Guest post by Stuart Gillespie, CEO of the Transform Nutrition Research Programme Consortium
On World Food Day 2012, nutrition is no longer the invisible, sectoral orphan of the development world. Momentum has been building since 2010 to reverse decades of neglect. With food prices again on the rise, solutions to undernutrition are increasingly recognized and interventions are being scaled up. There are still questions that need to be answered for sustained progress to be made – but this can be done in real time, learning as we act.
Ban Ki Moon highlighted malnutrition as a global priority in his speech to the UN General Assembly last month. This comes on the heels of David Cameron’s Olympic legacy event that secured commitments on hunger and nutrition from global leaders. For the first time a British prime minister spoke of the urgency of addressing child stunting which blights the lives of 180 million young children. 30 countries have signed up to the Scaling up Nutrition (SUN) movement which is galvanising political commitment in regions suffering the highest burden of undernutrition.
The development community and academics alike agree that malnutrition is a top priority. Earlier this year a panel of economic experts, including Nobel laureates, agreed that malnutrition is the most pressing development priority today (Copenhagen Consensus 2012). Chronic undernutrition impacts a child’s mental and physical ability undermining his or her future earning capacity. Waves of impact ripple out over time from the child, to households, communities and ultimately nation states, where undernutrition exerts a significant drain on economic growth.
We now have a clear body of evidence of what works in addressing undernutrition. There are three levels of response. First, a bundle of 13 nutrition-specific interventions including micronutrient supplementation, support for breastfeeding and appropriate complementary feeding that can effectively target the first 1,000 days of a child’s life starting with conception. If these interventions are brought to scale, one third of the undernutrition problem will be dealt with. Second, there are a range of broader (“indirect”) development actions (in agriculture, social protection, water and sanitation, etc) that hold huge potential for improving nutrition so long as certain modifications in design, targeting and implementation are made. “Nutrition-sensitivity” is a notion that is gaining traction now within the development community. But to make this happen, at the third level, there’s a need to cultivate and sustain enabling policy environments and nutrition-friendly institutional and legal frameworks. This is crucial for incentivizing and facilitating actions at the other two levels -- scaling up of direct interventions and maximizing the nutrition sensitivity of indirect interventions.
Nutritionists and programme managers have been focused on the first level for decades, the second for the last few years, and they are only now coming to realize the importance of the third level. Enabling environments are essential for the other two levels of action to succeed, and there is both an art and science in creating and sustaining them.
In the past, nutritionists did their research, made recommendations and then implored politicians to do the right thing. More often than not, it didn’t happen. Now, there is a new focus on opening up the black box of “political will” to better understand (and ultimately shape) policy processes, to make nutrition more visible, and to hold political leaders to account if the neglect continues.