Opening Remarks at the 35th Annual Session of the UN System Standing Committee on Nutrition

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Date: Monday March 3, 2008
Event: Opening of the 35th Annual Session of the UN System Standing Committee on Nutrition: “Accelerating the Reduction of Maternal and Child Undernutrition,” Melia Hotel, Ha Noi
Speaker: Dr Jean-Marc Olivé, WHO Representative in Viet Nam

It is a privilege to be here and to share a few thoughts, and I expect we will all contribute to a productive and enlightening experience over the course of this week. 

First, let me say that I concur with Ann Veneman on the importance of using this session, and related initiatives, as opportunities to strengthen and expand the collaboration among all parties working towards improved maternal and child health.  As one of the pilot countries for UN Reform, we are learning how to work more effectively together as a UN family to promote certain issues which are central to the mission of the UN and the needs of the countries we work in.

I am very happy to be here because, the UN Agencies that are part of the SCN have been accompanying Vietnam in its journey over the last decades, which have included very difficult times and, more recently, impressive economic growth and improvements in the nutritional status of its population.  Viet Nam is on track towards achieving MDG Goal 1, which calls for the eradication of extreme poverty and hunger.  Underweight in children under five is one measurement for that.  In this country the prevalence underweight in children has been reduced from 52%, in 1985, to 25%, in 2005. This is truly impressive, and the Government needs to be applauded for this success. We will continue to support the government of Viet Nam in consolidating these achievements.  Nevertheless, I am happy that this 35th SCN session is put under the theme of reducing maternal and child undernutrition and that it takes place here, in Hanoi.  This will draw attention to the fact that, despite the remarkable progress made, the different forms of undernutrition still prevail, in this country, particularly among women and children.  For example: Viet Nam is among the 36 countries that account for 90% of all stunted children worldwide.  We, all together, need to take more concerted action to address the critical issues of maternal and child undernutrition.

Ladies and gentlemen – chronic undernutrition easily slips through the gap.  Less severe forms such as stunted children, anaemic mothers and other micronutrient deficiencies are not always easy to see.  These deficiencies rarely make the front page of the newspapers.  Yet research proves that inappropriate nutrition in the mother's womb and in the first two years of life can result in life-long, irreversible physical and mental effects, limiting not only the health of young children, but their future economic wellbeing and welfare as adults

Most of you will be aware of the recent series of the medical journal The Lancet that summarizes what we know on maternal and child malnutrition and what we need to do.  You will hear more about this starting from today. Many of the effective nutrition interventions listed there have been successfully implemented in Vietnam.  Sometimes, however, I feel that in the area of nutrition too much attention is given to some magic pills and not enough to the basics.  Again, the importance of exclusive breastfeeding for six months and timely and appropriate complementary feeding came out clearly, and it was confirmed that breastfeeding promotion and behaviour change communication work.  Yet, in Vietnam, only 17% of infants below six months are exclusively breastfed.  People say this is cultural, but I wonder, how much has been invested in the past on breastfeeding promotion and behaviour change communication?  If we don’t invest, we won't yield returns.  Are existing laws and regulations enforced?  If I see infant formula sold in hospital shops and house-sized advertisements for breastmilk substitutes in front or renowned hospitals, if formula companies sponsor meetings of health professional associations that deal with maternal and child health, there is something wrong.  These practices are good examples of effective behaviour change communication, unfortunately, in the wrong direction. These practices deprive children of appropriate food. They need to stop, and more needs to be done on the positive side.

Severe forms of malnutrition have been successfully fought back, in Vietnam. You will hardly find any severely malnourished child.  The proportion of underweight is on the decline.  Therefore, it is justified focusing on accelerated action against stunting that affects more than two thirds of children.  Yet, 8% were still wasted, in 2006, and we need to also make sure that we don't leave any children behind.

Many nutrition interventions have shown to work, in Vietnam.  Salt iodization had made impressive progress in the past.  Vitamin A supplementation has lead to the disappearance of night blindness and other forms of severe vitamin A deficiency.  Weekly iron folate supplementation and regular deworming have shown impact.  Others could be easily implemented such as zinc supplementation as part of diarrhoea management.  Yet, more than one third of young children and pregnant women are anaemic.  Also iodine deficiency is on the rise again, and zinc supplements are not yet available.  This clearly shows that we need to do more.   For the interventions that work, we need to reach everyone and to concentrate on the window of opportunity from conception up to two years of life, and we shouldn’t loose focus.  The challenge in Viet Nam is to scale-up from "pilots" to national interventions. We need also to communicate properly the issue of stunting to ensure that we do not lay the ground for the "commercialization of stunting". This is a real danger in a country like Viet Nam, which very soon will be granted the middle income status.  Finally the issue of undernutrition and its underlying effects must also be fully integrated into the maternal, newborn and child survival agenda.

I am fully confident that Viet Nam will benefit from the deliberations during this week and that it will reshape and invigorate the action that the Government is taking to tackle maternal and child undernutrition.  The United Nations in Viet Nam -- especially UNICEF and WHO – will continue to work closely with the Government and in particular the Ministry of Health, the Ministry of Labour, Invalids and Social Affairs to address this issue, and will continue to reach out to other partners, such as bilaterals and NGOs.

On behalf of the United Nations Country Team in Viet Nam, I would like to thank all those who have contributed to preparing and hosting this SCN session, especially the Steering Committee and Secretariat, the Government of Viet Nam with special thanks to the Ministry of Health, the National Institute of Nutrition and the local Organizing Committee.

Thank you very much for you kind attention, I wish you all good health, fruitful debates and a successful 35th Session of the Standing Committee on Nutrition.

xin cam on.