Programme News

AGENCIES REPORT ON THEIR ACTIVITIES IN NUTRITION

How is Interagency Coordination in Countries actually meant to work?

The global agendas emanating from the series of international conferences during the 1990s have consistently emphasized a holistic approach to development. This in itself has demanded an increasingly intelsectoral perspective. In a climate of resource stringency in both national budgets and aid accounts, international agencies are under pressure to assist in the development of national strategies to fulfill these fundamental yet difficult cross-sectoral agendas.

To facilitate this process, three ACC¹ interagency task-forces were established in October 1995 on (1) an enabling environment, (2) employment and sustainable livelihoods and (3) basic social services. They were asked to provide United Nations Resident Coordinators and country-level teams with coherent guidance and support in their efforts to assist countries to translate the outcome of conferences into concrete national policies and programmes.

¹ACC is the United Nations Administrative Committee on Coordination - see Box on page 45

²JCPG is the Joint Consultative Group on Policy. JCGP agencies include UNDP, UNICEF, UNFPA, IFAD^, and WFP, with UNHCR and UNCDF as observers.

³CCPOQ is the Consultative Committee on Programme and Operational Questions; a subsidiary body of the ACC which incorporates the ACC Sub-Committees (Including the ACC/SCN).

Thematic groups have been established by the UN system in virtually all countries. Only six countries reported having no thematic groups in 1996. These were Angola, Kuwait, Libya, Saudi Arabia, Afganistan, and N. Korea. Besides meeting periodically for purposes of information exchange and networking, 58% of countries reported some tangible outputs from the work of these thematic groups. Typical examples of outputs are joint programming, development of sector plans, and mobilization of resources. Topics covered by various groups are wide ranging, from very broad themes such as UN Conferences (Colombia and Pacific Islands), to specific priority problems such as safe motherhood (Eritrea, Lesotho), unaccompanied children (Rwanda), natural disasters or disaster management (Kenya, Malawi, Lesotho, Bolivia, Guatemala, Indonesia, Laos, Moldovia and Romania). Most thematic groups include participation by Governments, bilateral donors and NGOs.

In order to characterize this wide range of topics into a form that could be assessed for their significance for nutrition programming, four clusters of thematic group topics were typically formed. These include principally, themes related to food security and agriculture (1), health and population (2), poverty (3), and HIV (4). The Table (next page) shows the frequency with which each of these types of thematic groups has been established by region. Some of the most recent groups are those in the food security and agriculture cluster that were set up with FAO as lead agency following the World Food Summit.

Thematic groups dealing with HIV issues were found more often than any other topic, and were established in 83% of countries (90% of countries in SSA) with UN system presence worldwide. In nearly half of all countries (62% of Asian countries) thematic groups related to health and/or population services have been established. About one third of countries have poverty related thematic groups, and a similar proportion have food security and agriculture related groups. About 28% of SSA countries have thematic groups in both the health, and food security and agriculture related topics. In other regions the figures for this are 48% for Asia, 12% for LAC, and 0% for Arab States and 14% for EE and CIS. Countries without thematic groups in either of these two clusters: 33% of SSA, 80% of Arab States, 29% of LAC, 35% of Asian and 58% of EE and CIS countries.

Table: Interagency Thematic Groups on Nutrition-Related Topics in Countries, 1997

	NUMBER OF COUNTRIES
REGION	reporting	with>0 thematic groups	with>0 active* groups (%)	with FSSA1 groups (%)	with health / nutrition2 groups (%)	with poverty3 groups (%)	with HIV/AIDS groups (%)
Sub-Saharan Africa	40	39	21 (53)	18 (45)	19 (48)	10 (25)	36 (90)
Arab States	10	7	4 (40)	0 (0)	2 (20)	4 (40)	7 (70)
Latin America & Caribbean	17	17	8 (47)	4 (24)	9 (93)	7 (41)	13 (76)
Asia	23	21	18 (78)	9 (39)	15 (62)	11 (48)	18 (78)
Eastern Europe & CIS	14	14	9 (62)	4 (29)	4 (29)	4 (29)	12 (86)
TOTAL	104	98	60 (58)	35 (34)	49 (47)	36 (35)	86 (83)

Source: "Resident Coordinator Thematic Groups" note by CCPOQ Secretariat, July 1997

*Thematic groups were considered 'active' if any outputs or achievements were reported for 1996

¹Food security and agriculture: includes thematic groups on food security, agriculture, sustainable rural development, disaster management and humanitarian issues.

²Includes thematic groups on Basic Social Services, safe motherhood, human development social programs, maternal mortality and population.

³Includes thematic groups on poverty, enabling environment, environment, sustainable livelihoods, rural development, refugees and rehabilitation.

In order for the thematic groups to fulfil their potential, a lot still has to be done. In addition to increasing their coverage, there is a need to adapt technical agendas and strategies of agencies into effective plans and operations for countries, translating cross-sectoral priorities of countries and international agreements into sectoral priorities. Successful national policy formulation requires capacity in, e.g., analytical work in sectors and activities contributing to nutrition and food security outcomes, analysis of national budgets to reassess intra-sectoral priorities, and impact evaluation of on-going policies and programmes. This will facilitate new and concrete opportunities for action, including joint programming, and will also improve the incorporation of policy guidelines in the Country Strategy Note process.

To ensure coherence and integration between macroeconomic and social policy frameworks, and in cross cutting policy dimensions such as food security and nutrition, it is important that the technical knowledge base for translating policy and normative thinking into operations is developed and made available at the country level, taking into account the priorities of individual countries. The lead agency (or agencies) mechanism for providing this kind of support is essential.

For further information please contact Shubh K. Kumar Range, Food Security and Agriculture Programme, Bureau of Development Policy, or Office of UN Support Services, Office of the Administrator, UNDP, 1 UN Plaza New York. Tel: 2129065871 Fax: 212 906 6973 Email: shubh.kumar@undp.org

Interagency Follow-up to the World Food Summit

The World Food Summit was aimed at renewing global commitment to the fight against hunger. Following the decision taken by the ACC (see Box 1) at its April 1997 Session, arrangements are now being made to establish an "ACC Network on Rural Development and Food Security" that will constitute the mechanism for promoting interagency follow-up to the Summit. Within the framework of the ACC, FAO and IFAD are taking action to ensure the early establishment and operation of the network.

The World Food Summit Plan of Action stresses that the main responsibility for the implementation and monitoring of the follow-up to the Summit lies at the country level, where governments have the primary responsibility for creating an economic and political environment that assures the food security of their citizens. The network will focus on country-level action supported by a group of interested organizations (including non-UN) at headquarters level, to form a two-tiered informal coordination mechanism. At country level, efforts to establish interagency thematic groups on rural development and food security within the Resident Coordinator System are currently underway. Full reporting to the ACC is foreseen in order to place the network activities within the broader context of interagency coordination carried out by the ACC. The ACC will then report to ECOSOC in the spirit of ECOSOC Resolution 1996/36 (see Box 2).

Box 1: What is the ACC? The United Nations Administrative Committee on Coordination (ACC) was established in 1946 to: · supervise the implementation of the agreements between the United Nations and the Specialized Agencies; · coordinate the programmes approved by the various organizations of the UN system; · promote cooperation within the UN system in pursuit of the common golas of the Member States The ACC meets twice a year, and is made up of the executive heads of the specialized agencies (ILO, FAO, UNESCO, WHO, World Bank, IMF, ICAO, UPU, ITU, WMO, IMO, WIPO, IFAD, UNIDO, WTO), the IAEA, and nine United Nations programmes (UNCTAD, UNEP, UNDP, UNICEF, WFP, UNDCP, UNHCR and UNRWA). Mr Patricio Civili in the curent secretary of the ACC and the secretariat offices are located in New York.

Source: 'ACC Network on Rural Development and Food Security' note. Information about the World Food Summit is available on the World Wide Web at http://www.fao.org/wfs/homepage.html. Information about the ACC and ECOSOC was obtained from the two websites, http://www.un.org/dpcsa/dpcea/accback.html and http://www.un.org/Overview/Organs/ecosoc.html, respectively.

Interagency Meeting: Africa Nutrition Database Initiative

A second meeting of the ACC/SCN working group on the Africa Nutrition Database (ANDB) Initiative was held on 29 September 1997 in Geneva. The Initiative, first proposed by the World Bank, aims to establish a query mechanism to facilitate quick access to good quality nutrition data for African countries. Participants attended from the FAO, UNDP, UNHCR, WHO, World Bank and SCN Secretariat. A new approach to the query system was proposed, based on mirror sites within the local area network of each organization, and it was agreed that access to the Database during the initial software testing stage, should be limited to within the UN system. A core group of indicators were selected for inclusion in the Database. Once this project is up and running, users will be able to submit queries from one access point, to retrieve data from a number of different nutrition databases.

A copy of the meeting report can be obtained from the ACC/SCN Secretariat, c/o WHO, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland. Fax: 41 22 798 8891 Email: accscn@who.ch

Asia Pacific Food Analysis Network (APFAN)

APFAN commenced in 1989 with about 20 members and has grown steadily to its current size of 350 members from 28 countries. Its aim is to serve the needs of food analysts and thereby to promote food safety and good nutrition. It does this through several programs as follows:

· Annual hands-on Workshops held at the Queensland Health Scientific Services Laboratory in Australia where food analysts from developing countries learn an analysis of their choice. The Fifth Asia Pacific Food Analysis Workshop (5AW) was held on November 7-14,1997.

· Conferences every three years are held in the region. The Third Asia Pacific Food Analysis Conference (3AC) was held in Manila in 1995 and the Fourth Conference (4AC) will be held in Chiang Mai, Thailand on November 16-19, 1998. A first announcement is available.

· Short, hands-on courses of 2 weeks to 6 months duration for individuals from food laboratories in developing countries, who need specific training in certain analyses, techniques or use and maintenance of equipment.

· Inexpensive, standard reference materials are available through ASEANFOODS, supported by APFAN, from Dr Prapasri of the Institute of Nutrition, Mahidol University, Bangkok, Thailand.

Food analysts may join APFAN by contacting Dr J Howard Bradbury, Coordinator of APFAN, Division of Botany and Zoology, Australian National University, Canberra, ACT 0200, Australia. Tel 61 2 62490775: Fax 61 2 62495573: Email Howard.Bradbury@anu.edu.au.

FAO

Food Composition Activities

The First FAO/UNU East, Central and Southern Africa Food Composition Network (ECSAFOODS) training course on the Production and Use of Food Composition Data in Nutrition, organized jointly with the Medical Research Council of South Africa, was held at the University of Western Cape, Cape Town, South Africa, from 23 June to 11 July, 1997. Participants came from Botswana, Ethiopia, Kenya, Malawi, Mozambique, Namibia, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. One professional from Benin attended as observer. The purposes of the course were: i) to review the status of food composition activities in the ECSAFOODS Region and the technical capacity to analyze and report on food composition; ii) discuss priorities for data review and data generation, together with the possible contributions from institutions in the region and, iii) discuss the steps required to compile mutually acceptable databases, with potentially interchangeable data, in each of the represented countries.

FAO organized jointly with the Latin American Nutrition Society (SLAN) and LATINFOODS, a Symposium on food composition activities, held in Guatemala City, Guatemala, from 10-12 November 1997. The Symposium was part of the XI Congress of SLAN and was aimed at strengthening the activities of LATINFOODS and its Subregional Centers. Ongoing food composition activities in Latin America were reviewed and recommendations for the development of a work plan at both national and regional levels were made.

FAO is providing technical and financial assistance to the Institute of Nutrition and Food Technology (INTA) of Chile, for the preparation of a regional food composition database for Latin America, and to publish and distribute it in both written and electronic form (CD-ROM).

FAO has also provided support for the publication of revised food composition tables in various countries. In addition, a project proposal for food composition activities in Central and Eastern Europe has been prepared with FAO technical assistance and submitted to the INCO-COPERNICUS programme of the EU for consideration and possible funding. Through its Technical Cooperation Programme (TCP), FAO is considering project proposals received from Guinea, and Nicaragua for direct technical assistance in this area.

Inter-Country Workshop on Nutrition Education and Food-Based Dietary Guidelines

Following two expert consultations on nutrition education and food-based dietary guidelines respectively, FAO is promoting the outcome of the consultations in different regions of the world. Inter-country meetings have been supported, partially with ILSI, as follows:

· Séminaire Atelier inter-pays sur l’éducation nutritionnelle, 9-13 June 1997, Lomé, Togo.

· Joint FAO/ILSI Europe Workshop on the development of local food-based dietary guidelines and nutrition education, 22-25 September 1997, Bratislava, Slovak Republic

· Joint FAO/ILSI Europe Workshop on the development of local food-based dietary guidelines and nutrition education, 3-6 November 1997, Vilnius, Lithuania

· Inter-country Workshop on nutrition education and consumer awareness in English-speaking countries of Near East, 3-6 November 1997, Cairo, Egypt.

· Regional Workshop on Diet, Nutrition and Lifestyles for Gulf countries, 6-8 December 1997, Bahrain.

Incorporating Nutrition and Household Food Security into Emergency Relief and Rehabilitation

The Nutrition Programmes Service provided technical assistance to WFP in the organization of a three-day training workshop on household food security and nutrition for Ministry of Health and WFP field staff in Rwanda. Invitations were also extended to relevant Ministries, NGOs and international organizations. The workshop, which drew extensively on participatory techniques, clearly demonstrated the need for intersectoral collaboration and decentralised planning to address the specific needs of vulnerable population groups in a given area and make the best use of available resources.

During a visit by a staff member of the Food and Nutrition Division to the Crop and Food Supply Assessment Mission in Burundi (19-30 June), efforts were made to strengthen the co-ordination of UN agencies operating in the country (particularly WHO. UNICEF, WFP and FAO), NGOs and government institutions in assessing the extent of malnutrition among the civilian population affected by the conflict and developing appropriate interventions.

Codex Alimentarius Commission 22^nd Session, 23-28 June 1997

The dual problem of protecting consumers while at the same time facilitating trade in agricultural and food products, led to the creation in 1962 of the Joint FAO/ WHO Food Standards Programme. The Programme operates through an inter-governmental body - the Codex Alimentarius Commission, which currently has 159 member countries. The standards, guidelines and recommendations of the Commission are used by the World Trade Organization as reference points. FAO, the major sponsoring body of the Codex Alimentarius Commission (~80%), provides technical assistance to developing countries of the sort provided for in the WTO Agreements. FAO gives assistance to countries in developing food quality and safety legislation, food inspection and analytical services, food control programme management, import/export inspection and certification programmes, contaminants monitoring and more recently in the area of food hazard analysis, risk assessment, risk management procedures.

The Commission held its 22^nd Session from 23-28 June, 1997, covering a wide-ranging agenda that included food safety and hygiene, food labelling and additives. The meeting was attended by 444 participants from 86 countries. Some highlights of the Session are summarized below.

Food hygiene code revised. The Commission approved a major revision of the code of practice so that it includes all aspects of the food chain, from production on-farm to preparation in the home, concentrating on the handling, processing and distribution of food products where most of the risks can be controlled.

Are unpasteurized cheeses safe for human consumption? In some countries (mostly European), a number of dairy products, particularly soft cheeses, are traditionally manufactured from unpasteurized milk. Some countries, including the USA, requested that pasteurization should constitute the backbone of these Codex standards as a widely accepted and recognized safety measure. A number of European countries however, hold the view that there are other approaches that could achieve safety. Commission participants agreed to return to this issue at the next session in Rome 1999. In the meantime, the matter was referred back to the Codex Committee on Milk and Milk Products and Food Hygiene for further examination.

Is the use of bovine somatotropin (BST) universally acceptable? BST, designed to increase milk production, is not authorized for marketing and administration to dairy cows in the territory of the European Union and a number of other countries. On the other hand, BST is fairly widely used in animal husbandry in the USA and elsewhere. The Codex Commission decided to request that the latest scientific evidence be provided for further consideration. The matter will be further examined by the Committees on Veterinary Drug Residues and on General Principles.

How low is 'low fat'? In order to facilitate trade in foods claiming to be 'low fat', 'sugar free' or 'light', the Commission approved new guidelines governing such claims as a supplement to the General Guidelines on Claims. For example, to claim that food is 'light' or 'reduced' it must be at least 25% less in energy content than the standard product. The guidelines provide a number of definitions and general requirements concerning consumer information.

Maximum residue limits for pesticides in food. Over 2 500 Maximum Residue Limits (MRLs) are currently approved by the Commission. During the June meeting, the Commission deleted 315 MRLs (covering 39 pesticides) from the Codex list as being obsolete. This means that no level of residue is acceptable for those pesticides.

Source: FAO; FAO News Highlights 1997; WHO Press Release, June 1997; Web: http://www.fao.org/waicent/faoinfo/aconomic/esn/codex/codex.htm/ Further information about the Codex Alimentarius Commission can be obtained by emailing codex@fao.org

Hazard Analysis and Critical Control Point (HACCP)

The HACCP is a control system. It is based on prevention and control of known food hazards by controlling critical points in the food processing, production or manufacturing. It is a management tool that provides a structured approach to the control of identified food hazards that would be ordinarily achieved using traditional inspection, sampling and testing procedures. By using a HACCP system, control is transferred from end product testing - testing for failure - into the design and manufacturing - preventing failure. Today, HACCP is considered to be one of the most effective and efficient ways to enhance food quality and safety, and will soon be required as a mandatory programme for producers to successfully export their food products to many food importing countries.

FAO has developed a HACCP based system training programme for Training of Trainers which will soon be published and available for general use as a harmonized approach to providing practical training in HACCP implementation. The training programme is based entirely on the Codex Alimentarius Commission system of scientifically supported food standards, Codes of Practices and various guidelines on food hygiene, microbiological criteria and on HACCP application and implementation. FAO provides technical assistance in food quality and safety matters and this training programme on the implementation of HACCP based systems is expected to provide significant enhancement to national food safety programmes through training programmes at national training institutions.

For further information about the HACCP and technical assistance projects from 1988-1997, please contact the Food and Nutrition Division, FAO, Via delle Terme di Caracalla, 00100 Rome, Italy. Fax: 396 5225 4593

Joint FAO/WHO Expert Consultation on Vitamin and Mineral Requirements

A joint FAO/WHO expert consultation aiming to review, revise and update vitamin and mineral requirements is planned for September 21^st-30^th 1998, in Bangkok, Thailand. Recommendations for vitamin and mineral requirements were last published in 1974 (Handbook on Human Nutritional Requirements, FAO/WHO, Rome, 1974), although this has since been updated for certain vitamins and minerals. For example, requirements for folate, vitamin A, iron and vitamin D requirements were revised in 1985. The panel will consider all essential vitamins and minerals with the aim of ensuring that the latest scientific developments are being incorporated into current recommendations.

For further information, please contact Dr Joan Conway, Project Coordinator (FAO), Food and Nutrition Division, FAO, Viale dell Terme di Caracalla, 00100 Rome, Italy. Tel: 5705 3322 Fax: 5705 4593 Email: Joan.Conway@fao.org

Nutrition in GTZ

The Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH, is the German agency for technical cooperation which plans and implements contributions to projects in more than 90 developing economies in Africa, Asia, East Europe and Latin America. Funds are allocated on a project-by-project basis by the German Federal Ministry for Economic Cooperation and Development. GTZ also works for other German Ministries, federal states, the European Union and Development Banks, such as the World Bank and the Asian Development Bank. Around 8% of the budget is dedicated to food emergency and food and nutrition security programmes.

In the late 1980s, GTZ made efforts to integrate nutrition as one central aspect into development projects. The importance of nutrition in the development process has been stressed again more recently in the context of poverty alleviation, which is of crucial priority for German development policy. In several GTZ-assisted projects in Indonesia, nutritional surveys have been carried out to target the poor, to diagnose and analyze the magnitude, severity and causes of poverty, to identify the resources available to reduce poverty, and to set a baseline for monitoring the impact of the projects. Presently, this experience has been extended to GTZ-assisted projects in other countries. With these activities, nutrition has received a new emphasis in the German technical cooperation.

According to GTZ, there are three programme types that may require nutritional expertise in the future.

1. Freestanding nutrition programmes at the grass roots and policy levels

Currently, most nutrition programmes are freestanding food and nutrition security programmes, operating at the grass roots level and targeting directly chronic and transitory food insecurity of vulnerable communities and groups. In addition there are programmes which influence and improve nutritional policy at the governmental level. Advanced training programmes in applied nutrition belong to this category.

2. Emergency relief programme

Over the last decade, the German government has increased efforts in emergency programmes and as a result, the activities of GTZ in this area have expanded substantially, with food and nutrition playing a major role in emergency relief programmes.

Advanced training programmes supported by GTZ · Institute of Nutrition, Federal University of Rio de Janeiro, Brazil (1983-87) - MSc (2y) · Department of Applied Human Nutrition, Agricultural Faculty, University of Indonesia, Jakarta, Indonesia (since 1990). Diploma (5mo); MSc (2y); Diploma (4mo) · National Institute of Nutrition, Ministry of Health, Hanoi, Vietnam (since 1993) - MSc (2y); Diploma (4mo)

3. Poverty oriented programmes

Recent experience in the field of poverty alleviation has produced an additional area of action. The design and monitoring of poverty alleviation projects and the evaluation of their impact requires expertise in nutritional epidemiology and planning. In particular, expertise is needed in the following areas: identification of target groups with the greatest needs; identification of causes of problems and potentials for solutions; formulation of problem-solving strategies; and defining monitoring and evaluation. As a result, development agencies such as GTZ need community nutrition professionals with interdisciplinary and intersectoral, problem-oriented knowledge, skills, and attitudes to respond flexibly and innovatively to challenges. Most academic training however, does not respond to these needs and knowledge on indicators for targeting, identifying causalities, monitoring, evaluating and implementing poverty alleviation programmes is still inadequate. Focusing academic training and research in the field of nutrition on needs will help to improve the quality of programmes and thus also the quantity of basic needs-oriented activities.

This article was submitted by Rainer Gross (team leader of the GTZ-assisted SEAMEO-TROPMED community nutrition project at the University of Indonesia), Rolf Korte (head of the Health, Population and Nutrition Division at GTZ), Hans Pfeifer (senior desk officer of the department of food security in GTZ), and Werner Schultink (team member in the SEAMEO-TROPMED community nutrition programme in Indonesia). For further information about nutrition activities in GTZ, please contact Dr Rainer Gross, GTZ/SEAMEO, P.O. Box 3852. Jakarta 10038, INDONESIA. Tel: 62 21 391401; Fax: 62 21 391 401; Email gtzseame@indo.net.id

Nutrition Activities at the International Atomic Energy Agency (IAEA)

To many people it may seem strange that IAEA has a nutrition programme. In fact the nutrition group is called the 'Nutritional and Health-Related Environmental Studies Section' and is nested in the Division of Human Health, which in turn is part of the Department of Research and Isotopes. The main aim is not to "do" nutrition but to bring isotopic techniques from concept to field application and to show that they can be used to address the nutritional issues of the day. The group works within IAEA's normal programme that:

· supplies research fellowships (often linked to other activities);
· manages coordinated research projects (CRPs);
· brings technical expertise to major technical cooperation projects.

Currently, there are two CRPs devoted entirely to nutrition. First, the thorny question of the measurement of vitamin A status is being tackled by the use of labelled isotope techniques to measure whole body stores; the methodologies are currently being developed and field-tested. Second, a regional CRP in Latin America is using deuterium labelled water to measure breast milk intake in infants. In this case, a well-established procedure is being used in a standard way to investigate the effects of a various factors (smoking, breast-feeding promotion and advice, supplementation) on milk production and infant growth. Other CRPs, such as one on osteoporosis for example, also have implications for nutrition. Three new CRPs are expected in 1998.

Isotope-aided studies of nutritional factors associated with chronic and degenerative diseases during aging. A number of programmes using isotopic techniques are well established in industrialized countries to assess the role of specific nutrient deficiencies or excess in the development of cardiovascular disease, diabetes and other chronic diseases of the elderly. The methods and experience need now to be transferred to the developing world (especially to countries in transition) where under-nutrition in childhood may predispose individuals to greater risks in later nutritional affluence.

Isotope-aided studies of nutrient interactions in developing country populations exposed to multiple nutritional deficiencies. The aim of this project is to develop methods to evaluate micronutrient interactions by non-invasively measuring absorption, stores, turnover and balances in chronically undernourished populations.

Isotopic evaluations in infant growth monitoring (in collaboration with WHO). Here, collaboration with WHO focuses on nutrient requirements. WHO's nutrition programme is developing new growth curves based on breastfed infants (see page 55), and IAEA will use stable isotope methods to measure the breastmilk and other nutrient intakes that have produced the normal growth.

In addition to these activities, nutrition monitoring has been built into several technical cooperation projects in which interventions (not always nutritional) are expected to have a benefit on the nutritional status of the population.

For further information, please contact Dr Andy Coward, Nutritional & Health-Related Environmental Studies, IAEA, POB 100, A-1400 Vienna, Austria. Fax: 431 220607; Email w.a.coward@iaea.org

International Dietary Energy Consultancy Group (IDECG) - Workshop on Causes and Consequences of Intrauterine Growth Retardation

An IDECG workshop on causes and consequences of intrauterine growth retardation (IUGR) was held in November 1996, and the proceedings of this workshop are currently in press as a supplement to the European Journal of Clinical Nutrition. Data presented at the meeting confirmed that the prevalence of IUGR in most developing countries is a major public health problem and that population-wide strategies to reduce it are urgently needed. The causes of IUGR are multiple and interactive, and their relative importance varies with time, place and population. In developing countries, the major determinants of IUGR are nutritional: low gestational weight gain (primarily due to inadequate energy intake), low body mass index at conception (reflecting chronic maternal undernutrition) and short maternal stature (primarily due to undernutrition and infection during childhood). Malaria is a major determinant in malaria-endemic areas. In industrialized countries, cigarette smoking is by far the most important etiologic determinant, followed by low gestational weight gain and low pre-pregnancy body mass index.

IUGR is associated with impaired immunocompetence, increased morbidity and mortality in infancy and growth deficits persisting into adulthood. Neurological, cognitive and behavioural deficits appear to be most marked from the pre-school years through adolescence. Several epidemiological studies have shown associations between low birth weight and earlier and higher prevalence of hypertension, coronary heart disease, adult onset diabetes, chronic respiratory disease, autoimmune thyroid disease and some forms of cancer (see also feature in SCN News No. 14). A systematic review¹ of 126 available randomized controlled trials testing the efficacy of 36 kinds of prenatal interventions aimed at reducing IUGR provide strong evidence of benefit only for three of them: balanced protein-energy supplementation, strategies to reduce maternal smoking and anti-malarial prophylaxis. The proceedings of this meeting will be available from the IDECG Secretariat early next year.

¹Gulmezoglu, M., de Onis, M. & Villar, J. (1997). Effectiveness of interventions to prevent or treat impaired fetal growth. Obstetrical and Gynaecological Survey, 52(2), 139-149. UNICEF Nutrition Paper of the Month, September 1997.

The proceedings of earlier IDECG workshops are available on the following topics:

· Chronic energy deficiency: consequences and related issues
· Activity, energy expenditure and energy requirements of infants and children
· The effects of improved nutrition in early childhood: the INCAP follow-up study
· Early supplementation feeding and cognition
· Protein-energy interactions
· Causes and mechanisms of linear growth retardation
· Effects of protein-energy malnutrition on behavioural development
· Energy and protein requirements

Interested professionals working in these areas can obtain these publications free of charge from the Secretariat of IDECG, c/o Nestle Foundation, P.O. Box 581,1001 Lausanne, Switzerland. Fax: 021 320 33 92

This article was submitted by Dr. Lawrence Haddad, Director FCND, 1200 Seventeenth Street, NW, Washington D.C. 20036, USA. Fax: 2024674439. Email: IFPRI@CGNET.COM

Food Consumption and Nutrition Research at IFPRI: A Brief Profile of Activities

Since its inception in the late 1970s, the mission of the Food Consumption and Nutrition Division (FCND) at the International Food Policy Research Institute (IFPRI) has been to generate and disseminate information and analysis for use by decision makers to help design and implement policies and programs to help poor individuals obtain access to food and generate improved nutrition status. In that capacity, the Division is currently undertaking around 20 research and outreach projects in 12 countries in sub-Saharan Africa, South Asia and Latin America. FCND's current work in nutrition focuses on the following.

· Urban malnutrition - levels, determinants, responses (Accra and Lima).

· The development of food and nutrition indicators (Honduras, Mali, Malawi, India).

· The impacts of group-based credit on food consumption and nutrition (Bangladesh, Malawi, Madagascar, Egypt).

· The analysis of tradeoffs between female employment and the provision of care (Ghana, Peru, Bangladesh).

· The nutrition impact of changes in the design of cash and food subsidy systems (Egypt, Mozambique).

· The implications of the human rights agenda for food and nutrition policy research.

· The linkage between global food demand projections and the projected numbers of malnourished children.

· The linkages between democracy and nutrition and health indicators.

· The implications of agricultural technology adoption for micronutrient consumption and child development (Bangladesh).

· The links between women's status and child health outcomes (Ethiopia, South Africa, Bangladesh, Peru).

· The IFPRI-led initiative involving other centers of the Consultative Group on International Agricultural Research (CGIAR) to determine the potential for micronutrient malnutrition reduction through the breeding of nutrient-dense staple foods (e.g. improving the zinc density in wheat).

IUNS: 50 years of International Cooperation (1947-1997)

In 1946 a proposal to form the International Union of Nutritional Sciences was discussed at a meeting convened in London by the British Nutrition Society. In 1948, the principal objectives of the Union were defined as being the exchange of information, the organization of international congresses and the publication of results of scientific investigation. Since then the Union has grown steadily. The work of the Union is directed by the General Assembly, which meets at the time of the international congresses. The next international congress (the XVII International Congress of Nutrition), will be held in Vienna, Austria, 24 August -1 September, 2001.

The IUNS has recently published its 1995/1996 Annual Report which aims to inform readers about IUNS activities and the activities of Adhering Bodies, Affiliated Bodies, consultative groups and some nutrition and health-related international agencies. This report will be useful to nutritionalists, nutrition-related scientists and other interested professionals. It is hoped that the report will serve as a background information for representatives of various Adhering Bodies to contribute ideas to the IUNS Assembly or Council in laying the IUNS policy and plan as well as the activities in the next few decades.

For further information, please contact the IUNS Secretary General, O.M. Galal, UCLA School of Public Health, 10833 Le Conte Avenue, Los Angeles, CA 90024-1772, U.S.A. Tel: 1 310 206 9639 Fax: 1 310 794 1095 Email: ogalal@ucla.edu.

United Nations Research Institute for - Social Development (UNRISD)

Advancing the Social Agenda: Two Years after Copenhagen

A one-and-a-half day public meeting sponsored by UNRISD on 9-10 July 1997, Geneva, ended with concrete recommendations for follow-up to the World Summit for Social Development held in Copenhagen in 1995. Development of a legally binding convention for the eradication of poverty and development of South-South solidarity, were among eight points identified for concrete action by Ambassador Juan Somavia, Chairman of the UNRISD Board.

The central theme of social integration was explored in three sessions at the meeting. The session on ethnic diversity reminded the public that over 8000 ethnicities live in 185 states. The need to co-exist peacefully is thus crucial, as most conflicts are related to ethno-political struggle. Emphasis was placed on meeting basic human security needs such as jobs, education, income, food, health and personal safety for all groups if long-term stability is to be achieved. The session on healing the wounds of war took this concept further, stressing that in post-conflict societies rebuilding involves not only physical reconstruction but also reconciliation and forgiveness among affected parties. Finally, the session on urban social problems called for: a legal structure to protect and promote collaborations between local authorities and community organizations; large-scale capacity building for community-based organizations, NGOs and local authorities; and re-orientation of the education of city planners.

Source: UNRISD press release, July 1997

Food Security in Cambodia: A Preliminary Assessment

A major challenge facing countries that have been devastated by war and social upheaval is the restoration of a minimum level of food security. In Cambodia this challenge is particularly great as decades of turmoil have resulted in widespread poverty and vulnerability as well as the breakdown of state and community institutions.

In a 1997 UNRISD discussion paper, Vincent Tickner assesses what is known about the current state of food security in Cambodia, identifies the major factors underpinning food insecurity and considers the role of government and international agencies in dealing with related food security problems. The author identifies principal agro-ecological, institutional and economic factors affecting food security at both national and household levels. He argues that although certain government and international agencies identify food security as a priority development issue, they have not put in place policies or programmes to address the issue directly or systematically. The author also suggests that many international agencies have failed to comprehend the range of strategies and responses that most Cambodians have developed to overcome food insecurity. Agencies that intervene to support food insecure populations should begin by considering household coping strategies, thus building on what people are already doig to overcome this situation.

A copy of this discussion paper can be obtained at $5 for readers from the North or $2.50 for readers from the South. Source: UNRISD discussion paper 80 and UNRISD press release, April 1997. A list of UNRISD's free and priced publications, and more information about UNRISD research programmes can be obtained by contacting Rosemary Max, Programme Information Officer, Reference Centre at: the United Nations Research Institute for Social Development, Palais des Nations, 1211 Geneva 10, Switzerland. Tel: 41 22 798 84 00 / 798 58 50 Fax: 41 227400791: Email: info@unrisd.org of max@unrisd.org: World Wide Web; http://www.unrisd.org.

Micronutrient Initiative Ottawa

Expert Consultation on Determinants of Anemia

An expert consultation on determinants of anemia sponsored and hosted by the Ml was held September 16-17, 1997 in Ottawa. The consultation was chaired by Rebecca Stoltzfus. Stuart Gillespie served as rapporteur and some 14 experts attended. The objectives of the consultation were to analyse evidence on the etiologies of anemia including deficiencies of iron, folate, other micronutrients, malaria, hookworm, schistosomiasis, etc., to determine the relative contributions of each to anemia in different regions and different age groups; to identify efficacious and effective interventions; to identify gaps in knowledge and to identify the implications of the above for policies and programs, relating particularly to the issue of integration. The importance of each determinant of anemia in each age/physiologic group should conceivably influence the mix of interventions appropriate for the target group. A matrix was developed to look at each determinant in each age/physiological group and Africa was used as an example. The participants also assessed the relative importance of each determinant for each age group. For example, the biovailability of iron in complementary foods given to breastfed infants less than one year old was considered the primary determinant of anemia in this age group, whereas malaria was considered the primary determinant of anemia in women in first pregnancy (in malarious areas). Tools for assessing each of the determinants in the field were also proposed. A report of the meeting will be available by December 30,1997.

Micronutrient Initiative/UNICEF - Eastern and Southern Africa Consultation on Anemia

The MI and UNICEF Regional Office for Eastern and Southern Africa co-sponsored and participated in an Eastern and Southern Africa Consultation on Anemia, held on 17-19 November 1997, in Arusha, Tanzania. Meeting participants included representatives from national Ministries of Health, Agriculture, Industry, as well as from the research and university communities, food industry and health and nutrition program managers. The meeting aimed to raise awareness of the problem and consequences of anaemia, to discuss a mix of interventions appropriate for the prevention and control of anemia in the region, to review the status of anemia prevention and control strategies in the region, and to develop a workplan and follow-up actions.

Source: Janice Johnston, Senior Program Officer, Micronutrient Initiative, International Development Research Center, P.O. Box 8500, 250 Albert Street, Ottawa, Ontario K1G 3H9, Canada. Tel: 613 236-6163 x 2427 Fax: 613 236-9579 E-mail: jjohnston@idrc.ca

WFP Initiative on "Ending the Inheritance of Hunger"

Children under five, and pregnant and breastfeeding mothers, have special food needs. Inadequate nutrition in the first years of life and before is likely to damage health, mental development and future labour productivity. The high demands of reproduction deplete a woman's nutrient stores, increasing her vulnerability to disease and reducing her capacity to work and care for her children. The consequences of "early malnutrition" reach beyond the individuals and families involved. Society as a whole suffers losses when children cannot learn, when poor health restricts productivity, and when malnourished women give birth to the next generation that will also be malnourished.

Assistance to mothers and children "at risk" features prominently in the core policies and strategies that govern WFP activities. One of the strategic goals set by the WFP Mission Statement is to provide food aid "to improve the nutrition and quality of life of the most vulnerable people at critical times in their lives". WFP has begun to elaborate this mandate and the strategic implications of increasing its focus on tackling early malnutrition. In 1997, WFP/WHO conducted a thematic evaluation of supplementary feeding programmes targeted to children under five and mothers (document WFP/EB.3/97/5/Add.4). At the request of WFP, WHO conducted a literature review on the role of supplementary feeding and a review of recent WFP-assisted projects of this type (document WHO/FSF/FAP/97.1, Food Aid Programmes Unit, WHO). The role of food assistance in addressing the food needs of women and children at critical times of their lives was discussed at a 2 day technical consultation held in Rome in early May 1997. On 31 May 1997, a seminar entitled "Ending the Inheritance of Hunger" was organized by WFP in partnership with the United Nations University. It brought together representatives of WFP's Executive Board and of other Member States, United Nations agencies, NGOs and eminent scholars (R. Fogel, C. Garza, N. Scrimshaw, A. Sen). Copies of lectures from this seminar are available from the Strategy and Policy Division, WFP (see below).

Based on this process, WFP prepared a policy paper entitled "Reaching Mothers and Children at Critical Times of their Lives" (document WFP/EB.3/97/3-B). In October 1997, the WFP Executive Board considered this paper and endorsed the following policy and operational principles for food assistance.

Greater focus on tackling early malnutrition. WFP will increase the share of food assistance to contribute to improving the nutritional status of mothers and children at critical times in their lives.

Advocacy. Problems of early malnutrition will receive priority attention in the assessment of country needs for food assistance. WFP will define and communicate this focus in the context of the United Nations country strategy process and through dialogue with national authorities and the bilateral donor community.

Priority groups. WFP will limit its assistance to those women and children whose nutritional vulnerability is directly linked to a lack of sufficient and appropriate food intake. Priority will be given to malnourished children and undernourished pregnant and breastfeeding mothers. Food delivery performance, child growth and birth weight are the key indicators for monitoring progress. Food assistance with a focus on the prevention of early malnutrition will require careful analysis and verification that supplementary feeding is indeed the best means of achieving this objective.

Food rations. Commodities included in the food basket will be micronutrient-fortified to the extent possible. WFP will strengthen its assistance to the local production of low-cost blended foods.

Cost-effectiveness. The appropriateness of the food aid intervention will be judged on the basis of its targeting and transfer efficiency. In LDCs, where it is needed most, such assistance may involve higher costs.

Safeguarding the effectiveness of food assistance. To ensure that its food assistance is fully effective, WFP will take pro-active measures such as: strengthened efforts to integrate WFP's work with other United Nations agencies; increased collaboration with NGOs and bilateral donors; and, especially in post-emergency situations and in remote areas where food needs are greatest, increased flexibility to meet a minimum of non-food expenditure such as training, nutrition education materials, weighing scales, growth charts, etc. from WFP's own resources.

Duration of assistance. The sustainability and appropriate duration of WFP food assistance to address early malnutrition must be considered in terms of its long-term benefits. Its duration should be determined in light of need, the recipient countries' own capacities and commitment, and the actual performance of the WFP-assisted programmes. Nevertheless, suitable exit strategies will need to be identified at the outset of any WFP involvement in supplementary feeding activities.

Development in relief. WFP will continue to make optimum use of targeted supplementary feeding programmes through MCH structures as a safety net during the phasing out of general relief programmes. WFP will encourage the alignment of financial, technical and administrative resources in relief situations with the longer-term strengthening of MCH services for populations in remote, food-insecure areas.

Source: Strategy and Policy Division, WFP, Via Cristoforo Colombo 426, 00145 Rome, Italy. Email: Wolfgang.Herbinger@wfp.org (Tel: 396 6 513 2621) Dianne.Spearman@wfp.org, mokbelm.who.ch. Many WFP documents are available on the Web via the WFP homepage: http://www.unicc.org/wfp/Wfphome.html.

WHO

WHO Multicentre Growth Reference Study

WHO continues its efforts towards the development of a new international growth reference based on healthy growing breastfed infants from different countries (see article in SCN News No. 14). For the past few months the Working Group on the Growth Reference Protocol has been working to produce the generic study instruments, that is, the study questionnaires, interviewer guides, measurement and standardization protocols, manual of operations, standardized data entry forms, and data entry software. The instruments will be finalized at a meeting of the Working Group in Pelotas, Brazil from 16-18 December 1997.

One of the main distinguishing features of the new reference is that it will be based on an international sample of infants. The formulation of a truly international growth reference will avert the political difficulties that arise from using a single country's child-growth pattern as a worldwide "standard" for optimal growth. To this end it is envisaged that the study will involve 6 to 8 geographically diverse sites, covering North and South America, Europe, sub-Saharan Africa, and Eastern, South and Western Asia. Thus far two sites have been selected: Brazil in South America (Principal Investigator. Professor Cesar Victora) and the USA in North America (Principal Investigator Professor Kathryn Dewey). The Brazilian site, located in Pelotas, initiated data collection in July, 1997 and is serving to pilot test the protocol and study instruments.

The initiative has been very well received by governments and research institutions. As a direct result of a write up in SCN News No. 14 earlier this year, requests were received from several countries and these applications are being evaluated to ensure selection of the most appropriate settings for successful implementation. Norway will participate as a study site, and site evaluation visits to Argentina, Bangladesh, China, Oman and Turkey will be conducted before the end of the year. At the same time funds are being sought for developing country participation as well as for the central coordination of the study by WHO/HQ. Because of its magnitude, is clear that this ambitious international undertaking will not succeed without the support of the international nutrition community.

The study continues to attract considerable attention within the international scientific community. Formal presentations in this connection will be made at the XII International Congress of Pediatrics (Amsterdam, August 1998). In addition, a number of research papers based on the work of the WHO Working Group on the Growth Reference Protocol are being submitted for publication to peer-reviewed journals (for example, see Pediatrics, 1997, Vol. 100 No. 5). The UNU Food and Nutrition Program is cooperating closely with WHO on this project and WHO hopes to have the support of other agencies in the future.

This activity is of great public health significance for the well-being of children. The new international growth curves based on breastfed infants will serve the world community for many years to come.

For further information, please contact Dr Mercedes de Onis, The WHO Multicentre Growth Reference Study, Nutrition Programme, World Health Organization, 20, Avenue Appia, 1211 Geneva 27, Switzerland. Tel: 41 22 791 3320 Fax: 41 22 791 0746/4156 Email: deonism@who.ch

Joint FAO/WHO Consultation on Exposure Assessment of Food Chemicals

As a follow-up to an earlier consultation on predicting dietary intake of pesticide residues, a Joint FAO/WHO Consultation on Food Consumption and Exposure Assessment to Chemicals was held from 10-14 February 1997 at WHO Headquarters in Geneva, to address issues related to estimating food consumption at the international level, assessing risks posed by acute hazards in foods and harmonising exposure assessment methods across various food chemicals, including nutrients. An Executive Summary of the report highlighting the important recommendations is available from the Programme of Food Safety and Food Aid (FSF) at WHO. The full report will be available in the near future from the Programme of Food Safety and Food Aid, WHO (see next page).

Study Group on Safety of Aquaculture Products

A Study Group on food safety issues associated with products from aquaculture convened in Thailand from 22-26th July 1997. The meeting was jointly organised by the Fisheries Department of FAO, the Network of Aquaculture Centres in Asia and the Pacific (NACA) and the Programme of Food Safety and Food Aid (FSF) of WHO. The Study Group considered food safety issues associated with farmed finfish and crustaceans, particularly those associated with biological and chemical contamination that may occur during the production of these aquatic products. It discussed the identification and quantification of hazards and how to implement measures for control of potential food safety hazards, including current national and international programmes. Further information can be obtained from the Programme of Food Safety and Food Aid, WHO (see below).

Joint FAO/IAEA/WHO Study Group on Wholesomeness of Irradiated Food

A Joint FAO/IAEA/WHO Study Group on the whotesomeness of food irradiated with doses above 10 kGy, was convened from 15-19th September 1997 at WHO Headquarters in Geneva. The Study Group reviewed all relevant data related to the toxicological, microbiological, nutritional, radiation chemical and physical aspects of food exposed to doses greater than 10 kGy and came to the unanimous conclusion that the food is safe for consumption. Food irradiated under proper conditions to all doses appropriate to the intended technological objectives is safe to consume and adequate for nutrition and that the process is self-limiting, which means that no upper dose limit should be imposed.

The presence in food of harmful microorganisms such as Salmonella species, Escherichia coli O157:H7, Listeria monocytogenes, or Yersinia enterocolitica is a problem of growing concern to public health authorities all over the world. For certain products, food irradiation may be the best method to ensure the absence of these microorganisms, although in some instances, an upper limit of 10 kGy for the overall average dose could preclude the effective use of the technology. In the case of irradiation of spices, the need for a greater dose has already been recognised in several countries, and still higher doses are required for sterilisation of food.

As with other food pasteurisation and sterilisation technologies, the objective of processing with ionising radiation is to destroy pathogenic and spoilage microorganisms without compromising safety, nutrition and sensory quality. The group concluded that food treated with doses greater than 10 kGy can be considered safe and nutritionally adequate when produced under established Good Manufacturing Practise.

For further information, please contact the Programme of Food Safety and Food Aid, WHO. Tel: 41 22 791 2555 Fax: 41 22 791 4807 Email: foodsafety@who.ch

Integrated Management of Childhood Illness (IMCI)

More than 11 million children die each year before reaching the age of five. Seventy percent of these children die from one or more of five causes - malnutrition, acute respiratory infections, diarrhoea, measles and malaria. Of these, malnutrition is the major underlying factor (see graphic in SCN News No. 14).

At least 5 million of these deaths can be prevented through successful worldwide implementation of the WHO/UNICEF joint strategy of Integrated Management of Childhood Illness (IMCI), according to WHO. The IMCI advocates simple preventative measures along with a holistic approach to the management of childhood illness, such that a child being treated for one illness is also checked and treated for the other major childhood killers.

The First Global Review and Coordination Meeting on IMCI, was held in Santo Domingo, Dominican Republic, from 9-12 September 1997, where participants from multilateral and bilateral aid agencies, NGOs and public health specialists reviewed the urgent need to put IMCI strategy into practice. Participants agreed that the three main goals of the IMCI are

· to train health workers;
· to improve the ability of health systems to deliver quality care;
· to improve family and community practices in relation to health care.

In the meeting's closing "Call for Action", participants agreed that IMCI "has the potential to significantly improve the quality of child health care, reduce unnecessary hospitalization and to substantially reduce childhood mortality". A call for the IMCI to be adopted as part of national health ministries' policies and to receive substantially more financial support both nationally and internationally was made in order for IMCI to be made available to all children of the developing world.

Source: WHO Press Releases September 1997. Details of the IMCI strategy are available on the World Wide Web, via the WHO Division of Child Health and Development home page (http://cdrwww.who.ch/pub/imci/toc.htm). For further information, please contact Dr J.L. Tulloch, Director, CHD, WHO, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland. Tel: 41 22 791 2632 Fax: 41 22 7914853 Email: tullochj@who.ch

World Bank

Update on nutrition lending data in World Bank assisted projects

Since 1976, the World Bank has allocated project funds to improve nutrition through self-standing nutrition projects, health and education projects and to a lesser extent through agriculture and social fund projects. Typical nutrition interventions are community nutrition, maternal and child nutrition, school-based nutrition and health, information, education and communication on nutrition and micronutrient programs.

The graph shows an overview of the average lending figures per year and shows the trend in nutrition lending over the last decades. All numbers are estimates and based on projections; i.e. not actual disbursement.

Yearly Average of Nutrition Lending in Millions of US$

The World Bank allocated over 1.2 billion dollars to address nutrition in the last eight years - an average of 153 million per year. An estimated total of 1.3 billion in funds will be allocated to nutrition interventions in the upcoming years - an average of 303 million dollars per year. South-East Asia, with yearly average lending of 66 million per year, and Latin America, with yearly average lending of 43 million are the regions with the highest estimated lending for nutrition. The Africa region however, has the highest number of projects that allocate funds to nutrition, with a yearly average of 20 new projects per year, which include nutrition.

More specific data is available on lending for micronutrients. The Bank has lent an estimated total of US$ 155 million¹ to address micronutrient deficiencies since 1976, with a significant increase in lending for micronutrients during the last decade. From only US$ 230.000 in the period between 1976-1979 and US$ 705.000 in the period between 1980-1989, US$ 154 million was allocated to micronutrients in the period between 1990-1997. The following table shows the yearly average per micronutrient.

¹All the lending figures are based on estimates from project appraisal documents i.e. projected allocations.

Source: Claudia Rokx, The World Bank, 1818 H Street, N.W., Washington DC 20433, USA. Email: Crokx@worldbank.org

Yearly average lending per micronutrient

Period	Number of projects	Vitamin A control	Iron-deficiency control	Iodine-deficiency control
1976-1979	1	US$ 16.000	US$ 60.000
1980-1989	1	US$ 18.000	US$ 35.250	US$ 17.250
1990-1997	10	US$ 4.450.000	US$ 5.066.000	US$ 9.800.000