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2. Challenges to support a policy package to sustainably prevent diet related NCDs - Perception that health behaviour is a personal choice and government policy is made bearing that in mind - Infectious disease prevention, deficiency and treatment is a priority over health promotion and that is a bottleneck for policy promotion affecting also resources in place for the health promotion agenda - The economic narrative that these policies damage the economies - Silo policy-making within governments and the trade-offs between different government departments when implementing these policies - Not... قراءة المزيد enough public pressure for the promotion of these policies - Globalization - The impact of the food industry lobby (especially large multinational corporations) in building the narrative, funding research and influencing policy making - For small countries it is difficult to implement healthy food policies (e.g. locally grown foods) as larger countries have a lot of influence on the marketing of unhealthy commodities. - Trade not prioritising, and thus undermining, public health -Need for more evidence (e.g. cost-effectiveness analyses) on policy action focusing on implementation of the package of policies rather than instrument by instrument -There is no single silver bullet, multiple actions on multiple fronts are required - No sufficient tools to manage conflicts of interest and industry interference in policy shaping and making (especially when having multisectoral participation) - Ministries of health do not have the lead on the promotion of these policies - Need for demonstrating and communicating the broad public support base for these policies and the demand for change up against corporate capture of consultation processes and lack of access and poor infrastructure for civil society to influence decision making - Misconception driving a siloed approach to food policies and regulations (not including a life-course approach). - Weak collaboration within governments regarding food and nutrition, eg. with education, agriculture sectors. -Absence of a clear definition of what is “healthy” and “unhealthy” - Reformulating existing foods is necessary but not sufficient -COVID has made NCDs fall down the list - Companies are not being targeted. There is a need for policies that address power imbalance. - Industry resources to dominate consultation processes (need for guidelines on consultation processes). -Persistent argument against regulatory measures and deference of responsibility to the individual -Industry actions on the pandemic: Social responsibility actions (e.g. Sponsoring vaccination) -No plan for obesity prevention and the need of civil society to speak out - Worsening of some behaviors due to the pandemic. Pandemic also increased barriers to healthy foods, influenced affordability and increased exposure to unhealthy food marketing. - Multisectoral collaboration/policy coherence is absent - coordination of government agencies is very difficult - e.g. trade/industry or agriculture will often adopt policies that make unhealthy food cheaper, or foreign affairs will take trade-motivated positions in diplomacy -Lack of transparency in policy processes قراءة القليل

From this Independent Dialogue and according to the questions discussed by the break-up groups, the main conclusions include de following: 1.Expectation of participants on what the UNFSS would achieve for diet-related NCDs: - That there is more policy cohesion between law, trade and nutrition - That the Summit considers health consequences of food systems - That nutrient-based approaches (deficiencies, fortification, reformulation) are balanced with a holistic approach including the consequences of food processing and food systems - That coalitions are formed to move the dial - That the Summit... قراءة المزيد facilitates a shift to health and sustainability (human, animal and planetary health) as a primary objective for policymaking - That food systems narrative is changed, that silos are broken and the mindset around multi-stakeholder action (risks and benefits) is changed - That an agreement is established between food systems and links with climate change and economic growth. Nutrition should be seen as a tool that can support both agendas. - That policies that shape the food environment are identified and invested in, not expecting individuals to have full control over diet behaviour - That there is stronger ministerial will and strong leadership from governments, such that diet is moved to the top of the priority list at the summit. - That there is a common definition of nutrient profiling -especially for children. - That better fiscal policies to promote healthy diets are recommended. - That there is recognition of the negative role of ultra-processed food industry in policy promotion (Conflicts of interest) - That more Indigenous people’s voices are heard قراءة القليل

The following key messages and themes emerged from the interactive dialogue and plenary with guided discussions among representatives from governments, civil society: - Consensus on the need for complementary package of policies to address diet related NCDs (restrictions to marketing and taxation of unhealthy foods, and front-of-package labeling systems on food products). Given the regulatory nature of these measures, and the evidence of industry interference in these types of nutrition policy-making processes, participants noted a need for tools, transparency and protective mechanisms to mini... قراءة المزيدmize risk of industry interference in public health policy and avoidance of conflicts of interest. It is not possible to have a one policy approach. A policy package approach is essential towards a vision of an environment that is coherent and all the messages that are coming from that environment come from a healthy direction. It is about saying to large food corporations what is acceptable and what is not and having a leverage playing field for healthier choices. - Participants recommended a common global definition of what is healthy or unhealthy food/diets, clarifying and including terms like ultra-processed food products. - Insights were gained on how India is responding to the double burden of malnutrition and building healthy food systems by recognizing that undernutrition and inappropriate nutrition (which contributes to diet related NCDs) are all interlinked. It was important also to recognize the need for good balanced nutrition policy during all the life course. India has an approach of eating healthy, eating safe and eating sustainably (including a health, environmental, sanitation, etc. connectivity). It was also highlighted the importance of bringing this connection to the SDG agenda and engage with multiple stakeholders across the country in a practical way at the district level (e.g. school meals). - The experience shared by Finland on notable wins and success factors in the country included the reduction of premature mortality through changes in the diet (e.g. reduction of salt and saturated fats); the adoption of a universal approach which targets the whole population and age groups: food belongs to everybody and every person need a good diet; the health-in-all-policies approach which is supported by legislation and intersectoral mechanisms; the economy of wellbeing approach emphasizing the interlinkages between social, economic and environmental sustainability; the political leadership for SDG’s in the Prime Minister Office nurtures coherent sectoral policies, supports government programmes, promotes healthy diets, coherent policies, and political leadership. As challenges, it was pointed out that the past 10 years it has become increasingly difficult to maintain success. School meals investment pays back (e.g. 1 dollar of investment pays 9 dollars back) but other approaches are needed (e.g., agricultural policies, fiscal measures, public procurement, warning labels, among others), Transforming food systems is a challenge but comes with opportunities and success stories. It is important that there is a joint effort towards better cooperation and coordination at the global level. - The majority of participants also showed interest in being part of a coalition in support of a policy package for healthy diets within the Summit context and beyond. Discussants also noted as main challenges to implementation of a package of policies: - Multiple stakeholders having a place at the table at the policy making level, including those with conflicts of interest. - The dominant prosperity/capita/development narrative being consistently focused on what will damage economies instead of also considering investment in health, environment and well-being aspects as keys to development and prosperity. - Silo policy making within governments and trade offs between government departments which are not fully transparent, understood and foster incoherence - The negative impact the food industry lobby has on political processes, funding and biasing research and driving the narrative and definition of what foods are unhealthy, coopting tenuous health and sustainability attributes as a marketing tool even when a product’s nutritional value is negligible or harmful. On immediate steps and shifts necessary to address the challenges participants agreed on the need to: - Engage and align with new allies from other sectors rather than only the health sectors. - Influence the influencers (the cooks, the bloggers, etc) to also influence policy making Build the bridge between academics and the policy makers to enable policy makers to be better informed. - Share tips and lessons learned between countries (peer to peer) and a global governance to encourage multiple country support - Increase transparency in policy discussions - highlight the iimportance of NCDs and dietary options, and making sure these are incorporated within the pandemic response. - Tackle and expose lobby power of food industry, build the evidence and take action - Build and grow civil society competency and national protection for underage consumers - Have more courageous Member States engaged in this agenda. قراءة القليل

The overarching theme of this Independent Dialogue focused on creating healthier food environments by way of a package of effective and evidenced based policies (including front-of-package labelling, marketing restrictions and taxation of unhealthy foods) to help to address diet-related NCDs, leveraging the opportunity presented by the UN Food Systems Summit and beyond. Some of the key issues raised or emerging from this discussion were the need to identify common ground to improve diets, the importance of identifying the barriers and challenges that need to be addressed in order to pursue a f... قراءة المزيدood system transformation, also how policy packages can respond to specific local contexts. Further, the Dialogue emphasised the importance of strengthening appreciation that healthy or unhealthy diets are not a personal choice but rather a consequence of the food environment that needs to be shaped and nurtured with collective and coherent decisions around these policy areas, and how the pandemic has also shown the need to invest more in sustainable food systems and environments. The environment must enable and facilitate healthy choices and it must be coherent also in the sense that marketing restrictions, clear information on packaging and taxes of unhealthy products should be jointly promoted, while policies in areas such as trade, urban design and development and education should be complementary and coherent and not undermine the development of sound public health policy. It is important to level the playing field of competition, and incentives the availing of better options, so that unhealthy food steps back and healthy food comes forward. While the agenda influences consumers, producers and retailers, and supporting the environment, but also about changing the economic dynamics and levelling the playing field. It is difficult to prove large impact if the environment is not coherent. The idea behind a coherent policy package is that by implementation of it we are creating a health promoting food environment, and supporting all people’s right to health and food including children and those most vulnerable. قراءة القليل

The orientation for agriculture production, whether it is for businesses and profit or to fulfill the rights of the communities for food. The extent of the role of import as a source for domestic food supply. While some participants recognize the importance of import to fulfill domestic demands, some say that import should only be pursued as a complementary strategy.

a)Optimizing food domestic supply chain and availability to guarantee safe and nutritious intake, b) Strengthen community-based farming c) Share responsibility for more stakeholders participating in the food systems, engage more with the private sectors and smallholder farmers d) Fortification to increase nutritious value of locally produced food, e) Increase social protection to make nutritious food more affordable f) Change production orientation from productivity to nutrition-sensitive agriculture g) Education for behavioral changes on nutritional consumption amongst low-income families. h)... قراءة المزيد Use import as a complementary strategy to meet national food demand. i) Create a clearer career trajectory to entice young farmers to enter the agricultural workforce and start the regeneration process. j) Collaboration with other agriculturally advanced Southeast Asian countries to learn best practices in agriculture قراءة القليل

a) Domestic food supply chain needs to be optimized and made more efficient for both the accessibility of food and the welfare of farmers. b) International collaboration is needed through opening up trade linkages as complementary sources of food supply and through best practices sharing. c) Education on nutrition is important as the biggest drive for malnutrition is consumption behavior. d) Ensuring welfare for farmers at the community level through regulation and strengthening community-based farming. e) Ensure that low-income families have access to food through better targeted social prote... قراءة المزيدction. قراءة القليل

The breakout room discussions covered (1) the impact of the long domestic supply chain on prices and food safety, (2) balanced international trade to fulfill domestic consumption, (3) the health and nutritional values of the food circulated in the market, (4) food loss and waste, (5) Equitable food production, (6) Youth and agriculture innovation, (7) Food prices disparity between producers and consumers prices, and (8) inability of policies to respond to challenges of food systems on the ground