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CORE GROUP

GLOBAL HEALTH PRACTITIONER

CONFERENCE

ACCESS TO NUTRITION INDEX:

PROGRESS AND PLANS

FALL 2016

Agenda

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1. Introductions

2. The Access to Nutrition Foundation: positioning and goals

3. The importance of improving nutrition globally

4. The Access to Nutrition Index methodology

5. The Access to Nutrition Index 2016: Findings and Recommendations

6. Focus on marketing of breastmilk substitutes – key findings

7. The Access to Nutrition Index 2016 impact

8. Future plans

9. Q&A

1. Access to Nutrition Foundation

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• Key product: Global Nutrition Index of F&B

companies, published every two years (first Index

2013, second Index 2016, third Index planned 2018).

• In addition: country Spotlight Indexes. Pilots have

been done in South Africa, Mexico and India. India

Spotlight Index to be published in 2016.

• Covers both forms of malnutrition: over- and

under-nutrition.

• Not-for-profit established in The Netherlands in 2013

• Independent of industry - funded by Bill & Melinda

Gates Foundation, Wellcome Trust and Children’s

Investment Fund Foundation.

• Multi-stakeholder approach.

• Rigorous and objective: Independent Advisory Panel

and Expert Group.

Mission: Improving nutrition for all

For more information see: www.accesstonutrition.org

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Encourage improvements in companies’ policies, practices and performance to result in:

• Greater consumer access to more nutritious foods and beverages

• An environment facilitating the consumption of healthier foods and beverages

Investors

Provide context for company engagement

Media

Raise profile of industry role in malnutrition

Civil society

Facilitate effective advocacy

Policymakers

Inform regulatory and policy agenda

Academics

Stimulate research on best practices

Provide companies a tool for

benchmarking their nutrition practicesServe as an impartial source of

information for interested stakeholders

Stimulate

dialogue and

action

Given its size and reach, the private sector can make a significant contribution to addressing obesity and

undernutrition.

ATNI seeks to

Accountability

tool

2. What ATNF aims to achieve – our theory of change

3. We are suffering a global nutrition crisis

5 Source: 2016 Global Nutrition Report

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No Causes of deaths, 2012 Deaths (million)

% of

deaths

Since

2000

1 Ischaemic heart disease 7.4 13.2 Up

2 Stroke 6.7 11.9 Up

3 COPD 3.1 5.6

4 Lower respiratory infections 3.1 5.5

5 Trachea, bronchus, lung cancers 1.6 2.9

6 HIV/AIDS 1.5 2.8

7 Diarrhoeal diseases 1.5 2.7

8 Diabetes mellitus 1.5 2.7 Up

9 Road injury 1.3 2.3

10 Hypertensive heart disease 1.1 2.0 Up

25.8 29.8%Diet & lifestyle related = bold

Poor nutrition kills millions annually, makes millions ill

WHO statistics

• Overweight and obesity are linked to more

deaths worldwide than underweight.

• 65% of the world's population live in a country

where overweight and obesity kills more

people than underweight. This includes all

high-income and middle-income countries.

• Globally, 44% of diabetes, 23% of ischaemic

heart disease and 7–41% of certain cancers

are attributable to overweight and obesity.

• Over 800 million people in the world still go

hungry.

• In 2014, 159 million children were affected by

stunting (low height-for-age) while 50 million

children were affected by wasting (low weight-

for-height).

• Poor nutrition continues to cause nearly half of

deaths in children under five.

• Over 2 billion people are affected by

micronutrient deficiencies, or "hidden hunger",

due to inadequate vitamins or minerals.

F&B industry has an important role to play …

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Although the industry is still growing

globally, it is increasingly clear that

consumers want healthier products,

more information and more

responsible marketing from F&B

manufacturers.

Companies must be part of the

solution.

ATNI provides an ‘accountability

tool’ to investors and other

stakeholders to understand what

companies are doing and how they

are improving over time.

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• 22 of the largest global food and beverage companies were assessed and ranked for the 2015 Global Index. 19 of the 25 companies assessed on the 2013 Global Index.

• ATNI Methodology assessed companies against international guidelines, norms and accepted good practices.

• Companies’ commitments/ performance/ disclosure assessed, weighted. Categories (see next slide) also weighted. Important to note the Index assesses companies’ actual performance, not just disclosure /reporting, as many other Indexes only do.

• Assessment was based on guidance from a panel of nutrition experts.Suggestions from extensive stakeholder consultations held during 2014 substantially strengthened the methodology.

• Company assessments were conducted by the research firm Sustainalytics, and used publicly available documents, supplemented by additional information provided by each company via an online data platform.

• Each company is rated on a scale of 0 to 10 based on their nutrition-related commitments, practices and disclosure across seven different Categories.

• The companies that sell baby food and where sales of baby food make up 5% of their total retail revenues were also assessed on their marketing of breast-milk substitutes: Danone, Heinz, FrieslandCampina and Nestlé plus two pharmaceutical companies that are among the largest breast-milk substitute producers globally: Mead Johnson and Abbott.

4. 2016 Global Index methodology and research

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Global Index methodology

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5. Overall 2016 ATNI ranking

• Unilever leads the Index, with a

score of 6.4 out of 10.

• Nestlé and Danone also remain

in the top three, as in 2013.

• Mars (16 to 5) &

FrieslandCampina (19 to 8) have

improved the most.

• Eight have risen, six fallen, five

stayed the same, three new

entrants.

Overall findings Global Index 2016

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The world’s largest food companies must step up efforts to

address the global nutrition crisis

• Some companies have made improvements but the industry as a whole is moving too

slowly: the average score has only increased to 2.5 from 2.2 in the 2013 Index.

• All companies must invest more in embedding nutrition into their global businesses.

– To tackle obesity, they should adopt stronger nutrition strategies and policies and

use robust nutrient profiling systems to measure the nutritional value of all of their

products and make their foods healthier, among other things.

– To tackle undernutrition, they must invest within their businesses and work with

governments and civil society to find innovative ways of providing affordable and

accessible foods for poorer people.

• Companies must take a global approach; some US companies particularly must not just

focus on their home markets.

• The marketing practices of all six of the baby food manufacturers evaluated fall short of

international standards, undermining breastfeeding - the optimal form of nutrition for

infants.

Companies need to do much more on undernutrition

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Undernutrition remains largely neglected by companies | Few

have made specific commitments | Little translation into action

• The top three companies on the Index also top the undernutrition sub-ranking.

• Mars and Ajinomoto show leading practice in some areas.

• Although many companies plan to expand into emerging economies, none have

integrated a commitment to undernutrition at a strategic level; they need to do much more

strategy and market research.

• Only four companies provided evidence of initiatives to formulate products specifically for

the undernourished – through targeted micronutrient fortification – in high-priority

countries.

• Experts urge a focus on particularly high-priority countries –few companies seem to be

aware of which they are - and on two key population groups: women of childbearing age

and children under two, which few companies also state a focus on.

6. Infant food and formula (BMS) marketing is a

critical nutrition issue

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• Substantial tension between companies’ commercial

interests and infants’ health ….

• Absolutely no question that breastfeeding gives

babies the best start in life, and protects health over

their lifetime – Lancet Breastfeeding Series, January

2016.

Company FY2014

global

market

share

FY2014

baby food

revenues

($m)

Share of

company’s

FY2014

revenue

1 Nestlé SA 23.7% 13,370.6 14%

2 Group Danone 12.3% 6,913.1 26%

3 Mead Johnson Nutrition Co 10.6% 5,953.3 100%

4 Abbott Laboratories Inc 7.1% 4,012.0 18%

5 Royal FrieslandCampina 3.0% 1,686.3 10%

Source: Euromonitor 56% 31,935

Total global baby food sales in 2014: US$50 billion

Detailed new analysis of BMS marketing

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Are world’s six largest baby food companies

marketing breast-milk substitutes (BMS) in

line with the 1981 WHO Code?

BMS 1: Corporate Profile

• Is the company’s BMS marketing policy aligned with The

International Code?

• Does the company have good procedures, training programs,

incentives, auditing systems etc?

• Does the company publish its policies, procedures, results of

audits etc?

BMS 2: In-country assessment (Vietnam and Indonesia) of

companies’ marketing practices using IGBM Protocol

• IGBM protocol originally developed in late 90s/early 2000s by

stakeholder group including many UK church investors.

• Seen as only credible methodology to use for such studies by

key nutrition/BMS stakeholders (UNICEF, STC, others).

• Conducted by independent global health research company,

Westat.

• Includes

• Interviews with healthcare workers and > 800 bmothers

• Evaluation of Informational posters and flyers

• Media monitoring (TV, print and online adverts)

• Analysis of in-store promotions

• Analysis of labels

• Detailed reports for each country.

Detailed separate BMS Scorecards

No company markets BMS in line with The International Code;

all need to make substantial improvements

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Companies’ BMS scores incorporated into Index

score

16 19-10-2016

“We are extremely pleased to receive this independent

recognition of our efforts to improve nutrition,” says Unilever

spokesperson. “We recognize more hard work is needed to

embed nutrition in our global ambition ‘to make sustainable

living commonplace.’’

Unilever, Jan 2016

“Health and nutrition are core to the evaluation of the food

industry from both a financial and non-financial

perspective. The Access to Nutrition Index provides us with an

invaluable tool with which to assess corporate strategy on

nutrition, as well as helping us to deepen our dialogue with the

companies in this critical area."

BNP Paribas, Jan 2016

“We are looking very much forward to working with the report

and the recommendations for improvements.”

Arla, Jan 2016

“You have done an amazing job at spelling out all the issues

and complexities so clearly and thoroughly. I am deeply

impressed by how you have managed this whole process and

I know we will be citing the report frequently”. (BMS)

UNICEF, Jan 2016

7. Initial response to 2016 Global Index

8. Future plans

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• First India Index: Late 2016

• First India Index due to be published towards the end of this year.

• Will include Corporate Profile (analysis of commitments, performance and disclosure, Product Profile

(analysis of the nutritional quality of products) and BMS assessment (analysis of compliance of marketing

with Indian regulations and the WHO Code).

• This can be a useful test of whether multinational companies truly apply their ‘global’ policies in an

individual country. Also enables comparison of local and multinational companies’ on nutrition, and provides

further evidence on BMS marketing compliance.

• Feasibility study: 2017

• Project to look at whether and how ATNF might develop new Indexes within the F&B sector to encompass

retailers, food service companies, fast food companies, develop further Spotlight (individual country)

Indexes, and opportunities to innovate research methods.

• NGOs will be consulted.

• Action research program initiating in 2017

• ATNF to begin collaborative research to develop guidance on how companies can improve their

performance in key areas where it is currently weak (e.g. Affordability and Accessibility of healthy products,

Undernutrition) or where progress has stalled (e.g. Marketing to Children). NGOs will be involved in

roundtables and research.

• Global Index: March 2018

• Consultations on revising the methodology will start in early 2017 – aiming to keep methodology mostly the

same, to enable easier comparison with 2016 results.

• Research will start early 2018.

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9. Discussion