Remarks at the 7th National Nutrition Forum and the Annual National Nutrition Committee Meeting 2021

Your Excellency, Kikeo Khaykhamphithoune, Deputy Prime Minister of the Lao PDR and chair of the National Nutrition Committee,

Esteemed Ministers and Government Representatives,

Distinguished Ambassadors,

Development Partner Representatives,

Ladies & Gentlemen, colleagues,

All protocols observed,

Lao PDR has been successful in reducing poverty and improving living conditions and finds itself at a critical juncture in its development process. Reckognised as such, as it embarks on the second year of the 9th National Socio-Economic Development Plan, it was recommended for graduation in 2026, from LDC status last year.

However, -- and although overall nutrition levels have improved, malnutrition is a continuing development challenge in Lao PDR, with the country facing a “triple burden” of persistent under-nutrition, micronutrient deficiencies (“hidden hunger”) and an emerging trend of overweight and obesity.

We have heard today that development progress has not translated into sufficient progress on nutrition, with the COVID-19 pandemic risking to undermine the impact of recent years. Poverty, inequality, and locational disadvantage are key influential factors in the nutrition situation in Lao PDR.

Despite the efforts to continually expand agricultural food production, it is not translating into less hunger and improved nutrition status – both around the world or in Lao PDR. We are seeing food systems globally driven by economic priorities and an increasing disconnect between producers and consumers.

In Lao PDR, subsistence farming is still the way of life for 80 percent of the rural population, supplemented with livestock rearing, foraging wild food sources, and collection of fish from local water supplies. With the disappearance of forest coverage in the wake of the expansion of commercialized agriculture, and an increasing population, these traditional food system choices and diets are changing as access to wild foods decline, often being replaced by less nutritious foods products.  Households increasingly consume foods purchased at the market, as there is an increase in the availability of comparatively cheap, highly processed foods and beverages, which are often high in salt, sugar and fat.

We all have these on our shelves, such as instant noodles, cookies, instant rice porridge, sodas and flavoured drinks, which are harmful for growth and development of children and youth, and the health of all populations. These foods often replace diverse and nutritious foods, and can lead to overweight and obesity, linked to non-communicable diseases, such as heart disease and diabetes, and therefore not only pose a public health burden, but can hamper the growth and prosperity of the nation.

Although there is ongoing work to address all forms of malnutrition and food insecurity, to ensure safe and nutritious food for all, to date there has been little consideration of the role of the food system in driving these issues, beyond the availability and affordability of foods. We must emphasize a broader, more comprehensive assessment of the food system’s impact on safe and nutritious food for all.

Some of the opportunities to support and increase nutrition and food security, considering the impact of COVID-19, include, targeted education of farmers on production of nutritious foods; provision of in-kind or cash support to areas with acute insufficient access to food; fortifying staple foods such as rice and including fortified foods in social safety net programmes such as the school feeding programme by the Ministry of Education and Sports in collaboration with the WFP; selectively allowing agricultural traders greater movement; and continued focus on households’ awareness about nutritious and safe foods.

And while we must strengthen these efforts to ensure affordability and equitable access to nutritious and safe foods for all population groups, we must not forget the many other factors that play a role in influencing consumption patterns and thus in shaping nutrition of the population, including the interpersonal and socio-cultural factors that influence our food choices and diets.

For most of us, eating involves interactions with other people. For young children, caregivers are the key gatekeepers: they decide what young children will eat and they usually buy, prepare, and feed them. As children age and become more independent, their dependence on their caregivers decreases, and their food choices are strongly aligned with their broader social aspirations, they watch and model people who are important to them including their peers, social influencers and/or school staff.

Personal preferences and tastes are important factors that interact to decide what ends up on our plates. While food preferences develop and are reinforced early in life, older children and adolescents often make decisions related to their preferences on their own, and are strongly influenced by personal likings, taste preferences, self-efficacy, and body image, rather than knowledge and education about food and nutrition.

Social norms and practices also influence diets. Social beliefs about certain foods might limit whether these are fed or consumed by young children or pregnant women. Additionally, with social media, the internet, and television, in addition to marketing and advertising across these platforms, and in places where children and adolescents usually socialise, social trends and norms are increasingly becoming more global.

Hence, it’s not only the foods which are available and accessible to us, as well as the knowledge, skills, experience, income, and time which limit what food is procured, prepared, and consumed. It is also our interpersonal food environments and the factors in our external food environments including regulations, legislations, fiscal policies and more, that influence the diets and ultimately the nutritional status of children, adolescents, women and men in Lao PDR and with it, the future of the country.

I would like to take this opportunity to congratulate the Government of Lao PDR for putting in place strong regulations on the promotion of breastmilk substitutes. The legislation and the associated efforts to monitor and enforce the decree, that limits the influence of unscrupulous marketing techniques to convince mothers to feed their children substitutes rather than the much superior breastmilk.

However, more can and must be done. In many countries, efforts to control the external food environment have been taken, such as bans on sugar-sweetened beverages in public institutions such as in or near schools, and fiscal policies, for instance, taxes on ultra-processed foods high in fat, sugar, and salt, which include sodas, cookies, chips, and crackers – even instant noodles.

These are efforts that should also be considered in Lao PDR. Collaborating with the private sector is crucial to achieve an enabling environment, that was stressed earlier by our representative from the private sector and the SUN Business Network here today.

We must ensure that the evolving food system is not only conducive to good nutrition – it must be held accountable to specifically target efforts to achieve improved nutrition outcomes and ensure that the demand and consumption of diverse and nutritious foods in considered to be central to the wider food system agenda in Lao PDR.

Furthermore, given the traditional food practices in rural Lao PDR, securing traditional food systems that primarily provide for the most vulnerable communities in Lao PDR, should be a key consideration in transitioning to a nutrition-centred approach to food.

Nutrition aspects are an essential part of the food system and this needs to be acknowledged by all stakeholders, from producers to consumers as well as development partners. We need to follow an integrated approach when tackling food system challenges. In this regard, I would like to highlight the Food Systems National Dialogue that took place in June last year and was led by the Ministry of Agriculture and Forestry in collaboration with UN agencies and in close consultation with many stakeholders.

The National Dialogue revealed the existence of trade-offs between competing goals in areas such as economic development, public health, food security, environmental issues, and social equity to name a few. These challenges are not unique to Lao PDR but valid for countries around the world and need to be tackled collectively.

Therefore, connecting to global and regional initiatives is key for Lao PDR. The Global Food Systems Summit that followed during the annual huighlevel segment of the UN GA provided a platform for establishing collaboration and exchanging good practices between countries and sectors. International networks such as the Scaling Up Nutrition (SUN) Movement and UN Nutrition are important institutions that raise awareness of nutrition issues.

In this context, the UN country team is currently exploring opportunities to strengthen collaboration with these institutions and in turn encouraging them to collaborate more strongly with the UN Food Systems Coordination Hub to draw attention to the synergies but also inherent trade-offs that needs to be managed between many different actors and sectors to not jeopardize the wellbeing of people and inclusive prosperity for all.

There is an urgent need that all actors in the food system rally together to take action whether through nutrition education, sensitisation, training, social media campaigns, marketing techniques, or economic incentives and disincentives. Only then will the food system have meaningful impact on the nutrition outcomes and development to the benefit of the people of Lao PDR.

Thank you for your attention today.