Despite significant progress made in child survival responses, millions of children under the age of five continue to die from preventable causes, with malnutrition contributing to 45 percent of those deaths. For those who live, one quarter — approximately 165 million children — suffer from stunting, one of the most measurable signs of malnutrition.
Stunting is what happens when a child’s brain and body do not have the right kind of food or nutrients to fully develop, particularly in the 1,000 days between conception and age 2. A stunted child is at greater risk of infection, disease and early death, and her future ability to learn and earn is irreversibly impacted.
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We all want children to survive, but simply surviving is not enough; children must thrive as well. This is only possible if they are well-nourished. A strong nutrition foundation is essential for building a strong immune system. It is also the starting point of any effective health system. With child mortality rates still unacceptably high and malnutrition such a significant contributor to these rates, it is obvious there is significant scope and opportunity to bring health and nutrition approaches closer together.
There is good news on this front. At long last, we are witnessing an increase in political will towards improving global nutrition, both from donor countries and developing nations. There are now 53 countries that have signed on to the Scaling Up Nutrition Movement — founded in 2009 on the principle that we need to ensure good nutrition for all if we are to overcome the world's biggest challenges. The United Kingdom’s 2013 Nutrition For Growth Summit brought world leaders together to address hunger and improve global nutrition. And most recently, nutrition was at the forefront of Canada’s Saving Every Woman, Every Child: Within Arm’s Reach Summit, where world leaders and experts gathered to determine new ways to stop children and women dying from a lack of access to basic and inexpensive solutions. Canada committed $3.5 billion over five years, with improving nutrition, particularly for women and children in developing countries, as a key pillar.
These political events have been critical in shining a light on the role of nutrition for the survival and development of the world’s children. Yet the final goal of ending preventable deaths for women and children continues to elude us because there are missed opportunities in our global efforts.
As the new president of the Micronutrient Initiative, a global nutrition organization that reaches 500 million people in more than 70 countries every year, and with a background in public health, I arrived from previous work with UNICEF, the World Health Organization and the World Bank with an allergy to missed opportunities and a strong curiosity about how the Micronutrient Initiative could add the most value possible. One question that drives me, and the people I work with, is: Are we missing opportunities to add value for the people we exist to serve?
The people we serve do not have a rotation of afflictions that justify a siloed approach, separating the delivery of nutrition and health. They do not have tuberculosis on Tuesday, followed by malnutrition on Wednesday or pneumonia on Thursday. A mother does not have time to show up for mosquito bednet distribution day at a health post and then have to travel to a clinic where someone determines if her child is malnourished enough to qualify for severe acute malnutrition treatment. For many, hunger and sickness are inseparable. Does our global approach reflect this reality?
If we provide vitamin A every six months and don’t harness that platform effectively for deworming or other interventions, that’s a missed opportunity. Or when we successfully treat a child for severe acute malnutrition only to have them back on treatment again six months later because they’re not getting the ongoing community-based nutrition support they need, that’s a missed opportunity. And when we don’t take advantage of social protection or school feeding programs to deliver everything they can for women and children, and in particular for adolescent girls, that’s a missed opportunity.
Yet, who is accountable for missed opportunities in global health and, on the opposite end, who is responsible for identifying unharnessed ways to add value? All of us are. We know that the effectiveness of many public health interventions is compromised by poor underlying nutritional status. Children must start life with their basic nutrition needs met and their development potential protected. More must be done to ensure vulnerable people receive health and nutrition services in the most integrated way possible. We can and must eliminate missed opportunities in the spaces between nutrition and health, and nutrition and other sectors.
Feeding Development is an online conversation hosted by Devex in partnership with ACDI/VOCA, Chemonics, Fintrac, GAIN, Nestlé and Tetra Tech to reimagine solutions for a food-secure future from seed and soil to a healthy meal.