Poor diet and resulting malnutrition, in all its forms, are among the greatest global health and societal challenges of our time.[1] Before the Covid-19 pandemic, we lost almost 250 million years of life prematurely, every year, worldwide due to child and maternal malnutrition, and almost 170 million years due to dietary risks associated with non-communicable diseases (NCDs).[2] That is, one in every seven premature deaths was attributable to poor diet, with the majority of that diet-related burden experienced in low- and middle-income countries.[3]
As a result of the Covid-19 pandemic, malnutrition and related premature deaths are projected to increase.[4] The impacts of the pandemic have exacerbated food insecurity, poor diets and malnutrition globally, threatening a lasting impact on children and adults.[5] Given the additional impacts of worsening climate change,[6] the need for more equitable, resilient and sustainable food and health systems has never been more urgent.[7]
Recognising the need to tackle poor diets and malnutrition, national governments and multilateral organisations have endorsed 2021 as the Nutrition Year of Action. In June 2021, the leaders of the G7 noted that responsible investments in food security, food systems and nutrition are essential to support Sustainable Development Goal 2 (zero hunger) and the World Health Assembly global nutrition targets. The G7 leaders have further encouraged strong commitments in these areas to be announced at the G20, the UN Food Systems Summit, UN Climate Change Conference (COP26) and the Tokyo Nutrition for Growth (N4G) Summit in 2021.[8]
The key nutrition events throughout 2021, and a climate of urgency, present unprecedented opportunities for actors to make commitments and drive action towards improving nutrition. This should be a turning point in driving collaboration to win the fight against poor diets and malnutrition. All stakeholders must collaborate and coordinate efforts for nutrition commitments that are bold and SMART (that is: Specific, Measurable, Achievable, Relevant and Time-bound).
To support the shared goal of ending poor diets and malnutrition in all its forms, we need a comprehensive framework for accountability, as called for by the joint statement of the Tokyo N4G Summit and the UN Food Systems Summit. This framework should monitor all nutrition actions according to common principles, methods and approach. It should also encourage and recognise stronger commitments by monitoring how these translate into scalable and impactful actions.
Commitments must be consistently and publicly shared, tracked and consolidated into usable insights that can inform and drive better action through decision-making across sectors. As part of this shared goal, the Global Nutrition Report (GNR) has been endorsed by the government of Japan and the N4G Accountability Working Group, as well as the GNR’s Stakeholder Group, to lead and drive forward global accountability for nutrition.
The GNR is committed to developing the world’s first independent and comprehensive global accountability framework for nutrition: the Nutrition Accountability Framework (NAF). The aim is to drive stronger nutrition action and accelerate progress in tackling poor diets and malnutrition in all its forms across all locations and sectors. Stakeholders are encouraged to use the NAF Platform to register and report on their nutrition commitments.
Since 2014, the GNR has been collecting and analysing the most comprehensive data on nutrition, and tracking commitments, as part of the 2013 and 2017 N4G summits. Those making commitments to help drive faster and fairer progress to tackle poor diets and malnutrition include governments, aid donors, civil society organisations, multilateral organisations and businesses. The GNR is building on its existing tools and expertise, further drawing on elements from other accountability frameworks,[9]to create an independent and comprehensive global accountability framework that will better serve decision-makers and the nutrition community.
The NAF is designed to record all new commitments on nutrition, monitor their impact and set out requirements for SMART commitment formulation. The framework is redefining how nutrition-related commitments should be formulated, registered, qualified, assessed and reported.[10] It is developing a new architecture to allow nutrition stakeholders and decision-makers across sectors to take meaningful action, track their impact and receive recognition for doing so.
The GNR will work together with all those committed to improving nutrition to leverage pre-existing reporting mechanisms, collate the best available data and unify reporting on progress and how that translates into impact. This will facilitate reporting on actions taken, identify gaps in action, measure impact, determine the most impactful actions and allocate resources where they are most needed. Past N4G commitments made at the 2013 and 2017 summits will continue to be recorded and tracked through the GNR N4G Commitment Tracker. New commitments made in 2021 and later will be recorded, tracked and publicly shared through the GNR’s NAF Platform to monitor all nutrition commitments, including N4G commitments.
This webpage aims to provide an overview of the NAF and introduce key components. Together with other webpages (The Nutrition Action Classification System, The SMARTness of nutrition commitments, Developing the NAF Platform's Commitment Registration Form, A guide to the NAF Platform's Commitment Registration Form, plus FAQs and a glossary of terms), this content is ‘live’. We will regularly update the NAF Platform and online resources on the Global Nutrition Report website as the framework develops and based on feedback from stakeholders. Specifically, we plan to update supporting content towards the end of 2021 to explain the processing of registered nutrition commitments. We plan further updates in 2022 and beyond, after developing the methods for tracking and progress assessment.
Vision
The ultimate vision of the GNR, and of the NAF, is a world free from malnutrition in all its forms. The framework’s mission is to drive greater action to achieve this. The goal is to inform, shape and inspire action with data and evidence on policy, practice and financing that result in greater accountability and progress in tackling poor diets and malnutrition globally.
Through the NAF, the GNR has developed a common system, language and principles to unify tracking of nutrition action. This will support all stakeholders and decision-makers across sectors in their effort to take meaningful action to tackle poor diets and end malnutrition.
Objectives
Within the GNR’s role as an independent, credible and respected ‘go-to’ global resource, and the primary accountability mechanism for nutrition commitments, the NAF has the following objectives.
- Record and monitor nutrition commitments made by all stakeholders including governments, donors (such as donor governments and philanthropic organisations), civil society organisations, the private sector, and multilateral organisations including UN agencies (Who can make commitments).
- Establish common principles for monitoring global nutrition accountability and provide evidence-based criteria, processes, technical support and guidance for how nutrition commitments should be formulated, registered and reported.
- Become the primary public resource for tracking progress against nutrition commitments by presenting standardised accountability indicators and highlighting gaps in and opportunities for nutrition policy and financing.
- Inspire and empower all stakeholders to take strong nutrition action across all sectors, by providing them with high-quality, comprehensive and credible data, information and recommendations, and recognising their efforts.
- Ensure sustainability of global nutrition accountability monitoring through leveraging existing resources and infrastructures, continuous funding and annual reporting by stakeholders.
- Continuously monitor and evaluate the NAF in order to drive processes and enable faster, efficient, effective and real-world adaptations.
To achieve its objectives, the GNR will develop the NAF. The graphic shared here summarises this global accountability framework for nutrition action, from formulating and registering a nutrition commitment to reporting on progress and taking more action. Embedded within the framework are the elements presented within this section, including methods and approaches, which have been developed to support its operationalisation.
The Nutrition Accountability Framework: A global accountability framework for nutrition action
Define and classify nutrition actions
As part of the NAF, we have developed an evidence-based and comprehensive system to define and classify nutrition actions. The aim of the classification system is to help all stakeholders understand the type of ‘nutrition actions’ they can take, and to identify areas that might require attention or prioritisation. The classification system further provides a foundation for efficient tracking and standardised reporting of nutrition commitments.
Establish methods for the qualification of nutrition commitments
To ensure that all nutrition commitments registered through the NAF are well-defined and eligible, we have developed methods and criteria for commitment qualification. The nutrition commitment qualification system takes place at the commitment-making stage. To qualify, a commitment must be SMART and stakeholders must report progress annually to the GNR. Of note, if a particular commitment is to be announced at a summit (e.g. the N4G Summit or the UN Food Systems Summit), additional requirements may apply. For example, N4G commitments require alignment with the principles of engagement.[11]
Establish a technical advisory working group
We will form a technical advisory working group to provide input to the Independent Expert Group (IEG). The working group will include representatives of nutrition accountability and monitoring mechanisms operating primarily at the global scale. The process for identifying and selecting this group will be publicly communicated and include relevant terms of reference. The working group will be formed specifically for the NAF, with its remit being purely technical. The group will advise on methods and approaches to support the development of the global accountability framework for nutrition action.
The technical advisory working group will support and advise the GNR in developing and implementing the NAF. This group will provide technical guidance on NAF efforts, including processing of nutrition commitments, validating self-reported information, establishing accountability indicators, reporting on and assessing progress, and identifying areas of potential synergies. Over time, the working group will aim to consolidate and harmonise existing accountability mechanisms, as far as possible, to maximise information and knowledge sharing and minimise duplication of effort and reporting fatigue.
Formulate and register nutrition commitments
To help stakeholders to formulate and register their commitments with the NAF, we have developed a standardised, publicly accessible and interactive platform. For all key pledging moments, this includes embedded guidance and detailed examples of how to formulate SMART commitments. The registration form will be available only in English in 2021; there are plans to translate the registration form into other languages as the NAF evolves and secures further resources.
Process and verify eligibility of nutrition commitments
Once nutrition commitments are registered to the NAF platform, the GNR will review these for completeness, clarity of responses and inconsistencies. If necessary, commitment-makers will be contacted for clarifications. For all nutrition commitments, the qualifying criteria are whether the commitments are SMART. For nutrition commitments made in the context of the N4G Summit in 2021, an additional specific qualifying criterion is the requirement for manufacturers of breast-milk substitutes to commit to an action plan to achieve full compliance with the International Code of Marketing of Breast-milk Substitutes by 2030, in both policy and practice. The government of Japan will facilitate this assessment, in collaboration with the Access to Nutrition Initiative.[12]
To process N4G commitments, we will follow a staged approach. The first stage, pre-summit, will consist of limited verification checks (e.g., commitment type, thematic area) to generate a draft list of the commitments to be announced at the Tokyo summit. The second stage, post-summit, will be a full review of the registered commitments to verify SMARTness, with clarification sought from commitment-makers as needed. This will determine final eligibility within the first quarter of 2022. For all other commitments (those made outside the N4G Summit), we will complete full verification within the same timeframe. In 2022, we will launch a synthesis and analysis report on the nutrition commitments made in 2021, the Nutrition Year of Action.
Recognise commitment for action
After review and verification, we will publish commitments on the NAF Platform. In 2021, this platform will include basic visualisations and descriptive data on the registered commitments. The goal for 2022 and beyond is that the platform will serve as a publicly accessible and interactive database of nutrition commitments that can be used to generate standardised and validated indicators of accountability. Registered commitments will also be searchable against a wide range of criteria such as action area, location and stakeholder group. We will highlight notable commitments or country cases, based on transparent selection criteria, to serve as examples or inspiration on the website, or as case studies in press releases and future GNR publications.
Report on progress
Starting in 2022, the GNR will track the annual progress of all registered commitments, based on self-reported data. We will expand the NAF to include a progress assessment survey, which commitment-makers can complete digitally and submit for their registered commitments. Progress assessment will be primarily based on tracking the progress of the commitment indicator(s) as these were laid out in the commitment registration. The GNR has plans to develop a process for validating the self-reported information, as well as to identify well-established and validated accountability indicators against which progress will be assessed. These plans will be developed with the input of the technical advisory working group.
Assess and recognise progress
The GNR will develop consistent and standardised criteria for assessing progress, building on existing methods and approaches, and further informed by the technical advisory working group. We will assess the reported progress and make publicly available the progress status of each commitment (e.g., ‘no progress made’ or ‘on track’). Achievements and best practices will be shared on the NAF Platform. The GNR will include details of progress made towards all commitments on an annual basis.
Tracking and assessing progress will prompt ongoing dialogue and debate about the pace and scale of change. It will also provide a basis for regularly updating the NAF classification and qualification systems. Measuring progress and highlighting notable achievements will serve as a continuous learning process that enables stakeholders to identify and revisit, refine and steer towards priority nutrition actions to address changing needs at the national, regional and global levels. This will ultimately lead to more commitments and more action.
Independence
The IEG of the GNR oversees and is responsible for the design and implementation of the NAF, and the monitoring, tracking and reporting on nutrition commitments. Independence ensures that the NAF can act in line with its objective – to provide standardised, unbiased and unified reporting on nutrition commitments and progress made towards meeting them.
Collaboration
The GNR will work with all stakeholders to ensure that the tools developed and outcomes arising from the NAF will best serve the needs of the global nutrition community and inspire actions to tackle poor diets and end malnutrition in all its forms. In particular, the technical advisory working group is intended to serve as a new hub that will identify how best to bring together existing global nutrition accountability tracking mechanisms in order to reduce duplication of efforts and reporting fatigue.
Excellence
The principle of excellence applies to the performance and outcome of all NAF processes, resources and publications. In particular, it applies to the intrinsic scientific quality and rigour of all content produced, including in terms of its adequacy, clarity, completeness and transparency. It also applies to the effective communication of content and conclusions drawn and to the actual and perceived credibility of the NAF. All NAF outputs should be based on the best data, evidence and methodology available at the time of their preparation.
Accessibility
The NAF is designed to be publicly accessible and will be provided through a user-friendly platform. All resources related to the NAF will be available on the GNR website. They will be initially in English, in 2021, with plans for translations in other languages thereafter.
Integrity
All actors and processes under the NAF abide by the principle of integrity, which refers to acting with honesty, respect, fairness, objectivity, and in an ethical and responsible manner, and to do no harm.
Transparency
As a framework for monitoring and reporting global action on nutrition, the NAF provides transparency – in a clear and understandable manner – to all developed processes. It also contributes to the sharing of data and best practices. High levels of transparency allow stakeholders and the public to understand how the NAF is built and the extent to which stakeholders are addressing nutrition issues, and to engage with them about their approach and impact. Transparency should also extend to openness, dialogue and engagement with other relevant bodies and third parties.
Inclusivity
The NAF tracks and reports nutrition actions from all groups and institutions interested in contributing to addressing poor diets and malnutrition in all its forms. It aims to be as relevant as possible to the broadest range of stakeholder groups, with different priorities and levels of authority.
Recognition
The NAF aims to inform and inspire nutrition action among different stakeholder groups and across geographies. It plans to encourage stakeholders to do better every year, thereby demonstrating their increasing contribution to addressing global nutrition challenges. The intention is to highlight ‘success stories’ reflecting best practice, and to provide an equal opportunity for all stakeholders to be recognised for their actions.
Commitment
To maintain alignment with evolving knowledge and actions, the GNR will monitor NAF methods and processes. These will be revised and expanded at regular intervals, as needed, while retaining comparability over time. Members and experts involved in the NAF must commit themselves to contributing actively to the work of the framework and are expected to conduct themselves in an exemplary fashion in all activities relating to the NAF.
The NAF is part of the GNR and is therefore governed by the same structures. The GNR is a multi-stakeholder initiative, consisting of a Stakeholder Group, an IEG and host (the current host is PATH).
The Stakeholder Group, headed by two co-chairs, consists of high-level members of stakeholder groups. This group provides strategic oversight and direction to the GNR, setting its strategic vision, and is further responsible for the appointment of the chair of the Independent Expert Group and the host organisation. The Stakeholder Group reviews progress against delivery of the GNR and provides advice as required, but without interfering with the report’s independence. The group also champions and builds support for the GNR, promoting its findings through its members’ institutions to drive action to tackle poor diets and malnutrition.
The IEG, headed by its chair, leads the development of the GNR and its content, including data, analysis, synthesis of evidence and conclusions and recommendations, and is accountable for the quality and independence of the GNR. The chair appoints group members through an open competitive process to cover areas relevant to the GNR, including the NAF. Members are appointed to the group as individuals independent of their institutions. IEG members are international experts with diverse and synergistic skills who have an advisory role but can take on additional roles. They are collectively accountable for the quality and independence of the GNR.
The GNR host supports the IEG in developing the GNR, through data analysis, research support, and coordinating and managing functions. It also leads on fundraising and on the production, communication and dissemination of the GNR, as well as maintaining the website and managing all digital assets.
The GNR is funded by a range of donors, including government aid agencies, multilateral agencies and philanthropic foundations. Funding agencies have no involvement in the development of GNRs content, including its conception, design, analysis, conclusions, recommendations and messages.
The NAF aims to attract commitments from a wide audience: effectively all stakeholders worldwide with interest and capacity to tackle poor diets and malnutrition in all its forms. These stakeholders include:
- Country governments at any administrative level, such as ministry, municipality or any other national/regional/local authority or body that provides financial or non-financial aid to their own country to tackle poor diets and end malnutrition
- Donor governments, meaning any government that provides financial or non-financial aid to other countries to tackle poor diets and end malnutrition
- Donor organisations, including philanthropic organisations
- Private sector food businesses, including in the food systems/production and agri-food industry
- Private sector non-food businesses, such as private healthcare facilities, health insurers and private schools
- Civil society organisations and non-governmental organisations
- Multilateral organisations, including UN agencies and international collaborative initiatives or movements
- Academic and non-academic research institutions.
During this first year of its development, the NAF is being designed specifically to support the monitoring of nutrition commitments at two major events in the Nutrition Year of Action – the UN Food Systems Summit (September 2021) and the N4G Tokyo Summit (December 2021).
- Only new or strengthened commitments for nutrition are accepted. This includes all N4G commitments made in the Nutrition Year of Action (2021). The N4G commitment tracker will separately assess the progress of past N4G commitments made in 2013 and 2017.
- The commitment registration process is open to all stakeholders committing to nutrition actions.
- A basic version of the NAF Platform is now live, allowing users to register their commitments for nutrition actions online.
- An updated version of the platform will be available by December 2021, which in addition to allowing registration of nutrition commitments, will also include basic visualisations and descriptive data regarding the registered commitments.
- A report on the new commitments made during the Nutrition Year of Action will be published in the spring of 2022.
Over time, as the NAF evolves, it will also include the following activities.
- Expanding the NAF Platform to allow stakeholders to report annually on progress made towards their commitments.
- Incorporating the progress assessment of the N4G commitments made in 2013 and 2017.
- Actively reaching out to more stakeholders to invite them to register nutrition commitments and join the NAF.
- Expanding the nutrition classification system to include more action areas.
- Engaging with existing nutrition accountability and/or tracking mechanisms, to maximise synergies and minimise duplication of effort.
- Visualising registered nutrition commitments on the platform and serving as a public resource of nutrition actions taken worldwide by countries and other stakeholder groups.
Last updated: 18 October 2021.
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Footnotes
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Global Nutrition Report: Action on Equity to End Malnutrition. Bristol, UK: Development Initiatives, 2020.
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Collaborators Global Burden of Diseases Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396 (10258): 1223–49.
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Collaborators Global Burden of Diseases Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396 (10258): 1223–49.
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Headey D, Heidkamp R, Osendarp S, et al. Impacts of COVID-19 on childhood malnutrition and nutrition-related mortality. Lancet 2020; 396 (10250): 519–21. Available at: www.nature.com/articles/s43016-021-00319-4
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Headey D, Heidkamp R, Osendarp S, et al. Impacts of COVID-19 on childhood malnutrition and nutrition-related mortality. Lancet 2020; 396 (10250): 519–21. Available at www.nature.com/articles/s43016-021-00319-4; UNICEF. COVID-19 and children. 2021. Available at: https://data.unicef.org/covid-19-and-children/; UNICEF. COVID-19 continues to disrupt essential health services in 90 per cent of countries. 2021. Available at: www.unicef.org/press-releases/covid-19-continues-disrupt-essential-health-services-90-cent-countries
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World Meteorological Organization. Climate change indicators and impacts worsened in 2020. 2021. Available at: https://public.wmo.int/en/media/press-release/climate-change-indicators-and-impacts-worsened-2020; NASA. Global Climate Change. The Effects of Climate Change. 2021. Available at: https://climate.nasa.gov/effects/
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Global Nutrition Report: Action on Equity to End Malnutrition. Bristol, UK: Development Initiatives, 2020; UNICEF. COVID-19 continues to disrupt essential health services in 90 per cent of countries. 2021. Available at: www.unicef.org/press-releases/covid-19-continues-disrupt-essential-health-services-90-cent-countries; Organisation for Economic Co-operation and Development. OECD Policy Responses to Coronavirus (COVID-19). COVID-19 and global food systems. 2020. Available at: www.oecd.org/coronavirus/policy-responses/covid-19-and-global-food-systems-aeb1434b/
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Carbis Bay G7 Summit Communique. Our Shared Agenda for Global Action to Build Back Better. Cornwall, UK, 2021.
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Access to Nutrition Initiative. Global Access to Nutrition Index 2021. Methodology. Development, structure, scope, contents, scoring and results presentation. 2020; World Health Organization, UNICEF. Global Nutrition Monitoring Framework: Operational guidance for tracking progress in meeting targets for 2025. Geneva: World Health Organization, 2017; Sustainable Energy for All. Accountability Framework.; United Nations, Food and Agriculture Organization of the United Nations. Guidelines for the Development of a Criteria and Indicator Set for Sustainable Forest Management. 2019; UN Office for Disaster Risk Reduction. SENDAI Framework. Voluntary Commitments. 2019; EU Platform on Physical Activity and Health. Monitoring Framework. Available at: https://ec.europa.eu/health/archive/ph_determinants/life_style/nutrition/platform/docs/eu_platform_mon-framework_en.pdf
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Nutrition for Growth Accountability Working Group. Final Paper. 2020. Available at: https://nutritionforgrowth.org/wp-content/uploads/2020/10/Accountability-WG-Final-report-designed-VF_Compressed.pdf
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Nutrition for Growth. Commitment-Making Guide. 2021. Available at: https://nutritionforgrowth.org/wp-content/uploads/2021/04/CommitmentGuide_4.27.21.pdf
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Access to Nutrition Initiative. Global Access to Nutrition Index 2021. Methodology. Development, structure, scope, contents, scoring and results presentation. 2020; World Health Organization, UNICEF. Global Nutrition Monitoring Framework: Operational guidance for tracking progress in meeting targets for 2025. Geneva: World Health Organization, 2017; Sustainable Energy for All. Accountability Framework.; United Nations, Food and Agriculture Organization of the United Nations. Guidelines for the Development of a Criteria and Indicator Set for Sustainable Forest Management. 2019; UN Office for Disaster Risk Reduction. SENDAI Framework. Voluntary Commitments. 2019; EU Platform on Diet, Physical Activity and Health: Monitoring Framework. Available at: https://ec.europa.eu/health/archive/ph_determinants/life_style/nutrition/platform/docs/eu_platform_mon-framework_en.pdf