5. Towards an Action Agenda for Business
With the approach of key summits and events, and ‘resilience’ high on the agenda as a result of COVID-19, the next 18 months offer a window of opportunity for business engagement on nutrition.
Sentiment around business action on nutrition is changing. Governments, donors and development actors are increasingly recognizing the pivotal role that the private sector can play, both in mobilizing much-needed funding to support nutrition interventions and in leveraging its expertise and reach to deliver innovative new solutions. The investment community is waking up to the centrality of health and well-being to the sustainability agenda, and pioneering companies are trialling new ways of tracking and strengthening their contributions to improved nutrition and human capital development.
However, time is of the essence. Targets to reduce the prevalence of childhood stunting and wasting and of anaemia among women, and to increase rates of exclusive breastfeeding, are supposed to be met in five years’ time; the broader SDG nutrition targets in 10 years’ time. On current trajectories, these targets will not be met.138 Without rapidly accelerated action from all stakeholders, the costs of malnutrition will rise, the drag on human capital and sustainable development will be more severe, and the SDG agenda will be at risk.
5.1 A window of opportunity
The next 18 months offer an important window of opportunity for businesses to engage in the fight against malnutrition and to help drive progress towards the World Health Assembly targets and wider SDG nutrition targets. Over this period, a series of high-level international events and moments will together provide the foundations for more ambitious and coordinated action to reshape the food system – and the wider economy – to deliver nutritious diets for all.
Coming midway through the UN’s Decade of Action on Nutrition, the Tokyo Nutrition for Growth Summit (currently due to take place in December 2020) will serve as a key moment for the pledging, renewal and ramping up of commitments from governments, multilateral organizations, financiers, investors, civil society and businesses to fill the investment gap that persists around undernutrition. It is also hoped that the summit will boost commitments signalling collective action to tackle the double burden of malnutrition that now threatens the future of societies around the world. The outcomes of the summit will form the basis of a new ‘2020 Compact’ designed to mobilize and accelerate cross-sector action towards achievement of SDG 2.139
In 2021, the UN secretary-general will host the first UN Food Systems Summit to ‘raise global awareness and land global commitments and actions that transform food systems to resolve not only hunger, but to reduce diet-related disease and heal the planet’. The summit will call for engagement from all actors with a stake in shaping the food system, including business stakeholders from across the economy – notably those working in infrastructure, information and technology, financial services and transport, among many others. The summit will offer businesses that have not previously engaged in the nutrition agenda an opportunity to signal a commitment to integrated action to deliver against the SDGs, including by contributing to improved nutrition.
Discussions at the 26th Conference of the Parties (COP26) to the UN Framework Convention on Climate Change (UNFCCC), postponed until 2021, will also address the question of how to feed the global population nutritiously and sustainably. As highlighted in a recent special report on climate change and land by the Intergovernmental Panel on Climate Change (IPCC), food systems are a major driver of climate change, and their transformation in support of delivering food and nutrition security for all within the limits of the planet is recognized as a priority for action. Similar issues will be addressed at the 15th Conference of the Parties to the Convention on Biological Diversity (CBD), as global leaders from government and the private sector seek to establish a new pathway for sustainable agriculture that supports – rather than destroys – biodiversity.
Perhaps most importantly, the next 18 months will be a period of rapid change as public and private decision-makers around the world respond to the COVID-19 pandemic and begin preparing for recovery amid an anticipated global economic recession of unprecedented scale. The challenges to which the pandemic gives rise are innumerable, and there is a very real risk of a rolling back on progress made in tackling malnutrition and poverty over recent decades. But there are also opportunities. Governments, business leaders, financiers and investors are coalescing around the need to prioritize public health and resilience. These themes are already the focus of the communities of practice mentioned above, and will now inevitably move to the top of the agenda for the G7 and the G20, as well as for national governments and regional bodies across low- and middle-income countries.
The challenges to which the COVID-19 pandemic gives rise are innumerable, and there is a very real risk of a rolling back on progress made in tackling malnutrition and poverty over recent decades
Tackling malnutrition can be a catalyst for driving public health and resilience, and ‘building back better’. As the world comes to terms with the fallout from COVID-19, corporate leaders will come under scrutiny from their shareholders and stakeholders to answer difficult questions: How will you continue to deliver financial returns against the backdrop of a global recession? How will you support small and medium-sized businesses along your value chain? How will you build the resilience of your workforce to future disease outbreaks? Investing in improved nutrition, among the workforce of today and of the next generation, will be a critical ingredient in shoring up productive economies, stalling the spread of poverty, and building the resilience of populations, communities, businesses and households to future public health, economic and environmental shocks.
The Tokyo Nutrition for Growth (N4G) Summit marks the next major milestone in the global fight against malnutrition. Commitments being prepared by public and private stakeholders ahead of this summit will focus on five core themes:
- integrating nutrition into universal health coverage;
- investing in climate-smart food systems that promote healthy diets and nutrition and support producer livelihoods;
- building resilience in conflict-affected and fragile settings by tackling malnutrition and its underlying drivers;
- promoting data-driven accountability; and
- securing new investment and innovation in nutrition financing.140
These are themes that span far beyond the N4G framework and that will need to guide action, from all stakeholders, to tackle malnutrition in all its forms. Delivering against these themes cannot fall to the private sector alone, and many of the requisite actions and investments will need to be society-wide, driven by governments, donors and international development leaders. But businesses can play a major and central role, both unilaterally and through partnership, above all in advancing transparency and accountability around corporate activity and its impact on nutrition, and in ramping up investment in initiatives to tackle malnutrition.
Concerted efforts will be required – from companies, as well as from civil society and government partners – to develop the evidence base to support proven and effective corporate strategies on nutrition. Currently, that evidence base is weak, owing to limited reporting of nutrition-related corporate activities. As more companies report transparently on relevant initiatives both in the workplace and in the context of corporate sustainability programmes, and trial new ways of delivering improved nutrition outcomes among their stakeholders, examples of best practice – and of learnings from failed interventions – will emerge to inform future action.
For now, it is possible to identify broad actions that business leaders from all sectors can and should take to strengthen their response to the global burden of malnutrition.
5.2 Recommendations for business action
5.2.1 Commit to improving nutritional outcomes among all employees and suppliers
Implement group-wide minimum workplace policies on nutrition. While malnutrition is a global problem, it requires a locally tailored response. As the results of our model show, the relative burden of undernutrition and overweight/obesity varies between countries and sectors, as well as between occupations and sociodemographic groups. To be effective, company actions on nutrition need to be informed by needs and priorities at country level, and even at site level. Actions will need to take into account additional factors that could affect the efficacy or uptake of a given intervention or initiative, including local dietary preferences and perceptions and stigmas surrounding underweight and overweight. Nevertheless, existing and emerging evidence on the potential for workplace interventions to improve the nutritional outcomes of employees points to a small number of basic measures that companies can and should commit to as a minimum. These include:
- mandatory nutrition training for employees on the foundations of a healthy diet and safe food preparation;
- support for breastfeeding mothers, such as flexibility on working hours to allow for continued feeding at home and a private space in work to express milk;
- provision of nutritious and subsidized food in the workplace, with portion control measures and labelling to signal healthier choices;
- the integration of nutritional status monitoring into regular health checks, for example blood pressure measurement and weight monitoring, together with advice on improving nutritional outcomes; and
- the inclusion of healthy-eating messages and incentives into health and well-being programmes.
None of these policies is in itself a silver bullet but, collectively, they have the potential to positively impact the nutritional well-being of employees.
Support supply chain partners in introducing similar minimum policies. MNCs with long and complex supply chains are in a unique position to support action across an ecosystem of smaller businesses operating in low- and middle-income countries. Where capacity or know-how is lacking, particularly among SMEs, MNCs should look to provide resources and guidance to help supply chain partners implement a minimum policy package. Where necessary, they should consider incentivizing the engagement of supply chain partners, for example through longer contract terms and shorter payment terms. Ultimately, by making such a package a precondition for continuing the business relationship, MNCs can – and should – mobilize action far beyond their own operations.
Work towards following best-practice guidance where available. Evidence of the efficacy of different interventions to improve nutritional outcomes among workers and their families remains scant. Nevertheless, efforts are under way to collate examples of best practice and develop new guidance for businesses. Findings and initiatives emerging from the newly established alliance between GAIN and the Consumer Goods Forum on workforce nutrition interventions should become the first port of call for companies looking to establish, improve and scale up their own programmes and policies.141 Companies should also look to work with platforms such as the SUN Business Network and FReSH initiative, which facilitate and support company-level and collaborative action among the food and beverage industries and beyond.
5.2.2 Seek out partnerships – with business, government and civil society – to deliver improved nutrition to communities and populations
Integrate nutrition into existing corporate sustainability programmes. Investment in support of improved nutritional outcomes among the communities and populations within which companies operate need not require new, dedicated CSR programmes. Many existing programmes relating to WASH, education and women’s health, among others, could be easily adapted to include a nutrition element and yield positive results both in terms of nutrition security and the original goals of the programme. Examples of possible adaptions include: integration into women’s empowerment programmes of guidance on breastfeeding and nutrition during a child’s first 1,000 days of life; inclusion of advice on safe food preparation within community WASH programmes; monitoring of nutrition risk indicators such as blood pressure and BMI during community health checks; and targeting of education and schooling programmes in regions with a high burden of poverty and malnutrition.
Collaborate to deliver effective large-scale solutions. Partnerships are an important means through which companies may participate in the design and delivery of solutions at a scale that may not be possible through unilateral action. Cooperation with governments, donor agencies and development partners can be critical in ensuring that investments are sustainable and effective, particularly for companies without previous experience in this space. The pooling of resources and expertise through such partnerships can create enabling conditions for the delivery of large-scale nutrition programmes – such as the fortification of staple foods or the distribution of ready-to-use therapeutic foods in emergency situations – for which partners working unilaterally may lack the expertise, reach or financial resources. Collaboration between companies, particularly those working in the same region, can also help to accelerate delivery of improved nutrition at population level – a common good from which no single company will derive a competitive advantage.
Commit financial resources at a meaningful scale. Companies from all sectors should use the upcoming Tokyo Nutrition for Growth Summit as a high-profile opportunity to make meaningful financial commitments towards improved nutrition. In addition to workplace pledges, companies should look to make financial and non-workplace programmatic commitments of a scale that can lead to real impact – an example of progress in this area involves India’s Tata Trusts, which has pledged $50 million a year through to 2025 and which is on course to meet this commitment.142 In addition, companies can signal their commitment to financing research and development – among partners or internally – to accelerate the scale-up and distribution of innovative new solutions, from technologies to support improved productivity through to digital platforms for the dissemination of nutrition training and advice. Blended finance mechanisms, including The Power of Nutrition, offer an alternative means of making and fulfilling unilateral commitments, allowing companies to pool their contributions with other companies, foundations and government donors to support the scaling up of proven interventions.
Documenting success stories is key, but so too is reflecting on the failures and limitations of any given intervention and on who was not reached among vulnerable and/or target communities
5.2.3 Commit to full transparency and good governance around company action on nutrition
Monitor, evaluate and report on all nutrition-related activity. Companies already implementing relevant programmes and policies should commit to monitoring and evaluation, and to rigorous reporting – both internally and against public commitments such as those under the N4G framework. This will be essential to building the evidence base of what works and what does not. Documenting success stories is key, but so too is reflecting on the failures and limitations of any given intervention and on who was not reached among vulnerable and/or target communities.143
Ensure full disclosure of conflicts of interest. All businesses, but most importantly those in the food and beverage sectors, should be open and transparent in reporting on vested interests when entering into partnerships with public or civil society actors or platforms.144 Such vested interests need not preclude corporate involvement in nutrition activities, but registering those interests and engaging in critical debate with internal and external stakeholders on their possible influence on project design or outcomes should be a priority.145 A commitment to openness and disclosure in this way is critical not only to nutrition-related research, but to all partnership initiatives, lobbying activities and research funding.
Support the integration of nutrition into ESG frameworks. Malnutrition and the impact of business on the nutrition of stakeholders are becoming material risks both to the companies concerned and to institutional investors and asset managers. The investment community is in a strong position to drive greater corporate accountability and influence companies’ impact on nutrition. The integration of nutrition metrics by ESG data providers and sustainability-focused investor groupings can ramp up pressure on poorly performing companies and create a new culture of transparency around the issue. But businesses’ cooperation, through full disclosure, with these ESG frameworks will be critical to success. For those serious about delivery against SDG 2 and the wider SDG agenda, a proactive approach to supporting the measurement of companies’ nutrition impacts – in the workplace and among the wider community and population – is a fundamental first step.
Ensure food and beverage products are supportive of improved nutrition. Companies in the food and beverage sectors have a particular duty to ensure that their products and practices contribute to, rather than threaten, improved nutrition in low- and middle-income countries. This is true not only of the products themselves but of their marketing. There is strong evidence, for example, of the negative impact that the marketing of products high in fat, salt and sugar to children can have in driving overweight, obesity and diet-related disease. Harmful practices, such as non-compliance with the International Code of Marketing of Breastmilk Substitutes or with best-practice guidance on the use of nutritional claims about foods and nutrition products, undermine both trust in industry and progress towards overcoming malnutrition. For companies professing to support improved nutrition through CSR activities, workplace nutrition programmes and healthier product ranges, a commitment to ‘doing no harm’ should be an urgent priority.
138 FAO et al. (2019), The State of Food Security and Nutrition in the World 2019.
139 Tokyo Nutrition for Growth Summit 2020 (2019), ‘Commitment-Making Guide’.
140 Ibid.
141 GAIN (2019), ‘CGF and GAIN announce new Alliance to roll out improved nutrition in the workplace’.
142 Development Initiatives (2019), ‘Nutrition for Growth Commitment Tracking’, updated 20 October 2019, https://globalnutritionreport.org/resources/nutrition-growth-commitment-tracking/ (accessed 21 May 2020).
143 World Bank (2010), What Can We Learn from Nutrition Impact Evaluations: Lessons from a review of interventions to reduce child malnutrition in developing countries, Washington, DC: World Bank, doi: 10.1596/978-0-8213-8406-0 (accessed 3 Apr. 2020).
144 Eggersdorfer, M. and Bird, J. K. (2016), ‘How to achieve transparency in public-private partnerships engaged in hunger and malnutrition reduction’, in Biesalski, H. K. and Black, R. E. (eds) (2016), Hidden Hunger: Malnutrition and the First 1,000 Days of Life: Causes, Consequences and Solutions, World Review of Nutrition, Vol. 115: pp. 224–32, doi: 10.1159/000442109 (accessed 1 Apr. 2020).
145 Alexander, N., Rowe, S., Brackett, R. E., Burton-Freeman, B., Hentges, E. J., Kretser, A., Klurfield, D. M., Meyers, L. D., Mukherjea, R. and Ohlhorst, S. (2015), ‘Achieving a transparent, actionable framework for public-private partnerships for food and nutrition research’, The American Journal of Clinical Nutrition, 101(6): pp. 1359–63, doi: 10.3945/ajcn.115.112805 (accessed 1 Apr. 2020).