By Nabeeha M. Kazi, Managing Director, Humanitas Global
Photo Credit: AFP/Getty Images
In advance of the G8 annual summit, The Lancet unveils today a follow up to its 2008 Maternal and Child Nutrition Series. The new Series takes a closer look at the progress around our global maternal and child nutrition response, and the new and emerging areas of concern.
In my recent visit with Professor Robert Black of Johns Hopkins University, who led the Series, we talked about why there was a need for a new Series now. He noted that five years after the 2008 Series was an appropriate time to look back and see what had been accomplished.
"We were aware that there was substantial momentum. What we wanted to look at was the evidence base as it stands now, and see if the momentum that was building for nutrition could be enhanced and accelerated."
Professor Black emphasized that there is clearly increased interest and support for nutrition, but there are still significant problems and unaddressed needs. In addition, we have a real opportunity to enhance programs and get at real impact on nutrition, development and mortality.
The new Series sets into motion a re-evaluation of the problems of maternal and child undernutrition and the emerging challenges of overweight and obesity in women and children in low-income and middle-income countries (LMICs).The four papers that are part of the new Series include:
Paper 1: Prevalence and consequences of nutrition conditions during the life course from girl's adolescence through pregnancy to childhood.
Paper 2: Evidence around nutrition-specific interventions, health outcomes and costs associated with expanding reach and impact of interventions.
Paper 3: Nutrition-sensitive interventions and approaches and their impact on improved nutrition and health status.
Paper 4: Characteristics of an enabling environment where nutrition programs can yield the desired impact.
There also is a set of comments that examines current nutrition efforts and responses, along with what should be done moving forward to address the needs of women and children in the LMICs.
The Series notes that we have an "unfinished agenda for undernutrition." There is tremendous momentum, attention and commitment to tackle malnutrition. In fact, the 2008 Lancet nutrition Series gets credit for mobilizing leaders around key calls to action, springboarding the Scaling Up Nutrition (SUN) movement, and advocating for a revision in national strategies to focus on nutrition challenges in the first 1,000 days from conception to age 2 of a child.
However, despite this progress, the papers note that we are still lagging in achieving "substantially improved outcomes globally." As the Series notes, "global improvements in nutrition still represent a massive unfinished agenda."
There is recognition that as we move into the next phase of work we must:
- Account for and simultaneously respond to the rapidly escalating burden of overweight and obesity in adults and children
- Build enabling and sustainable environments for effective nutrition responses
- Promote nutrition interventions very early in pregnancy and, ideally, before conception
- Leverage the current evidence base to account for context-specific realities
- Better integrate the expertise and knowledge of leaders across sectors (including the private sector)
- Mobilize additional resources to meet the US$9.6 billion financing gap
The Series is meant to foster enhanced dialogue and even greater, expanded action to build upon the momentum we are seeing around nutrition. However, the Series can only do so much. Professor Black agrees and reminds the global community of this:
"The real action that has to happen is at country level. While we do speak to what would be the right environment at a country level, countries are different -- they have different circumstances and different needs. It's very difficult in a global Series to be that nuanced. What needs to happen next is meeting the specific needs in-country and implementing what are considered the most powerful interventions with the greatest impact on populations."
The new Lancet Series is an opportunity to build upon what we know, leverage the collective knowledge-based assets for country and context-specific responses and ensure that the tremendous momentum that has been in place continues.
As the Series notes, if we have the right funding, policies, systems, programs and multi-sectoral commitments in place we can not only fight malnutrition swiftly and with a vengence, but also build approaches and a nutrition-centered paradigm that sticks.
