Time to be bold: N4G must be about enlarging the nutrition pot, not simply polishing it

London, 7 October 2021 - 

I remember well the first Nutrition for Growth Summit in 2013 in London. I wrote the framing paper for that Summit: why should we invest in improving nutrition status? Answer: because 45% of under 3 mortality is linked to malnutrition.

Because malnutrition damages brain development and impairs other critical functions such as immunity. Because malnutrition related risk factors drive the burden of disease powerfully in each country. Because malnutrition undermines performance in school. Because malnutrition makes adults more likely to live in poverty. Because malnourished mothers are more likely to have malnourished babies. Because malnourished infants are more likely to suffer diet related disease later in life. Because freedom from malnutrition is a right. Because the benefit cost ratios of scaling up nutrition action are off the charts at 16:1. Because malnutrition reduction commands only USD1m of ODA. Because malnutrition is preventable. 

These reasons have not changed, but the world, 8 years later, has.  

Since 2013 there has been progress, don’t get me wrong. Comparing the 2013 and 2020 the Joint Child Malnutrition Estimate Reports tell us that the numbers of stunted children declined by 11%, wasting by 8% and overweight by 14%. Not bad, but too slow and too uneven.  

But even this level of progress is under severe pressure from the triple threat of COVID-19, climate change and conflict.

On COVID-19, according to the IMF, in 2024 the GDP of Sub-Saharan Africa, Asia (excluding China) and Latin America will be 6-8% below pre-COVID projections. The Standing Together for Nutrition projects that these income declines together with health system overloads and food system disruptions associated with COVID-19 could increase stunting by 3m and wasting by 13m in the next 2 years unless funding to nutrition is doubled. 

Woman wearing a red veil over head picking tomatoes from a food stall

But even this level of progress is under severe pressure from the triple threat of COVID-19, climate change and conflict. © GAIN

On climate, the impacts of global warming on global GDP make the above impacts of COVID look like a blip. SwissRe’s estimates of the GDP declines in 2050 due to global temperature rises of 3.2% (compared to the Paris target of <2%) are 30% for the ASEAN countries, 23% for the Middle East and Africa, and 13% for South America.  

On conflict the Oslo Peace Research Institute trends report of 2021 notes the rapid rise in the number of conflicts globally since 2011 and the sobering reality that most conflicts take decades to resolve. 

This is disheartening. But these 3 crises are facts we cannot ignore. Action on nutrition is an indispensable part of the solution and will help to turn the tide. N4G must be the place and time that we firmly seize the opportunities. 

For climate, we must establish common cause with those working hard to reduce GHG emissions. Moves to reduce beef consumption in places where it is above national food based dietary guidelines are good for health but also good for GHG emissions.

In contexts where animal source food (ASF) consumption such as meat, eggs and dairy needs to increase for populations at risk of malnutrition, the environmental footprint of the relevant ASF production systems needs to be much smaller. Climate and nutrition champions should be allies working together for lower beef consumption where it is a health risk (and a driver of GHGs) and they should be allies working together for more environmentally sustainable animal source food production systems everywhere. 

For COVID we must establish nutrition as a default element of a universal health care response to the virus. Where vaccine coverage is low (it is still <5% in Africa), and even where it is not, good nutrition status is essential for immune system strength, keeping the co-morbidities at bay that ramp up the severity and deadliness of COVID-19.

Action on nutrition is an indispensable part of the solution and will help to turn the tide. N4G must be the place and time that we firmly seize the opportunities.

To build resilience in conflict affected areas -and anywhere - good nutrition status is essential. If resilience is the ability to keep functioning in face of adversity, good nutrition fuels the power within. We know that food price rises stoke conflict, and so efforts to address seasonal malnutrition are likely to contribute to reducing the tensions that beget conflict. 

Those of us who have a burning passion for reducing malnutrition need to connect our solutions to these three political priorities: be open to new ideas both personally and in our organisations. This is where the world’s attention, political energy, and resources currently are. We can either lament that or link to it. We can be proactive with confidence, after all we have much to offer. But we should also do it with humility.  Persuasion is an "away game". We need to go where these communities are, mentally and physically.  We should not be so arrogant to think they should come to us. 

If I had to write the framing paper for N4G 2021, it would have many of the same themes as 2013. Good nutrition status is a right and is still an incredible investment. But such a paper would respond to our moment in time more broadly and make the case for deliberately and determinedly connecting nutrition with the climate, COVID and conflict constituencies. The sister summit for nutrition in this special year, the UN Food Systems Summit, has made the ground more fertile for nutrition in these three areas - just take a look at UN Secretary General Antonio Guterres’ Statement of Action.  

Now we all need to go out and plant nutrition action: in our own fields, yes, but also in the fields of our potential allies - with them.  

N4G must be about being bold for nutrition and enlarging the nutrition pot, not simply polishing it.