|Ending Malnutrition by 2020: An Agenda for Change in the Millennium - Final report to the ACC/SCN by the commission on the nutrition challenges of the 21st century (ACC/SCN, 2000, 104 p.)|
|6. Vision and Goals for the Future|
The Commission now wishes to extend this vision to encompass a new paradigm of nutrition which incorporates the double burden of undernutrition and diet-related adult disease. This double burden is amplified by the link between maternal and fetal undernutrition and a population's later susceptibility to adult diet-related disease. This susceptibility is displayed when food consumption patterns change during economic development. Thus, there is a synergy between early undernutrition together with adult lifestyles which may help to explain the pandemic of non-communicable diseases. Our vision encompasses the development and implementation of national and international strategies which will allow societies and individuals to improve their life expectancy with minimum health handicaps from these preventable disorders in middle and old-age. It is not enough to acknowledge this moral imperative. The commitment needs to be translated into effective and strategic action.
We now know what needs to be done and have seen that rapid but sustained improvements in nutrition are possible. It is clear that current international support systems are inadequate. Current UN goals relating to undernutrition are incoherent and unambitious, which is why the Commission is challenging the UN to consider a new goal of ending malnutrition by 2020.
This, we believe, is ambitious but achievable. The 2020 date was chosen recognising that international conferences and summits have specified targets already for 2010 and 2015. This Commission is reporting well after these meetings, so a 2020 date is chosen to allow time to both formulate and implement new strategies. To specify an early date for achieving radical improvements in health would be unrealistic.
The 2020 date also takes account of our analyses of the potential rate of improvement in the global burden of underweight, children when this rate is based on the success of one country i.e. Thailand (see figure 6.1). The Commission highlights the issue of childhood undernutrition since it contributes long-term to the global burden; combating undernutrition and other forms of malnutrition, i.e. obesity, diabetes, coronary heart disease and cancer, now needs to be brought into a single strategy so that developing countries can limit the double-handicap of diet-related diseases (see below),
To assess how goals should be achieved, there is a need to assess why the international community has failed to implement existing knowledge before now. The outcome of such an assessment, coupled with proposals put forward in this Report, should then be the basis for regional taskforces to develop coherent strategies. We challenge the UN, national governments and other agencies to implement these proposals and turn words into action.