"Never before in human history have we been so forwarded of what would happen if we neglect [undernutrition]. But never before in history have we ever been so forearmed with the knowledge to change it."
The task of reducing undernutrition can sometimes feel incredibly daunting. Understandably so when you consider that:
- 165 million children suffer from stunted growth and another 52 million children suffer from acute malnutrition - causing their weight drops to such a low level that they are at high risk of death.
- It crosscuts numerous sectors, making nutrition 'everyone's problem and no one's responsibility.'
- There are numerous pathways to undernutrition, which means improving nutrition is about more than just addressing raw calorific intake, making it distinct from hunger.
Yes the challenge ahead of us is truly daunting.
But then I remind myself that we have never been in a stronger position to tackle undernutrition. Over the last few years' nutrition, which had been neglected for so long, has been rising up the political agenda and developing momentum, which ultimately led to the Nutrition for Growth event in June 2013. On the anniversary of this historic event, which saw new advances in interventions, massive political attention and unprecedented financial pledges, it is a great opportunity to take stock of what we have achieved this last year and remind ourselves of what we can achieve if we see this through. We have the potential to reach 500 million women and children with nutrition interventions, reduce the number of stunted children by 20 million, and save at least 1.7 million children through life saving interventions, such as the treatment of severe acute malnutrition. But we must maintain the momentum - financially, politically, programmatically and publicly.
In London last June, the Nutrition for Growth summit made history by generating $4.1 billion for direct nutrition interventions. A truly astounding figure, especially given that only a few years prior direct nutrition interventions made up only 0.3% of Official Development Assistance. This was a fantastic start, but we still have a long way to go to reach the $9.6 billion a year needed a year to effectively tackle undernutrition. The 2016 Hunger Summit, during the Rio Olympics provides the perfect opportunity for new commitments.
That said, we have to remember that while money is necessary, it is not sufficient on it's own to tackle undernutrition. Last year was also an opportunity to share best practices, learn from each others successes and share new innovations that could bolster nutrition efforts. Today, the evidence base has never been stronger. Of course it's not perfect, but a lack of evidence and solutions are no longer viable excuses for inaction. We know how to prevent children from becoming malnourished and we know how to effectively treat children with the most severe form of acute malnutrition. We know that if we scaled up 10 life-saving interventions in the first 1000 days of life (from pregnancy to age two), we could reduce the number of stunted children by 33.5 million and reduce the rate of severe acute malnutrition by more than 60%.
One year on from the Nutrition for Growth event the membership of the Scaling Up Nutrition (SUN) movement, which has both driven and been driven by this developing momentum, has increased astronomically. Last June 35 countries had signed on, and today, one year on, 50 countries have joined the SUN movement, signifying their commitment to scaling up nutrition. While there is still ample room for improvement on the coordination and collaboration of nutrition efforts, today's international nutrition system is a far cry from the "fragmented and dysfunctional" system described in the 2008 Lancet series.
Only this week did the United Nations released the proposed goals and targets on Sustainable Development for the Post-2015 Development Agenda, in which there is a stand along goal on nutrition that calls to "end hunger, achieve food security and adequate nutrition for all, and promote sustainable agriculture." This includes target to reduce both stunting and wasting. This is important not just for progress on nutrition, but also for numerous other health and development goals. It is widely recognised that the slow gains in the Millennium Development Goals, and the reason why many of them will not be met by 2015, is because of the lack of progress on nutrition. We are on the right path, but we must maintain the momentum to ensure that a goal on nutrition is prominent in the final post-2015 development framework.
Perhaps most importantly, we are starting to see commitments translate into implementation. DFID, who spearheaded this event and created an amazing opportunity for the world to address undernutrition, have launched nine new projects to increase spending to tackle malnutrition in some of the world's poorest countries, including a £36 million nutrition programme in Ethiopia that will reach 3.5 million children with nutrition interventions. DFID is making great progress, but we cannot forget that £280 million of DFID's commitment is contingent on being matched by others. This is a great opportunity to leverage new funding and boost commitments, but this pot of money is yet to be matched.
While we are making great progress, there are still major challenges ahead.
The World Health Assembly (WHA) target aims to see stunting rates fall from 165 million to 100 million by 2025. However, Lawrence Haddad, Senior Research Fellow in the International Food Policy Research Institute, says that "current projections suggest we will be well short of that," if we carry on as if it is business as usual, "something in the region of 135-125 [million]."
What's more out of 84 low and middle-income countries only two are on track to achieve four out six WHA indicators:
• 40% reduction in the number of children under-five who are stunted
• No increase in childhood overweight
• Increase the rate of exclusive breastfeeding in the first 6 months up to at least 50%
• Reduce and maintain childhood wasting to less than 5%
Only 13 are on track to achieve three out of six WHA indicators.