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Mobilizing against child malnutrition

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???????????????????????Shutterstock A group of African girls sitting on a mat and dividing their meal. Photo credit: Shutterstock

A child born at the start of 2020 was less likely to become malnourished than a child born at the turn of the Millennium. Investment, innovation and commitment has seen rates of malnutrition fall. Yet despite this progress, malnutrition is still blighting lives around the world. What’s more, it is being dramatically exacerbated by the COVID-19 pandemic, which has rolled back decades of progress in child undernutrition and worsened the growing challenge of overweight and obesity. Poverty and food shortages have increased food insecurity and shifted diets towards cheaper less nutritious foods, particularly in low-income and conflict-affected countries.  This has been compounded by disruptions to health and nutrition delivery systems, which are crucial in preventing, diagnosing and treating malnutrition.

Malnutrition is devastating for children

Malnutrition contributes to 45% of under-five deaths. For those that survive, the long-term impact robs them of a healthy, productive future. Many countries face the double burden of undernutrition and obesity, which carries an economic, as well as human, cost by depriving them of a valuable workforce – their human capital.

Already, 45 million children under five suffer from wasting (low weight for height) and close to 150 million are affected by stunting (low height for age) globally.  Malnutrition in infancy causes irreversible damage to children’s physical and mental development, undermining educational achievement and employment opportunities in later life. The effects often start before birth as a growing number of expectant women suffer from maternal anemia due to undernutrition. Undernutrition is cyclical. Undernourished children are more likely to grow into malnourished adults. And malnourished adults are more likely to have undernourished children. But that cycle can be broken with the right support. Innovative approaches and greater action from the private sector will be necessary to boost financing for effective nutrition-specific interventions.

"Unless the world mobilizes to tackle malnutrition, by the end of 2022, 14 million more children could suffer from wasting and 3.6 million more could face stunting, leading to additional economic losses of at least $44 billion."

Undernutrition is not the only problem. Obesity and overweight currently affect over 2 billion individuals globally, 70% of them in low- and middle-income countries.  Increases in food prices are leading many people to rely on less nutritious or even unhealthy foods. Obesity significantly increases the risk of COVID-19-related hospitalizations and ICU admissions, and causes non-communicable, chronic conditions such as diabetes, increasing pressure on already stretched health systems.

Global Action Matters

In dozens of developing countries, the World Bank, alongside trust funds such as the Japan Trust Fund for Nutrition and the Global Financing Facility for Women, Children and Adolescents (GFF), provide technical assistance, capacity development and financing to scale up evidence-based interventions, such as promoting breast feeding, monitoring infants’ weight and height and training health workers in child feeding practices, that reduce stunting and wasting and improve nutrition results.

Save the Children is partnering with the World Bank to focus on nutrition activities on the first 1,000 days   – the “window of opportunity for good nutrition” that lasts from the start of a woman’s pregnancy to the child’s second birthday – working in partnership with other organizations, including the World Bank.

In Papua New Guinea, where half of all children under five are stunted, Save the Children collaborates with partners to implement the World Bank-funded National Nutrition Strategic Plan (2018-2022). In two Nigerian states, Kogi and Oyo, Save the Children will provide a package of nutrition services that include counselling, micronutrient powders, Vitamin A, deworming and treatment of diarrhea for children aged 6-59 months, and iron-folic acid tables and malaria prophylaxis for pregnant women. and deliver micronutrient powders for children aged 6-23 months and iron-folic acid tablets for pregnant women. The project, funded by the World Bank and the Government of Nigeria, with technical support from The Power of Nutrition, Dangote Foundation and the Bill and Melinda Gates Foundation will benefit 1.6 million women and half a million children.

Tackling malnutrition must be properly funded

Nutrition is at the heart of human capital and the 2030 Sustainable Development Goals. Addressing undernutrition and obesity is critical to support global human development and economic recovery from the devastating impact of the pandemic . Some studies suggest that businesses in developing countries collectively lose up to $850 billion a year due to malnutrition-related low productivity. Recent estimates indicate that $11 billion will be needed annually for nutrition-specific investments if we are to meet the 2030 nutrition targets.

Donors and national governments need to prioritize nutrition and generate more resources. With technical support from development partners, they must spend efficiently and make sure that existing funds deliver the best results, including through the use of tools such as public expenditure reviews and the Optima Nutrition tool developed by the World Bank with the Bill and Melinda Gates Foundation.

The continued financing gap for nutrition, worsened by the economic impact of the pandemic, means a wide range of sources must be found.  Catalytic financing, like that provided by the GFF can increase domestic resources by aligning them with external funding and private sector resources. As the primary food suppliers around the world, private sector companies also have a key role to play in transforming and strengthening food systems, likely to be further affected by climate change, to deliver healthier foods and prevent obesity and undernutrition.

The Nutrition for Growth (N4G) Summit Offers Opportunity for Action

The N4G Summit hosted by the government of Japan – which has been strengthening its international leadership on nutrition – comes at a critical time, more than halfway through the UN Decade of Action on Nutrition, with 4 years left to achieve the World Health Assembly nutrition targets, and 9 years to reach the SDGs. Together, governments, development partners like the World Bank and Save the Children as well as private sector players, can work to ensure that people around the world have access to optimal nutrition  in order to lead healthy lives and reach their full potential. Strong financial commitments, that are in-line with Principles of Engagement and done through the Global Nutrition Report’s Nutrition Accountability Framework, have the potential to be transformative. By focusing on stronger health and nutrition services within UHC, promoting breastfeeding, supporting livelihoods and access to nutritious foods, and addressing the unique contexts of fragile settings, commitment-makers can deliver a successful summit that leaves no child behind.


Authors

Juan Pablo Uribe

Global Director, Health, Nutrition & Population and the Global Financing Facility, World Bank

Inger Ashing

Chief Executive Officer (CEO) of Save the Children International

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