Briefs

WHAT YOU SHOULD KNOW

Nutrition lays the foundation for human health and development. Good nutrition is particularly important to the growth and development of infants and young children during the critical 1,000-day window between a woman’s pregnancy and her child’s second birthday.

Malnutrition is a widespread and urgent problem. Malnutrition is the underlying cause of almost half of all child deaths each year. Nearly one in four children worldwide are living with the consequences of chronic childhood malnutrition (stunting), while 51 million children suffer from acute malnutrition (wasting). Increasingly, countries are burdened by undernutrition and obesity at the same time. Progress has been made, but some efforts are still off track. If the United States is serious about ending the need for foreign assistance, progress on maternal and child nutrition must be accelerated.

Malnutrition especially impacts the health and potential of women and girls. One in three women suffers from anemia, a micronutrient deficiency that effectively undercuts investments made in her health, education, and economic empowerment. Hemorrhage, a condition exacerbated by anemia, remains the leading cause of maternal mortality, accounting for 27% of maternal deaths.[1]

Proven, costed interventions exist that demonstrably save lives. Research shows that scaling up high-impact, high-priority nutrition interventions[2] during the 1,000-day window can protect children from both nutritional and developmental risks. Leading scientists, health experts, and economists agree that improving nutrition during this critical window is one of the best and most cost-effective investments we can make to achieve lasting progress in global health and development.

Global nutrition efforts are aligning with national ownership. Under the Scaling Up Nutrition Movement, 60 countries are working to end malnutrition in all its forms by building political ownership and developing costed nutrition plans. The World Bank and African Development Bank have also called on finance ministers in high-burden developing countries to reduce stunting by investing in nutrition.

Nearly one in four children suffer from physical and cognitive stunting caused by chronic undernutrition. Yet a growing body of scientific evidence indicates that children who are well nourished early in life have healthier brain development, stronger immune systems, fewer chronic diseases, and higher IQs.

RECOMMENDATIONS FOR CONGRESS

Make nutrition a key U.S. global development priority. In order to unlock the transformative power of nutrition in saving lives and promoting growth, Congress must reaffirm and grow its commitment to global health through a scaled-up approach to nutrition programs. In doing so, Congress will elevate the vital role of nutrition in achieving long-term global health and development goals. Expanded leadership and deeper engagement in the support of global nutrition efforts, from both Congress and the administration, are essential to accelerate progress, to galvanize action, to leverage investments from other donors and governments, and to reach globally agreed-upon health targets.

Increase funding to scale up proven nutrition interventions. Congress has provided modest but steady increases in nutrition program funding[3] over the past several years, in large part due to the compelling new evidence supporting the most cost-effective, high-impact interventions. Congress also supported the development of the U.S. Agency for International Development (USAID) Multi-Sectoral Nutrition Strategy and the U.S. Government Global Nutrition Coordination Plan, then additionally called for the U.S. Government Global Food Security Strategy to prioritize improved nutrition. Congress must provide sufficient resources to fully operationalize these strategies, along with the U.S. roadmap to reduce preventable child and maternal deaths. Because malnutrition requires a multisectoral response, the U.S. government also needs to ensure robust nutrition-related investments are made in other development sectors. Continuing the current level of funding will not allow these efforts to fully deliver on their promise.

Mom breastfeeding Credit: Bill & Melinda Gates Foundation

WHY THIS INVESTMENT IS IMPORTANT

Nutrition lays the foundation for human health and development. Good nutrition is particularly important to the growth and development of infants and young children during the critical 1,000-day window. Leading scientists, health experts, and economists agree that improving nutrition during this window is one of the best and most cost-effective investments that can be made to help achieve lasting progress in global health and development. Children who are well nourished early in life have shown healthier brain development, stronger immune systems, fewer chronic diseases, and higher IQs.

Without specifically addressing malnutrition — the underlying cause of so many health, development, and economic challenges — the United States will not reach the development gains it hopes to achieve. The United States must maximize the return on its investment in development assistance and, among the 17 potential development investments, nutrition interventions consistently generate some of the highest returns.[4]

The benefits of improved nutrition reach far beyond global health. For that reason, prioritizing nutrition programming and increasing related resources can have a multiplier effect. Without due consideration for women’s nutritional health, investments to promote their overall health and economic well-being will not yield the maximum returns possible. Investments in child health and well-being are the cornerstone for productive adulthoods, robust communities, and well-functioning societies. Integrating nutrition with the agenda to improve children’s lives is not only key to their survival, but a holistic approach to helping the next generation reach its full potential.

A 2016 World Bank report found that the current level of global funding for nutrition is vastly insufficient to meet the four global nutrition targets.[5] The study found that, over a period of 10 years, an additional $70 billion in nutrition-specific financing would be needed, for a total of $109 billion. Such an investment would yield tremendous returns: 3.7 million child lives saved, at least 65 million fewer stunted children, 860,000 fewer child deaths from wasting, 265 million fewer women suffering from anemia, and 105 million more children exclusively breastfed as compared to a 2015 baseline.[5]

While this level of investment is ambitious, it is not unprecedented. A subset of high-impact, high-priority interventions have been identified that would serve as a “down payments” toward reaching targets. For example, breastfeeding is both an investment in saving children’s lives — more than 800,000 each year — and in improving their health and well-being. It is also an investment in human capital that can benefit a country’s economy.[6] Every $1 invested in breastfeeding generates an estimated $35 in economic returns. Suboptimal breastfeeding is associated with economic losses of more than $300 billion annually.[7]

High-level U.S. government investment in nutrition upholds America’s legacy of leadership, vision, and goodwill, unlocking additional resources from other donors and country governments, alike, and improving overall health and well-being on a global scale.

Contributors

Aaron Emmel, American Academy of Pediatrics, aemmel@aap.org
Saul Guerrero, Action Against Hunger, sguerrero@actionagainsthunger.org
Asma Lateef, Bread for the World, alateef@bread.org
Mannik Sakayan, 1,000 Days, mannik@thousanddays.org
Jordan Teague, Bread for the World, jteague@bread.org


Citations

[1] “Levels & Trends in Child Mortality,” UNICEF, 2018. http://bit.ly/2Fr2oOe.

[2] This subset of interventions for urgent scale-up includes the following: vitamin A supplementation for children; promotion of good nutrition and hygiene practices for infants and young children; antenatal micronutrient supplementation; intermittent preventive treatment of malaria for pregnant women; iron and folic acid supplements for adolescent girls; staple food fortification; pro-breastfeeding social policies and national breastfeeding promotion campaigns; and treatment of severe or acute malnutrition.

[3] While the Global Health Programs – USAID (GHP-USAID) account is not the only source of funding for U.S. global nutrition programs, it supports vital services such as providing nutrition education to improve maternal diets, enhancing nutrition during pregnancy, promoting exclusive breastfeeding, and improving feeding practices for infants and young children. Resources from GHP-USAID, Global Health Programs – State, Food for Peace (FFP), Development Assistance (DA), and the Economic Support Fund (ESF) also support the promotion of diet quality and diversification (fortified staple foods, specialized food products, community gardens), along with the delivery of nutrition services such as micronutrient supplementation and community management of acute malnutrition.

[4] “Repositioning Nutrition as Central to Development: A Strategy for Large-Scale Action,” The World Bank, 2006. http://bit.ly/2BhEyk3.

[5] “Investing In Nutrition: The Foundation for Development,” The World Bank, 2016. http://bit.ly/2QbSy6Y.

[6] “Nurturing the health and wealth of nations: the investment case for breastfeeding,” WHO, 2017. http://bit.ly/2qVEH6z.

[7] Rollins, Nigel and Nita Bhandari, et al. “Why invest, and what it will take to improve breastfeeding practices?” The Lancet, January 2016; 387(10017):491-504. http://bit.ly/1OYImG9.

©2019 Global Health Council