The international nutrition system: Fragmented, dysfunctional and desperately in need of reform

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Public release date: 16-Jan-2008

http://www.eurekalert.org/pub_releases/2008-01/l-tin011108.php

Contact: Dr. Bruce Cogill

bcogill@...

Lancet

The international nutrition system: Fragmented, dysfunctional and

desperately in need of reform

The international nutrition system – made up of international and donor

organisations, academia, civil society, and the private sector – is

fragmented and dysfunctional, and needs reform. These are the

conclusions of Professor Saul , London School of Hygiene and

Tropical Medicine, UK, and Dr Bruce Cogill, Unicef, New York, USA, and

colleagues, authors of the fifth and final paper in The Lancet's Series

on Maternal and Child Undernutrition.

The authors say: “Financial, intellectual, and personal linkages bind

these organisations loosely together as components of an international

nutrition system…we argue that such a system should deliver in four

functional areas: stewardship, mobilisation of financial resources,

direct provision of nutrition services at times of natural disaster or

conflict, and human and institutional resource strengthening.”

Their analysis of evidence to date finds that currently, there are

substantial shortcomings in each of the areas above. Fragmentation, lack

of evidence for prioritised action, institutional inertia, and failure

to join up with promising developments in parallel sectors are recurrent

themes. Many problems are systemic within organisations in the field.

The authors say: “The funding provided by international donors to combat

undernutrition is grossly insufficient and poorly targeted, and is

inappropriately dominated by food aid and supply-led technical

assistance. Much more investment is needed in human and institutional

capacity for nutrition in low-income and middle-income countries.”

They suggest five priority areas for action to create a much stronger

international nutrition system. First, a new global governance

structure, in which all stakeholders in undernutrition could come

together to press for ways forward for the most pressing issues. The

authors say this should take place within the next six months. Secondly,

they call for a more effective UN: namely that the UN standing committee

on nutrition becomes a forum that makes individual UN agencies

accountable for results. Thirdly, less duplication by parallel

organisations, eg, among individual donor projects coexisting with

various initiatives. Fourthly, more investment in capacity strengthening

in countries with high burdens of undernutrition, with the authors

stating strengthening of regional and sub-regional networks should be a

priority, due to its potential to reach a larger number of beneficiary

countries.

Finally, the authors call for research leadership in areas that matter;

on the editors of academic journals with an interest in maternal and

child undernutrition to meet in 2008 to develop a strategy to increase

the profile of the subject; on major donors to clarify how their funding

will reduce the imbalances highlighted in the series; and on research

and training groups in high-income countries to use their expertise to

progress scaling up of successful nutrition projects.

The authors conclude: “The moment is ripe for these reforms. Their

implementation would transform the political salience of undernutrition,

and offer the chance of a better, more productive life to the 67 million

children born each year in the countries most severely afflicted by

undernutrition.”

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Dr Bruce Cogill, UNICEF, New York, USA. T) +1 / +1 646 288

4648 E) bcogill@...

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