Dr Lawrence Haddad, Executive Director of The Global Alliance for Improved Nutrition (GAIN)
The Covid-19 crisis has made it ever clearer that inequity is a maker and a marker of malnutrition. The crisis hurts the nutrition status of the most vulnerable first and hardest. In turn, the malnourished will be more susceptible to the virus. This report shows us how to move towards greater equity and, hence, improved nutrition outcomes.
Gerda Verburg, United Nations Assistant Secretary General and Coordinator of the Scaling Up Nutrition (SUN) Movement
The 2020 Global Nutrition Report is launched in the midst of the Covid-19 crisis. This is not only a health crisis followed by an economic crisis. In many developing countries, it is a health and nutrition crisis, combined with a socioeconomic crisis. Lockdowns impact people’s income, and their capacity to achieve food and nutrition security. Closed schools mean that school-meals programmes are no longer providing nutritious meals for children. Smallholder farmers and food producers, often women with few rights and limited ability to make decisions, will be particularly affected. In any new normal after this crisis, nutrition must be understood and recognised as an indispensable part of health, food, education and economic development. Particular attention must be paid to equity, the theme of this year’s report, ensuring that all forms of policy, action and systemic change support the poorest and most vulnerable, leaving no one behind.
Henrietta H. Fore, Executive Director, United Nations Children’s Fund (UNICEF)
As the 2020 Global Nutrition Report highlights, now more than ever, we need to strengthen our collective efforts to ensure that the most vulnerable children benefit from good diets and nutrition services and practices. In particular, we need food systems and food environments that deliver nutritious, safe, affordable and sustainable diets for all children, no matter where they live.
As we enter the final decade of the 2030 Agenda for Sustainable Development, we have an opportunity to accelerate our progress towards this goal, by more rigorously collecting, analysing and applying good-quality data to shape programmes that can bring us closer to ending malnutrition in all its forms. UNICEF is proud to be part of this important effort.
Shinichi Kitaoka, President, Japan International Cooperation Agency (JICA)
Ahead of the Nutrition for Growth Summit, the 2020 Global Nutrition Report is a must-read. The world is in the middle of a war with the unprecedented threat of Covid-19. The endeavour to address malnutrition in all its forms, in addition to medical intervention, is an indispensable element in combating such infectious diseases. Balanced intake of nutritious food is essential for improving fundamental immunity. In this sense, we should emphasise the importance of improving nutritional status as a preventive measure, key to establishing a resilient society. Because good nutrition for everyone is also an important element of human security, taking swift action on nutrition will help to protect lives and dignity. Based on this understanding, JICA will make continued efforts to tackle malnutrition.
Dr Qu Dongyu, Director-General, Food and Agriculture Organization of the United Nations (FAO)
The call for transformation of food systems – to make healthy diets available, accessible, attractive and safe – has never been more relevant than now. The emergence of Covid-19 has highlighted the fragility of our food systems. We need to seize upon this crisis as an opportunity to rebuild and reshape food systems to be more resilient, equitable and sustainable. This calls for united action on all fronts to end the inequities in food systems that fail to make nutrition accessible and affordable for all. We should not settle for a world where over 800 million people go to bed hungry and where over two billion do not have access to quality diets. FAO stands ready to work with all stakeholders to make this food-systems transformation a reality and to ensure that no one is left behind.
David M. Beasley, Executive Director, World Food Programme
Again this year, the Global Nutrition Report holds up a mirror to the world that reflects how well we are keeping our promise to end malnutrition. While we see encouraging instances of progress, the current global reality of conflict, and Covid-19 and its consequences, will throw us a significant curveball, and, as always, it’s the vulnerable who will suffer most. Let’s use this year’s report to examine, reflect and reset, and create a world where we like the face we see in the mirror.
Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization
Health inequities based on social factors such as employment status, income level, gender and ethnicity have significant social and economic costs to both individuals and societies. Inequities are at the root of many of the world’s greatest public health challenges. The focus of the 2020 Global Nutrition Report on “Action on equity to end malnutrition” highlights dramatic inequities in the burden of stunting, wasting, obesity, micronutrient deficiencies, and diet-related non-communicable diseases. It clearly lays out the issues in our health systems and food systems that limit the ability of vulnerable populations to receive the nutrition and care they need to live healthy and productive lives. Now is the time to take dramatic action and commit ourselves to eliminating inequities in malnutrition.
Rt Hon. Anne-Marie Trevelyan MP, Secretary of State for International Development of the United Kingdom
The 2020 Global Nutrition Report is an important reminder that the world needs to work together to tackle malnutrition, which has such a major impact on people’s lives. We must use these findings as a catalyst for more progress. The release of this report during the Covid-19 outbreak serves to remind us that those who are malnourished, including girls and women, will be particularly vulnerable to this disease, and Covid-19 will likely exacerbate malnutrition in low- and middle-income countries. The UK remains committed to a humane and responsible approach to preventing and treating malnutrition. It is part of our ambition to end the preventable deaths of newborns, children and mothers by 2030. Furthermore, preventing malnutrition can support efforts to boost economic productivity and resilience in low- and middle-income countries to reduce the impact of climate change. The UK especially supports the calls in this report to address inequalities in all forms of malnutrition, to make nutrition an integral part of healthcare provision and to support a shift to healthier, equitable and sustainable diets. Investment and action on nutrition is more crucial than ever.
Amir M. Abdulla, UN Nutrition Chair, United Nations System Standing Committee on Nutrition (UNSCN)
The theme for this year’s report is timely and important: action on equity to end malnutrition. This edition of the Global Nutrition Report focuses on the inequities in basic social services and malnutrition outcomes. Earlier reports, including previous editions of the Global Nutrition Report, have already identified inequality as a major determinant for malnutrition. As the editorial of UNSCN News 43 (2018, ‘Advancing equity, equality and non-discrimination in food systems: pathways to reform’) states, “we need to reframe the problem of hunger and malnutrition as a problem of social justice, to address power in the food chains, to narrow the divide in social protection schemes and to strengthen the accountability of government”.
The Covid-19 pandemic shows the interconnectedness of the various systems that determine nutrition outcomes: the food, health and socioeconomic systems. It also shows that these systems now function in a way that means the most powerful and rich suffer less from the pandemic. Let’s join forces and use the lessons of this year’s Global Nutrition Report to address inequities in the system to end all forms of malnutrition and leave no one behind.
This report was produced by the Independent Expert Group of the Global Nutrition Report, supported by the Global Nutrition Report Stakeholder Group and the Secretariat at Development Initiatives. The writing was led by the co-chairs M.G. Venkatesh Mannar and Dr Renata Micha, supported by group members and supplemented by additional analysts and contributors.
Members of the Independent Expert Group: M.G. Venkatesh Mannar (co-chair), University of Toronto and Cornell University, Canada and US; Dr Renata Micha Lorena (co-chair), Tufts University, US; Lorena Allemendi, Fundacion InterAmericana del Corazón Argentina, Argentina; Ashkan Afshin, University of Washington, US; Philip Baker, Deakin University, Australia; Jane Battersby, University of Cape Town, South Africa; Zulfiqar Bhutta, Center for Global Child Health, Hospital for Sick Children, Toronto, Canada, and the Center of Excellence in Women and Child Health, Aga Khan University, Pakistan; Camilla Corvalan, University of Chile, Chile; Mariachiara Di Cesare, Middlesex University London and Imperial College London, UK; Kevin Chen, China Academy for Rural Development of Zhejiang University, China, and International Food Policy Research Institute, China; Carmel Dolan, Emergency Nutrition Network, UK; Chika Hayashi, UNICEF, US; Jorge Fonseca, USDA ARS Food Quality Laboratory, US; Laurence Grummer-Strawn, World Health Organization (WHO), Switzerland; Anushree Rao, Concern Worldwide (maternity leave); Cynthia Rosenzweig, NASA Goddard Institute for Space Studies, US; Dominic Schofield, Global Alliance for Improved Nutrition (GAIN) Canada, Canada.
Additional authors: Jody Harris, Institute of Development Studies, UK, and Nicholas Nisbett, Institute of Development Studies, UK, contributed to Chapter 1; Jordan Beecher, Development Initiatives (DI), contributed to Chapter 2; Luz Maria De-Regil, independent consultant, Canada, contributed to Chapter 3; Jessica Fanzo (former co-chair of the Independent group), Johns Hopkins University, US, contributed to Chapter 4 at the early stages of its development; Mary D’Alimonte and Jack Clift, Results for Development (R4D), US, contributed to Chapter 5; Daniel Coppard and Richard Watts, DI, UK; Sam Ashby, Jordan Beecher and Dean Breed DI, UK, made contributions throughout the report.
Content editing of the draft report was provided by Rebecca Brown, Jane Keylock and Tamsin Walters, NutritionWorks, UK. An additional review to support authors was completed by Sharon Friel, Australian National University, Australia.
Data analysis in the report was led by Jordan Beecher, with support from Sam Ashby, Dean Breed, Georgia Colston, Adam Hughes, Alex Miller and Richard Watts, DI, UK.
Data, advice and research support was provided by: Mary D’Alimonte, Kyle Borces, Jack Clift and Augustin Flory, R4D, US; Ashkan Afshin, Amelia Apfel, Michael J. Assmus, Julia Devin, Lucas Earl, Simon I. Hay, Damaris Kinyoki, Aubrey Levine, Erin Mullany, Dean Owen and Megan Schipp, Institute for Health Metrics and Evaluation, US; Phillip Baker, Deakin University, Australia; Yarlini Balarajan, Chika Hayashi, Julia Krasevec, Richard Kumapley, Roland Kupka, and Vrinda Mehra, UNICEF, US; James Bentham, University of Kent, UK; Elaine Borghi, Laurence Grummer-Strawn and Lisa Rogers, WHO, Switzerland; Mariachiara Di Cesare, Middlesex University London, UK; Emilio Colonnelli and Évariste Nicolétis, Food and Agriculture Organization (FAO) Committee on World Food Security (CFS); Carmel Dolan, Emergency Nutrition Network, UK; Kaia Engesveen, WHO, Switzerland, assisted by Ellen C. Andresen, Dana Hawwash, Diva Fanian, Elisa V. Garcia, Ana E. Pineda, Veronika Polozkova, Camilla Warren, Laeticia Toe and Marisa Tsai; Jessica Fanzo, Johns Hopkins University, US; Oliver Fiala, Katherine Richards and Christopher Twiss, Save the Children, UK; Patrizia Fracassi, William Knechtel and Jean Sebastien Kouassi, Scaling Up Nutrition (SUN), Switzerland; Chika Hayashi and Vrinda R. Mehra, UNICEF, US; Arja Huestis, Monica Kothari and Jolene Wun, PATH (MQSUN+), US; Bin Zhou, Imperial College London, UK.
Authors of the ‘Spotlight’ panels: Jordan Beecher, DI, UK, wrote Spotlight 2.1; Damaris K. Kinyoki, Amelia Apfel, Megan F. Schipp, Lucas Earl, Julia Devin and Simon I. Hay, Institute for Health Metrics and Evaluation, US, authored Spotlight 2.2; Alok Kumar, NITI Aayog, Government of India, India, Rajan Sankar, Tata Trust, India, and Basanta Kumar Kar, independent consultant, India, contributed Spotlight 3.1; Prabhu Pingali, Tata-Cornell Institute, India, wrote Spotlight 4.1; Derek Headey, International Food Policy Research Institute (IFPRI), Myanmar, authored Spotlight 4.2; Phillip Baker, Priscila Machado, Kate Sievert, Kathryn Backholer, Colin Bell and Mark Lawrence, Deakin University, Australia, contributed Spotlight 4.3; Kathrin M. Demmler, GAIN, UK and Matin Qaim, University of Göttingen, Germany, wrote Spotlight 4.4; Camilla Corvalan, University of Chile, Chile, and Fernanda Mediano, University of North Carolina at Chapel Hill, US, and University of Chile, Chile, authored Spotlight 4.5; Zulfiqar A. Bhutta, Center for Global Child Health, Hospital for Sick Children, Toronto, Canada, and the Center of Excellence in Women and Child Health, Aga Khan University, Pakistan, Bianca Carducci and Christina Oh, University of Toronto, Canada, contributed Spotlight 4.6; Richard Watts, DI, UK, wrote Spotlight 5.1; J.S. Kouassi, SUN, Switzerland, Mary D’Alimonte, R4D, US and Kedar Mankad, Bill and Melinda Gates Foundation, US, authored Spotlight 5.2; Carol Levin, University of Washington, US, Dale Davis, Helen Keller International, US, Aulo Gelli, IFPRI, US, Mary D’Alimonte and Augustin Flory, R4D, US, wrote Spotlight 5.3; Meera Shekar, World Bank, US, Jonathan Kweku Akuoku and Jean Sebastien Kouassi, SUN, Switzerland, contributed Spotlight 5.4; Leslie Elder, Global Financing Facility, US, authored Spotlight 5.5; Greg S. Garrett, former GAIN, Switzerland, contributed Spotlight 5.6.
The Independent Expert Group, under the leadership of co-chairs M.G. Venkatesh Mannar and Dr Renata Micha, would like to sincerely thank all the people and organisations that supported the development of the 2020 Global Nutrition Report.
The core Global Nutrition Report team at Development Initiatives worked closely with M.G. Venkatesh Mannar and Dr Renata Micha, and in support of the wider Independent Expert Group, to bring this year’s report to life. The project was managed by Hannah Sweeney and Nathalie Willmott. Data analysis was led by Jordan Beecher, with extensive analysis and research across the report by Sam Ashby, Dean Breed, Georgia Colston and Adam Hughes. Harpinder Collacott and Charlotte Martineau contributed to the report and provided editorial guidance. Communications were managed by Telche Hanley-Moyle, supported by James Harle and Anna Hope. Amy Cox led outreach and engagement. Simon Murphy managed production of the report, with support from Alice McAndrew and Georgina Carver. Dan Coppard, Tony German and Judith Randel carried out quality reviews on the report. Additional communications advice on the report’s messaging and design was provided by Portland Communications. Editing was done by Nina Behrman, and design by Definite.design and Soapbox.
We are also grateful to peer reviewers from Global Food Security for carrying out the external peer review of the report this year: Namukolo Covic, Mario Herrero, Thorne Lynam, John McDermott and Boyd Swinburne.
The Independent Expert Group is guided by the Global Nutrition Report Stakeholder Group, which provided feedback on the outline, draft and outreach plans for the report: Dr Mohamed Abdi Farah, SUN, Office of the Prime Minister, Federal Republic of Somalia, Somalia; Victor Aguayo, UNICEF, US; Francesco Branca, WHO, Switzerland; John Cordaro, Mars, Incorporated, US; Juliane Friedrich, International Fund for Agricultural Development, Italy; Lawrence Haddad, GAIN, UK; Martin Hoppe, BMZ, Germany; Kate Houston, Cargill, US; Lauren Landis, World Food Programme, Italy; Anna Lartey, FAO, Italy; Dr Ferew Lemma, Ministry of Health, Ethiopia; Dr Cornelia Loechl, International Atomic Energy Agency, Austria; Erin Milner, USAID, US; Katherine Richards, Save the Children UK; Tadashi Sato, Japan International Cooperation Agency, Japan; Ben Siddle, Irish Aid, Ireland; Carla da Silva Sorneta, European Commission, Belgium; Rachel Toku-Appiah, Graça Machel Trust; Gerda Verburg, United Nations and SUN Movement; Frits van der Wal, Ministry of Foreign Affairs, Netherlands; Neil Watkins, Bill & Melinda Gates Foundation, US.
We are particularly grateful to the co-chairs of the Stakeholder Group: Abigail Perry, DFID, UK, and Lucy Sullivan, Feed the Truth, US.
We also received written contributions from people whose work could not be included in this year’s report but nevertheless informed our thinking: Lawrence Haddad, GAIN, UK; Luc Laviolette, Global Financing Facility, USA; Donald Mavundese, Azita Shamsolahi and Paul Stuart, Send a Cow, UK; Will Nicholson, Food Foundation, UK; James Ronicle, Ecorys, UK; Meera Shekar, World Bank, USA; and members of the Independent Expert Group.
The 2020 Global Nutrition Report was made possible through funding from the Bill & Melinda Gates Foundation, the European Commission, the government of Canada, Germany’s Federal Ministry of Economic Cooperation and Development (BMZ), Irish Aid, the UK’s Department for International Development (DFID) and the US Agency for International Development (USAID). The views and opinions expressed in this report are those of the authors and may not necessarily reflect the views or opinions of the donors.
Finally, we thank you, the readers of the Global Nutrition Report, for your enthusiasm and constructive feedback from the 2014 Global Nutrition Report to today. We aim to ensure the report stays relevant using data, analysis and evidence-based success stories that respond to the needs of your work, from decision-making to implementation, across the development landscape.
Copyright 2020: Development Initiatives Poverty Research Ltd.
Suggested citation: 2020 Global Nutrition Report: Action on equity to end malnutrition. Bristol, UK: Development Initiatives.
Disclaimer: Any opinions stated herein are those of the authors and are not necessarily representative of or endorsed by Development Initiatives Poverty Research Ltd or any of the partner organisations involved in the 2020 Global Nutrition Report. Not all Independent Expert Group members will necessarily agree with every word in the report. The boundaries and names used do not imply official endorsement or acceptance by Development Initiatives Poverty Research Ltd.