Chapter 05

Governance as a driver of food and health system transformation

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Chapter 5 of 10
Contents
5.1 Share section

Key findings

  • Governance plays a central role in shaping whether food and health systems can deliver healthy diets, maintain essential nutrition services and reduce inequities under climate stress. Recent advances in nutrition governance, including the wider use of SMART (Specific, Measurable, Achievable, Relevant and Time-bound) commitments and formal accountability frameworks, have improved transparency and comparability across actors, thereby strengthening procedural accountability.
  • Despite procedural improvements, a persistent gap remains between commitments on paper and progress in practice. Institutional fragmentation, siloed mandates, misaligned financing architectures and weak connections between climate policy and nutrition delivery have limited the ability of food and health systems to withstand shocks and achieve sustained nutrition outcomes.
  • Financing arrangements have been a key contributor to this gap. Short‑term, project‑based funding, declining official development assistance and the failure to account for the health and environmental externalities of current food systems have constrained investment in long‑term, integrated and equity‑focused transformation, while unmanaged conflicts of interest have further complicated governance and accountability.
  • Substantive nutrition outcomes have been more likely where governance arrangements have moved beyond procedural accountability to embedding commitments within coherent financial, institutional and resilience frameworks. Approaches that strengthen cross‑sector coordination, align public finance with nutrition and climate objectives, empower communities and link accountability to delivery have been better positioned to support equitable and resilient food and health system transformation in a changing climate.

If you would like to know more about any of the terms used in this chapter, you can visit the report glossary.

5.2 Share section

Introduction

Within a changing climate, effective governance is key to promoting healthy diets for everyone. Governance shapes how food systems and health systems function, as both stand-alone and interconnected domains (Box 5.1). It also dictates how responsibilities, resources and delivery capabilities are shared across different sectors. As climate change leads to more frequent and severe shocks, governance plays a crucial role in determining whether food and health systems can maintain dietary quality, provide essential nutrition services and reduce inequities.

Recent years have witnessed significant progress in nutrition governance.[1][2] The widespread adoption of SMART (Specific, Measurable, Achievable, Relevant and Time-bound) commitments and formal accountability frameworks, from the Organisation for Economic Co-operation and Development’s Development Assistance Committee to the NAF, has increased transparency, monitoring and comparability across actors. This shift from vague pledges towards clearly articulated responsibilities represents meaningful progress in procedural accountability. For instance, the accountability frameworks have advanced the clarity, specificity and measurability of commitments themselves. However, procedural advances alone are insufficient. Clearly defined commitments must be supported by financial, institutional and delivery systems capable of withstanding climate-related shocks and reaching those most at risk.[3][4] Without governance arrangements that align commitments with financing, resilience planning and equity objectives, even well-specified commitments risk falling short of their intended impact.

Within this context, the current advances in accountability offer a chance to improve nutrition governance, moving beyond procedural compliance towards more substantive forms of accountability. By facilitating better integration among food systems, health systems, climate policy and public finance, governance can help embed nutrition commitments within the financial, institutional and resilience frameworks required to deliver sustained and equitable nutrition results under climate stress.[5]

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Box 5.1. Effective governance

Effective governance is defined as the rules, institutions, coordination arrangements and accountability processes that allow public and non-state actors to plan, fund, implement and monitor joined-up action. Within the context of this report, effective governance more closely refers to the capacity to set up, implement and coordinate action across the food, health, climate, social protection and other sectors that shape nutrition outcomes across food and health systems.

5.3 Share section

From procedural accountability to substantive accountability

Building on recent advancements in accountability, nutrition governance now features clearer commitments, stronger reporting requirements and improved monitoring mechanisms. The wide adoption of SMART commitments and formal accountability frameworks has improved transparency and comparability among different actors, helping to advance the global nutrition community towards more clearly articulated responsibilities. These developments mark important progress in procedural accountability and have consolidated the foundations of nutrition governance.[6][7]

However, as climate-related risks intensify, procedural accountability alone is unlikely to be sufficient to deliver sustained and equitable nutrition outcomes. The effectiveness of commitments increasingly depends on whether they are part of coherent governance strategies that connect goals with the capacity to deliver.[8] This highlights the need for substantive accountability, which refers to how well commitments are embedded within financial, institutional and policy frameworks that support implementation, withstand shocks and tackle structural inequities.

5.4 Share section

The gap between procedure and substance

The persistent gap between procedure and substance is rooted in the same governance and financing structures that commitments are meant to fix. Systemic roots of this gap include institutional fragmentation and siloed mandates, misaligned financing architecture and vertical disconnects and climate marginalisation.

Institutional fragmentation and siloed mandates: The gap between procedural and substantive accountability is a direct and predictable consequence of deep institutional fragmentation.[9][10] Governance is fractured horizontally (across sectors) and vertically (from global to local). This fragmentation is particularly damaging when addressing cross-cutting threats. For example, risks like antimicrobial resistance and zoonotic diseases, such as Avian influenza, are intrinsically linked to food production activities like intensive livestock farming and cannot be managed by a ministry of health alone.[11] They require governance that substantively binds agriculture, environment and health. Yet, current fragmented structures tend to produce procedural responses including commitments that are formally registered and reported but lack the cross-sectoral mandates, shared financing or joint delivery mechanisms needed to address the underlying problem.

Misaligned financing architectures: Financing mechanisms may mirror and reinforce institutional fragmentation. In practice, many financing arrangements favour short-term, procedurally defined projects. Traditional funding streams like international aid and philanthropic funding are vital but carry structural risks such as ‘political vulnerability’ and ‘donor dependency’ (Table 5.1). These characteristics incentivise funding bodies to favour projects that are easily measurable, carry low political risk and deliver rapid, visible results (e.g. a vitamin supplementation programme). Conversely, the long-term, complex, substantive reforms required for transformation face structural disincentives. Such reforms are politically challenging and often misaligned with annual aid budget cycles.

The most significant misalignment is the failure to account for the ‘hidden costs’ (health and environmental externalities) of the current system.[12] As the recent EAT-Lancet Commission on sustainable and just systems for healthy foods suggests, public finance (via subsidies) can incentivise the production of commodities that drive these externalities, while private finance prioritises sales of products that may therefore inadvertently perpetuate existing problems. This problem goes beyond misaligned incentives alone, raising questions about corporate political activity within nutrition governance. Evidence shows that commercial actors can shape research agendas, lobby against public interest regulation and influence policy processes through funding relationships, institutional access and revolving-door ties with regulators. Within such contexts, conflicts of interest play out in governance arrangements that place commercial actors in positions where profit motives can shape rule setting, implementation or oversight.[13] This means that engagement with private actors requires clear safeguards, including disclosure requirements, transparency regarding funding, participation and limits on decision-making roles (where conflicts are high) and institutional firewalls between regulatory functions and commercial influence.[14]

Emerging instruments like blended finance and development impact bonds are promoted as solutions but remain marginal.[15][16][17] Their high transaction costs, bespoke design and the difficulty of standardising metrics for complex social outcomes mean they are not yet scalable alternatives. They remain complements to, not substitutes for, the core public financing that should be reformed.

Vertical disconnects and climate marginalisation: The gap between procedural and substantive accountability is reinforced by a vertical disconnect between global goals and national implementation tools. Global goals are becoming more substantive. For instance, the 28th UN Climate Change Conference United Arab Emirates Declaration explicitly links climate and food.[18][19] However, the formal instruments of national implementation fail to translate this integration. Nutrition remains critically under-prioritised in these climate policy instruments. A 2025 analysis found that only 2% of Nationally Determined Contributions (NDCs) and 16% of National Adaptation Plans (NAPs) included explicit resource mobilisation plans targeting nutrition.[20] While public climate funding has grown, the share directed to food systems declined between 2017 and 2022.[21] These figures show a governance gap between climate policy and nutrition delivery. Nutrition is sometimes mentioned in climate plans, but rarely linked to budgets, mandates or implementation systems. The higher inclusion in NAPs than NDCs suggests that nutrition enters more easily through adaptation planning than through mitigation or resource mobilisation. Even so, inclusion remains limited. Better integration will require cross-sector authority, aligned budgets and nutrition indicators within climate planning and reporting.

Table 5.1. Major financing sources for nutrition and resilience: Opportunities and challenges

Financing source Opportunities and benefits Challenges/risks Illustrative examples
Domestic public
financing (e.g.
government budgets) 		Aligned with national plans; high potential for realigning existing capital (e.g. subsidy reform) and raising new revenue (e.g. health taxes on specific foods). Limited fiscal space (e.g. post-Covid-19 debt); political economy of reform (e.g. lobby groups); nutrition is often under-prioritised. Nutrition budget within national health or agriculture ministries.
Official
development
assistance 		Provides catalytic capital and technical support for domestic policy reform (e.g. subsidy repurposing). Declining volumes due to geopolitical/national pressures; short-term priorities (humanitarian aid) crowd out long-term reform; donor dependency. Donor-funded vitamin supplementation; school feeding; crisis response programmes.
Private-sector
investment 		Mobilises large-scale capital for supply chain efficiency, fortification and innovation in sustainable foods. Pervasive conflicts of interest (e.g. ultra-processed food industry); commercial motives often conflict with public health/sustainability goals; risk of undue policy influence. Food industry research and development into fortified staples.
Philanthropic
funding
(e.g. foundations) 		Flexible and risk tolerant; can act as a catalyst by funding innovation, accountability platforms and policy research. Dependent upon donor priorities; limited scalability; accountability concerns. Foundation-supported nutrition initiatives or catalytic platforms.
Innovative finance
(e.g. blended finance,
impact bonds) 		Incentivises outcomes within niche applications; can de-risk private investment in specific areas (e.g. climate-resilient infrastructure). High transaction costs and complexity; difficulty in standardising metrics; remains small scale with low uptake; not a substitute for core public finance. Development Impact Bond for maternal and child health; blended finance vehicle for climate-smart agriculture.
5.5 Share section

Pathways to substantive transformation

The gap between procedural and substantive accountability is not inevitable. Several proven governance interventions demonstrate how to embed financing, cross-sector coordination, climate alignment, resilience and equity within commitment design and delivery. However, these interventions depend on institutional and political conditions that are not present in all settings. Their transferability depends on factors such as cross-ministerial coordination capacity, sustained political commitment, administrative capability and the ability to sustain funding over time. These conditions are especially important within many low- and middle-income contexts, where N4G commitments often face tighter fiscal constraints and weaker implementation systems.

Multisectoral coordination moves beyond siloed commitments by institutionalising cross-sectoral action. For example, Denmark’s 2021 dietary guidelines substantively combine health and climate aims through binding public procurement standards.[22] Ethiopia’s Seqota Declaration binds multiple ministries to ending child stunting through an aligned, multisectoral financing mechanism.[23] At the global level, the Committee on World Food Security’s Voluntary Guidelines on Food Systems and Nutrition (2021) provide a consensus framework for coherent policies, and the Alliance of Champions for Food Systems Transformation commits members to integrate their national pathways into NDCs and NAPs.[24][25]

Community-led governance ensures equity becomes a design principle rather than a checkbox. For example, Brazil’s National Plan for Agroecology and Organic Production embeds family farming and local knowledge within state structures, backed by dedicated budgets linking farms to school feeding.[26][27] Multi-level food laboratories and urban food policy councils embed participatory processes that shift power to affected communities.[28][29]

Capital redirection represents an additional substantive lever. This requires reforming the US$540 billion in annual agricultural subsidies towards sustainable, nutrition-sensitive production[30][31] (Box 3.2), and implementing fiscal tools (taxes on certain foods and beverages) that internalise health externalities while funding public health programmes. Table 5.2 presents a framework mapping these reforms into practical actions, organised around four strategic shifts and delivered through three policy levers.

Table 5.2. Mapping strategic goals to policy actions for resilient food systems

Strategic goals
and policy actions 		Strengthen governance
and coordination 		Mobilise and align
financing 		Empower communities
and consumers
Policy coherence and
cross-sector integration 		Establish integrated governance structures such as food system councils and Committee on World Food Security guidelines; mandate a One Health approach. Repurpose harmful subsidies (approximately US$540 billion) with just transition mechanisms; implement health taxes on specific foods and beverages to internalise hidden costs. Promote demand-side strategies including dietary guidelines and waste reduction; regulate food environments through marketing restrictions and labelling.
Resilience and
climate adaptation 		Integrate food systems into climate strategies including non-communicable diseases and National Adaptation Plans; link nutrition and climate data. Develop blended finance targeting substantive outcomes such as climate-resilient value chains. Expand shock-responsive social protection to safeguard dietary quality; buffer climate and economic risks.
Equity and
accountability 		Institutionalise community participation in governance through food policy councils; recognise community rights, including food sovereignty. Create equity-sensitive financing facilities targeting smallholders and women, blending public, private and philanthropic resources. Support participatory structures that elevate local knowledge and agency in decision-making.
Data, monitoring
and impact 		Evolve monitoring platforms such as the Nutrition Accountability Framework to track substantive integration of finance, climate and equity, alongside SMART criteria. Link financing to substantive performance through outcome-based accountability rather than just inputs. Build disaggregated and locally relevant data systems to guide inclusive policies and track equity.

Abbreviation: SMART, Specific, Measurable, Achievable, Relevant and Time-bound.

Source: Food and Agriculture Organization of the United Nations, United Nations Development Programme, United Nations Environment Programme. A multi-billion-dollar opportunity: Repurposing agricultural support to transform food systems. Rome, Italy: Food and Agriculture Organization of the United Nations, 2021.

The framework operates through the following four interconnected shifts that collectively move food system governance from procedural alignment towards substantive transformation.

Policy coherence and cross-sector integration form the foundation, requiring coordination to become enforceable rather than aspirational. Integrated food system councils or equivalent platforms must be equipped with formalised authority and shared key performance indicators across ministries, ensuring health, agriculture and climate portfolios are jointly accountable for outcomes.[32] Financial levers operationalise these mandates through subsidy repurposing and fiscal instruments that reward sustainable production and healthy consumption (e.g. health taxes on specific foods and beverages), and demand-side policies align market incentives with public objectives.[33]

Resilience and climate adaptation then embeds nutrition firmly within national climate architecture. By incorporating nutrition targets into national plans, governments position resilience as a shared metric across ministries and unlock climate finance for nutrition-relevant actions.[34] Blended finance mechanisms channel public and private capital into climate-resilient value chains, and shock-responsive social protection systems ensure households maintain dietary quality during crises.[35][36]

Equity and accountability ensure governance reform translates into fairness and inclusion by moving decision-making closer to affected communities. Embedding participatory mechanisms and rights-based approaches within national frameworks gives local actors a genuine voice in agenda setting and monitoring.[37][38] Financing windows targeted to women, smallholders and marginalised groups provide the means for participation to deliver tangible outcomes, and community-led monitoring and grievance systems transform accountability from top-down audit into continuous dialogue.

Data, monitoring and impact complete the cycle by transforming accountability into a driver of substantive change. Platforms like the NAF should evolve from static registries of SMART commitments into dynamic tools that measure how well pledges integrate financing, climate, resilience and equity.[39][40] Linking funding allocations to these substantive indicators creates feedback loops that direct resources towards genuinely integrated actions, and disaggregated, locally relevant data enables communities to verify progress and guide correction.[41][42] Together, these four shifts create a governance system within which accountability measures are integrated continuously, financing flows towards substantive outcomes and communities shape the policies affecting their nutrition security under climate stress.

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Footnotes

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  22. Danish Veterinary and Food Administration. The Official Dietary Guidelines – Good for health and climate. Glostrup, Denmark: Danish Veterinary and Food Administration, 2021. https://en.foedevarestyrelsen.dk/food/nutrition-and-health/the-official-dietary-guidelines

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