Nutrition for Growth (N4G) commitment
1. Committed to support countries as they formulate good public health policies, particularly with reference to the promotion and protection of breastfeeding and adequate complementary feeding, and to strengthen monitoring systems for nutrition in countries.
2. Specifically, the organization is working on further expansion of the guidance on chronic undernutrition and maternal nutrition.
3. WHO will also complete development of a monitoring framework and will produce a report on the achievement of global targets in 2014.
WHO delivered on this commitment through continuously supporting regions and countries in the formulation, implementation and monitoring of nutrition and public health policies, and in monitoring the implementation of policies.
According to the latest Status report 2022 on the Marketing of breast‑milk substitutes - National implementation of the International Code, as of March 2022, a total of 144 WHO Members States have adopted legal measures to implement at least some of the provisions in the Code. Of these, 32 countries have measures in place that are substantially aligned with the Code. This is seven more countries than reported in 2020, reflecting the fact that most of the new legislation and regulations enacted in 2020-2021 were closely aligned with the Code. A further 41 countries have measures that are moderately aligned and 71 have included some provisions; while 50 have no legal measures at all.
Examining these numbers by region, the WHO African, Eastern Mediterranean, and South-East Asia regions have the highest percentage of countries substantially aligned with the Code. The report also identifies provisions specifically pertaining to the digital marketing of breast-milk substitutes.Report is available at https://www.who.int/publications/i/item/9789240048799
There has been significant progress in industrially produced trans-fatty acids (TFA) elimination around the world, as outlined in the third monitoring report on the global progress towards the related 2023 global target. The report shows that mandatory TFA policies are currently in effect for 3.2 billion people in 57 countries; of these, 40 countries have best-practice policies in effect, covering 1.4 billion people (18% of the global population). https://www.who.int/publications/i/item/9789240031876
Food Safety is an essential element of nutrition. In May 2022, WHO Member States approved the new WHO Global Strategy for Food Safety 2022-2030 – Towards stronger food safety systems and global cooperation-, which will support countries in their efforts towards reducing the burden of foodborne diseases and to build forward-looking and evidence-based food safety systems with coordinated governance and adequate infrastructures. https://www.who.int/publications/m/item/draft-who-global-strategy-for-food-safety-2022-2030
Following its proclamation by the General Assembly in 2018, the World Food Safety Day celebrations on 7 June 2021, joint by 90 countries, focused on the immediate and long-term benefits of producing and consuming safe food and recognized the intrinsic connections between the health of people, plants, animals, the environment and economy. https://www.who.int/publications/i/item/9789240034013
Moreover, for strengthening national nutrition surveillance systems, under the WHO-UNICEF Technical Expert Advisory group on nutrition Monitoring (TEAM) umbrella:
i) WHO and UNICEF published the first ever global guidance on National Nutrition Information Systems (NNIS) that outlines core concepts of a NNIS and is entitled “The Fundamentals Series”, available at https://apps.who.int/iris/handle/10665/359737;
ii) published a set of new and updated indicators to assess infant and young child feeding (IYCF) practices at household level, entitled “Indicators for assessing infant and young child feeding practices: definitions and measurement methods” available at https://www.who.int/publications/i/item/9789240018389;
iii) WHO collaborated with UNICEF on the District Health Information System (DHIS2) Standard Nutrition Module, launched in early December 2021, that is providing countries with standardized metadata packages to strengthen data use and support nutrition monitoring efforts using routine administrative data for interventions focusing on children and women.
The first Global Action Plan for Child Wasting (GAP), developed by FAO, the office of the UN High Commissioner for Refugees, UNICEF, WFP and WHO with inputs from other key stakeholders, presents a framework to accelerate progress in preventing and managing child wasting and achieving the SDG target on child wasting and roadmaps of 22 out of 23 frontrunner countries, which was launched at the Tokyo Nutrition for Growth Summit (N4G) in Dec 2021. WHO and UNICEF support 15 frontrunner GAP countries to produce updated context-specific nutrition policies and treatment protocols covering the prevention and treatment of wasting, which are integrated within the national health system. www.childwasting.org/the-gap-framework
Moreover, according to its mandate, WHO released in 2021/2022 various normative products to support countries in the implementation of the ICN2 commitments, including
• Effective regulatory frameworks for ending inappropriate marketing of breast-milk substitutes and foods for infants and young children in the WHO European Region (https://apps.who.int/iris/handle/10665/352003)
• Infant and young child feeding counselling: an integrated course (https://www.who.int/publications/i/item/9789240031692)
• Frequently asked questions: COVID-19 vaccines and breastfeeding based on WHO interim recommendations (https://www.who.int/publications/i/item/WHO-2019-nCoV-FAQ-Breast_feeding-Vaccines-2021.1)
• 2nd Edition of Guideline: infant feeding in areas of Zika virus transmission (https://www.who.int/publications/i/item/9789240029187)
• Implementation guidance on counselling women to improve breastfeeding practices (https://www.globalbreastfeedingcollective.org/reports/implementation-guidance-counselling-improve-breastfeeding-practices)
• Compendium of Skilled Breastfeeding Counselling Case Studies (https://www.globalbreastfeedingcollective.org/reports/compendium-skilled-breastfeeding-counselling-case-studies)
• WHO released guidelines on maternal and newborn care for a positive postnatal experience; https://www.who.int/publications/i/item/9789240045989,
• updated the Training course on the inpatient management of severe acute malnutrition, https://www.who.int/publications/i/item/9789240029781, and
• is in the process of finalizing WHO guidelines on child wasting.
Moreover, an acceleration plan to support member states in implementing the recommendations for the prevention and management of obesity over the life course, that outlines how the Secretariat is supporting Member States in implementing the recommendations based on individual country needs and priorities and the reporting format; https://apps.who.int/gb/ebwha/pdf_files/WHA75/A75_10Add6-en.pdf
In light of COVID-19, WHO in collaboration with OIE and UNEP issued further guidance to reduce the public health risks associated with the sale of live wild animals for food in traditional food markets, that national governments should consider adopting urgently with the aim of making traditional markets safer and recognizing their central role in providing food and livelihoods for large populations. https://www.who.int/publications/i/item/WHO-2019-nCoV-Food-safety-traditional-markets-2021.1
Recent action on monitoring include: WHO in partnership with UNICEF and USAID published an analytical framework on the Multi-sectoral impacts of the COVID-19 pandemic on nutrition outcomes, available at https://www.who.int/tools/covid19-nutrition-analytical-framework .
This is a practical tool to assist policymakers and programme implementers in identifying and assessing the potential pathways through which the COVID-19 pandemic affects nutrition determinants, services and status at the population level, and also has the potential to support an integrated systems approach to address nutrition challenges caused or intensified by COVID-19 and that are likely to be relevant in future pandemics and other health, environmental or humanitarian crises.
Moreover, WHO has supported over 40 countries in the WHO European Region through the WHO European Childhood Obesity Surveillance Initiative, which measures overweight and obesity in children using standardized height and weight measurements of over 300,000 children every three years.
WHO also continued supporting the implementation of the Global Nutrition Monitoring Framework, through 12 workshops for national and regional capacity building on monitoring countries’ progress toward the nutrition targets, as well for data analysis.
WHO has published several reports together with partner organisations. At the global level, the State of Food Security and Nutrition in the World in 2021, the 2021 Global Nutrition Report analysis and discussion of global data on hunger and malnutrition, informing the monitoring of the nutrition-related targets of the SDGs; and the WHO-UNICEF-WB Joint Child Malnutrition Estimates 2021 Edition and the 2021 Edition of WHO Global Anaemia estimates were published.
WHO has regularly tracked progress on the achievement of global nutrition targets and on the implementation of nutrition policies through the SDGs Extended report 2021 Edition; and through the Global database on the Implementation of Nutrition Action (GINA) that includes information on nutrition-related policies, actions and mechanisms for monitoring or coordination in 201 countries and territories. WHO also reported on the progress of the WHO General Progress of Work 2019-2023 on the three SDG targets (childhood stunting, wasting and overweight) , which is communicated to WHO Member States through a delivery-for-impact approach at higher levels of the organization.
In May 2022, the WHA approved the development of monitoring tools and compilation of comprehensive reports on progress towards global obesity targets and in the implementation of policies and programmes, as part of the Acceleration Plan on Obesity. https://apps.who.int/gb/ebwha/pdf_files/WHA75/A75_10Add6-en.pdf
At least half of the individual commitment components are assessed to be on course