Unhealthy diets and poor nutrition are among the greatest global health and development challenges we face today. Together they affect at least one in three people and no nation is untouched. The United Nations Decade of Action on Nutrition 2016-2025 (the Nutrition Decade) provides a catalyst for aligning actions to improve nutrition everywhere, within a shared framework and timeline. Nutrition is also firmly positioned in the Sustainable Development Goals (Target 2.2 is ending all forms of malnutrition by 2030) and is recognised as a bedrock for achieving all SDGs.

Although some countries are making steady progress on nutrition (especially child stunting and wasting) the majority are making little to none because of shortfalls in governance, policy and programming responses. There is therefore a need for greater commitment to nutrition action from all stakeholders involved including political leaders, government administrators, civil society groups, businesses, international organizations, researchers and on-the-ground implementation teams.

A new policy brief and review to inform ‘commitment-building’ action

Key factors that generate and sustain commitment for nutrition are detailed in a new policy brief Driving Commitment for Nutrition within the UN Decade of Action on Nutrition by the World Health Organization and the Food and Agricultural Organization. The brief guides action to increase commitment by all stakeholders. It is informed by a comprehensive literature review of the factors that enable, sustain and constrain commitment across all country-contexts and forms of malnutrition.

What can stakeholders to drive commitment for nutrition?

Although what works to drive commitment will be context-dependent, ten key actions are apparent;

• Building cohesive and highly-capable nutrition actor networks with strategic and operational capacities for managing the politics of nutrition advocacy and policy-making. Forming and strengthening such networks may be accelerated through, for example, fostering strong leadership and creating opportunities for consensus and capacity-building.
• Attaining and sustaining non-partisan high-level support from political leaders is important for sustaining long-term commitment. This may be more likely when there is strong social accountability (e.g. a mobilized civil society) and when parliamentarians are directly involved in overseeing nutrition policy responses, government agencies and expenditures.
• Nutrition actor networks adopting a unified narrative about malnutrition (including its causes, solutions and ideal governance arrangements) and speaking with a common voice. Such networks may also generate commitment when they can sensitise broader policy discourses (e.g. social or economic policy reforms) to nutrition objectives.
• Mobilizing civil society coalitions can raise public awareness, generate demand for action, inform policy development and implementation, and act as a powerful mechanism for holding governments and other stakeholders to accountable. This may be more likely when civil society groups are meaningfully involved in governance and policy decision-making.
• Establishing and designing effective institutional systems for coordinating action. Coordinating agencies located within central government with sufficient authority, capacities, financial resources and leadership, with strong cooperation incentives e.g. enabling legislation, policies and operational plans, and dedicated financing mechanisms are more effective.
• Responding to emerging opportunities and counteracting threats. Long-term changes in societal conditions as well as shorter-term events can present opportunities or challenges for commitment building. For example, drought and food insecurity may focus attention directly onto nutrition or related issues; sustained economic growth may provide greater resources for action; the election of a new government may present a window of opportunity for nutrition advocates.
• Establishing robust data collection and reporting systems can inform the development of a unified discourse, inform policy design decisions and ongoing policy calibration in response to changing conditions and implementation challenges, and provide a foundation for effective accountability systems.
• Mobilizing financial resources and effective financing. Establishing nutrition line items within government budgets, expanding budgetary commitments and adopting results- or performance-based financing mechanisms may enhance accountability, create entitlements among politicians, administrators and citizens, as well as incentivise cooperation.

Commitment is not something that simply exists or emerges; it has to be created and strengthened over time through sustained actions by cohesive, responsive and strongly-led nutrition actor networks. Accelerating the development of such networks should be a core task for all actors involved, including international development partners.

About the author

Dr Phillip Baker is a Post Doctoral Research Fellow at the Institute for Physical Activity and Nutrition, Deakin University, Melbourne. His research focuses on the political drivers of food and nutrition policy, food systems change and the nutrition transition, and policies for improved population nutrition  in Australia and internationally.

Professor Corinna Hawkes is Director, Centre for Food Policy at City, University of London. Her work aims to inform and influence the development and delivery of effective public policies to encourage healthy eating worldwide.

Dr Alessandro Demaio is CEO of the EAT Foundation, founder of the Sandro Demaio Foundation and an Honorary Fellow with the Melbourne School of Population & Global Health at the University of Melbourne. From 2015 to 2018, he was Medical Officer with the World Health Organization.

Competing interests

We have read and understood the BMJ Group Conflicts of Interests Policy and declare we do not have any conflicts of interests.