It was a fantastic achievement. For decades we have known about the devastating impacts of hunger and undernutrition, yet for the first time in history leaders from all over the world united specifically around nutrition. With the commitments made we now have the potential to save 1.7 million lives from now until 2020. That’s a spectacular 625 children’s lives saved each day.
Some very promising, and exciting, announcements were made on the day. I am particularly pleased with the announcement to publish an annual global report on nutrition to monitor progress on tackling undernutrition. This will help us review our progress and share best practice, both in tracking resources spent but also in ensuring real impact against undernutrition.
While we should be pleased with what we have achieved – it was not small feat – we should not become complacent. This is just the beginning and there is still work to be done, some questions that need answering, and some areas that require a bit more fleshing out.
So my first question is… how big of a dent have we made in the nutrition financing? $4.1 billion was pledged by the Donor governments and Foundation donors for nutrition specific interventions and $19 billion for nutrition sensitive. But how big a dent will this make given the overall size of the problem?
Nutrition sensitive pledges
An estimated $19 billion (£12.5 billion) was committed for nutrition sensitive interventions – interventions that address the underlying causes of undernutrition. This is indeed welcome, as evidence suggest that nutrition sensitive interventions will be needed to address more than three-quarters of stunting. However, it is unclear what proportion of this is new money and what was re-committed money that was already in place for programmes, such as water and sanitation, agriculture and gender empowerment, that fit under the umbrella definition of nutrition sensitive interventions. Interventions like these are good in their own right, but, unsurprisingly, evidence shows us that they need to be actively designed and implemented with nutritional outcomes in mind if they are to have impact on nutrition.
Take access to water and sanitation as an example. Improving access to clean drinking water will only result in reductions in undernutrition and stunting if they are targeted appropriately – to reach adolescent girls and children the first 1000 days of life and the poorest and most marginalized segments of society. Mothers are recommended to exclusively breastfeed their child for 6 months, which provides optimal nutrition for the infant. After this period health guidelines recommend that mothers start to introduce complementary nutritious foods alongside breastfeeding. However, they need to have access to safe clean water to prevent diseases such as diarrhea, which can lead to, and exacerbate, undernutrition.
It is a huge job to ensure that the entire $19bn has the full impact on nutrition that it could, and needs to be a key part of the monitoring framework.
Nutrition specific pledges
According to the new Lancet series on Maternal and Child Nutrition it will require $9.6 billion per year for 10 nutrition specific interventions – interventions that have a direct affect on individual’s nutrition – to address just under a quarter of stunting. So the total bill to address nutrition (specific interventions only) until 2020 is roughly $67 billion.
The exact split between domestic financing and donor support for nutrition will vary widely from country to country. But if we assume an average of 40% of countries costed plans will be provided by donors, with national governments funding the rest, that puts the cost to donors at just under $27 billion ($3.8 billion per year) and just over $40 billion ($5.7 billion per year) for national governments, for the period until 2020. The Nutrition for Growth event reached a total of $4.1 billion over the next 7 years. That works out to roughly $585 million per year – 15% of the $3.8 billion that is required globally by donors.
However, it is important to note that this first pledging moment is aimed at addressing undernutrition in 20 high-burden countries (16 SUN countries with costed plan and four additional high burden countries). It is not a global target like the one presented in the Lancet. So $4.1 billion for 20 countries (roughly $29 million each per year) is quite significant.
This is a great a start. In fairness with what we know now we probably don’t have the capacity to spend any more than half of what is required – $13.5 billion – appropriately and sensibly over the next 7 years. We are still finding our feet and there will be a lot of lessons learned over the next couple of years. Our task right now is to maintain awareness, build the evidence base and generate further energy and action.
The Government of Brazil is due to host another Hunger Summit in 2016, during the Rio Olympics, to review progress and make additional commitments. I hope that this will bring further financial commitments, though it was not expressed if these commitments will be political, financial, or both. What’s more, I hope that this will provide an opportunity to scale up nutrition in other high burden and SUN countries, which did not have costed plans this time around. It will be a critical moment to renew and refocus energy around nutrition.
Right now we need to make sure we hold funders and governments (donor and domestic) to their commitments. Undernutrition could be ended in a generation but only with maintained commitment and accelerated action.
The views and opinions expressed herein are those of the author and do not necessarily reflect the views of RESULTS UK