Nutrition continues to enjoy high visibility and increasing political commitment on a global scale. The Bill & Melinda Gates Foundation just announced a $776 million pledge to fight malnutrition in five countries over the next six years.
Food security and nutrition is on the agenda for the June G-7 summit, and many donors are to announce additional nutrition-related commitments at next month’s Financing for Development conference.
The heightened attention is rightly deserved. Eliminating undernutrition in young children can prevent more than a third of child deaths per year, increase school attainment by at least one year, boost wage rates by 5% - 50%, and boost gross national product in Africa and Asia by 11%.
But while the donor and government dollars for nutrition are greater now than at any other time, they still fall short of what is needed to close the global malnutrition gap. Today, an estimated 795 million people are undernourished, two billion people are overweight or obese and another two billion suffer from micronutrient deficiencies.
So even with the Gates Foundation pledge, and its unlocking of potentially $430 million from the UK, the total global foreign aid spending toward nutrition sits at less than 1%.
In the 2013 Lancet series on Maternal and Child Nutrition, Bhutta et al. found that if the set of 10 proven interventions to improve maternal and child nutrition were scaled to 90% coverage across 34 countries, in additional to nutrition-sensitive interventions, we could dramatically reduce the number of stunted children in the world by 80%.
However, we simply will not achieve the scale needed through public sector and NGO-led nutrition programs alone. Working with and/or unleashing the positive power of the private sector is critical.
The nutrition community, however, is stuck in a stand-off with companies that could play critical roles in the ability to improve nutrition. In public health, for example, sector leaders including WHO have found ways to work effectively with ‘Big Pharma,’ which has led to the massive scale-up of vaccine coverage, insecticide-treated bed net coverage, and tens of millions of people accessing life-saving drug therapies that fight HIV and tuberculosis. We must find a way to overcome the distrust that holds the community back from working alongside the private sector.
I recently spoke on a panel at a GAIN Symposium, “Making a difference in the first 1000 days” I left the symposium agreeing with many in attendance that the nutrition community need to move beyond on whether or not to engage with the private sector and move forward to an action-oriented discussion on “how” we engage.
The following are some ideas and approaches so we can deliver on the promise of improved nutrition.
• Invest in catalytic talent in key government institutions that can drive nutrition action at country level, just as many others in global health are doing e.g. Born Free Africa, Leadership for the Last Mile, African Nutrition Security Partnership.
• Take a hard look at the current leadership and financing architecture for nutrition: is it set up to deliver? To date, it has served the community well to raise nutrition on the political agenda, and financing has started to come in. Is a different set/type of leadership and leadership architecture needed to transition to delivering on this promise?
• Strike a truce!: Multilateral and UN agency heads and CEOs of the world’s food and beverage companies need to find common ground from which they can work together in order to see proven nutrition interventions truly brought to scale. Without better private sector engagement, the nutrition community will be hard pressed to achieve the existing World Health Assembly and Nutrition for Growth targets.
• Hedge against continuation of status quo Invest in more social entrepreneurs/social enterprises for nutritious food enterprises.
• Consider Cash: Give Directly an NY-based NGO that delivers cash transfers directly to some of the poorest households in Uganda, Kenya and soon in Rwanda, is challenging traditional aid models and forcing the question: when is it just as or more effective to give cash? In many contexts, cash transfers have been shown to improve nutrition outcomes, and at a fraction of the cost of traditional delivery programs.
As we accelerate to the Millennium Development Goals to a new, post-2015 development era, there is an opportunity to improve engagement with the private sector, while innovating in our approaches to improving nutrition around the world.
This opportunity should not be missed.
Jessica Johnston is Vice President for Programs and Operations for the MDG Health Alliance and Office of the UN special envoy for financing the health Millennium Development Goals and for malaria.
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