is a need to put in place mechanisms to interconnect countries in a global platform or forum with clear established objectives and outcomes, bringing together nutrition actors with government representatives at its core. Referred to by several participants as one effective mechanism for developing capacities through empowering country players, such a forum was considered essential to ensure a space where national nutrition managers could engage in supranational issues. » Informal arrangements were considered by all as not enough. The country representatives agreed that a legal and binding framework is required for nutrition, with a clearly defined institutional home for multisectoral coordination and programming at the country level. Many good examples were mentioned. Without a national structure at the appropriate level, the government representatives felt that the whole national nutrition system was less sustainable and implementation from the national to the community level would be weakened. They also identified some key structural gaps that need strengthening, such as the effective use of information for decision-making, and highlighted that such a forum could help in achieving that. » The country representatives called for the global community to practice what it preaches and also to set up groundbreaking and long-lasting global governance mechanisms for nutrition that are inclusive and bring together multiple stakeholders. One of the most important consensus points among Alexander Müller and Denise C. Coitinho