PANEL 8.3 BUILDING CIVIL SOCIETY’S CAPACITY TO PUSH FOR POLICIES ON OBESITY AND NONCOMMUNICABLE DISEASES
CORINNA HAWKES I
n 2011, the 193 member governments of the United Nations made a series of commit- ments to prevent and control noncommunica- ble diseases (NCDs) (United Nations General Assembly 2011). Governments committed to, among other things, advance policies for healthy diets, improve governance of obesity by engaging multiple sectors, and build the capacity of nongovernmental organizations (NGOs). WHO established a roadmap for implementing and monitoring these commit- ments in its Global Action Plan for the Prevention and Control of NCDs 2013–2020 (WHO 2013b) and Global Monitoring Framework (WHO 2013a).
As public interest watchdogs, civil soci- ety organizations (CSOs) have a unique role to play in monitoring the implementation of these commitments. Yet—as these documents recognize—to do so effectively, they need greater capacity. Significant investment can pave the way. For example, Denmark’s devel- opment cooperation agency, Danida, has since 2010 funded a series of NCD alliances in East Africa (Kenya, Rwanda, Tanzania, Uganda, Zanzibar) (NCD Alliance 2014a). Modeled on the global NCD Alliance, the organizations bring together groups concerned with heart
disease, cancer, diabetes, and lung diseases to raise the political profile of NCDs, build public awareness, and provide support for education, treatment, and patient concerns (Ministry of Foreign Affairs in Denmark [DANIDA] 2008). Another example is the Obesity Prevention Program at Bloomberg Philanthropies (2014), which has provided a US$10 million, three- year grant to Mexican civil society organiza- tions and research institutes to build obesity prevention into their work. Facilitated by funding and international monitoring tools, these CSOs work to hold governments to account. The Healthy Carib- bean Coalition (2014b)—an alliance of more than 40 health-based NGOs—published an assessment of progress in 2014, guided by the benchmarking tool developed by the global NCD Alliance (2014b). The assessment identi- fied nutrition as the area of least progress; no countries reported having nutrition strate- gies or policies on food marketing to children, despite having committed to implementing the WHO recommendations on marketing to children (Healthy Caribbean Coalition 2014a). Investments in global-scale monitoring are needed to bring together national-level data. WHO has several instruments for
assessing progress on international commit- ments on obesity and NCDs, including a 2010 survey of countries’ capacity to prevent and control NCDs (WHO 2010c) and the Global Database on the Implementation of Nutri- tion Action (GINA) (WHO 2014d). CSOs have developed more detailed tools. For example, the World Cancer Research Fund Interna- tional’s NOURISHING Framework includes a regularly updated repository of healthy eating policies from around the world (WCRF 2013). The International Baby Food Action Network (2014) and UNICEF monitor the actions of 198 governments toward implementing the WHO International Code of Marketing of Breast- milk Substitutes. To improve accountability, funders should invest in increasing staffing capacity in national CSOs. They should also finance the time-consuming process of collecting and collating information on NCD policy imple- mentation and indicators of good nutrition governance. CSOs need to engage with the research community in this process and develop projects and proposals for monitoring policy and governance to hold their govern- ments to account.
are comprehensive and sometimes mapped well onto the stated N4G commitments (Table 8.8).
Conclusions
• A response rate of 92 percent is respectable. Nonetheless, given repeated requests and offers of help completing the templates over a five-month period, it is disappointing that 8 percent of signatories did not respond.
• There are more “on course” ratings than “off course” ones, which is encouraging.
• The “not clear” category is dominant. This reflects the difficulty of identifying clear commitments (what do they actually mean? who actually made them? are they time bound?), tracking progress, and identifying accountability (have commitments been met?).
• A rating of “on course” can be achieved by making and
meeting a very modest commitment, while an “off course” rating can be achieved by making a challenging commitment and then falling just short of it (as happened, for example,
TABLE 8.8 OTHER ORGANIZATIONS’ PROGRESS IN MEETING N4G COMMITMENTS Other organizations CABI
CGIAR
Policy/program commitments Not clear On course
Global Alliance for Improved Nutrition (GAIN) On course Naandi Foundation
Grand Challenges Canada Source: Authors.
No response Not clear
Note: On course = progress made is on course for meeting the N4G commitment. Not clear = the commitment was too vague to assess whether the commitment was met, or the reported evidence on progress was too vague or only partially reported. No response = organization did not respond to requests for progress.
ACTIONS & ACCOUNTABILITY TO ACCELERATE THE WORLD’S PROGRESS ON NUTRITION
63
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118