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Summary

This chapter first reproduces a fictional speech that I published in 2008, an election year for the Presidency of the United States. The candidates were Barack Obama and John McCain, both Senators at the time. In this imaginary speech, I expressed my thoughts on what the winner of the election might say about the steps he would take to give high priority to meeting the challenge of climate change. Climate change is not something the world can safely continue to procrastinate about. We cannot wait until coastal cities become abandoned before we start mitigating sea level rise. Waiting too long means doing too little and acting too late. There is a timescale built into the climate change issue by physics and chemistry, and the broad public has not yet fully realized the urgency of it. Climate change is fundamentally a moral and ethical problem, in my view. What do we who are alive today owe to the next generation, and to subsequent generations? We are literally creating the planet our children will live in. We must act energetically and wisely. Everything depends on what people and their governments do.

Objective:

To evaluate the extent of implementation of public policies aimed at creating healthy eating environments in Senegal compared to international best practice and identity priority actions to address the double burden of malnutrition.

Design:

The Healthy Food Environment Policy Index (Food-EPI) was used by a local expert panel to assess the level of implementation of forty-three good practice policy and infrastructure support indicators against international best practices using a Likert scale and identify priority actions to address the double burden of malnutrition in Senegal.

Setting:

Senegal, West Africa.

Participants:

A national group of independent experts from academia, civil society, non-governmental organisations and United Nations bodies (n =15) and a group of government experts from various ministries (n =16) participated in the study.

Results:

Implementation of most indicators aimed at creating healthy eating environments were rated as ‘low’ compared to best practice (31 on 43, or 72 %). The Gwet AC2 inter-rater reliability was good at 0·75 (95 % CI 0·70, 0·80). In a prioritisation workshop, experts identified forty-five actions, prioritising ten as relatively most feasible and important and relatively most effective to reduce the double burden of malnutrition in Senegal (e.g. develop and implement regional school menus based on local products (expand to fourteen regions) and measure the extent of the promotion of unhealthy foods to children).

Conclusions:

Significant efforts remain to be made by Senegal to improve food environments. This project allowed to establish an agenda of priority actions for the government to transform food environments in Senegal to tackle the double burden of malnutrition.

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23 - If I Were President

Summary

Evaluation and prioritisation of actions on food environments to address the double burden of malnutrition in Senegal: perspectives from a national expert panel

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23 - If I Were President

Summary

Evaluation and prioritisation of actions on food environments to address the double burden of malnutrition in Senegal: perspectives from a national expert panel