Ho Chi Minh City. Back home now. So how was our congress, Rio2012? My one-word message to the organisers is written here on the wall in Rocinha, Rio's biggest favela, and it's how Gail Willett standing in front of it felt also. Parabéns – which is the Portuguese for 'congratulations'. What follows are a few snapshots. Like other speakers and participants, I got heavily involved and engaged in just a few of the sessions on offer.

Was our congress different? I think it was. We seem to be on the way to distinguishing ourselves from the herd of biomedical nutritionists who, since long, have been having their congresses. And I could feel the enthusiasm. It is more: I found the participants – mostly women this time – resonating with the more action-oriented (should I say activist?) positions coming either from the platforms or from the floor. At least that was what the applause and stamping and whistling told me in the sessions I attended.

Was the overwhelming female presence in the sessions a gender issue? I think it was: for once, the other way around…and add to that the male majority among the main speakers...

Were the social programme and the logistics of the congress well organised? Yes indeed they were. The transport, hotel arrangements and daily meals for speakers rolled out without a hitch. The cocktail reception for the speakers with its music and dinner in the restaurant with the fabulous Guanabara Bay view was a sheer delight. So was the party for all participants at the Scenarium antiques-full nightspot in Lapa which saw many of us dancing until midnight. Many many thanks, dear Brazilian organisers and hosts.

First some comments on process. It's often assumed that ultra-democratic old-timers like me don't mind if sessions get rather out of hand. Well actually I do mind, especially when this means that many of the people attending meetings have little opportunity to say their piece. Time-keeping during sessions often ran over. I know the organisers wanted to prevent this, but sometimes they failed. This cut time from questions and interventions and contributions from the floor.

I thought the system of having written questions sent up to the session chairs from the floor worked less well, than the conventional system whereby fixed microphones are placed in the aisles, and people queue behind and wait to ask questions and also make comments. Written questions cannot be real interventions, and the more speakers, the more voices are heard, which is surely good. This conventional method adds liveliness to the final part of sessions, and makes the job of the person chairing the session less cumbersome and less subjective. In several sessions strong-minded people in the audience over-rode the instructions and insisted on making interventions from the floor, in some cases obviously to the relief of session chairs.

Session chairing styles? There was a spectrum. Philip James, who hosted a plenary session on processing and industry featuring Walter Willett and Carlos Monteiro [ed: see Reggie Annan's and Geoffrey Cannon's column sthis month] was an example of an effective while remarkably interventionist and even aggressive chair. He put the speakers on the spot in the manner of a television host, even to the point of cutting across their responses. I understand from colleagues responsible for the programme that all hosts of sessions had been asked to do a vigorous job. But most hosts sat back and let the speakers do their thing, even to the point of allowing speakers to veer off-topic and to over-run.

Now some comments on content. Here I mention two other sessions I attended. One was on so-called 'public-private partnerships'. I repeat my own intervention. 'If this session would have been a trial, the verdict on so-called 'public-private partnerships' would have been: Guilty!' I think I got the sense of the meeting, judging from the roar of applause.

The other session was in the final series of parallel sessions before the final plenary on the last day. Most congress participants were still in evidence at this late stage, itself a tribute to the organisers and to Brazil. This 'discussion and debate' was on the Scaling Up Nutrition (SUN) initiative. My readers will know I am severely critical of SUN, as a scaled-up 'public-private partnership'. I was also critical of the session itself. The sheer number of people on the platform got very close to preventing any discussion and debate, in favour of a session designed to 'tell' us that the SUN was rising and get used to it.

Fortunately Denis Coitinho Delmuè, the session chair, agreed to an over-run. Some representatives of 'SUN countries' explained the long preparatory process in their home lands – no hard results to share yet. Then a representative of the 'public-private partnership' the Micronutrient Initiative gave her opinion about the role of the private sector. Then a representative of the 'public-private' Gates Foundation-funded Global Alliance for Improved Nutrition (GAIN) 'partnership' proclaimed that 'SUN needs the private sector'.

Four or five fiery interventions followed, in effect denouncing the whole session. In response, we were told that the 'Roadmap II' for SUN will soon be up for discussion and 'we were welcome to participate in its formulation'. If this session had also been a trial I wonder what the verdict would have been. I guess that would all depend on who would have been selected to be jury, witnesses, lawyers and judge.

The congress featured a large number of working groups on key policy issues. Too many, I think: it would have been better to have restricted the total number to six or less. The other problem with the working groups was that they necessarily took up a lot of time, and took a lot of the most active and engaged participants away from the main sessions. I understand that the organisers are likely to recommend that in future congresses, workshops are held on two extra days before the congress. I agree.

Another problem in Rio (apologies for all these grumbles, I really loved Rio2012 overall) was to do with the venue itself. Being held in a 'vertical university' the main plenary room was easy to find! So were the main parallel session rooms, high up in another building. But the workshop rooms, which were under-flagged classrooms sometimes at the end of long corridors, were hard to find. I have this picture in my mind of colleagues still a month afterwards, wandering the corridors with a phrasebook, mastering the Portuguese for 'excuse me do you know where is the workshop on 'scaling up competencies in workforce development'.... I jest...

I co-chaired a working group on how civil society organisations could become more vocal and active in influencing policy making. I had a good six weeks preparatory work with my two co-chairs from Brazilian consumer organisations. We got along wonderfully from day l. But only a dozen people showed up for the two days of work. However, we had high quality, and we agreed strong recommendations.

We agreed that civil society must have more access to public policy-making. Correspondingly, civil society organisations need to be a lot more active. Official policy-making bodies need to be opened to full civil society participation – as is the case in Brazil. We all need to move away from a mentality of addressing nutrition as a shish-kebab of many isolated issues and problems skewered by tragedy. Instead we should focus on the skewer itself – unjust power.

We were severely critical of traditional NGO agendas that are either gradualist or technocratic, or both. They have to move from a welfare perspective to an economic justice perspective; from a primarily ethical motivation to a political motivation. This requires new commitments, selecting a new set of priorities, and thinking again on who their strategic allies and enemies are. Being non-political means being part of the problem. Usually conciliation is no good: confrontation is needed: exertion on pressure from a position of earned and gained power. As one working group participant said, political forces are fought with political actions, not with morals, not with technical fixes. Denunciation is not enough. Civil society organisations have to propose new strategies to overcome malnutrition. The policies we are addressing are, after all, issues of mass life or death. Here below is a scheme that we began to develop. More work on this is needed. Help please!

Here above is for me an inspiring picture, taken in the hotel of the speakers. It's inspiring because it includes current and previous senior UN officials; very senior scientists who headline medical-style nutrition conferences and whose papers set agenda in high-impact journals; courageous activists; and young people who are being inspired and who already are being inspiring.

I am proud to be among them, crouching at the front, left! I'll mention just some of the people in this picture which for me captures the so far unique spirit of Rio2012. Standing left is my dear comrade Urban Jonsson, former head of nutrition for UNICEF in New York. Next to him are the two most influential nutrition scientists and campaigners in the US, Walter Willett and Marion Nestle. Next to them is their peer in the UK, Philip James, and behind them is my Pan American Health Organization comrade Enrique Jacoby. Fourth from the right is Barbara Burlingame, now head of nutrition at the Food and Agriculture Organization of the United Nations.

And it's the folks in front that are also inspiring. Next to me is the socially and politically committed economist and nutrition scholar Barry Popkin. Then four women who are shaping our future. Vivica Kraak, an outstanding policy analyst from the US, who brilliantly organised the picture, who is now working with Boyd Swinburn (the skinhead third from the right, standing). Patti Randall of Baby Milk Action, who personally and professionally is a civil society organisation beacon.

And then the new generation, who are thank goodness already filling our worn-down shoes as committed, informed, unstoppable fiery furnaces for justice and equity: Modi Mwatswana from the National Heart Forum in London, and Ina Verzivolli from Baby Milk Action in Geneva. For me this picture is a sign of what's done and what's to come.

Very well. Our website is now saying all the time: Rio2012: What next. No question mark. And so. what now, for us?

We do not need more knowledge. The issue is the disconnect between knowledge and policy, and between knowledge and policy, and action. All of us, as professionals, as citizens, as family members, and especially those of us who are or will be parents, are facing multiple crises. These include the population, financial, food, fuel, and climate change crises. Impoverished populations and communities suffer most from these crises. What can we in the Association, and what can all my dear readers not (yet) members of the Association, do, now? I invite you all to think about this and to network with me, as I will continue to network with those who most inspired me at our congress – and again, so many thanks to all the friends and colleagues most of all in the great country of Brazil who created it. My proposals will be in my next month's column.

I have said already in my contributions to our website, as I said a couple of times at our congress: the question is, what do we do as from next Monday? At Rio2012 we had 1,800 participants. Would I be happy if 300 of them joined our ranks, preferably as Association members, certainly as public health and nutrition activists? You bet! In all honesty, I would be happy with 150; that would already make a difference.

The Association has added responsibilities after Rio. These include to engage new and old converts to bring good nutrition and health to the millions that do not have it. In session after session, it was made plenty clear that the hurdles and strategic enemies to overcome are stupendous and powerful. Rio2012 was a good start.

Acknowledgement and request

You are invited please to respond, comment, disagree, as you wish. Please use the response facility below. You are free to make use of the material in this column, provided you acknowledge the Association, and me please, and cite the Association’s website.

Please cite as: : Schuftan C. Rio2012: What next. [Column] Website of the World Public Health Nutrition Association, June 2012. Obtainable at www.wphna.org

The opinions expressed in all contributions to the website of the World Public Health Nutrition Association (the Association) including its journal World Nutrition, are those of their authors. They should not be taken to be the view or policy of the Association, or of any of its affiliated or associated bodies, unless this is explicitly stated.

This column is reviewed by Geoffrey Cannon.