Chapter 01

Introduction

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Contents
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Key findings

  • Climate change is increasingly affecting nutrition outcomes through its combined impact on food systems and health systems. Long-term climate shifts and more frequent shocks interact with conflict, pandemics and economic crises to disrupt food value chains and strain health services, influencing what diets people can access and afford and increasing the risk of malnutrition in all its forms.
  • The delivery of essential nutrition services continues to depend on health systems, but progress towards healthy diets for all has been closely linked to how food and health systems function together under climate stress. Across contexts, more integrated policy and programmatic approaches that extend beyond direct service provision have been better positioned to improve diet quality, access and resilience.
  • Global commitments increasingly reflect the interconnected nature of nutrition, climate, equity and food systems, yet the transition from commitment to implementation remains uneven. Limitations in nutrition information systems, fragmented action and growing fiscal constraints have made it difficult to assess whether commitments are sufficiently integrated across sectors or capable of protecting nutrition outcomes in a changing climate.

If you would like to know more about any of the terms used in this chapter, you can visit the report glossary.

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Introduction

While progress has been made towards establishing more sustainable and healthy food systems, pressure to protect nutrition within climate change is intensifying. Climate and environmental stress and rising rates of malnutrition and non-communicable diseases are deeply interconnected and complex challenges.

Climate shocks and stressors often compound with pandemics, conflicts, and political and economic crises, severely hindering the resilience of food and health systems.[1] Achieving healthy diets for all requires both systems to function effectively and in coordination. Health systems deliver essential nutrition interventions, including counselling and support, breastfeeding promotion, supplementation, and prevention and treatment of malnutrition, with immense potential to contribute to the global nutrition targets. There is broad agreement that policy and programmatic action must go beyond direct service provision to adoption of multisectoral approaches, including within health, agriculture and food systems, to improve access, affordability and quality of available diets.[2]

Long-term climate shifts and more frequent extremes disrupt food value chains and health services simultaneously, shaping what people can access, afford and eat.[3]Through changing agroecological conditions and supply chain interruptions, climate pressures reduce agricultural productivity, lower the nutritional value of some crops and raise food prices.[4][5][6] These shifts constrain food and nutrient availability and increase the risk of hunger, malnutrition in all its forms and diet-related non communicable diseases, while pushing households towards less expensive, less nutritious diets and contributing to premature mortality.[7][8]

At the same time, climate change threatens the continuity of health service delivery as well as the functioning of food systems by damaging infrastructure, disrupting supply chains for essential commodities and increasing disease burdens that strain already limited capacity.[9][10] The Covid-19 pandemic illustrated how rapidly such shocks can overwhelm health systems, with cascading effects on nutrition services.[11] Additionally, climate change can exacerbate the vulnerability of food supply, leading to increasing risks of contamination and outbreaks of food-borne diseases, which has implications for nutrition and health.[12]

Coordinated action must occur within planetary boundaries. Food systems contribute approximately one-third of global greenhouse gas emissions,[13] creating a major policy challenge: while animal-source foods can support good nutrition within specific contexts and for specific population groups, their nutritional value, health implications, environmental impact, cultural role, accessibility and affordability vary widely.[14] Meats such as beef and mutton contribute up to 100 times the emissions per unit weight compared to plant-based foods,[15][16] and pork, poultry, fish and processed dairy have approximately 10 times the impact of plant-based alternatives,[17][18] with substantial regional variation. Realigning food systems with both human health and environmental goals while maintaining health system capacity under climate stress represents one of the central challenges this report addresses.

Early research linking agriculture to nutrition has underscored the limitations of siloed interventions. Integrated approaches that connect food and health systems show promising results. For example, Sierra Leone combined national dietary guidelines with nutrition training for agricultural extension workers and school-based nutrition programmes, strengthening linkages between agriculture and health services while promoting biofortified crops and dietary diversity.[19] Such examples demonstrate the potential of coordinated action, yet they remain the exception rather than the norm. They also show that food systems transformation requires action across multiple actors and incentives so that nutritional quality, resilience and equity are prioritised alongside output and income generation.

As 2030 approaches, governments, development partners, civil society and businesses face a dense landscape of goals and pledges. Progress towards Sustainable Development Goal 2 (zero hunger) remains off track, while debates about the pace and nature of change reveal tensions in implementation. Some argue that transformational change is essential, as “incremental change in food systems will not be enough”.[20] Others, including many national policymakers, anticipate that a series of incremental changes can collectively deliver meaningful improvements in both planetary and human health. Neither perspective is likely to succeed in isolation, nor is there a single policy capable of transforming food systems on its own. For national policymakers, the practical challenge is to build credible pathways that coordinate action across food, health, social protection, climate and finance systems.

Commitments under the Paris Agreement have yielded slow progress towards limiting the mean global surface temperature to 1.5°C, with 2025 set to be either the second or third warmest year on record.[21] While the UN Food Systems Summit established the urgency of a food systems transformation in 2021, the recent EAT-Lancet Commission characterised this transformation as critical to realise sustainable and just systems for healthy foods by 2050.[22][23] The Nutrition for Growth (N4G) Paris 2025 Summit highlighted the need for commitment makers to address malnutrition in all its forms across multiple thematic areas, ranging from health to sustainable food systems, resilience, financing and accountability. Its recommendations emphasised the interconnectedness of food, nutrition, social protection and health, spanning priorities from better integration of nutrition into health service delivery to food systems transformation, strengthening resilience and reducing inequities in access to essential nutrition services and nutritious diets.[24]

These global commitments and recommendations have generated increasingly explicit expectations linking health, climate, equity and economic prosperity, reflecting the interconnected nature of contemporary challenges.[25][26][27] Yet, monitoring delivery against these expectations remains difficult,[28] with weak nutrition information systems representing a major challenge to tracking commitments specifically and healthy diets more broadly. The Global Nutrition Report launched its Nutrition Accountability Framework (NAF) in 2021, offering an infrastructure for doing so (Box 1.1). By registering and classifying commitments across actors and action types, the NAF creates an opportunity to assess not only whether commitments address food systems or health systems individually, but whether they truly integrate across both domains in ways that account for climate risks and build resilience.

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Box 1.1 The Global Nutrition Report’s Nutrition Accountability Framework

The Nutrition Accountability Framework is a global public platform that was established by the Global Nutrition Report in 2021 for committing to and monitoring nutrition action. It serves as a register of nutrition commitments made by governments, donors, civil society, businesses and other actors, and classifies these commitments into three categories: enabling actions (such as governance, coordination and data systems); policy actions (such as legislation, regulation and guidelines); and impact actions (such as direct service delivery and financing). The framework supports the use of SMART (Specific, Measurable, Achievable, Relevant and Time-bound) commitments to strengthen clarity and comparability. By providing a comprehensive and transparent tracking system, the framework enables systematic assessment of progress towards nutrition targets and of the coherence and integration of commitments across sectors.

Coordinated action is becoming increasingly difficult in a weaker multilateral and financing environment. Multilateral coordination is under strain, and nutrition actors face sharper fiscal constraints. Recent reductions in official development assistance, including major bilateral cuts, are projected to reverse gains in malnutrition reduction and threaten the delivery of essential services, including treatment of severe acute malnutrition.[29] Current estimates suggest that aid cuts affecting the equivalent of 44% of donor financing directed to the World Health Assembly (WHA) nutrition targets could leave 2.3 million children without treatment for severe acute malnutrition and contribute to approximately 369,000 additional child deaths annually.[30]

In this environment, integration across food, health, climate and social policy is not only a programmatic goal, it is a fiscal and strategic necessity.[31] Recognising that stand-alone nutrition funding is unlikely to expand in the near term, initiatives such as the N4G Global Compact for Nutrition Integration seek to embed nutrition objectives within climate, trade, productivity and economic policy domains.

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Report objectives

It is within this context that the current report focuses on three core goals.

First, it examines how food and health systems can build resilience to compounding climate, health and conflict shocks, drawing on country-level evidence of integrated responses. Climate change is projected to leave an additional 28 million children suffering from wasting and 40 million affected by stunting,[32] while simultaneously disrupting the health systems needed to prevent and treat malnutrition. Yet, climate, health and food system agendas continue to evolve separately. Food systems transformation is often treated as distinct from health system reform, while climate strategies may set mitigation targets without addressing nutrition implications or health system vulnerabilities.[33] This report examines how shocks and stressors, including pandemics, conflict and environmental crises, disrupt food and health systems, and analyses country-level strategies that have successfully integrated responses across production, supply chains, health and nutrition service delivery and social protection to safeguard nutrition outcomes under stress.

Second, the report examines the alignment and integration of commitments made over the past five years and assesses how far they have moved from pledge to implementation. Drawing on data from the NAF, it analyses commitments made at the N4G Tokyo 2021 and Paris 2025 Summits, examining alignment with food systems goals, the intersection of food and health system actions and the integration of gender equity and climate resilience. This analysis employs four enabling functions: 1) leadership and governance; 2) financing; 3) operational capacity; and 4) research, monitoring and data.

To facilitate the integration of actions across health and food systems within a changing climate for policy and program action, this report proposes an analytical framework to navigate interconnections between climate, food, health and nutrition.

Third, it explores system-level solutions that cut across food and health systems within a changing climate, assessing synergies and critical trade-offs and making comparisons that will be of value to decision-makers. Recognising the complexity faced by policymakers, research institutions, civil society organisations and other actors working to achieve healthy diets for all, the report acknowledges that no silver bullet exists.[34][35][36] To facilitate the integration of actions across health and food systems within a changing climate, the report puts forward an analytical framework that sheds light on these interconnections and the actions that can help commitment makers navigate them. The report also recognises that hard choices will need to be made; even synergistic bundles of interventions may create adverse effects in other sectors or geographies. Making such trade-offs explicit is critically important and can lead to more balanced solutions that mitigate harms for the most vulnerable groups.[37]

The specific objectives of this report are to:

  • Examine resilience to compounding climate, health and conflict stressors and shocks, drawing on country-level evidence of integrated responses.
  • Enumerate evidence on interventions that support both human and planetary health.
  • Assess the role of gender-sensitive approaches in promoting nutrition and healthy diets.
  • Examine the role of governance and financing to support sustainable transformation of food and health systems in support of healthy diets for all.
  • Assess the commitments made at the N4G Tokyo and Paris Summits with a focus on the intersectionality of food and health system commitments, the integration of gender into commitments and whether governance- and financing-focused commitments are supportive of the N4G goals.
  • Use existing evidence and knowledge from frameworks to develop a roadmap for future commitment making.
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Report structure

The report is structured as follows:

  • Chapter 2 investigates food systems resilience to shocks and stressors (pandemics, conflict and environmental crises) and reviews country-level strategies that have safeguarded nutrition outcomes for the most vulnerable populations during crises through integrated action across food systems, health services and social protection.
  • Chapter 3 reviews strategies to mitigate and adapt to climate change while supporting sustainable healthy diets, examining climate-smart agriculture and dietary transitions and reducing food loss and waste (FLW) with attention to synergies and trade-offs of relevance for policy and program implementation.
  • Chapter 4 applies a gender lens to climate, food and health systems, examining women’s roles as agents of change, how climate change amplifies gendered nutrition and health risks and strategies to integrate gender equity into food and health systems actions.
  • Chapter 5 examines governance as a driver of transformation, contrasting procedural accountability with substantive accountability that embeds commitments within financial, institutional and resilience frameworks.
  • Chapter 6 assesses N4G commitments from the Tokyo 2021 and Paris 2025 Summits, examining alignment with food systems frameworks, the intersection of food and health system actions, the presence of substantive accountability and gender integration across nutrition-related sectors.
  • Chapter 7 presents a new analytical Food and Health Systems for Equitable Nutrition (FHEN) Framework for achieving healthy diets through integrated food and health system transformation within climate change. This framework synthesises insights from the review of existing evidence and frameworks and the commitment analyses, providing a tool for future commitment makers to design integrated pledges that account for synergies and trade-offs across the four enabling functions (leadership and governance; financing; operational capacity; and research, monitoring and data).
  • Chapter 8 provides actionable recommendations for policy and commitment makers.
  • Chapter 9 discusses the challenges of implementing these recommendations under current fiscal constraints, including reductions in official development assistance.
  • Chapter 10 concludes by synthesising the report’s core argument that nutrition outcomes require coordinated action across food and health systems, positioning the analytical framework as a practical tool for navigating complexity, and identifying the integration of nutrition into universal health coverage and primary healthcare as a foundational policy lever for sustained progress.

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Executive Summary - 2026 Global Nutrition Report

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Footnotes

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  2. Food system transformation is a shift in a range of activities across production, processing, distribution, marketing, consumption and disposition of foods which translates into healthier diets, greater environmental sustainability and more equitable distribution of benefits and risks. This requires changes in how value chains function, including fairer returns for smallholders, stronger voice and access for vulnerable groups and healthier food environments that shape what people can access, afford and choose to eat. (Ruel MT, Alderman H. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? The Lancet 2013; 382: 536–51.)

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  19. Food and Agriculture Organization of the United Nations. Improving Food Systems for Nutrition and Health. Rome, Italy: Food and Agriculture Organization of the United Nations, 2016. https://openknowledge.fao.org/server/api/core/bitstreams/02c4f309-7b6c-4e5b-9a3b-1b30c542470f/content.

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