A/HRC/43/44 available and less expensive than nutritious alternatives, particularly for the rural and urban poor.26 32. That dependence has an impact on market stability: for example, between 2011 and 2017 the 50 countries most dependent on food commodities experienced rising undernourishment. 27 In 2018, an estimated 381 million undernourished people and 73 million stunted children under the age of 5 lived in low- and middle-income countries that were highly dependent on commodities.28 Asia continues to show the highest prevalence of undernourishment, with more than two thirds of all wasted children under 5 living in Asia in 2018.29 There is a “dire picture of undernourishment” in sub-Saharan Africa owing to the dependence on imported food, internal conflicts and droughts. Latin America and the Caribbean are experiencing a slow rise in undernutrition.30 33. Meanwhile, for the first time in history, there are more obese than undernourished people in the world, with obesity rates having nearly tripled since 1975.31 Overweight adults are now increasing at 13.2 per cent per annum, compared to 11.7 per cent in 2012, leading to 4 million deaths globally. More than 40 million children worldwide are overweight, with Africa and Asia the most burdened.32 Those numbers have implications for individual health outcomes and the greater health-care landscape: the economic impact of obesity is estimated at $2 trillion, or 2.8 per cent of the world’s GDP – roughly equivalent to the costs of armed conflict.33 34. These alarming rates of obesity and diet-related diseases are associated with the “supermarketization” of food systems, especially in Africa. Studies have found that middleclass Africans are more likely to purchase highly processed foods rather than fresh foods.34 These trends are also present in Latin America, where supermarketization and fast food chain diffusion have contributed to a rise in malnutrition and in particular obesity.35 The food industry targets children, marketing highly processed, low-nutrient foods across multiple media, especially in urban areas.36 If current trends continue, 70 million infants and young children will be overweight or obese by 2025 (A/71/282, para. 14). New developments 35. Following the second international conference on nutrition in 2014, the United Nations declared the Decade of Action on Nutrition in April 2016, demonstrating a commitment to a coherent, inclusive, transparent nutrition policy (A/71/282, para. 4). However, only Brazil, Ecuador and Italy have made specific, measurable, achievable, relevant and time-based (SMART) commitments for action in the context of national nutrition-related policies.37 Other countries (Argentina, Chile, Costa Rica and Mexico) have launched labelling regulations and practices to warn children and adolescents about unhealthy food and beverages, shielding them from targeted marketing. 26 27 28 29 30 31 32 33 34 35 36 37 See High Level Panel of Experts on Food Security and Nutrition, Report No. 12: Nutrition and Food Systems (September 2017). FAO and others, The State of Food Security and Nutrition in the World 2019: Safeguarding Against Economic Slowdowns and Downturns (Rome, 2019), p. 64. Ibid. Ibid., p. 28. Ibid., p. 9. See WHO, “Obesity and overweight” (16 February 2018). United Nations Children’s Fund, WHO and the World Bank Group, “Levels and trends in child malnutrition. Joint child malnutrition estimates: key findings of the 2019 edition” (2019). United Nations Children’s Fund and Special Rapporteur on the right to food, “Protecting children’s right to a healthy food environment” (November 2019). See Kate Lyons, “Supermarkets are creating an obesity crisis in African countries, experts warn”, The Guardian (3 October 2017). See Barry M. Popkin and T. Reardon, “Obesity and the food system transformation in Latin America”, Obesity Reviews, vol. 19, No. 8 (April 2018). UNICEF, The State of the World’s Children. Children, Food and Nutrition. Growing Well in a Changing World (October 2019), p. 105. See WHO, “Global database on the implementation of nutrition action (GINA): commitments by country”, available at https://extranet.who.int/nutrition/gina/en/commitments/summary. 9