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Brazilian National Food and Nutrition Policy: celebrating 20 years of implementation

To celebrate 20 years of the Brazilian National Food and Nutrition Policy (PNAN) means to celebrate the evolution of the food and nutrition agenda both within the Brazilian Unified National Health System (SUS) and in its relations with different areas of government and civil society.

The development from the first 11. Ministério da Saúde. Portaria nº 710, de 10 de junho de 1999. Aprova a Política Nacional de Alimentação e Nutrição. Diário Oficial da União 1999; 15 jun. to the second 22. Departamento de Atenção Básica, Secretaria de Atenção à Saúde, Ministério da Saúde. Política Nacional de Alimentação e Nutrição. Brasília: Ministério da Saúde; 2012. edition of the PNAN can be considered remarkable, but the maturation and repercussion of the guidelines on the organizational processes of the SUS in the interfederative and intersectoral dialogue is even more evident. The challenges have also been intensified in recent years, as the food and nutrition field has become more complex and disputed. This stems from the place occupied by food in the political and economic, and more recently, environmental context. Such disputes have these same origins 33. High Level Panel of Experts on Food Security and Nutrition. Nutrition and food systems. A report by the High Level Panel of Experts on Food Security and Nutrition. Rome: High Level Panel of Experts on Food Security and Nutrition, Committee on World Food Security; 2017. (HPLE Report, 12).,44. Rede Brasileira de Pesquisa em Soberania e Segurança Alimentar e Nutricional. VIGISAN: Inquérito Nacional sobre Insegurança Alimentar no Contexto da Pandemia da COVID-19 no Brasil. Brasília: Rede Brasileira de Pesquisa em Soberania e Segurança Alimentar e Nutricional; 2021.,55. Swimburn B, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, et al. The global syndemic of obesity, undernutrition, and climate change: The Lancet Comission Report. Lancet 2019; 393:791-846..

Since its first edition, PNAN has proven to be a robust and essential public policy. The approach to the agenda and its challenges has an internal coherence capable of dealing with a rapidly changing reality. Thus, even if some topics have currently gained greater visibility, such as food systems and food environments, for instance, the approach of the different guidelines welcomes them as well as supports the identification of study needs, training of professionals, organization of care, and intersectoral interfaces, among others.

Likewise, both in the specific guideline on food and nutrition security and transversally in the others, topics historically present in our reality that have gained dramatic contours in recent years, such as inequalities and violations of human rights in general and to adequate food can be identified.

The definition of PNAN’s actions and priorities has always been guided by systematic exchange with national and international research centers, either by the accorded definition of research agenda priorities that could fulfill gaps, or by funding research through public notices.

The evolution is clear, but there is still a long way to go. This agenda has consistently had meaning and importance in the daily life of our communities, but it has not always had repercussions in institutional environments. Thus, among the challenges posed for the advancement of PNAN, we highlight: the qualification and expansion of nutritional care in SUS (to expand the results of the efforts regarding primary and other levels of care); the incidence of training processes for health professionals in general, in addition to nutritionists; and the expansion of intersectoral articulation so that the food and nutrition agenda becomes a topic present in the definition and planning of other sectors. As examples there are the expansion of availability and access to healthy foods and the advancement of regulatory measures that disseminate health-promoting food environments, considered as mediators between production and supply chains and food choices. Overcoming the challenge of intersectoral articulation is essential to expand the opportunities for shared planning so that potential results and impacts respond systemically to the priorities of the food and nutrition agenda.

For all these reasons, the initiative of the General-Coordination of Food and Nutrition of the Brazilian Ministry of Health, in partnership with the Pan American Health Organization, to propose and support the realization of this thematic issue in celebration of the 20th anniversary of PNAN is very timely. The topics covered by PNAN, the interface of the authors with areas of knowledge related to this policy and regional diversity were considered for the construction of this thematic issue. It presents 18 articles, including a debate article with eight comments and one reply, 12 original articles, one literature review, one essay, one perspective article, one on methodological issues, and two interviews. Among the topics covered by the articles there are: the evolution of PNAN in the last 20 years; PNAN in primary care and its organization for obesity-related care; the NOVA food classification, which is based on the extent and purpose of food processing, and its repercussion on policies in Brazil and worldwide; the promotion of adequate and healthy eating; the evolution of regulatory measures and strategies adopted to protect the food environment; and conflicts of interest and corporate political activities in the definition of food and nutrition policies.

The breadth of the PNAN makes it unfeasible to thoroughly address all of its dimensions in one thematic issue. Topics related to health inequities and inequalities, such as nutritional care for indigenous peoples, black populations, traditional peoples and communities, equally important to those included in the thematic issue, were not sufficiently addressed despite the efforts made to do so. These topics, as well as being challenges for the implementation of PNAN, are also challenges for research in food and nutrition.

We believe and hope that this thematic issue may contribute to the growing and ongoing discussion on policies and actions - including knowledge production - necessary for the prevention and control of all forms of malnutrition, nutritional care, protection and promotion of adequate and healthy food and full accomplishment of the rights to health and food.

  • 1
    Ministério da Saúde. Portaria nº 710, de 10 de junho de 1999. Aprova a Política Nacional de Alimentação e Nutrição. Diário Oficial da União 1999; 15 jun.
  • 2
    Departamento de Atenção Básica, Secretaria de Atenção à Saúde, Ministério da Saúde. Política Nacional de Alimentação e Nutrição. Brasília: Ministério da Saúde; 2012.
  • 3
    High Level Panel of Experts on Food Security and Nutrition. Nutrition and food systems. A report by the High Level Panel of Experts on Food Security and Nutrition. Rome: High Level Panel of Experts on Food Security and Nutrition, Committee on World Food Security; 2017. (HPLE Report, 12).
  • 4
    Rede Brasileira de Pesquisa em Soberania e Segurança Alimentar e Nutricional. VIGISAN: Inquérito Nacional sobre Insegurança Alimentar no Contexto da Pandemia da COVID-19 no Brasil. Brasília: Rede Brasileira de Pesquisa em Soberania e Segurança Alimentar e Nutricional; 2021.
  • 5
    Swimburn B, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, et al. The global syndemic of obesity, undernutrition, and climate change: The Lancet Comission Report. Lancet 2019; 393:791-846.

Publication Dates

  • Publication in this collection
    29 Oct 2021
  • Date of issue
    2021

History

  • Received
    04 Aug 2021
  • Accepted
    05 Aug 2021
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