IX-c. Strategizing the Reduction of Global Malnutrition

What are--or should be--the specific obligations of the international community with regard to humanitarian assistance generally, or with regard to the human right to food and nutrition in particular? If the international community has specific obligations, how should it act to honor its obligations? Which agencies have what duties? How can the international community, as a duty-bearer, be held accountable?

In advancing nutrition rights within nations we know that it is wise to work with nutrition programs that are already in place. In many cases the rules under which people have access to these programs can be revised to guarantee that those who are most needy are assured of receiving services. Similarly, we should recognize that there already are institutional arrangements for dealing with nutrition issues at the global level. We need to see how their methods of work can be adapted so that they help to carry out the obligations of the international community, and thus help to advance nutrition rights globally.

The most prominent international governmental organizations (IGOs) concerned with nutrition are the Food and Agriculture Organization of the United Nations (FAO), the World Food Council (WFC). the World Food Programme (WFP), the International Fund for Agricultural Development (IFAD), the World Health Organization (WHO), and the United Nations Children's Fund (UNICEF). They are governed by boards comprised of member states. Responsibility for coordinating nutrition activities among these and other IGOs in the United Nations system rests with the Administrative Committee on Coordination/Subcommittee on Nutrition (ACC/SCN). Representatives of bilateral donor agencies such as the Swedish International Development Agency (SIDA) and the United States Agency for International Development (USAID) also participate in ACC/SCN activities. There are also numerous international civil society organizations (ICSOs) concerned with nutrition.

The main role of the IGOs is not to feed people directly but to help nations use their own resources more effectively. In much the same way, a new regime of international nutrition rights would not involve massive international transfers of food. Its main function would be to press and help national governments address the problem of malnutrition among their own people using the food, care, and health resources within their own nations. There may always be a need for a global emergency food facility to help in emergency situations that are beyond the capacity of individual nations, but a different kind of design is needed for dealing with chronic malnutrition. Moreover, as chronic malnutrition is addressed more effectively, nations would increase their capacity for dealing with emergency situations on their own. Over time the need for emergency assistance from the outside would decline.

The IGOs could use their leverage to press for the establishment of nutrition rights within the nations they serve. For example, the World Food Programme could make it known that in providing food supplies for development it will favor those nations that are working to establish clear nutrition rights for the most needy in their nations. All of the IGOs could be especially generous in providing assistance to those nations that create national laws and national agencies devoted to implementing nutrition rights. Poor nations, relieved of some of the burden of providing material resources, would be more willing to create programs for recognizing nutrition rights. Such pledges by international agencies could be viewed as a precursor to recognition of a genuine international duty to recognize and effectively implement rights to adequate nutrition.

The IGOs are concerned with the problems of famine and chronic malnutrition, but these are only a part of their broad agendas. For example, the FAO gives a great deal of attention to the interests of food producers, and WHO deals with the full range of health issues. UNICEF, too, addresses a very broad range of subjects. Moreover, the division of responsibilities among the IGOs for dealing with nutrition has not yet been worked out adequately. Thus malnutrition has not yet gotten the commitment of attention and resources needed to really solve the problem. The concept of moving progressively toward a global regime of nutrition rights could be the basis for working out a global program of concerted action by the IGOs.

How can the world deal decisively with the problem of widespread chronic malnutrition? Imagine that a global meeting was held in which all governments and concerned international organizations were represented. Imagine further that they were determined to end malnutrition in the world and wanted to draw up concrete action plans toward that end. We can also suppose that they agreed to commit resources to the effort at a rate up to, but no greater than, the overall amounts now spent on food- and nutrition-related international assistance programs.

What might the action plan look like? In some respects it would echo the World Declaration on Nutrition and the Plan of Action for Nutrition approved by the world's governments in Rome in December 1992. Certainly the early parts of those texts describing the nature of the problem and the seriousness of the governments' concerns would be similar. The big differences would be in the operational sections specifying who exactly is making what commitments to do what, in what time frame, with what sorts of accountability. The conference participants in 1992 went as far as they could go, but in the new agreement contemplated here we would look for a business-like contract, with clearly elaborated responsibilities and commitments.

At the 1992 meeting the major parties were the nations of the world, and the concerned IGOs stood to the side as facilitators of the meeting. The focus was on the formulation of national plans of action, not a global plan of action. In the new negotiations envisioned here the IGOs would be at center-stage, working out their roles in the new nutrition rights regime. They would have to work out the division of responsibilities among them so that each could make its own best contribution to assuring that people are adequately nourished. Of course it would always have to be recognized that the IGOs are not independent agents, but are instruments of, and accountable to, their member nations.

Strategically, the program of action would begin the work of alleviating malnutrition with the very worst cases, and then as those problems were solved, move to dealing with less severe situations. Rules would be established so that the targets of action would be selected on the basis of clear measures of need, thus reducing the possibilities for making politicized selections. The IGOs could continue to carry out other functions, but with regard to the challenge of addressing serious malnutrition their actions would be coordinated under the new global program of action, the contract adopted at the meeting.

At the core of the new arrangement would be the establishment of a new global body that had responsibility for seeing to it that the terms of the contract negotiated at the meeting were carried out. This new agency, created by national governments working together with the IGOs, would see to it that those that made agreements, and thus incurred obligations, carried out their obligations in fact.

The IGOs would support national governments in dealing with malnutrition among their own people. Local and international nongovernmental organizations would be a part of the system in that they would help to identify and report serious cases of malnutrition, they would help to provide services, and they would monitor to make sure that national and local agencies carried out their work of alleviating malnutrition.

It would be agreed that where there was serious malnutrition and national agencies could not or would not solve the problem, the IGOs would have the authority and the duty to become directly involved. The nature of that involvement would have to be worked out. Concrete programs of action would have to be designed to fit particular cases, but the planning exercise would establish general procedures and guidelines for action. Consideration would have to be given to issues of consent, costs, logistics, risks, and so on. Intervention would not be automatic and indiscriminate, but there would be an agency in place that would be prepared to assess the situation and act under suitable internationally accepted guidelines. Initially, the international community would have a firm duty to assist only where there was consent from governments of the nations receiving assistance.

There have been comparable global planning efforts before, not only the World Declaration and Plan of Action on Nutrition formulated at the International Conference on Nutrition held in Rome in December 1992, but also the International Undertaking on World Food Security of 1974, the Plan of Action on World Food Security of 1979, the Agenda for Consultations and Possible Action to deal with Acute and Large-scale Food Shortages of 1981, and the World Food Security Compact of 1985. The major differences between these earlier efforts and the Global Action Plan outlined here are the prominent roles of the international governmental organizations as actors, the sharply focused purpose and program of action, the clear contractual commitments, and most importantly, the creation of a central agency responsible for assuring that the commitments are honored. Moreover, while previous plans had somewhat obscure and difficult purposes, the objective of reducing malnutrition among children worldwide to virtually zero is a clear and achievable objective.

Of course the idea of ending serious malnutrition in the world through establishment of a regime of hard international nutrition rights is idealistic. Nevertheless, the idea can be useful in setting the direction of action. We can think of the IGOs as having specific duties with regard to the fulfillment of nutrition rights. We can move progressively toward the ideal by inviting IGOs to establish clear rules and procedures which they would follow as if they were firm duties.

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Section IX-c last updated on June 13, 1999