Undernutrition, obesity and governance: a unified framework for upholding the right to food

Abstract

This paper addresses the need for conceptual and analytic clarity on nutrition governance, an essential underpinning of more effective approaches for undernutrition, the ‘single greatest constraint to global development’ and obesity, which already accounts for 4% of the world’s disease burden and is growing rapidly.The governance of nutrition, which is essential to designing and implementing policies to realise the right to food, is among the most important and most defining duties of society. But research and action on nutrition governance are hampered by the absence of conceptual rigour, even as the continuing very high burden of undernutrition and the rapid rise in obesity highlight the need for such structures. The breadth of nutrition itself suggests that governance is both needed and sure to be complicated.This analysis explores the reasons attention has come to governance in development policy making, and why it has focused on nutrition governance in particular. It then assesses how the concept of nutrition governance has been used, finding that it has become increasingly prominent in scholarship on poor nutritional outcomes, but remains weakly specified and is invoked by different authors to mean different things. Undernutrition analysts have stressed coordination problems and structural issues related to the general functioning of government. Those studying obesity have emphasised international trade policies, regulatory issues and corporate behaviour.This paper argues that the lack of a clear, operational definition of governance is a serious obstacle to conceptualising and solving major problems in nutrition. To address this need, it develops a unified definition of nutrition governance consisting of three principles: accountability, participation and responsiveness. These are justified with reference to the social contract that defines modern nations and identifies citizens as the ultimate source of national power and legitimacy. A unified framework is then employed to explore solutions to nutrition governance problems.

An accountability evaluation for the International Food & Beverage Alliance's Global Policy on Marketing Communications to Children to reduce obesity: A narrative review to inform policy

“…National legislation neither addresses cross‐border marketing nor protects children across regions and globally from excessive HFSS products aggressively promoted by the IFBA firms. HFSS food and beverage marketing is inextricably related to global food and nutrition governance for health and trade, and enforcing international and legally binding standards to promote healthy food environments that protect children's rights . The transnational nature of IFBA firms highlights the complexity of global governance and presents formidable challenges for national governments to hold IFBA firms accountable for transnational corporate impunity, which exempts firms from penalties for the injurious consequence of their marketplace actions that adversely influence children's diet, health, and well‐being.…”

Multisectoral action for health in low-income and middle-income settings: how can insights from social science theories inform intragovernmental coordination efforts?

“…Some efforts on coordination have focused on the strategic framing of problems and solutions. 69 70 Institutionalisation and entrenchment of such frames are associated with the development of broader government reforms in developed countries such as ‘Joined up’ government in the UK, ‘Whole of Government’ in Australia and Horizontal government in Canada. 19 …”

Governing multisectoral action for health in low-income and middle-income countries: unpacking the problem and rising to the challenge

“…Case studies of multisectoral collaboration for health in LMIC are used to illustrate the relevance of the framework. Bump 60 focuses on the development of frameworks on nutrition governance, an archetypal multisectoral issue. Based on an extensive literature review, Bump observes how papers addressing governance of obesity differ significantly from those addressing governance of undernutrition and seeks to develop a synthetic governance framework that encompasses both aspects of nutrition.…”