The rationale for the Index is simple: obesity and undernutrition affect over three billion people and threaten a global health catastrophe. Globally one in three people are now either undernourished, overweight or obese. Over the next ten years malnutrition is set to continue to increase. Over the last 35 years obesity has more than doubled and it has now reached epidemic proportions. Obesity and diet-related diseases affect countries of all income levels. Globally 41 million children under 5 are considered to be overweight, and the bulk (31 m) live in developing countries. By 2030 half of the world population is expected to be overweight or obese. The costs for the obesity epidemic is now approximately 2 trillion USD annually, which is around 3% of global GDP. At the same time undernutrition affects billions of people globally, increasingly in the form of hidden hunger where people have sufficient food but lack access to adequate micronutrients. Half of the deaths of young children are linked to undernutrition and a substantial amount (12%) is attributed to sub-optimal breastfeeding. Without the support and engagement of the food and beverage industry, it would be impossible to tackle this challenge. The aim of the Index is therefore to promote a more objective public debate around these issues, and encourage companies to do more to address nutritional needs of customers and society at large.
ATNI was conceived by the Global Alliance for Improved Nutrition (GAIN) in 2010. GAIN was then joined by two other leading global not-for-profit bodies concerned about health and nutrition issues: the Bill & Melinda Gates Foundation and the Wellcome Trust. Together they incubated and funded the development of ATNI as a comprehensive and independent assessment of the nutrition policies and practices of the largest companies in the food and beverage industry. From the outset, the three partners determined that ATNI would transition after its initial Index to be an independent body with its own legal structure, governance and funding arrangements. In 2013 the Access to Nutrition Foundation was therefore established in Utrecht, the Netherlands.
For the 2016 Index, the Children’s Investment Fund Foundation (CIFF) joined the Bill & Melinda Gates Foundation and the Wellcome Trust in funding the Index. GAIN is no longer involved in the operations nor the funding of ATNI.
ATNI is now being embraced as an independent benchmarking and accountability tool that works with industry, nutrition experts and civil society to measure companies’ contributions to good nutrition against international norms and standards. Since the first Index, companies have increased their engagement with the research process (17 out of 22 were actively engaged). This shows a positive trend highlighting how the Index can enable the food and beverage industry to shape their policies and practices to help consumers around the globe eat better food.
This Index underscores the important role of food and beverage manufacturers in addressing obesity and undernutrition, both of which are among the world’s most pressing public health concerns. These public health challenges affect billions of people, and efforts to address them are vital to ensure that people around the world can live healthy and productive lives.
Due to the pervasive and increasing role of their products in diets in many countries, global food and beverage manufacturers have the potential to make a powerful contribution to addressing these challenges through their business practices and through their non-commercial and philanthropic giving.
The ATNI is the only systematic effort to compare companies’ contribution to addressing global nutrition challenges in a consistent way. It provides all those concerned with addressing obesity and undernutrition with an objective picture of what companies are already doing, where they are doing well and where they can improve. In this way it focuses attention on where corporate practices are weak or inconsistent and where additional intervention is needed, either by companies, through further research or changes to government policy. Because of its rigorous methodology, it helps to move beyond the anecdotal and to present a compreunhegenuine collaborative action.
The results of ATNI allow for comparison of company performance on delivering better access to nutrition as measured against international guidelines and expert guidance.
Companies did not have a choice whether to be included in ATNI, which selected the world’s 20 largest companies by F&B sales (see the website for more information Company selection). Companies also could not pay to be evaluated (funding for ATNI was provided solely by the Bill and Melinda Gates Foundation, the Wellcome Trust and CIFF). However, companies had the option not to take part in the engagement phase of the research. For companies that chose not to participate, their evaluation was based solely on publicly available information.
The methodology has been significantly expanded and strengthened since 2013 to better reflect stakeholders’ expectations. A quarter of all scored questions were new questions and many indicators also required more detailed, specific information or quantitative data. This means that exact one-to-one comparisons of results between 2013 and 2016 are not possible, although general orders of magnitude may still be compared.
The Access to Nutrition is currently the only independent means of comparing companies to each other on their global performance on delivering better access to nutrition through all relevant business functions. ATNI’s assessment is based on international guidelines and experts’ guidance. Companies are assessed not only on publicly available information but also on information not in the public domain that was obtained through direct engagement with them.
While ATNI is not intended to be an investable index, it does have the support of both investment managers and large institutional asset owners from around the world. ATNI has produced an Investor Statement in support of the Index, and its current signatories collectively manage over $3.0 trillion. ATNI is designed to be of value to them by providing insights into companies’ performance on nutrition issues which can be integrated into their financial analyses or used as a basis for engagements with companies on these critical issues.
The next global ATNI will be published in April 2018.
Yes. As 2013 was the first time that the Index was carried out, there were many learnings from the process and the methodology. Together with shifts in nutrition knowledge, these informed improvements in the methodology for the 2016 Index. ATNI held intensive stakeholder consultations with companies, civil society organizations and investors throughout 2014 to evaluate the approach of the first Index. The Access to Nutrition Foundation’s Expert Group consisting of a broad range of nutrition experts fed into the process of strengthening the methodology for the 2016 Index, making it more robust and concise by adding more indicators, particularly quantitative ones, and by updating the existing indicators. For future Indexes we expect to continue updating the methodology in line with newly developed knowledge, guidelines and policies on nutrition.
Companies are scored on an absolute scale from 0 to 10 using a system that rewards good practices rather than penalizing poor ones. A score of 0 indicates that no evidence was found for any nutrition-related commitments or practices. A score of 10 signifies best practice as determined by consensus judgments against established international codes and guidelines and other norms set out in the ATNI assessment methodology.
Both undernutrition and obesity related diseases are critical public health issues with extremely wide prevalence. The World Health Organization now considers obesity a global epidemic and undernutrition inflicts pernicious damage on an estimated 2.3 billion people. The ATNI recognizes that food and beverage companies can play a role in addressing both challenges. In particular, there is significant untapped potential for companies to address undernutrition, particularly as they expand their presence in markets where undernutrition is still prevalent.
That is not the case. ATNI assessed companies on a broad range of activities that they undertake to improve access to nutrition, both with respect to the products they make and how they exercise their influence on consumer choice and behaviour. Companies undertake additional activities that are specific to addressing undernutrition, including their efforts around fortified products. This assessment approach was developed with the advice of the ATNI Expert Group and feedback from the public consultation on the methodology.
There is currently no universally accepted system for determining the nutritional quality of products relative to one another. As a result, there is no international standard for what can be considered a “healthy” product. This creates inherent limitations on ATNI’s assessment of company practices as several indicators in the ATNI methodology depend on companies’ own definitions of “healthy” products, which can vary significantly. A proxy approach is used in this version of the Index that assesses the quality of companies’ nutrient profiling systems – i.e., how companies determine the nutritional quality of their own products.
Not for the Global Index. Given the extremely large number and heterogeneity of products sold by companies assessed by ATNI, it was not within the current scope of the Index to profile the nutritional composition of companies’ products globally (or to identify a reasonably sized sample of products for profiling that would be sufficiently representative of their portfolios).
However, ATNI has assessed the nutritional quality of a random sample of each company’s products in each of the three country-level, or “Spotlight”, Indexes (in India, Mexico, and South Africa) in 2013. This work was carried out by an expert team at Oxford University.
Only companies with more than five per cent of sales in non-OECD countries are assessed on undernutrition. As a result, ConAgra, Kraft and Campbell Soup were not assessed on undernutrition. Ferrero has, furthermore, not been assessed on commercial indicators related to the fortification of their products because their products cannot be fortified. Also some companies were not assessed on certain aspects that did not relate to their business: e.g. some companies were not assessed on fruits and vegetables targets because their portfolio does not contain these nutrients.
ATNI evaluates the contribution all companies are making to improving consumers’ access to nutrition around the world. This is determined both by efforts that companies have undertaken to improve the nutritional quality of their product portfolios and the efforts they make in many other aspects of their businesses, such as how they support consumers in understanding what comprises a healthy diet and a healthy lifestyle, how they label their products, how they present their products in marketing materials, offering a wide choice of products in varying sizes, and how they engage with governments and policymakers. Thus if a company with a seemingly less healthy portfolio receives a higher overall score on the ATNI, it is due to strong performance in other categories evaluated by the Index.
ATNI aims to evaluate the contribution all of the companies are making to improving consumers’ access to nutrition. This is done by evaluating their efforts on improving their product portfolio, how they support consumers in understanding what comprises a healthy diet and a healthy lifestyle, how they label their products, how they present them in marketing materials, whether they offer a wide choice of products in varying sizes, and how they engage with governments and policymakers. Companies can improve their nutrition-related practices in all of these areas regardless of the composition of their product portfolios.
We are confident that the methodology used provides both a common platform through which to evaluate companies as well as being flexible enough to accommodate different business models and product portfolios.
The IGBM Protocol was selected as the methodology to assess marketing practices within India following extensive consultation in 2015/16 with a wide range of BMS stakeholder input and support (e.g. Helen Keller International, PAHO, Save the Children UK, USAID, WHO, UNICEF (NY), UNICEF (UK), World Bank, 1000 Days, Bill & Melinda Gates Foundation, Children’s Investment Fund Foundation and GAIN).
Companies that manufacture breast-milk substitutes (BMS) are assessed on their BMS marketing practices because breastfeeding is an integral part of good nutrition from the beginning of life, particularly in low-income settings where breast milk can be a lifesaver for vulnerable infants. The marketing policies of major manufacturers have an impact on the decisions of mothers whether and how long to breast feed their babies. The study assessed the marketing of eight baby food producers whose products were found in the study area – Greater Mumbai.
Companies did not have a choice whether to be included in ATNI. However, companies had the option not to take part in the engagement phase of the research. For companies that chose not to participate, their evaluation was based solely on publicly available information.
For more details about the methodology please visit the Resources section of the website.
For the first India Index, it was decided to focus solely on companies’ marketing practices, as these are of greatest interest to local stakeholders. Further, if stakeholders are interested in the policies and management systems of the multinational BMS companies, the research and findings of the 2016 Global Index are relevant to the Indian context, as the companies’ policies and management systems apply globally.
Greater Mumbai was chosen as the geographical location for the study on the advice of ATNF’s Expert Group. It has one the highest population densities in India and high GDP per capita, likely making it an appealing market for infant foods companies. Moreover, a similar study had previously been carried out in Delhi by PWC on behalf of FTSE4Good; ATNF, therefore, wished to conduct its study in a different location.
The assessment included all companies whose products were found in the study area – Greater Mumbai. In total 44 products were found made by 8 companies:
Only Amul and Nestle are constituents of the India Index and therefore receive a BMS score which is taken into account in their overall India Index score by making a deduction of between 0 and -0.75 (out of 10).
ATNI Indexes are designed to assess the overall contribution companies make to preventing and addressing obesity and diet-related chronic diseases, and to undernutrition. While we recognize the critical importance of supporting and promoting breastfeeding, ATNF has chosen to include BMS companies rather than exclude them, and to assess whether their marketing of BMS complies with the International Code and subsequent WHA resolutions, and the IMS Act of 1992, amended in 2003. This enables comparison with their competitors who do not manufacture BMS.
Products eligible for inclusion were defined as ‘all packaged foods and non-alcoholic beverages manufactured by the included companies available for purchase in India.’ However, several types of product were excluded from the analysis: unprocessed meat, poultry, fish and raw agricultural commodities (e.g. fresh vegetables, grains); plain tea and coffee, and condiments such as herbs, vinegars and spices because nutrient profiling is not appropriate for these single ingredient foods; infant formulas, and baby food and baby beverages, because these products are not consumed by the general population and the selected models are not appropriate for their evaluation.
7 out of 10 companies that have been assessed for the India Index submitted additional data during the research process. In addition, two companies that have experience with the fortification of commodities agreed to participate in interviews.
Companies provided their feedback during various company consultation meetings that have been organized in India between 2013-early 2016. They were offered the opportunity to go into the online data-gathering platform and to engage with Sustainalytics once initial desk-based research was completed.
Companies were all offered the opportunity to review their draft Scorecards and check them for factual accuracy. The ATNI project team have also responded to companies’ questions throughout the process and kept them updated about progress. In November 2016, one month prior to the launch, ATNF organized a meeting to share launch plans.
The India Spotlight Index is modelled on the Global Access to Nutrition Index, which was initially developed over a three-year period (2010 – 2012) through extensive, multi-stakeholder consultation with companies, governments, international organizations, civil society, academia, and investors. It was guided by advice from an independent, multi-stakeholder advisory panel and a group of international experts on nutrition, including Dr. Pandav and Dr. Yadav from the All India Institute of Medical Sciences (AIIMS).
In 2012 the India Index was piloted by assessing the ten largest companies by revenue. The pilot used the Global Index Methodology adapted where necessary to reﬂect the local regulatory context. In addition, ATNF undertook a pilot ‘Product Proﬁle’ exercise, to evaluate the nutritional quality of around 50% of all foods and drinks made available for sale by the ten companies. The pilot outcomes were discussed with the companies involved but were not published.
After piloting the concept of an India Spotlight Index, ATNF consulted extensively with stakeholders on how the India Spotlight Index should be developed to suit the Indian context. Various companies, industry associations (Confederation of Indian Industry (CII) and The Federation of Indian Chambers of Commerce (FICCI), civil society organizations, academia and policymakers were involved in roundtables, meetings and one-on-one consultations. The ATNF Expert Group, again, provided advice on all aspects of the methodology.
The stakeholder consensus was that ATNI had potential in India. They also appreciated and supported adapting the methodology to the Indian context, particularly focussing on topics of great importance and relevance in India, including food fortiﬁcation for the undernourished, consumer education, clean water and sanitation, food safety and companies’ approach to Corporate Social Responsibility (CSR), given the recently introduced CSR tax (which companies can allocate to addressing nutrition)i. Stakeholders also supported assessing the role of companies in stemming the alarming increase of overweight and obese people in India and diet-related diseases, such as diabetes.
In April 2016, the ﬁnal draft methodology was presented to the companies shortlisted for inclusion in the ﬁrst India Spotlight Index.
The India Index methodology comprises three components:
In the India Index, all companies are given two separate scores and ranks – one for the Corporate Proﬁle and one for the Product Proﬁle. As in the Global Index, the Corporate Proﬁle scores of Nestle India and Amul have been adjusted based on their scores in the BMS assessment. The maximum adjustment is -0.75.
The Corporate Proﬁle methodology assessed companies in India against international and national guidelines, norms and accepted good practices. Suggestions from extensive stakeholder consultations held in India between 2013 and 2016 strengthened the methodology and helped adapt it to the Indian context. Company assessments for the 2016 Spotlight Index were conducted by the global responsible investment research ﬁrm Sustainalytics, a leading global environmental, social and governance research and ratings firm. It combines publicly available company information with its own analysis and information provided by the companies.
ATNF commissioned The George Institute for Global Health, based in Sydney, Australia, with ofﬁces and extensive experience working in India, to undertake the Product Profile research, assessing the nutritional quality of products sold by the ten Index companies.
The BMS marketing assessment was carried out by specialist research organization Westat, based in Rockville, Maryland (U.S.), working closely with The Centre For Media Studies (CMS) Research House, based in New Delhi, which undertook the in-country data collection.
ATNI evaluates the contribution all companies are making to improving consumers’ access to nutrition. This is determined both by efforts that companies have undertaken to improve the nutritional quality of their product portfolios and the efforts they make in many other aspects of their businesses, such as how they support consumers in understanding what comprises a healthy diet and a healthy lifestyle, how they label their products, how they present their products in marketing materials, offering a wide choice of products in varying sizes, and how they engage with governments and policymakers. Thus, if a company with a seemingly less healthy portfolio receives a higher overall score on the Corporate Profile, it is due to strong performance in other categories evaluated by the Index.
To provide a more balanced overview of companies’ efforts, the Product Profile assessment has been added to the Corporate Profile assessment.
Companies compete on an equal footing in the marketplace and face the same pressures and incentives to tackle nutrition issues. Additionally, consumers are generally unaware of companies’ ownership structures and operating models; they simply consume their products. Given these market realities, we believe it is fair to compare these companies’ efforts relative to undernutrition and obesity.
Companies’ ownership structures do determine how much information they are required to publish about their financial performance. If they choose not to voluntarily publish much information about their approach to nutrition, this hampers ATNI’s ability to fully evaluate their efforts, as well as other stakeholders to do the same.
ATNI aims to evaluate the contribution companies are making to improving consumers’ access to nutrition. This is done by evaluating their efforts on improving their product portfolio, how they support consumers in understanding what comprises a healthy diet and a healthy lifestyle, how they label their products, how they present them in marketing materials, whether they offer a wide choice of products in varying sizes, and how they engage with governments and policymakers. Companies can improve their nutrition-related practices in all of these areas regardless of the composition of their product portfolios.
We are confident that the methodology used provides both a common platform through which to evaluate companies as well as being flexible enough to accommodate different business models and product portfolios.
During the assessment it was found that Ruchi Soya that mainly sells cooking oils could not be assessed on various aspects of the Index (both CP and PP), e.g. marketing to children or NPS, therefore Ruchi has only been assessed on applicable Categories but not been ranked (in the future, also considering its merger with Adani Wilmar, this may change).
Also some companies were not assessed on certain aspects that did not relate to their business: e.g. Coca-Cola was not assessed on the reduction of salt and fats because their products do not contain these ingredients.
The 2016 India Spotlight Index ranked 10 of India’s largest food and non-alcoholic beverage manufacturers, including companies that are publicly listed, privately owned or cooperatives. These companies were selected based on their Indian revenues in FY2014 (using Euromonitor data). Together these companies account for sales of INR 869,177 million (app. USD 12,782 million USD), around 31% of the total sales of major food and beverage companies in India.¹
Revenues derived from non-food and beverage activities, such as pharmaceuticals were discounted. In addition, several exclusion criteria were applied.
In addition to the companies that are scored and ranked in the India Spotlight Index, four more companies (Adani Wilmar, Cargill India, ITC and KMF) that manufacture and fortify dairy, oil and wheat products were approached to be interviewed about their fortiﬁcation activities and efforts to tackle undernutrition. The purpose was to learn more about what these companies were doing to fortify these staples and disseminate that knowledge through this report. These four have not been scored and ranked but throughout the report, references are made to their fortiﬁcation/undernutrition practices.
The India Spotlight Index is modelled on the Global Access to Nutrition Index, which was initially developed over a three-year period (2010 – 2012) through extensive, multi-stakeholder consultation with companies, governments, international organizations, civil society, academia, and investors. It was guided by advice from an independent, multi-stakeholder advisory panel and a group of international experts on nutrition, including Dr. Pandav and Dr. Yadav from the All India Institute of Medical Sciences (AIIMS). The Global Index methodology is based, to the extent possible, on existing (international) standards, guidelines and frameworks, such as those developed by the World Health Organization (WHO), Codex, as well as industry best practices, such as the International Food & Beverage Alliance (IFBA) Responsible Marketing pledge.
The Corporate Profile in the India Spotlight Index largely follows the Global Index, it has however fewer indicators than the Global Index (120 versus over 200) and many indicators have also been simpliﬁed. Some India-speciﬁc questions have been added, e.g. concerning the use of CSR levy and food safety system certiﬁcation. Full details on the methodology as well as guiding research principles are published on www. accesstonutrition.org.
As for the Global Index, the India Index has a BMS component – assessing marketing practices of infant food manufacturers and it contains a Product Proﬁle assessment – assessing the nutritional quality of the products of all companies included in the India Index. The latter does not (yet) exist in the Global Index.
Each company has been provided with a summary Scorecard, which is also available on ATNI’s website. A large quantity of material was reviewed for each company, which has been summarized by ATNI in a format that stakeholders can easily understand. We have also published the full assessment methodology on the ATNI website.
Food and beverage (F&B) manufacturers in India have the potential – and the responsibility - to be part of the solution to the double burden. The serious health consequences of poor nutrition lend urgency to the need for India’s F&B manufacturers to proactively adopt impactful initiatives to improve the nutritional quality of their products, as well as other aspects of their businesses, augmented by other non-commercial practices (e.g. how they direct the mandatory Corporate Social Responsibility tax funds).
In India, the double burden of malnutrition poses a serious challenge –the need to tackle both persistent levels of undernutrition at the same time as rising levels of overweight and obesity. Severe undernutrition has been a national problem for generations and remains so today. According to the latest available data from the National Survey undertaken by the Ministry of Women and Child Development in 2013-14, the prevalence of stunting in children below ﬁve years is 39%. This equates to around 48 million children – or two in every ﬁve children under the age of ﬁve – making India home to the largest number of stunted children in the world. Moreover, among the same population, more than 70% suffer from iron deﬁciency, 65% are deﬁcient in vitamin A and 45% are zinc deﬁcient.
The gravity of this situation has been greatly compounded in recent years by an alarmingly rapid rise in levels of overweight and obesity in the population. India now ranks third, after the US and China, in terms of the absolute number of obese people. Around 20% of children and adolescents are overweight. These trends, which are predicted to increase substantially, are already causing serious pandemic diseases in the form of diabetes, heart disease, stroke and certain cancers.
By producing an Index tailored to the Indian context, ATNF hopes to contribute to ongoing efforts to address the double burden.
The Access to Nutrition Index (ATNI) is published by the Access To Nutrition Foundation (ATNF), an independent non-profit organization based in the Netherlands dedicated to objectively assessing and improving the contribution the private sector makes to addressing global nutrition challenges. The primary objective of ATNF is to publish, on a regular basis, a set of Indexes that assess and rate major F&B manufacturers’ nutrition policies, practices and disclosure. The Index methodology is developed with input from a wide range of global stakeholders including the WHO and other policy makers, academia, civil society organizations, industry and investors. Since its launch in 2013, more than 50 investment firms have become signatories to the ATNI Investor Statement, with nearly $4 trillion assets under management. The Index is funded by the Bill & Melinda Gates Foundation, the Wellcome Trust and the Children’s Investment Fund Foundation.
The ﬁrst Global Index was launched in 2013 and the second in 2016. It gained a positive response from stakeholders, including F&B manufacturers, NGOs and investors. Following the publication of the ﬁrst Global Index, ATNF that organizes, designs and publishes the Indexes, conducted research to explore the feasibility of launching Spotlight Indexes to assess companies in markets with a high double burden of malnutrition – India, Mexico and South Africa. The purpose of such Spotlight Indexes was to gather and publish empirical evidence of companies’ performance on nutrition, to strengthen the basis for national dialogue and action to address the double burden.
The Access to Nutrition Index rates food and beverage manufacturers´ nutrition-related policies, practices and disclosures worldwide on a recurring basis.
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