PHA-Exchange> SCN article

[cecilia florencio]

60

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Editor’s Note: The following is a response to the article by Judith Richter 
entitled, “Global public-private ‘partnerships’: bow do we 
ensure that they are in the public interest?” published in SCN News #26. SCN 
News encourages readers to respond 
to any of its articles in order to continue the debate towards improved 
international nutrition.

On Partners and Partnership

Cecilia A Florencio, University of the Philippines


There has been a significant change in the cast of characters in the nutrition 
story with the entry of industry and its quick ascendance to a key role.  It is 
appropriate that the nutrition community pay  greater attention to examining 
public-private “partnerships” for improved nutrition.  In weighing the merits 
and demerits of partnerships, public interest and well-being must be the 
overarching concern; a concern that diminishes in significance whenever 
government views the entry of the private sector primarily as “lightening its 
load” and sees its crucial part in the “partnership” as paving the way for the 
other party to play an even greater role.

Let us consider these examples. A government research institute heeded the call 
for micronutrient fortification, and how! It studied fortification of 
carbonated beverages with iron, zinc, iodine and vitamins A, B3, B6, B12, C and 
E.  The justification was consumption of fortified carbonated beverages, the 
favorite drinks of children and adults, rich and poor alike, can accelerate 
elimination of micronutrient deficiencies as well as improve the health of the 
general population.  How’s fortified carbonated beverage as the great social 
equalizer!

In connection with a healthy lifestyle campaign, a health ministry in 
partnership with a nationally-based Coca-Cola Export  Corporation  issued  
educational  material  containing  ten  tips.   The message “drink enough 
fluids everyday” was depicted in a picture with a softdrink bottle along with 
milk, soup and fruit juicefor variety.  Further, to promote a healthy 
lifestyle, a government nutrition scientist, a private nutrition foundation, 
and a former secretary of health lent their presence in a tri-media 
advertisement on soy sauce.  The line is soy  sauce  contained isoflavones 
and  isoflavones prevent  cancer.  It  is  naïve  to  think  the layman  would 
not conclude that soy sauce prevents cancer, 
even if the nutrition authorities in the advertisement were not directly 
endorsing the product.

Another “partnership” deserving  more  attention is that between government and 
international organizations.   There is value in sharing experiences, not only 
on what works, but also what does not because both provide lessons and 
challenges.  An example is the universal vitamin A supplementation programme in 
my country.  After five years of implementation, with the presence of so-called 
success factors (political leadership, sustainability, local government 
support, etc), the prevalence of vitamin A deficiency (in terms of serum 
retinol) in preschool children increased and remains a public health problem, 
not only nationally,  but all  16  regions  of  the  country  and  ten  highly  
urbanized cities.  Instead of presenting a more complete picture of the 
supplementation programme to generate a more enlightened discussion, the focus 
of a presentation by a nutrition scientist on the country’s experience during 
an international conference  on  vitamin  A  was  on  “success”  indicators  
and  “success”  factors.   Is  there  no  merit  in collective thinking about 
the place of vertical and particularistic micronutrient supplementation 
programmes as a preventive measure in a country where stunting and underweight 
in young children are very high and widespread, where daily diets are 
nutritionally inadequate, and where infection remains a major cause of 
morbidity?  There is a place for micronutrient supplementation and food 
fortification.  But, dietary diversification and improvement in dietary quality 
deserve priority when thinking about preventive strategies to address 
nutritional concerns.

There is a need to rethink the positive bias of nutrition publications and 
international get-togethers.  It is ironic that even as the nutrition community 
is still in search of indicators to measure programme performance in nutrition 
it trumpets  the  “successful”  and  whispers  the “unsuccessful.”  In  the  
end,  the  fundamental  questions  are:  What is public interest and well-
being?  Whose perspectives are sought and judiciously considered?  Who gives 
the answers?  Who reviews the answers?

Thinking about “nutrition thinking” is a worthy partner to 
incorporating “nutrition thinking” into the development process.

Contact: Cecilia A Florencio, cecilia.florencio at up.edu.ph

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SCN NEWS #27–DECEMBER 2003