Second Meeting of the WHO Nutrition Guidance Expert Advisory Group (NUGAG)
Subgroups on Micronutrients and Nutrition in the Life Course and Undernutrition
WHO Regional Office for the Eastern Mediterranean
15-18 November 2010, Amman, Jordan
The World Health Organization (WHO) has recognized the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. In May of 2005 the 58th World Health Assembly passed a resolution requesting the Director-General "to undertake an assessment of WHO's internal resources, expertise and activities in the area of health research, with a view to developing a position paper on WHO's role and responsibilities in the area of health research, and to report through the Executive Board to the next World Health Assembly". WHO asked its Advisory Committee on Health Research (ACHR) for advice on ways in which WHO can improve the use of research evidence in the development of recommendations, including guidelines and policies. The ACHR established the Subcommittee on the Use of Research Evidence (SURE) to collect background documentation and consult widely among WHO staff, international experts and end users of WHO recommendations to inform its advice to WHO. The Guidelines Review Committee (GRC) was established in 2007 with the purpose of developing and implementing procedures to ensure that WHO guidelines are developed in ways consistent with best practice, emphasizing the appropriate use of evidence.
The process described in the WHO Handbook for Guideline Development have been adopted as of 01 January 2009. Additionally, as part of implementing the outcomes and recommendations of the WHO Nutrition Programme Review undertaken in 2008, the Department of Nutrition for Health and Development (NHD) is strengthening its role in providing evidence-informed policy and programme guidance to Member States, in partnership with the Department of Research, Policy and Cooperation (RPC) as well as relevant internal partners and guided by the new WHO guidelines development process.
To implement this process, NHD in partnership with RPC and other internal partners have established the WHO Nutrition Guidance Expert Advisory Group (NUGAG) guided by the WHO Steering Committee for Nutrition Guidelines Development, which includes representatives from all Departments in WHO with an interest in the provision of recommendations in nutrition. The membership of NUGAG is for 2 years and includes experts from various WHO Expert Advisory Panels and experts from a larger roster developed through open calls for experts, taking into consideration a balanced mix of genders, multiple disciplinary areas of expertise, and representation from all WHO Regions.
Currently, the NUGAG consists of four subgroups : 1) micronutrients, 2) diet and health, 3) nutrition in life course and undernutrition and 4) monitoring and evaluation. The NUGAG implements a biannual programme of work on these areas and meets twice a year to provide advice on the following:
- The scope of the guidelines and priority questions for which systematic reviews of evidence will be commissioned
- The choice of important outcomes for decision-making and developing recommendations
- The interpretation of the evidence with explicit consideration of the overall balance of risks and benefits
- The final drafting of formulating recommendations, taking into account existing evidence as well as diverse values and preferences
WHO is convening a second WHO Nutrition Guidance Expert Advisory Group Meeting in Amman, Jordan from 15 to 18 November 2010 to continue with the process. This meeting will include two subgroups: 1) Micronutrients, and 2) Nutrition in Life Course and Undernutrition and is a follow-up to the meetings that took place in Geneva, Switzerland in February 2010 and June 2010 to provide input on the scope of the guidelines, choice of priority questions and identification of important outcomes for decision-making.
Objectives of the second NUGAG Meeting (Amman, 15-18 November 2010):
- Present the systematic reviews of the evidence and the GRADE Evidence profiles for nutrition interventions and discuss findings.
- Present and discuss draft evidence-informed recommendations and determine the strength of the recommendations, considering the balance of evidence for benefits and harms, and taking into account costs, values and preferences.
- Define implications for research in the areas discussed.
- Agree on a ‘review by’ date for the guideline validity, considering the ongoing research and controversies.
- Scope new guidelines and priority questions for targeted micronutrient interventions following the processes established in the WHO Handbook for Guideline Development.
Each subgroup will be discussing a set of guidelines according to the biennium workplan.
The sources of financial support for this evidence-informed guideline process include the Government of Luxemburg, Government of Japan, the Centers for Disease Control and Prevention (CDC), US Agency for International Development (USAID), National Institutes of Health (NIH), FANTA 2, and Academy for Educational Development (AED) with whom we have ongoing collaborations and established partnerships.