Breastfeeding and nutrition in the global policy context: The United Nations Decade for Action on Nutrition Laurence Grummer-Strawn Department of Nutrition for Health and Development, WHO World Breastfeeding Conference Johannesburg, South Africa December 12, 2016

The WHA global nutrition targets (2012)

Second International Conference on Nutrition (2014) FAO & WHO 2,200 participants Heads of State Ministers of Agriculture/Health/ Foreign Affairs Members of Parliament 170 countries In November 2014 over 2,200 participants from more than 170 governments, including Heads of State and Government and Royals, Ministers from Foreign Affairs, Agriculture and Health, Members of Parliament, representatives of the UN System and IGOs, civil society, the private sector, researchers and development experts met in Rome at the 2nd International Conference on Nutrition. The participants made 10 commitments and signed off a Framework for Action containing 60 recommendations for policy actions on sustainable food systems promoting healthy diets, international trade and investment, nutrition education and information, social protection, health systems delivery of direct nutrition interventions and health services to improve nutrition; water, sanitation and hygiene and food safety.

Outcomes of ICN2 Rome Declaration on Nutrition – 10 commitments Eradicate hunger and prevent all forms of malnutrition Increase investments Implement the commitments through the Framework for Action Integrate vision and commitments into the post-2015 agenda Framework for Action – 60 actions In November 2014 over 2,200 participants from more than 170 governments, including Heads of State and Government and Royals, Ministers from Foreign Affairs, Agriculture and Health, Members of Parliament, representatives of the UN System and IGOs, civil society, the private sector, researchers and development experts met in Rome at the 2nd International Conference on Nutrition. The participants made 10 commitments and signed off a Framework for Action containing 60 recommendations for policy actions on sustainable food systems promoting healthy diets, international trade and investment, nutrition education and information, social protection, health systems delivery of direct nutrition interventions and health services to improve nutrition; water, sanitation and hygiene and food safety.

ICN2 Framework for Action R 16: Facilities for breastfeeding R 21: Social marketing campaigns R 29: International Code of Marketing of Breast-milk Substitutes R 30: Protection of working mothers R 31: Health services including the Baby-Friendly Hospital Initiative R 32: Men participate in child care, while empowering women R 33: Emergency situations R 37: Exclusive and continued breastfeeding as part of stunting reduction

Sustainable Development Goals (2015) 17 Goals and 169 targets

Nutrition and Health All the nutrients an infant needs in the first six months of life.  Reduced risk of overweight or obesity Could save 820,000 children’s lives Lower rates of infectious disease and death 20,000 breast cancer deaths could be prevented Reduced risk of diabetes and ovarian cancer

Poverty and Education Reduced costs of infant formula Reduced health care expenditures Increased lifetime earnings Could add US$302 billion annually in GDP Improved intelligence (3 IQ points) Contributes to optimal early child development Improved reading and writing scores at age 6.5 years

Environmental sustainability Resource intense processing of formula Packaging, storage, transportation Heating and preparation in home

Decade of Action on Nutrition (2016)

Goals of the Decade of Action Increase activities conducted at the national, regional and global levels to implement the recommended actions in: Global WHA MIYCN targets ICN2 Framework for Action NCD risk factor reductions SDG targets

Leadership of the Decade of Action Lead by: In collaboration with: Using collaborating mechanisms:

Commitments to the Decade of Action WHA resolution in support of Decade urges Member States to make commitments Non-state actors also expected to make commitments WHO to maintain an open-access commitment database SMART commitments Specific Measurable Achievable Relevant Time-bound

Making SMART commitments Example: FFA R29: Adapt and implement the International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly resolutions Example 1 – By 2018, legislation will be established that implements the provisions of the International Code of Marketing of Breastmilk Substitutes Example 2 – By 2017, a functional unit will have been established in the Ministry of Health to effectively and actively monitor, implement and enforce sanctions in case of violations, with a first report produced by the end of 2018.

Decade content : 6 pillars sustainable food systems for healthy diets; aligned health systems providing universal coverage of essential nutrition actions; social protection and nutrition education; trade and investment for improved nutrition; enabling food and breastfeeding environments; review, strengthen and promote nutrition governance and accountability

Work Programme Vision for each pillar: Leading partner organization Collaborating actors UN Organizations NGOs Alliances Private sector Governments Convening and collaborating platforms Specific accountability mechanisms Fora and commitment conferences

“It is unprecedented that nutrition is so high in the political agenda of Member States and the Decade of Action on Nutrition is a unique opportunity to drastically change our food environment, to eradicate hunger and prevent malnutrition worldwide.” Dr. Margaret Chan, WHO Director-General 19 July 2016