By Laura Michéle, FIAN International and Kavya Chowdhry, FIAN International and Patti Rundall, IBFAN and Stefano Prato, SID 1
The potential of partnerships with the private sector dominated the narrative characterizing the initial phase of implementation of the 2030 Agenda for Sustainable Development. In relation to SDG 2, a prominent multi-stakeholder platform is the Scaling Up Nutrition ‘Movement’. As documented by a multi-country study, this case exposes how interventions promoted by MSPs often do not address the social, cultural, economic and political determinants of malnutrition and rather emphasize short-term, technical interventions, owing to private sector influence in the context of a consensus driven process.
The potential of partnerships with the private sector dominated the narrative characterizing the initial phase of implementation of the 2030 Agenda for Sustainable Development, overshadowing many of the other key dimensions outlined in Sustainable Development Goal (SDG) 17. In this context, multi-stakeholder partnerships (MSPs) engaging various actors, including the private sector, are considered “important vehicles for mobilizing and sharing knowledge, expertise, technologies and financial resources to support the achievement of the sustainable development goals in all countries, particularly developing countries”. 2
In the framework of the 2030 Agenda, as well as in other international policy processes, most governments and UN agencies have bought into the MSP paradigm, with only few openly voicing concerns about this approach. The same applies to many civil society organizations. Expressions of concern about the possible implications of close relations with the private sector and the blurring of roles and responsibilities occurring under the MSP approach, are often rejected as outdated, ideology-driven or anti-corporate. 3 While everyone has been happily jumping on the boat, surprisingly, there is to date very limited evidence of the actual positive contribution of such approaches, nor assessments of the risks they may pose to critical issues such as governance and human rights. 4
In relation to SDG 2, to “End hunger, achieve food security and improved nutrition and promote sustainable agriculture”, a prominent multi-stakeholder platform is the Scaling Up Nutrition (SUN) ‘Movement’. The initiative brings together governments, UN agencies, donors, business and civil society in a “collective action to improve nutrition”. SUN’s members include large transnational companies including food, beverage and agro-chemical companies, two of which sit on its Lead Group. 5 The initiative was launched in 2010 at a high-level meeting of the International Monetary Fund (IMF) and the World Bank (WB). To date, 60 countries have signed on to SUN and the initiative has substantial political and financial backing. The Bill & Melinda Gates Foundation (BMGF), as well as several bilateral donors and the EU are key funders of SUN. 6
SUN’s stated objective is to end malnutrition in all its forms and to ensure that “every child, adolescent, mother and family can realize their right to food and nutrition, reach their full potential and shape sustainable and prosperous societies”. 7 This goal is to be achieved through government-led collective actions in which all ‘stakeholders’ come together in a multi-sectoral approach. The establishment of ‘multi-stakeholder’ platforms at the national level is a key element in governments’ commitment to SUN and the initiative’s theory of change for improving nutrition.
The initiative was born at a time when the UN Standing Committee on Nutrition (SCN) was being drained of funding following accusations of inefficiency and inability to reach consensus on strategies to address malnutrition and hunger. A key criticism was the resistance, especially by the NGO constituency, to private sector participation in the SCN. 8 Since its origins, SUN has been based on the premise that there should be a greater focus on building global consensus on scientific and ‘evidence-based’ strategies to address malnutrition and hunger so that donor funding can be galvanized. The BMGF-funded 2008 series in the Lancet on Maternal and Child Undernutrition, re-evaluated in 2013, form the basis for the interventions promoted by SUN, with the majority of recommended initiatives involving fortified products and supplements of some kind. 9
A research study based on three country case studies investigating the impact of SUN on the right to adequate food and nutrition found serious concerns regarding the governance, functioning and accountability procedures, as well as the policy direction that the initiative promotes in member countries. 10
Restructuring of governance
There are multiple governance challenges that arise when multilateral institutions are replaced by multi-stakeholder platforms. The case of SUN illustrates some of these. It also shows the risks of SUN’s use of the rhetoric of ‘inclusiveness’.
Democratic deficits and top-down, elitist leadership
While SUN claims to be country-led and describes itself as a ‘movement’, the ways the initiative functions do not come close to this self-description. Most of the country members join SUN with a letter of commitment by a high-level government official to the SUN coordinator. There is no requirement for any democratic process or governmental scrutiny before deciding to join. This is despite the fact that affiliation to SUN carries important implications for the country’s governance and policy direction on food and nutrition.
SUN’s Lead Group, which determines the strategic direction and is entrusted with the overall responsibility for progress towards achieving the initiative’s objectives, is composed of ‘high profile’ leaders from business, the UN, governments, donors and civil society, who are appointed in their individual capacities by the UN Secretary General. Only two of the 26 current members of the Lead Group represent SUN country governments. 11 Several of the members are international donors and foundations.
The illusion of inclusiveness
Field research in selected SUN countries found interventions promoted by SUN to be ‘top-down’ with minimal participation of grassroots organizations representing the interest of communities affected by hunger and malnutrition. Participation by civil society is mostly composed by organizations engaged in service delivery and it is led by a select group of international NGOs, with limited accountability to local communities, while perspectives of organizations which have a more nuanced and critical approach to nutrition are hardly included.
There is no recognition of the diverse roles and responsibilities of the various actors participating in SUN, 12 nor of the immense power differentials that exist between and within ‘stakeholder’ groups. Neither at the international nor at the country level does SUN have mechanisms in place to identify or address these power asymmetries and facilitate meaningful participation of those most affected by malnutrition in all its forms.
Paving the way for private sector influence in public policy
The country studies have found that many SUN countries do not have effective mechanisms to address the conflicts of interest (COI) that occur in policy-making processes. At the same time, SUN pushes governments into trusting collaborative arrangements with the private sector, opening up policy space to it. This presents a huge risk for the human rights-orientation of public policies in the area of food security and nutrition. 13 While SUN developed a COI tool in response to civil society criticism, its COI definition strays from the original legal meaning and fails to address COI within entities: “Institutional conflicts of interest arise when an institution’s own financial interest or those of its senior officials pose risks of undue influence on decisions involving the institution’s primary interests.” 14 ,
Rather than resolving COI challenges, SUN’s emphasis is on promoting trust and dialogue, in the spirit of inclusiveness, rather than robust safeguards for protecting public interest policy-making.
Besides opening up space for private sector influence at country level, the fact that SUN’s international Lead Group includes large transnational companies allows them direct access to SUN’s policy direction. Moreover, meetings of the Lead Group members, which include the Gates Foundation, are regularly addressed by other key advocates of technical, private sector- or market-driven solutions to malnutrition, such as the World Bank and USAID. 15
Lack of external scrutiny and accountability for actions
The monitoring and evaluation processes in SUN consist primarily of internal self-reflections (Joint Assessment Exercises). SUN members at country level gather annually to report on where more support is required to realize joint goals and define the country priorities for the coming year. This then informs SUN’s leadership in decisions concerning the support provided to countries for scaling up and is the basis for assessing progress in relation to the four strategic objectives of the SUN initiative.
The initiative is based on the principle of ‘mutual accountability’, with members being supposedly accountable to one another for adherence to their commitments under SUN. However, it remains unclear how this is implemented in practice. SUN’s recent Mid-Term Review acknowledged that “there is a deficit in mutual accountability among the various actors. In practice, SUN members who are significantly dependent on international assistance are more rigorously assessed than are the funding providers”. 16
Importantly, accountability towards people outside of SUN, in particular those who might be affected by the interventions promoted by the initiative, is minimal, and limited to the individual lines of accountability of members. There are no complaint mechanisms in place 17 and SUN Lead Group members, as well as those leading networks under SUN, act in their personal capacities and are not liable for actions promoted under SUN. A further complication in holding SUN accountable for actions is that it does not act directly, but through SUN governments and its members. Attribution of responsibility for impacts resulting from actions promoted by SUN – including for foregone impacts that could have been achieved if the government took an alternative policy route – is therefore highly difficult to establish.
Shifting the policy agenda
Promotion of short-term medicalized nutrition interventions
A key characteristic of the interventions promoted by SUN is the narrow focus on the first 1000 Days of a child (from conception to two years) as well as the emphasis on technical solutions to address malnutrition. The case studies showed promotion of short-term nutrition solutions with a strong emphasis on the treatment of micronutrient deficiencies with medicalized, product-based interventions. While attribution is always difficult, and debate continues about the pros and cons (risks and advantages) of many of the products promoted by SUN members, there was little/no evidence that these interventions brought meaningful and long-term changes to the nutrition prospects of those affected by malnutrition and some evidence of negative consequences on indigenous food cultures and confidence in local foods. The nature of the interventions fostered dependencies rather than strengthening communities’ self-determination and capacity to feed themselves in dignity. Moreover, with the focus on undernutrition, factors that are recognized to exacerbate overweight, obesity and related non-communicable diseases, for example reliance on ultra-processed foods, 18 received hardly any attention – even though SUN now claims to address malnutrition in all its forms.
Support for industrial agriculture, distracting from the structural causes of malnutrition
Within food systems interventions, a significant bias was observed towards technological solutions, in particular, biofortified seeds and fortified foods, which entail human rights risks for small-scale food producers, indigenous peoples and consumers. None of the three countries, that were examined, had a strategy in place – nor one being devised – for fundamentally re-shaping food systems to support agro-biodiverse production, advance the realization of the rights of small-scale food producers, and promote diversified, healthy and sustainable diets.
By signing up to SUN, countries commit to align their nutrition priorities and strategies to those of the initiative, and thereby may forego alternative strategies. Even where affiliation to SUN does not introduce ‘new interventions’, it contributes to increased emphasis on certain approaches to the detriment of others, thereby possibly avoiding measures aimed at addressing the underlying structural causes of malnutrition.
More broadly speaking, the consensus orientation and lack of mechanisms for dispute resolution within SUN and other MSPs can be said to stifle dissenting opinions and weaken the long-standing debate that is vital for framing strategies to address problems in food security and nutrition.
The case of SUN shows that interventions promoted by MSPs often do not address the social, cultural, economic and political determinants of malnutrition and rather emphasize short-term, technical interventions, owing to private sector influence in the context of a consensus driven process. The resulting initiatives tend to only target a small part of the problem and largely benefit the private actors. SUN’s need to satisfy the needs of its private sector constituencies favours market-led approaches that inevitably over-emphasize commercially produced foods and technical interventions. Meanwhile SUN fails to address or even acknowledge the importance of issues such as power relations, social exclusion, exploitation, poverty, discrimination, low pay, land grabbing, genetically modified organisms (GMOs), abusive marketing of food products and child labour, all of which can cause forms of malnutrition and hunger. 19
Initiatives such as SUN further contribute to the consolidation of private sector influence on public food and nutrition policies. By shifting policy accountability from the state to multi-stakeholder platforms with multiple actors, the government becomes a facilitator among many, rather than the primary actor in addressing malnutrition. This makes it even more difficult for affected groups to hold the state accountable for compliance with its human rights obligations, and moves us further to a charity-driven, rather than a rights-based approach to food and nutrition.
Laura Michéle coordinates FIAN International’s work on nutrition, Kavya Chowdhry is Assistant of FIAN International’s Asia Team, Patti Rundall is Policy Director of Baby Milk Action/IBFAN UK and a Global Advocacy Spokesperson for IBFAN, and Stefano Prato is Managing Director of the Society for International Development (SID).
- 1 This article is based on a study conducted by FIAN International, IBFAN, and SID on the human rights impact of multi-stakeholder partnerships: the case of the Scaling Up Nutrition Initiative. Forthcoming 2019.
- 2 See https://sustainabledevelopment.un.org/sdinaction
- 3 Mokoro Limited (2015), p. 61.
- 4 HLPE (2018).
- 5 Royal DSM, a Dutch-based international chemical company producing micronutrient ingredients for the food and dietary supplements industry, and Java Foods, a Zambian company manufacturing instant fortified cereals and noodles.
- 6 Funders are the Bill & Melinda Gates Foundation, Canada, the EU, France, Germany, Switzerland, Ireland, the Netherlands, Norway, the UK and the USA.
- 7 SUN (2016), p. 6.
- 8 Schieck Valente (2015).
- 9 Black et al. (2013).
- 10 See note 1. The research was conducted at national level in two countries, Uganda, Guatemala, and at state-level in three states in India.
- 11 A list of current Lead Group members can be found at: https://scalingupnutrition.org/sun-supporters/sun-movement-lead-group/
- 12 The only guidance provided in this sense is that MSPs at national level should be convened by government focal points.
- 13 For a recent compilation of case studies concerning collaboration with food and beverage industry in public health policy and COI, see UK Health Forum (2018).
- 14 Lo/Field, Inst of Med. (US) Committee on Conflict of Interest in Medical Research, Education and Practice, eds. (2009). For a critique of SUN’s conflict of interest tool, see Richter (2015
- 15 See, for instance, Martens/Seitz (2015) and Birn (2014).
- 16 MQSUN+ (2018), p. viii.
- 17 The Business Network has a whistleblower mechanism that can be used for registering alleged breaches of its Principles of Engagement by companies participating in SUN. Besides being difficult to find (located at the bottom of the Global Members page of the Sun Business Network website: https://sunbusinessnetwork.org/network/global-members/), this mechanism concerns the activities of businesses that participate in SUN and not the actions promoted under SUN. No information is provided as to whether the mechanism has ever been used and what measures have been taken in response.
- 18 See https://www.who.int/ncds/prevention/en/
- 19 Schieck Valente (2015).
Birn, Anne-Emmanuelle (2014): Philanthrocapitalism, past and present: The Rockefeller Foundation, the Gates Foundation, and the setting(s) of the international/global health agenda. In: Hypothesis, 12(1).
Black, Robert E. et al. (2013): Maternal and child undernutrition and overweight in low-income and middle-income countries. In: The Lancet, Volume 382, Issue 9890, pp. 427-451.
HLPE (2018): Multi-stakeholder partnerships to finance and improve food security and nutrition in the framework of the 2030 Agenda. A report by the High Level Panel of Experts on Food Security and Nutrition of the Committee on World Food Security. Rome.
Lo, Bernard/Field, Marilyn J., Institute of Medicine (US) Committee on Conflict of Interest in Medical Research, Education, and Practice, eds. (2009): Conflict of Interest in Medical Research, Education, and Practice. Washington (DC): National Academies Press (US).
Martens, Jens/Seitz, Karolin (2015): Philanthropic Power and Development. Who shapes the Agenda? Aachen/Berlin/Bonn/New York: Brot für die Welt/Global Policy Forum/MISEREOR.
Mokoro Limited (2015): Independent Comprehensive Evaluation of the Scaling Up Nutrition Movement. Final Report. Main Report and Annexes. In partnership with Valid International & FEC Consulting Oxford.
sMQSUN+ (2018): Midterm Review of the Scaling up Nutrition Movement: Final Report. 22 December 2018. London.
Richter, Judith (2015): Conflicts of interest and global health and nutrition governance – The illusion of robust principles. In: BMJ RR, 12 February 2015.
Schieck Valente, Flavio (2015): The Corporate Capture of Food and Nutrition Governance: A Threat to Human Rights and Peoples’ Sovereignty. In: Right to Food and Nutrition Watch: Peoples’ Nutrition is not a Business (2015), pp. 15-20.
SUN (2016): SUN Movement Strategy and Road Map (2016-2020). Geneva.
UK Health Forum (2018): Public health and the food and drinks industry: The governance and ethics of interaction. Lessons from research, policy and practice. London: UKHF.