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A personal overview of the role and co-ordination of united nations agencies in food and nutrition
Nevin S. Scrimshaw
Senior Adviser, World Hunger Programme, The United Nations
University
A listing of acronyms of each of the agencies in the United Nations system concerned directly or indirectly with food and nutrition is overwhelming even to persons thoroughly familiar with them, but this presentation will describe them by categories, beginning with those represented on the ACC-SCN.
The ACC is the Administrative Committee on Co-ordination, made up of the heads of UN agencies, who meet at least twice a year. It has established several sub-committees for coordination, among them the Sub-Committee on Nutrition (SCN), established in 1977 as a partial successor to the Protein-Calorie Advisory Group (PAG) of the UN system. Through the SCN, the individuals responsible for nutrition programmes within their agencies meet once or twice a year. To maintain the independent expert advice formerly furnished by the PAG, the Advisory Group on Nutrition (AGN) was set up, with distinguished scientists, both biomedical and social, as its members. They are Mr. Sol Chafkin (Chairman), Dr. Fred Sai (Vice-Chairman), Dr. Priyani Soysa, Dr. Alberto Carvalho da Silva, Dr. Abraham Horwitz, Dr. Bede Okigbo, Dr. S. Venkitaramanan, and Dr. Ratko Buzina.
The UN agencies most directly concerned with nutrition are: the Food and Agriculture Organization (FAO), represented on the SCN by the Director of its Food Policy and Nutrition Division, Dr. Z. Sabry; the World Health Organization (WHO), represented by the head of its Nutrition Unit, Dr. Moisés Béhar; the United Nations Children's Fund (UNICEF), represented by its Deputy Executive Director, Mr. E. D. R. Heyward, who serves as SCN Chairman, and Dr. Les Teply; and the relatively new United Nations University (UNU), whose World Hunger Programme (WHP) is represented by the author. The other UN agencies participating are represented by the most senior officer concerned with nutrition. Describing the nutrition activities of these organizations alone could fill a monograph, so this summary must perforce be telegraphic.
In principle, the FAO is dedicated to raising levels of nutrition and standards of living and securing improvement in the production of all food and agricultural products. Its Food Policy and Nutrition Division assists member nations in: (i) formulating food and nutrition policy; (ii) integrating nutrition objectives in agricultural and rural development projects; (iii) assessing the needs for nutrition intervention and feeding programmes; (iv) planning, executing, and evaluating national improvement programmes, with emphasis on training, education, and better utilization of food aid and local resources; and (v) strengthening overall food control systems. It is thus closely concerned with food quality and safety. It co-operates with governments in the design and implementation of various intervention measures, including nutrition education, income-generating activities, food subsidies, weaning food development, food fortification, and reduction of food losses and waste. The FAO also collects, analyses, and disseminates up-to-date information on food habits, food availability, and food consumption, including national food balance sheets. Regional offices of the FAO are located in Bangkok, for the Far East; in Accra, Ghana, for Africa; and in Santiago, Chile, for Latin America; a liaison office for North America is located in Washington, D.C.
The Nutrition Unit of WHO is concerned with maternal and child nutrition, nutritional surveillance, and malnutrition of all types. It also seeks to draw attention to nutrition in all of the programmes of WHO, including primary health care, maternal and child health, infectious diseases, chronic diseases, health education, and health manpower development. Due to the decentralized structure of WHO, the regional offices are primarily responsible for collaboration with governments.
WHO convenes several expert committees, groups, or consultations per year on specific topics concerned with nutritional disease and maternal, infant, and child nutrition. Jointly, the FAO and WHO have developed estimates on nutritional requirements and safe allowances, and the Codex Alimentarius, a set of evolving food codes and model laws for adoption by national governments. WHO has recently organized a series of meetings jointly with UNICEF to develop a marketing code for breast-milk substitutes.
The WHO regional programme in its South-East Asian Regional Office (SEARO), in New Delhi, is directed to the development and strengthening of national capabilities for nutritional research and training and to the inclusion of nutrition and nutrition-related action in the plans and activities of different national sectors within the political, economic, and social realities of each country. A similar programme is planned for the Western Pacific Regional Office (WPRO), in Manila. Other WHO regional offices are the African Regional Office (AFRO), in Brazzaville, Congo; the European Regional Office (EURO), in Copenhagen, the Eastern Mediterranean Regional Office (EMRO), in Alexandria, Egypt, and the Pan American Health Organization (PAHO), in Washington, D.C.
In response to its mandate, UNICEF co-operates with governments in almost all fields with direct relevance to child development. This ranges through special studies, advocacy, planning, programming, implementation (including training), monitoring, and evaluation. The main target groups are needy infants and young children and pregnant and lactating women.
In addition to substantive interaction with governments in the above-mentioned fields and in the provision of funds, supplies, and equipment, UNICEF can also provide consultant services. Activities supported by UNICEF include applied nutrition, promotion of breast-feeding, promotion of home- and village level preparation of weaning foods, control of diarrhoeal disease, strengthening of nutrition in primary health care and maternal and child health programmes, control of deficiency diseases, and nutrition education, training, and surveillance. UNICEF collaborates, as appropriate, with specialized agencies of the United Nations in the various fields, and many of its programmes are conducted jointly with WHO, the FAO, or both. While regional offices mainly serve this function in WHO, the UNICEF country offices exercise considerable autonomy within policy guidelines. UNICEF has regional offices in Abidjan, Bangkok, Beirut, Geneva, Lagos, Nairobi, and New Delhi.
The United Nations University is a newcomer to the UN system with a major interest in nutrition. Its World Hunger Programme (WHP), begun in 1975, serves to strengthen the competence of existing institutions in developing countries by providing fellowships for advanced training, supporting applied research, and establishing networks of institutions for research and training in its priority areas, which are Hunger and Society, Hunger and Technology, and Hunger and Health.
Fellowships are awarded to individuals who already have basic academic training in their discipline and a permanent position of responsibility in an institution where they are expected to have an opportunity for applied or operational research after returning from their fellowship period. Fellows are chosen after visits by WHP staff members to their institutions and on the basis of institutional needs and commitments. Training is offered only at associated institutions (mainly in developing countries!, which provide broad, multidisciplinary applied training that is practical and relevant to the needs of the countries from which the Fellows are selected.
UNU associated institutions include the following. In Asia: the Nutrition Center of the Philippines (NCP), in Manila; the Central Food Technological Research Institute (CFTRI), in Mysore, India; and the Institute of Nutrition, Mahidol University (INMU), in Bangkok, Thailand. In Latin America and the Caribbean: the Institute of Nutrition of Central America and Panama (INCAP), in Guatemala; the Institute of Nutrition and Food Technology (INTA), in Santiago, Chile; the Universidad del Valle (UVC), in Cali, Colombia; and the University of the West Indies (UWI), in St. Augustine, Trinidad, and Kingston, Jamaica. In Africa: the Department of Nutrition and Food Science (DNFS), University of Ghana, in Legon. And elsewhere: the Tropical Products Institute (TPI), in London; the International Food and Nutrition Planning Program (IFNP), Massachusetts Institute of Technology and Harvard School of Public Health, in Cambridge, Mass., USA; and the Centre for Research in Nutrition (CRN), Laval University, Quebec, Canada.
The World Hunger Programme publishes the quarterly food and Nutrition Bulletin and various technical reports. The Bulletin carries reports of technical activities of the ACN and AGN. The UN University also sponsors frequent workshops on topics of relevance to the concerns of the Programme.
The World Food Programme (WFP) was established in 1963 as a semi-autonomous extension of the FAO to receive donated food commodities and distribute them to relieve hunger and meet emergency food needs in food-short countries. It supports supplementary feeding programmes on an emergency basis, and, where possible, extends its food aid through "food-for-work" programmes that can contribute infrastructure for agricultural production, such as rural access roads and draining and irrigation projects.
The World Food Council (WFC), created by the General Assembly on the recommendation of the 1974 World Food Conference, is the UN political organ dealing exclusively with world food and nutrition problems. Its mandate is to coordinate, review, and stimulate the implementation of the Conference's resolutions relating to food production, human nutrition, food security, food trade, and food aid. The WFC seeks agreements between countries and works to secure the co-operation of governments and agencies on needed food and nutrition policy actions. It is not an executive body with operational programmes.
The United Nations Educational, Scientific, and Cultural Organization (UNESCO) is represented on the SCN because of its concern for the inclusion of nutrition in its on-going education activities. It also pays attention to the impact of under-nutrition and malnutrition on human growth and development, and consequently on learning capacity and behaviour.
The United Nations Industrial Development Organization (UNIDO) has an agro-industry development programme that contributes indirectly to improved nutrition in rural areas.
While nutrition is not the direct concern of the International Labour Organization (ILO), the ILO nevertheless participates in the SCN because it recognizes the role of food and nutrition as essential to livelihood and labour productivity, including that of women. It is also interested in the development and implementation of appropriate technology, and has a project for small technological changes in the home aimed at better food preparation and preservation.
The office of the UN High Commissioners for Refugees (UNHCR) has responsibility for organizing food, shelter, and other relief for refugees. In the Asian region it has recently dealt with refugee concentrations in Thailand, Pakistan, and Bangladesh.
The International Bank for Reconstruction and Development (IBRD), better known as the World Bank, includes nutritional considerations in many of its projects dealing with the agricultural, urban, population, and education sectors. Since 1973, direct lending for national nutrition projects has also become a Bank strategy. To date, large nutrition projects are being financed in Brazil, Colombia, Indonesia, and India (Tamil Nadu). In addition, nutrition components currently exist in about 60 other Bank projects. Sector and economic studies in nutrition and related economic and social considerations, feeding programmes, and food subsidies have also recently been added to the Bank's activities. Nutrition research at the field level has also been undertaken or financed by the Bank since 1973, notably in the areas of nutrition and productivity and the effects of parasitic infections on malnutrition.
The United Nations Development Programme (UNDP) is the largest single channel for multilateral technical co-operation designed to speed the economic and social development of developing countries. Resident representatives have been appointed in most countries receiving UNDP assistance. About 85 per cent of UNDP programme resources are used for country programmes, with the remainder devoted to regional, inter-regional, and global activities. Most projects are implemented through the organizations of the UN system acting as participating and executing agencies. Many of the projects supported have direct or indirect impacts on nutrition.
The International Fund for Agricultural Development (IFAD), the newest of the funding agencies, holds promise because of its large resources, its concentration on increasing the agricultural production of poor countries, and its emphasis on improving the nutrition of the rural poor.
The United Nations Research Institute for Social Development (UNRISD), in Geneva, is studying food security systems in a number of developing countries. The United Nations Fund for Population Assistance (UNFPA) supports research and action programmes with nutritional impact.
The SCN can be represented as in figure 1 with its complement of member UN agencies, its AGN, and its links to the bilateral assistance agencies whose members attend its meetings and participate in its discussions. Its Secretary is Dr. Leslie Burgess, whose office is at FAO headquarters in Rome. Its role is to harmonize the efforts of the UN system and to encourage bilateral help between countries in a manner that complements and supports the efforts of the agencies. It has provided a forum for multi-agency collaboration on nutrition surveillance, for assessment of technical issues such as interrelations of nutrition and education, and for programmatic issues such as the evaluation of intervention programmes, the strengthening of institutions for training, research, and advisory services, and the inclusion of nutritional considerations in agricultural and rural development. It is seeking to assemble case studies of successful and unsuccessful nutritional intervention efforts and to provide a mechanism for assisting countries in developing project proposals in suitable form for requesting bilateral, multilateral, and international assistance.
The harmony among agency representatives themselves at these SCN meetings has been virtually without precedent at the central level of the UN system. Co-operation among the four agencies most concerned with nutrition-FAO, WHO, UNICEF, and the UN University -has been particularly effective under this institutional arrangement. The AGN, meeting both with the SCN and independently, has also been useful. The co-ordination that can be achieved at the central level, however, is intrinsically limited and must be supplemented by co-operation at the regional and country level. Because of their highly non-congruent structures, coordination of UN agencies at the regional level is often difficult, but at the country level it is usually, though not always, quite good. As in all human activities, personalities can transcend institutional arrangements either favourably or unfavourably.
There are a number of international organizations which are not UN agencies but which are also making important contributions to the solution of food and nutrition problems. These include the International Food Policy Research Institute (IFPRI), in Washington, D.C., and the Institute for Applied System Analysis (IASA), near Vienna, which has an extensive series of models of country-specific food supplies and consumption. Mention should also be made of international agricultural institutes. These include, in Asia: the International Rice Research Institute (IRRI), in Los Baños, Philippines; the International Crop Research Institute for the Semi-Arid Tropics (ICRISAT), in Hyderabad, India; and the Asian Vegetable Research and Development Center (AVRDC), in Taiwan. In Latin America: the International Center for Tropical Agriculture (c/An' in Palmira, Colombia; the International Maize and Wheat Improvement Center (CYMMYT), in El Batan, Mexico; and the International Potato Center (CIP), in Lima, Peru. In Africa: the International Institute of Tropical Agriculture (IITA), in Ibadan; the International Laboratory for Research on Animal Diseases (ILRAD), in Nairobi; the International Livestock Center for Africa (ILCA), in Addis Ababa; and the West African Rice Development Association (WARDA), in Monrovia. And elsewhere: the International Board for Plant Genetic Research (IBPGR), in Rome; and the International Centre for Agricultural Research in the Dry Areas (ICARDA), with headquarters in Beirut and a research station in Aleppo, Syria. ICARDA works on increasing the production of major food crops through breeding and improvement of farming systems; its programme also includes improvement of forage and pasture.
FIG. 1. Central Nutrition Co-ordination of the United Nations System
Finally, it must be noted that initiatives in the UN system are increasingly passing to the developing countries themselves. The developing countries are indicating to the UN agencies the kind of assistance they need and want, and are insisting that it complement and not displace their own growing expertise. This is a welcome trend that bodes well for the future of the developing countries and the world.