Nutrition and climate change
  Current state of play: Scoping review
                      Contents
                       Acknowledgements                                                                                                                                                 3
                       Abbreviations                                                                                                                                                    3
                       Executive summary                                                                                                                                                4
                       Background                                                                                                                                                       6
                       Objectives                                                                                                                                                       7
                       Methodology                                                                                                                                                      7
                       Limitations                                                                                                                                                      7
                       Findings                                                                                                                                                         8
                       1.    INTERNATIONAL ARCHITECTURE                                                                                                                                 8
                       2.  LINKS BETWEEN NUTRITION AND CLIMATE CHANGE                                                                                                                 10
                       3.  EVIDENCE BASE FOR THE EFFECTS OF CLIMATE CHANGE ON NUTRITION OUTCOMES                                                                                        11
                             3.1       Food pathway                                                                                                                                     11
                             3.2       Care pathway                                                                                                                                   14
                             3.3       Health pathway                                                                                                                                 15
                             3.4       Climate change and undernutrition                                                                                                              16
                             3.5       Climate change, obesity and diet-related non-communicable diseases                                                                              17
                             3.6       Vulnerable populations                                                                                                                          17
                             3.7       Evidence gaps                                                                                                                                  18
                       4.  CURRENT ACTIONS LINKING NUTRITION AND CLIMATE CHANGE                                                                                                      20
                             4.1       Governance and leadership                                                                                                                     22
                             4.2       Workforce/capacity                                                                                                                            22
                             4.3       Financing                                                                                                                                     22
                             4.4       Information systems and data                                                                                                                  22
                             4.5       Service delivery                                                                                                                              22
                             4.6       Technologies                                                                                                                                  22
                             4.7       Gaps/barriers in current actions on nutrition and climate change                                                                              23
                       5.  OPPORTUNITIES TO STRENGTHEN LINKAGES BETWEEN NUTRITION AND CLIMATE CHANGE  25
                       Conclusion                                                                                                                                                     27
                       References                                                                                                                                                    28
                       Annexes                                                                                                                                                         31
                             Annex 1            List of key informants                                                                                                                 31
                             Annex 2             Examples of conceptual frameworks of the links between nutrition  
                                                and climate change                                                                                                                   32
                             Annex 3            Examples of actions on governance and leadership from key informant  
                                                interviews (KIIs) and the scoping review                                                                                             35
                             Annex 4            Examples of actions on information and data from KIIs and the  
                                                scoping review                                                                                                                       36
                             Annex 5            Examples of actions on service delivery from KIIs and the scoping review                                                             37
           Nutrition and climate change – Current state of play: Scoping review
           Acknowledgments
           This review was completed by Anne Bush (ENN Consultant) and Stephanie Wrottesley (ENN Nutritionist) and  
           overseen by Emily Mates (ENN Technical Director), with review support from Bridget Fenn (ENN Nutrition 
           Epidemiologist). The authors would like to thank the key informants for taking the time to be interviewed and for  
           their valuable inputs. We were able to undertake this work through the generous support of the Eleanor Crook 
           Foundation and the Department of Foreign Affairs, Ireland. The ideas, opinions and comments included here are 
           entirely the responsibility of the document’s authors and do not necessarily represent or reflect the Department  
           of Foreign Affairs, Ireland, nor Eleanor Crook Foundation policy.
            Acronyms
            CLEAR          Consolidated Livelihood Exercise for Analysing Resilience                NDC            Nationally Determined Contribution
            COP            Conference of the Parties                                                NGO            Non-Governmental Organisation
            DR-NCD         Diet-Related Non-Communicable Disease                                    REAP           Risk-Informed Early Action Partnership                           © W
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            ENN            Emergency Nutrition Network                                              SDG            Sustainable Development Goal                                     /
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            FAO            Food and Agriculture Organization                                        SUN            Scaling Up Nutrition                                             O
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            GHG            Greenhouse Gas                                                           TFNC           Tanzania Food and Nutrition Centre                               Y A
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            IFAD           International Fund for Agricultural Development                          UN             United Nations                                                   R
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            IFPRI          International Food Policy Research Institute                             UNFCCC         United Nations Framework Convention on Climate Change            T
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            IIED           International Institute for Environment and Development                  UNFSS          United Nations Food System Summit                                R
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            IPCC           Intergovernmental Panel on Climate Change                                UNICEF         United Nations Children’s Fund                                   A
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            KI             Key Informant                                                            UNSCN          United Nations System Standing Committee on Nutrition            O
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            KII            Key Informant Interview                                                  USAID          United States Agency for International Development               : © W
            LDC            Least Developed Countries                                                WASH           Water, Sanitation and Hygiene                                    F
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                           London School of Hygiene and Tropical Medicine                                          Women’s Environment and Development Organization                 E
            LSHTM                                                                                   WEDO                                                                            V
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            NAP            National Adaptation Plan                                                 WFP            World Food Programme                                             Y
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                           National Adaptation Programme of Action                                                 World Health Organization                                        E
            NAPA           Non-Communicable Disease                                                 WHO                                                                             Y
            NCD
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        Executive summary                                                                                                        F
                limate change is one of the biggest challenges         findings concentrated on the impacts of climate change 
                facing both our, and future, generations.              on nutrition outcomes, rather than those of nutrition on 
        CThe climate crisis is accelerating faster than                climate change, since these are best aligned with the 
        previously anticipated, with various models predicting         perspective and experience of both KIs and Emergency 
        alarming to catastrophic impacts of the climate crisis         Nutrition Network (ENN).
        on humans and the environment. In a world where 
        undernutrition is declining very slowly and overnutrition      Links between nutrition and  
        is increasing rapidly, climate change will have                climate change
        multifaceted and severe effects on nutritional status and      The interrelationship between climate change and 
        therefore survival, health and development outcomes.           nutrition is complex, working multi-directionally through 
        Climate change and nutrition have overlapping agendas          various pathways. Climate change exacerbates current 
        and enhanced collaboration could generate a common             threats to nutrition and food security. In addition, 
        agenda for both communities.                                   undernutrition further challenges the health and coping 
                                                                       mechanisms of vulnerable populations, lessening their 
        This scoping exercise aimed to explore existing                resilience and capacity to adapt to other consequences 
        linkages between nutrition and climate change, as              of climate change. All forms of malnutrition are 
        well as to examine if – and how – it is best to strengthen     predicted to rise as a result of climate change, with 
        linkages and where these efforts would be best placed.         poorer, rural households and women and children being 
        The scoping exercise was undertaken between                    disproportionally affected. 
        January and November 2021. A series of 21 key 
        informant interviews (KIIs) with stakeholders working          Many conceptual frameworks have been developed 
        in climate change and/or nutrition were conducted to           to illustrate the complex linkages between climate 
        gain an understanding of the available evidence,               change and nutrition. Most are based on UNICEF 
        current activities and gaps. Based on focal areas              conceptual framework for malnutrition and focus on 
        identified during stakeholder engagement, available            how climate variability and associated events affect 
        literature was reviewed. The literature review was             nutrition outcomes through the three underlying causal 
        therefore thorough but not systematic, and the                 pathways of food, health and care. 
        evidence presented is not exhaustive. While it is 
        recognised that climate change and nutrition are broad         Evidence base for the effects of climate 
        topics with links to many sectors, the themes, actions         change on nutrition outcomes
        and gaps presented in this report are centred around           A growing body of evidence focuses on the impacts 
        health because the work of many key informants (KIs)           of climate change on nutrition outcomes, primarily 
        focused on this sector and health is the main delivery         via the food pathway. It is predicted that the biggest 
        platform for many nutrition interventions. Similarly,          threat to health from substantial climate change is 
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