evidence-based blog of Filippo Dibari

Posts Tagged ‘WHO’

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.

UN: Levels and trends in child malnutrition – 2017

In Over-nutrition, Under-nutrition on March 11, 2018 at 11:03 am

Source: World Bank webpage

Capture

(download)

In May 2017, UNICEF, WHO and World Bank Group released the 2017 edition of the joint child malnutrition estimates for the 1990–2016 period, representing the most recent global and regional figures. A suite of on-line interactive dashboards were developed to enable users to explore the entire time-series (1990 – 2016) of global and regional estimates of prevalence and number affected for stunting, overweight, wasting and severe wasting. These estimates are presented by various regional and income group country classifications used by various agencies including the United Nations, UNICEF, WHO and The World Bank Group.

Note: Global estimates refer to the aggregate of the UN regions.

WHO: e-Library of Evidence for Nutrition Actions (eLENA), now on a mobile app

In Over-nutrition, Under-nutrition on June 16, 2017 at 8:26 pm

from WHO webpage

eLENA mobile phone application

Since 2011, the WHO e-Library of Evidence for Nutrition Actions (eLENA) has provided more than 1 million users with evidence-informed guidance and related information for nutrition interventions. Though the reach of eLENA continues to expand through a steady increase in the number of website users, there is a recognized need for access to eLENA content in settings without regular or reliable internet access.

In order to address this unmet need, the Nutrition Policy and Scientific Advice Unit of the WHO Department of Nutrition for Health and Development has developed an eLENA mobile phone application, eLENAmobile, which delivers much of the content of eLENA to smartphones and can be accessed anywhere – no internet connection required.

Download eLENAmobile for iPhones and Android smartphones now, at Google Play or the Apple App Store.

UNICEF/WHO/WB: Levels and Trends in Child Malnutrition

In Over-nutrition, Under-nutrition on June 7, 2017 at 7:02 pm

source: World Bank webpage

Capture

(download)

In May 2017, UNICEF, WHO and World Bank Group released the 2017 edition of the joint child malnutrition estimates for the 1990–2016 period, representing the most recent global and regional figures. A suite of on-line interactive dashboards were developed to enable users to explore the entire time-series (1990 – 2016) of global and regional estimates of prevalence and number affected for stunting, overweight, wasting and severe wasting. These estimates are presented by various regional and income group country classifications used by various agencies including the United Nations, UNICEF, WHO and The World Bank Group.

Note: Global estimates refer to the aggregate of the UN regions.

WHO: Updates on the management of severe acute malnutrition in infants and children Guideline

In Under-nutrition on April 27, 2015 at 7:02 am

(from WHO website)

Publication details

Editors: World Health Organization – 2013
Number of pages: 111
Languages: English, French

(Full document)

Overview

This guideline provides global, evidence-informed recommendations on a number of specific issues related to the management of severe acute malnutrition in infants and children, including in the context of HIV.

The guideline will help Member States and their partners in their efforts to make informed decisions on the appropriate nutrition actions for severely malnourished children. It will also support Member States in their efforts to achieve global targets on the maternal, infant and young child nutrition comprehensive implementation plan, especially global target 1, which entails achieving 40% reduction by 2025 of the global number of children under 5 years who are stunted and global target 6 that aims to reduce and maintain childhood wasting to less than 5%.

The guideline is intended for a wide audience, including policy-makers, their expert advisers, and technical and programme staff in organizations involved in the design, implementation and scaling-up of nutrition actions for public health. The guideline will form the basis for a revised manual on the management of severe malnutrition for physicians and other senior health workers, and a training course on the management of severe malnutrition.

Evidence

WHO Collaborating Centre: new Bachelor’s Degree in Global Nutrition and Health

In Over-nutrition, Under-nutrition on November 6, 2014 at 11:53 am

from the web page of the WHO Collaborating Centre at the Metropolitan University College

Being an official WHO Collaboration Centre makes the Bachelor’s Degree in Global Nutrition and Health part of a strong international network.

A WHO Collaboration Centre

The Bachelor’s Degree in Global Nutrition and Health under the Faculty of Health and Technology, Metropolitan University College, is designated as a WHO Collaboration Centre (WHO CC) for a four year period (2010-2013). The Metropolitan University College is hereby part of a global network comprising 80 other WHO Collaboration Centres, five of which are in Europe.

What is a WHO Collaboration Centre?

The Who Collaboration Centres (WHOOC’S) are a highly valued mechanism of cooperation in which relevant institutions are designated by WHO to support the implementation and achievement of the Organisation’s planned strategic objectives at the regional and global levels; enchanting the scientific validity of its global health work; as well as developing and strengthening institutional capacity in countries and regions.

“Prior to the establishment of the Centre, we regularly passed on our research results to WHO and EU projects dealing with nutrition and health in Europe, especially projects looking at the relationship between obesity and inequality, such as EURO-PREVOB and PolMark. In addition, staff at Global Nutrition and Health were involved in organizing the Move for Health days in 2008 and 2009”

Metropolitan research and development consultant Aileen Robertson, one of the key figures in the work with WHO

Definition:

A WHO Collaborating Centre is an institution designated by the Director-General to form part of an international collaborative network carrying out activities in support of the Organisation’s programmes at all levels.
WHO gains access to top centres worldwide and the institutional capacity to support its work and ensure the scientific validity of global health work.

A result of years of collaboration

Global Nutrition and Health’s cooperation with the World Health Organisation  began in 2006, and in recent years, the programme has worked with the WHO on a number of projects.

A seal of approval for the Bachelor Programme

Being a WHO Collaboration Centre brings many advantages for the bachelor programme:

  • It enhances our visibility, vital for our marketing programme
  • It is essential for the programme’s global objectives, that we receive many applications from potential student from different parts of the world
  • It opens the possibility for international collaboration with other WHO CCs
  • It opens the possibility of establishing international internship placements and agreements under WHO auspices increasing the possibilities for teachers and student to participate in research projects
  • It will help students to find internship places and work
  • It will increase job satisfaction

“I am convinced that Global Nutrition and Health’s designation as a WHO Collaboration Centre will have a positive impact on the future development and growth of the programme. It is a seal of approval that will be important for recruiting staff and students. “

Hanne Gillett, Head of the Bachelor Programme in Global Nutrition and Health

Future focus on inequality and nutrition

Future collaboration with the WHO will include research into nutrition, obesity and social inequality, courses and training in specific nutrition issues, and summer schools with nutrition training, e.g. for doctors and nurses. Study trips and internships will also be on the agenda.

UNICEF-WHO-The World Bank: Joint child malnutrition estimates – Levels and trends

In Over-nutrition, Under-nutrition on October 31, 2014 at 3:51 pm

from the WHO website

Since 2012 UNICEF, WHO and the World Bank have been reporting joint global and regional estimates of child malnutrition. The inter-agency team regularly revises the joint data sets and updates the global and regional trend estimates, from 1990 to the present. The estimates of prevalence and numbers for child stunting, underweight, overweight, wasting and severe wasting are derived by United Nations (UN), Millennium Development Goal (MDG), UNICEF, WHO regional and World Bank income group classifications.

In 2012 the inter-agency group derived estimates up to 2011, in 2013 up to 2012 and in 2014 up to 2013. The rationale being that country data are at maximum available from surveys conducted in the year previous to when the modelling exercise takes place.


A new UN body to combat global malnutrition?

In Over-nutrition, Under-nutrition on October 15, 2014 at 10:22 am

By Elena L. Pasquini 14 October 2014

from Devex web site

 

The United Nations is considering setting up a new body to address global malnutrition as early as next month, Devex has learned.

Tentatively called “U.N. Nutrition,” the new entity will be headed by UNICEF and the World Food Program, according to well-placed sources within civil society groups attending this week’s Committee on World Food Security, or CFS, in Rome. Over the weekend, the sources also participated in working groups ahead of the second International Conference on Nutrition — known as ICN2 — jointly led by FAO and the World Health Organization in November.

During the informal talks, the rumor circulated among attendees, Stefano Prato, managing director of the Society for International Development, told Devex in Rome.

“We had confirmation from U.N. insiders [and] also from delegates that there is a concrete plan,” he said.

Civil society groups believe the model for U.N. Nutrition could be Scaling Up Nutrition, a country-led global platform that seeks to unite governments, civil society, U.N. agencies, donors, businesses and researchers in a collective effort to improve nutrition through specific interventions — including support for breastfeeding and nutrition-sensitive approaches in areas such as agriculture or WASH.

“We are [also] quite sure that it will be based on PPPs, integrating governments and the private sector,” Prato added.

U.N. Nutrition could be launched a month from now in ICN2, and civil society organizations hope more details will emerge publicly this week so the plans are “disclosed with transparency” and CSOs are allowed to give feedback on whether “it’s the right answer to malnutrition, or if there are other [solutions].”

UN Nutrition vs. CFS

On Monday, the first session of the CFS was abuzz with gossip over the rumored new agency and how it will complement the current intergovernmental body and multistakeholder platform based in Rome.

For CSOs, the first question was which organization should take the lead in the fight against global malnutrition.

“Nutrition is not a problem of delivering, it is an issue of policies,” Prato said. “We believe the nutrition question has to be addressed through [shared] rules and regulations. That’s why we suggest a strong role for CFS.”

According to the SID official, the involvement of UNICEF and WFP says something about the direction the initiative is taking: “WFP and UNICEF are not organizations where there is a sovereign assembly, such as the FAO or WHO … programs [are] driven by donors and with also a quite restricted range of donors … It is not a context of democratic dialogue and those are not spaces for [defining] policy.”

Civil society, he insisted, wants malnutrition programs to be driven by policies rather than by donors or private sector interests.

“We don’t want this role bypassed by programs defined by donors without mechanisms of consultation and control,” Prato said. “What we fear is the establishment of mechanisms that are not legitimate and not accountable.”

In this scenario, a leading role for the private sector raise further concerns for CSOs, which believe strengthening local food systems based on the diversity of agricultural systems is the key to addressing malnutrition, instead of solutions based on delivery of products, fortification, dietary supplements or processed food.

“Clearly, big multinational corporations … are very much interested [in] that … approach,” Prato said. “What we fear is the participation of the private sector without clear rules of engagement and therefore [leading to] a conflict of interest.”

ICN2, a weak step forward?

The plans for a new U.N. body focused on nutrition is part a process that it is expected to reach its high watermark at the ICN2 in November, when FAO and WHO member states are expected to endorse Sunday’s consensus on a political declaration and framework for action to fight global malnutrition.

But according to Prato, the political declaration is “extremely weak,” as it doesn’t include tangible commitments or provide any timeframe for implementation. Moreover, the framework for action is nonbinding and there is “nothing new” in its concept.

“There is a dilution of the [centrality] of the right to food … the importance of local food systems is mentioned, but very poorly,” he said. “Above all, there are … no obligations … no control and accountability mechanisms … In short, it is fundamentally a big set of words.”

Prato would rather U.N. Nutrition stay within the framework of CFS. The SID official insisted CFS must comply with its mandate to properly address the problem of global malnutrition and argued its role should be strengthened ahead of ICN2.

Is a new U.N. body the solution to combat malnutrition? And how will it complement the current multistakeholder platform based in Rome? Please let us know your thoughts by sending an email to news@devex.com or leaving a comment below.

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WHO: Nutritional care and support for patients with tuberculosis

In Under-nutrition on December 1, 2013 at 10:19 am

by WHO, 2013 (download)

Overview

“This guideline provides guidance on the principles and evidence-informed recommendations on the nutritional care and support for patients with tuberculosis.

“Undernutrition increases the risk of tuberculosis and in turn tuberculosis can lead to malnutrition. Undernutrition is therefore highly prevalent among people with tuberculosis. It has been demonstrated that undernutrition is a risk factor for progression from tuberculosis infection to active tuberculosis disease and that undernutrition at the time of diagnosis of active tuberculosis is a predictor of increased risk of death and tuberculosis relapse. However, the evidence concerning the effect of nutritional supplementation on tuberculosis prevention and health outcomes among people with tuberculosis had not previously been systematically reviewed.

“Member States have requested guidance from the World Health Organization (WHO) on nutritional care and support for patients with tuberculosis.

“The primary audience for the guideline is health workers providing care to people with tuberculosis. However, the guideline is also intended for a wider audience including policy-makers, their expert advisers, and technical and programme staff at organizations involved in the design, implementation and scaling-up of nutrition actions for public health.”

 

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WHO: Promoting Healthy Growth and Preventing Childhood Stunting

In Under-nutrition on October 6, 2013 at 6:03 pm

from the WHO website:

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As part of the work on implementing the project “Promoting healthy growth and preventing childhood stunting”, the World Health Organization has worked with various experts to prepare nine papers for a supplement of the Maternal and Child Nutrition Journal. The papers will contribute to ongoing reflections on multiple aspects of the challenges presented by a World Health Assembly 2012 target for stunting reduction and ways to address them.

You can download the chapters (free) from the Maternal and Child Nutrition web site. September 2013. Volume 9, Issue Supplement S2. Pages 1–149

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