02 Oct 2015

The most important report on the global nutrition crisis

Leith Greenslade Vice Chair, MDG Health Alliance

How seriously the world takes the Global Nutrition Report and its ten Calls to Action will either make or break the achievement of most of the 17 Sustainable Development Goals.


Because the way the world responds to malnutrition will increasingly influence progress on poverty, health, education, gender equity, water, energy, economic growth, inequality, urban development, ecosystems and, of course, climate change.

The Report, launched in New York to a packed audience of 200 during the UN General Assembly, finds that all 193 countries have a serious malnutrition problem, with nearly half facing multiple serious burdens of malnutrition such as poor child growth, micronutrient deficiency, and adult overweight.

This means fighting malnutrition should enter the job descriptions of the leaders of all governments, development agencies, non-government organizations, and any group with an economic and human development mandate.

Another knockdown finding - 1 in 3 people worldwide are malnourished.

This means that every individual in the world is either malnourished, or has a family member or close friend who is. We need nothing short of peoples’ movements to address the global malnutrition epidemic. Recall the sexual revolution and think nutrition revolution.

And the numbers just keep coming - 2 billion people experience micronutrient malnutrition, 2 billion adults are overweight or obese, 800 million people are hungry, 400 million adults have Type 2 diabetes and 161 million children under age 5 are stunted.

While it’s true that all countries have serious malnutrition problems, some countries are hit especially hard. In Bangladesh, the Democratic Republic of the Congo, Ethiopia, Nigeria, and Pakistan, for example, more than half of all children are growing up stunted or wasted.

And how well positioned is the world to make progress against this sobering backdrop?

The Report lists 5 major hurdles to action - (1) weak global goals, (2) lack of investment, (3) sloppy commitments, (4) data gaps, and (5) failure to engage business.

Weak global goals…

The Report laments the weakness of the new Sustainable Development Goals for nutrition. Nutrition appears only once in Goal 2.2 which calls for an end to all forms of malnutrition, the achievement of child stunting and wasting targets, and special attention to the nutritional needs of adolescent girls, pregnant and lactating women, and older persons. Breastfeeding, overweight and obesity are not mentioned once. Of the proposed 169 targets, nutrition is mentioned in only one.

Lack of investment…

According to the Report, countries spend too little on improving the nutritional status of their people. A sample of 14 country budgets revealed nutrition expenditures ranging from .06% to 2.9%. Despite a doubling of official development assistance for nutrition in recent years, international donors still only allocate US$940 million to nutrition.

Things are looking up with the new Global Financing Facility in Support of Every Woman Every Child, the Power of Nutrition, and UNITLIFE, but the international health and development community is still not prioritizing nutrition. The Rio 2016 Nutrition for Growth Summit is a big opportunity to correct the massive underinvestment in nutrition that occurred under the Millennium Development Goals.

Sloppy commitments…

Let’s hope the next round of commitments made are SMARTer than the previous round collected at the 2013 Nutrition for Growth Summit. The Report finds that only 30% of these commitments are specific, measurable, assignable, realistic, and time-bound.

Data gaps…

The Report echoes the chorus of many other partners calling for a data revolution in global development statistics but makes a very strong case that nutrition is deserving of special prioritization.

Half of all countries simply did not have enough nutrition data for the authors to determine if they are on or off course for meeting global nutrition targets. Of the 12 highest impact nutrition interventions, only 4 have internationally comparable coverage data. Of the 6 interventions that do have some form of coverage data, only 13 countries collect them all.

Data gaps are particularly acute for women and babies. No data is available on the percentage of women who receive balanced energy-protein supplementation, calcium supplementation, or multiple micronutrient supplementation. 115 countries do not collect data on breastfeeding rates and most countries do not know what 6 to 23-month-olds are being fed.

Failure to engage business…

It’s clear the vast network of businesses that actually make the food we eat do not feel particularly accountable to global nutrition goals, probably because they haven’t exactly been welcomed to the table.

Of the small number of companies (29) who made commitments to Nutrition for Growth, only 12 report that implementation is on course and most of the 20 companies measured by the Access to Nutrition Index score below 5 out of 10.

The Report calls on the four large UN nutrition agencies—FAO, UNICEF, World Food Programme, and WHO—to establish an inclusive, time-bound commission to clarify the roles and responsibilities of business in nutrition. It will be important to include the emerging SUN Business Network in this effort - one of the most promising initiatives to engage businesses in the global nutrition agenda.

Despite these challenges, the Report provides enough bright spots to inspire. Only 1 country is on course for all five undernutrition targets, but it is Kenya which shows what is possible in sub-Saharan Africa. And in India - the eye of the storm when it comes to malnutrition - nearly all states achieved significant declines in stunting rates and massive increases in exclusive breastfeeding rates between 2006 and 2014.

An opportunity we can’t refuse…

Nutrition is no small matter. Our species’ relationship with what we eat has largely determined the course of human history and the way our food systems work (or don’t) is now increasingly determining the future of the planet.

We have entered a world where the greatest risk to human health is not where you live, or how many vaccines you’ve had, or who your sexual partner is, but what you eat every day.

Do our leaders get it?

They certainly turned out in force for the launch of the Global Nutrition Report - the Minister of Health for Indonesia, the Executive Director of the World Food Programme, the Chair of the Partnership for Maternal, Newborn and Child Health, the CEO of the International Rescue Committee and the Executive Secretary of the African Leaders Malaria Alliance - all speaking to an audience filled with leaders from the UN, business and civil society.

Truly independent assessments of progress are hard to come by in global development. The Global Nutrition Report pulls no punches but makes corrective action easy. What needs to be done has been served up in 10 very tangible and practical Calls to Action. All that remains is for our leaders to mobilize their constituencies to adopt and implement them.