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By Jomo Kwame Sundaram, Food and Agriculture Organization of the United Nations

In late September 2015, more than 150 heads of state and government, accompanied by thousands of senior officials, world-renowned experts, leaders of civil society and the private sector gathered at the United Nations in New York for the largest summit in history. The summit outcome, which bears the title Transforming our World: the 2030 Agenda for Sustainable Development, is remarkable in many respects. It is the product of a consultative process led and owned by the member states themselves, unfolding across the globe in waves over the past three years, and actively engaging citizens as well as governments, small and large organizations, experts and non-experts from all walks of life.

The 2030 Agenda builds on the scope and ambition of the Millennium Development Goals (MDGs). Drawing from the experience of the MDGs, member states have been unanimous in their conviction that sustainable development does not result from selecting among isolated problems and designing highly focused technical solutions. The leading insight behind the new Sustainable Development Goals is that sustainable development arises from recognizing that real world development is seldom confronted by a single problem for which there is a single solution, but rather proceeds by dealing with sets of interlinked problems for which creative, context-specific and people-centric solutions are required.

How this is all meant to work can be seen through the approach that is taken to malnutrition in the 2030 Agenda. Those who look for specific mentions of nutrition or malnutrition will almost certainly be disappointed. But they make a fundamental mistake in understanding how the new agenda conceives of the development process and how much of the new agenda is related to ending malnutrition.

How does Agenda 2030 pose the problem of malnutrition? First, and most explicitly, in Sustainable Development Goal 2: “End hunger, achieve food security and improved nutrition and promote sustainable agriculture” and in its multidimensional Target 2.3: “By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons.” Target 3.4 implicitly refers to obesity-related malnutrition and its impacts: “By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.”

And yet this is only the beginning. Much more can be added through specific targets, inter alia, on poverty eradication, women’s empowerment, improved sanitation, maternal health, access to water, and reductions of food loss and waste. As the UN Secretary-General has pointed out in his report to member states, there are at least 6 goals and 18 targets in the 2030 Agenda that are materially related to nutrition.

Malnutrition will not be ended without addressing the variety of social, economic, environmental, and cultural factors that contribute to it. An updated UNICEF conceptual framework makes a critical distinction between “basic,” “underlying,” and “immediate” causes of malnutrition and premature death.

– At the basic level, poverty, inequality, discrimination against women, and the excluded voices of children, the elderly, and other social groups in decision-making processes are fundamental impediments to lasting solutions.
– At the intermediate level, the emphasis is on the institutional structures and systems— especially systems for health and food, water, and sanitation, as well as deteriorating environmental conditions—that result from the basic causes, but also institutionalize the underlying poverty and inequalities.
– Finally, at the immediate level are the proximate causes—chiefly the lack of access to adequate nutrition or dietary intake and unavailability of appropriate health care: mutually reinforcing causes of poor nutritional status for individuals, households, and disadvantaged and vulnerable social groups.

Who will pull all of this together, and how will they do it? The 2030 Agenda does not specify. That responsibility is left to the member states and their many partners. But behind the agenda stands a new global structure for monitoring and evaluation, shared learning and capacity building, voluntary reporting and mutual accountability among partners. Embedded in this structure are all the institutions of the UN system that now not only have to meet new expectations, but are challenged to play a new role as enablers and facilitators of broad societal engagement to support government-led and owned political action to end malnutrition in all its forms.

Jomo Kwame Sundaram is Assistant Director-General and Coordinator for Economic and Social Development with the Food and Agriculture Organization (FAO) of the Uni

by Barbara T. Baylor, United Church of Christ

All people deserve the opportunity to reach their full potential — and part of this is being able to make choices that lead to good health and quality of life. But the United States has a widening gap between those who have a fair chance to make these choices and those who do not.

As the World Health Organization points out, large differences within countries in health outcomes are not only unnecessary and avoidable, but also unfair and unjust. Poverty, low socioeconomic status, racial discrimination, gender bias, disabilities, and mental health conditions all contribute to today’s significant health disparities in the United States.

An individual’s resources — such as money and power — most often shape the economic and social conditions he or she lives under. Another influence on people’s environments, though, is that of the policies and choices that decision-makers support. Policies that affect food security are one example.

In many states, people who have been convicted of a drug-related felony and have served their sentences are banned or restricted from participating in SNAP (formerly food stamps) and TANF (Temporary Assistance for Needy Families). These bans also apply to the formerly incarcerated person’s entire household, including children.

People with lower incomes are incarcerated at disproportionately higher rates, and many enter the prison system with chronic illnesses. Health problems are exacerbated by the prison environment, which can include overcrowded and unsanitary conditions, poor nutrition, lack of ventilation, and the impact of violence, trauma, and solitary confinement.

Ironically, people in correctional facilities are the only group in the United States with a constitutional right to health care. But when they return to their communities, they often do not have access to quality health care. It is not difficult to see that declaring people ineligible for assistance to get the food they need is also bad for their health. To a person with a chronic illness, going without food can lead to hospitalization (which, incidentally, costs much more than food assistance). A ban on food assistance for ex-offenders and their families works at direct cross-purposes to the goal of improving family and community safety and security.

The United States has a far higher rate of incarceration than most other high-income countries. Mass incarceration is now a public health crisis that has increased hunger and poverty. Health and human service providers and people of faith must view the problem through a social justice lens. This lens can help us see that often, people’s only “choices” range from bad to worse. In addition to enabling us to see situations as they are, a social justice lens can and should help find ways to expand the choices that are actually available to people!

Barbara T. Baylor is currently the Policy Advocate for Domestic Issues at the Washington, DC, Policy Office of the United Church of Christ. She holds a Master’s Degree in Public Health.