evidence-based blog of Filippo Dibari

2018 Global food policy report

In Over-nutrition, Under-nutrition on July 13, 2018 at 9:50 pm

from IFPRI web-page

Free Book on global – Pages: 150
IFPRI’s flagship report reviews the major food policy issues, developments, and decisions of 2017, and highlights challenges and opportunities for 2018 at the global and regional levels. This year’s report looks at the impacts of greater global integration—including the movement of goods, investment, people, and knowledge—and the threat of current antiglobalization pressures. Drawing on recent research, IFPRI researchers and other distinguished food policy experts consider a range of timely topics:

 

■ How can the global food system deliver food security for all in the face of the radical changes taking place today?

■ What is the role of trade in improving food security, nutrition, and sustainability?

■ How can international investment best contribute to local food security and better food systems in developing countries?

■ Do voluntary and involuntary migration increase or decrease food security in source countries and host countries?

■ What opportunities does greater data availability open up for improving agriculture and food security?

■ How does reform of developed-country farm support policies affect global food security?

■ How can global governance structures better address problems of food security and nutrition?

■ What major trends and events affected food security and nutrition across the globe in 2017?

The 2018 Global Food Policy Report also presents data tables and visualizations for several key food policy indicators, including country-level data on hunger, agricultural spending and research investment, and projections for future agricultural production and consumption.  In addition to illustrative figures, tables, and a timeline of food policy events in 2017, the report includes the results of a global opinion poll on globalization and the current state of food policy.

Opposition to Breast-Feeding Resolution by U.S. Stuns World Health Officials

In Over-nutrition, Under-nutrition on July 11, 2018 at 7:58 am

source: NY times web page

A resolution to encourage breast-feeding was expected to be approved quickly and easily by the hundreds of government delegates who gathered this spring in Geneva for the United Nations-affiliated World Health Assembly.Based on decades of research, the resolution says that mother’s milk is healthiest for children and countries should strive to limit the inaccurate or misleading marketing of breast milk substitutes.Then the United States delegation, embracing the interests of infant formula manufacturers, upended the deliberations.
American officials sought to water down the resolution by removing language that called on governments to “protect, promote and support breast-feeding” and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children.

When that failed, they turned to threats, according to diplomats and government officials who took part in the discussions. Ecuador, which had planned to introduce the measure, was the first to find itself in the cross hairs.The Americans were blunt: If Ecuador refused to drop the resolution, Washington would unleash punishing trade measures and withdraw crucial military aid. The Ecuadorean government quickly acquiesced.

The showdown over the issue was recounted by more than a dozen participants from several countries, many of whom requested anonymity because they feared retaliation from the United States.

Health advocates scrambled to find another sponsor for the resolution, but at least a dozen countries, most of them poor nations in Africa and Latin America, backed off, citing fears of retaliation, according to officials from Uruguay, Mexico and the United States.

“We were astonished, appalled and also saddened,” said Patti Rundall, the policy director of the British advocacy group Baby Milk Action, who has attended meetings of the assembly, the decision-making body of the World Health Organization, since the late 1980s.

“What happened was tantamount to blackmail, with the U.S. holding the world hostage and trying to overturn nearly 40 years of consensus on the best way to protect infant and young child health,” she said.In the end, the Americans’ efforts were mostly unsuccessful. It was the Russians who ultimately stepped in to introduce the measure — and the Americans did not threaten them.

During the deliberations, some American delegates even suggested the United States might cut its contribution to the W.H.O., several negotiators said. Washington is the single largest contributor to the health organization, providing $845 million, or roughly 15 percent of its budget, last year.

The confrontation was the latest example of the Trump administration siding with corporate interests on numerous public health and environmental issues.

In talks to renegotiate the North American Free Trade Agreement, the Americans have been pushing for language that would limit the ability of Canada, Mexico and the United States to put warning labels on junk food and sugary beverages, according to a draft of the proposal reviewed by The New York Times.

During the same Geneva meeting where the breast-feeding resolution was debated, the United States succeeded in removing statements supporting soda taxes from a document that advises countries grappling with soaring rates of obesity.

The Americans also sought, unsuccessfully, to thwart a W.H.O. effort aimed at helping poor countries obtain access to lifesaving medicines. Washington, supporting the pharmaceutical industry, has long resisted calls to modify patent laws as a way of increasing drug availability in the developing world, but health advocates say the Trump administration has ratcheted up its opposition to such efforts.

The delegation’s actions in Geneva are in keeping with the tactics of an administration that has been upending alliances and long-established practices across a range of multilateral organizations, from the Paris climate accord to the Iran nuclear deal to Nafta.

Ilona Kickbusch, director of the Global Health Centre at the Graduate Institute of International and Development Studies in Geneva, said there was a growing fear that the Trump administration could cause lasting damage to international health institutions like the W.H.O. that have been vital in containing epidemics like Ebola and the rising death toll from diabetes and cardiovascular disease in the developing world.

“It’s making everyone very nervous, because if you can’t agree on health multilateralism, what kind of multilateralism can you agree on?” Ms. Kickbusch asked.
Image

The opening of the World Health Assembly in May. After American officials pressured Ecuador, it was Russia that introduced a resolution in support of breast-feeding.CreditPeter Klaunzer/EPA, via Shutterstock
A Russian delegate said the decision to introduce the breast-feeding resolution was a matter of principle.“We’re not trying to be a hero here, but we feel that it is wrong when a big country tries to push around some very small countries, especially on an issue that is really important for the rest of the world,” said the delegate, who asked not to be identified because he was not authorized to speak to the media.He said the United States did not directly pressure Moscow to back away from the measure. Nevertheless, the American delegation sought to wear down the other participants through procedural maneuvers in a series of meetings that stretched on for two days, an unexpectedly long period.In the end, the United States was largely unsuccessful. The final resolution preserved most of the original wording, though American negotiators did get language removed that called on the W.H.O. to provide technical support to member states seeking to halt “inappropriate promotion of foods for infants and young children.”

The United States also insisted that the words “evidence-based” accompany references to long-established initiatives that promote breast-feeding, which critics described as a ploy that could be used to undermine programs that provide parents with feeding advice and support.

Elisabeth Sterken, director of the Infant Feeding Action Coalition in Canada, said four decades of research have established the importance of breast milk, which provides essential nutrients as well as hormones and antibodies that protect newborns against infectious disease.

A 2016 study in The Lancet found that universal breast-feeding would prevent 800,000 child deaths a year across the globe and yield $300 billion in  savings from reduced health care costs and improved economic outcomes for those reared on breast milk.

Scientists are loath to carry out double-blind studies that would provide one group with breast milk and another with breast milk substitutes. “This kind of ‘evidence-based’ research would be ethically and morally unacceptable,” Ms. Sterken said.

Abbott Laboratories, the Chicago-based company that is one of the biggest players in the $70 billion baby food market, declined to comment.

Nestlé, the Switzerland-based food giant with significant operations in the United States, sought to distance itself from the threats against Ecuador and said the company would continue to support the international code on the marketing of breast milk substitutes, which calls on governments to regulate the inappropriate promotion of such products and to encourage breast-feeding.

In addition to the trade threats, Todd C. Chapman, the United States ambassador to Ecuador, suggested in meetings with officials in Quito, the Ecuadorean capital, that the Trump administration might also retaliate by withdrawing the military assistance it has been providing in northern Ecuador, a region wracked by violence spilling across the border from Colombia, according to an Ecuadorean government official who took part in the meeting.

The United States Embassy in Quito declined to make Mr. Chapman available for an interview.

“We were shocked because we didn’t understand how such a small matter like breast-feeding could provoke such a dramatic response,” said the Ecuadorean official, who asked not to be identified because she was afraid of losing her job.

Designing programs to improve diets for maternal and child health: estimating costs and potential dietary impacts of nutrition-sensitive programs in Ethiopia, Nigeria, and India

In Under-nutrition on July 10, 2018 at 6:21 am

from: Health Policy and Planning, Volume 33, Issue 4, 1 May 2018, Pages 564–573

William A Masters Katherine L Rosettie Sarah Kranz Goodarz Danaei Patrick Webb Dariush Mozaffarianthe Global Nutrition and Policy Consortium.

(download here)

Abstract

Improving maternal and child nutrition in resource-poor settings requires effective use of limited resources, but priority-setting is constrained by limited information about program costs and impacts, especially for interventions designed to improve diet quality.

This study utilized a mixed methods approach to identify, describe and estimate the potential costs and impacts on child dietary intake of 12 nutrition-sensitive programs in Ethiopia, Nigeria and India.

These potential interventions included conditional livestock and cash transfers, media and education, complementary food processing and sales, household production and food pricing programs. Components and costs of each program were identified through a novel participatory process of expert regional consultation followed by validation and calibration from literature searches and comparison with actual budgets. Impacts on child diets were determined by estimating of the magnitude of economic mechanisms for dietary change, comprehensive reviews of evaluations and effectiveness for similar programs, and demographic data on each country.

Across the 12 programs, total cost per child reached (net present value, purchasing power parity adjusted) ranged very widely: from 0.58 to 2650 USD/year among five programs in Ethiopia; 2.62 to 1919 USD/year among four programs in Nigeria; and 27 to 586 USD/year among three programs in India.

When impacts were assessed, the largest dietary improvements were for iron and zinc intakes from a complementary food production program in Ethiopia (increases of 17.7 mg iron/child/day and 7.4 mg zinc/child/day), vitamin A intake from a household animal and horticulture production program in Nigeria (335 RAE/child/day), and animal protein intake from a complementary food processing program in Nigeria (20.0 g/child/day).

These results add substantial value to the limited literature on the costs and dietary impacts of nutrition-sensitive interventions targeting children in resource-limited settings, informing policy discussions and serving as critical inputs to future cost-effectiveness analyses focusing on disease outcomes.

Key message

Existing evidence on cost-effectiveness for nutrition improvement focuses on interventions to address specific diseases. We provide a novel participatory approach to assembling cost and impact data for 12 nutrition-sensitive interventions to improve diet quality in three countries: Ethiopia, Nigeria and India. Programs designed by stakeholders often use resource transfers to influence diets despite their high cost; programs altering food access have lower cost. Future work using these data will analyse net cost-effectiveness.

%d bloggers like this: