 I was asked to address statistics about the problem and the need for policy coherence. I'm going to do that and then also go beyond it to ask, well, what do we do as a very diverse group of concerned people from the region? How is the double burden of malnutrition in South and Southeast Asia perceived? Often as two separate problems. Recently a senior government planning officer from this region told me, we need to address the problem of people who are not getting enough food first before we can think about the people who are eating too much. Given the long and tragic history of hunger, famine and acute under nutrition in this region, this is hardly a surprising position to take. Nutritionists and food policymakers have concentrated for the past 50 years on getting enough food to people and addressing the high rates of poverty and under development that prevent access to food. And under nutrition certainly remains a problem in the region today. The prevalence of stunting among children is still 30 to 40 percent in most countries. South Asia has the highest prevalence of acute wasting among children in the world at 15 percent. And Southeast Asia is not far behind, with one in 10 children acutely wasted. A third of women of childbearing age have anemia. And colleagues in India have told me that among some cohorts of pregnant women they see anemia rates of up to 80 percent. These high rates of under nutrition have a measured impact on economic productivity. Between both Cambodia and Laos, for example, under nutrition costs around two and a half percent of GDP. That's $450 million for each of these countries every year. So against this backdrop, it's actually no wonder that implementing policy to reduce obesity and prevent diet-related chronic diseases is seen as a luxury. It's seen as investing in stopping people, thank you, stopping people from eating too much. Many argue that people who are overweight should use their willpower to eat less. They can wait for policy support until the hungry are fed, until children have the nutritional opportunity to develop to their full potential. But let's look a little more closely at this complex picture in which under nutrition persists as non-communicable diseases rise. What does this double burden of malnutrition actually look like? There are three aspects, all of which to me suggest that these problems are not as separate as they might first appear, and certainly echoes the colleagues' comment after Carlos' presentation. Because we are seeing under nutrition and diet-related non-communicable diseases coexisting within the same populations. In 2016, 20 million children were overweight in Asia. In all but one ASEAN country, there's a higher prevalence of overweight than underweight among adults. And this reflects the global situation. In 90% of the countries assessed in the Global Nutrition Report, they see a serious burden from at least two forms of malnutrition. The most common burden is childhood stunting, anemia among women, and overweight in adults. And it's not only under nutrition that's coming with economic costs. In the Philippines, the direct cost of diet-related chronic disease exceeds $60 million a year. Second, we also see this double burden of malnutrition existing within single households. 30% of households in Indonesia have over and under nutrition coexisting within that same household. The most common form this takes across the region is an overweight mother with an underweight child. But third, this double burden of malnutrition can coexist within the same individual person. For example, iron or iodine deficiency can occur in a woman who is overweight or obese. I want to make the case today that the problems of over nutrition and under nutrition are not as separate as they may seem. And in fact, to respectfully disagree with my colleague from Central Planning, addressing them as separate problems is only going to exacerbate the situation. Last month I was working in Ghana, and there, as in so many countries, the food environment increasingly favours food, high in calories, fat, salt, and sugar. These foods tend to be cheap, highly processed, readily available, and heavily marketed. And to echo Professor Monteiro's comments, diets across South and Southeast Asia reflect these food environments. They're heavily reliant on refined carbohydrates, mainly rice and wheat, while coarse traditional grains have become less available and less affordable. From 1999 to 2017, sales of processed food doubled across this region. In Vietnam, consumption of processed food rose fourfold during this time, from 15 kilograms per person per year to 60 kilograms. A third of rural food expenditure across South and Southeast Asia is spent on processed food. And it's more than 40% in urban areas. This is not a new phenomenon. This is something that's well-established across this region. But what I want to ask at this point is, when we encounter community struggling with both diet-related chronic disease and undernourished children, households with an overweight mother and an underweight child, overweight women with micronutrient efficiencies, are these separate problems? Instead, I'd suggest that we're actually seeing two sides of the same food supply. Alongside sociocultural and economic determinants of malnutrition, the double burden of malnutrition reflects these changes to the food system. Consuming a diet rich in calories but low in protein and micronutrients is a contributor to underweight among children. But if you're a young mother, consuming the same calorie-rich and nutrient poor diet, usually carbohydrate-heavy, is a sure recipe for overweight. Sweet biscuits, low in healthy nutrients and high in empty calories and usually associated with rising childhood obesity, are also used as weaning foods. One nutritionist in India described mothers explaining to her that they'd seen these sweet biscuits marketed. They saw that these were complete foods. The ad had shown that they had milk and whole grains. She had no idea that the high level of processing had stripped out most of what was good about these and replaced them with fat, salt and sugar. Leaving the infant undernourished and establishing lifelong dietary habits associated with diet-related chronic diseases. Diet quality and thus a food supply that delivers high nutritional quality is core to addressing all forms of malnutrition. Now you all know that what I'm saying isn't new. We know we need systemic changes in food systems that support good nutrition outcomes. We know we need to implement a holistic response to the double burden of malnutrition. Delivering this kind of change is the promise of policy. Interestingly, it is just what leaders across South and Southeast Asia have actually promised. The impact of malnutrition is devastating. Governments across the region are committed to taking action on the double burden of malnutrition in both their health and their economic regional action plans. So at this point you might be thinking, well, what's the problem? It sounds like it's already being done. We know what to do. Political will exists. We have a vision for a food system that supports good nutrition. There's a policy window in this region to address it. The challenge is that the kind of policy change we need goes far beyond nutrition policy as it's commonly understood. Unfortunately in practice, this kind of political commitment to addressing nutrition rarely extends outside of the health sector policy. Examples of policy success that follow this Asian leaders declaration reflect this. All of the successful interventions and policies that were showcased in the subsequent report were all health sector led, and most of them were health sector implemented. We rely heavily on settings based health promotion. Sometimes we have wins in education and wash, but by itself this is not enough. The policies that govern the food system actually sit elsewhere. They sit within agriculture, commerce, industry, trade and finance. Policies in these sectors are what shape food availability, affordability, processing and retail. For effective policy for the double burden of malnutrition, we need a radical rethink of what we mean by nutrition policy. People do need to be empowered with education about a healthy diet, but in addition to this we have to attend to the food environment in which they're making those decisions about what it is that they eat. We want this food environment to support access to affordable healthy food. If we're serious about coherent policy for the double burden of malnutrition, we need to complement the policy change in health with policy change in the economic sectors that govern the food supply. Unfortunately, when the health sector talks about nutrition in the economic sector, their voices often drowned out by others who have a vested interest in the food supply. Food is a major contributor to gross domestic product in every country in the region. And with economic liberalisation has come trade and foreign direct investment and transnational industry. These companies have enormous resources with which to influence food policy. The world's top 10 food companies, which own almost all the familiar international and local brands, have combined sales of over $400 billion a year. This is more than the gross domestic product of Thailand. These companies have strong business interests in maintaining a policy status quo that protects profits. And unfortunately, the most profitable foods are those that are highly processed and rarely good for health. Policy is politics. Policy reflects a compromise between policy makers, vested interests and policy. Food system policy is defined by political decisions and the differential power of actors to influence those decisions. The challenge for us in nutrition is to complement our excellent skills in generating evidence. Excellent skills in generating evidence with attention to the politics that stops that evidence from changing nutrition outcomes. And it's very possible. We have a lot to learn from our colleagues in economics and politics who fight these battles on a daily basis. I want to give you, as I conclude, three examples of success from this region that illustrate the challenges and the possibilities of food system change that benefits nutrition. First, the Government of India in its new Food Security Act has expanded the program from simply rice and wheat to include coarse grains and pulses in the public distribution system. I see this as a huge potential win for nutrition. But the more that India spends on its public distribution system, the tougher become the challenges at the World Trade Organization. Protecting policy space for food security in India has meant derailing the negotiations at the World Trade Organization until a compromise can be reached that puts food security before trade. And the Government of India has stepped up to the plate to make sure their concerns are heard at the global level. Second, the Government of the Philippines successfully introduced a soft root tax earlier this year, which in only two weeks, in two weeks had a measurable effect in reducing the use of high fructose corn syrup in beverages. But when this tax was proposed last year, it immediately faced strong opposition from the food industry on the basis of its impact on the poor. Perhaps also its impact on big business, but nobody was talking about that. But with clear support from the health sector, both nationally and internationally, as well as clear evidence for the negative impact of sugar-sweetened beverages on health, the tax was passed. Finally, the Government of Thailand was the first country in the world to introduce mandatory front-of-pack nutrition labeling on highly processed foods back in 2011. It wasn't on anyone else's radar. But what this cost the Government of Thailand was four years of battling at the World Trade Organization. Persistence paid off. So what does this mean and what can we do? What can we learn from these hard-fought successes? I'd like to propose four places to start. The first is to continue to assemble strong local evidence to underpin policy. This is essential to convince policymakers, both of the need to take action and of the solutions that they need to implement. Evidence alone is insufficient for policy change. We must engage with the politics. Second, we need to create coalitions. For example, CLASS, the Healthy Latin American Coalition, is a coalition with 250 member organisations across that region. They have developed a rapid response system for nutrition policy advocacy based on consensus position statements. When there's a nutrition policy crisis in a Latin American country, CLASS can organise and coordinate a strong public health voice that protects good policies. They don't have to gain consensus every time because they're operating on these pre-agreed statements. Third, expect pushback and set up arguments in advance. Industry is incredibly predictable. Having proactive consideration of their likely arguments is going to help minimise their impact. For example, when South Africa proposed their soft drink tax, industry argued strongly against it on the basis of job losses. But data from an independent think tank used by the public health sector showed that these estimates were vastly overrated and they could use those accurate data to deflect those concerns and keep policymakers focused on the health issues that were at the core of this decision. Finally, I would encourage you to talk and to listen to economic policymakers. Policymakers who govern the food supply often tell me that they have never had a nutritionist come and talk to them. In this very region, the head of a ministry with responsibility for food processing asked me point blank, but what does my ministry have to do with nutrition? We need to make it easy for them. We need to do some legwork to understand and respect the constraints and the policy priorities that they're working within and to help them identify opportunities for specific policy action that can improve food systems for better nutrition outcomes. And above all, be persistent. If it was easy, it would already have been done. Thank you.