As a champion for women and girls, I’ve pushed to increase access to education, sanitation and health services for women and girls across Africa. Through this, I noticed that one major factor underlies success in all these areas: proper nutrition. Despite being the ones mostly in charge of cooking, women and girls are more likely to eat last and least — meaning they give up the best part of the meal to their husbands, sons and brothers before serving themselves.
For most of us, having enough of the right kinds of food is a given. If our children come home from school with a disappointing test score, we don’t wonder if their performance is linked to our own micronutrient balance during pregnancy.—
Lacking the right balance of nutrition can impact a child’s growth and development, their ability to fight infections and their performance in school and later in the workforce. For most of us, having enough of the right kinds of food is a given. If our children come home from school with a disappointing test score, we don’t wonder if their performance is linked to our own micronutrient balance during pregnancy. If we miss out on a promotion at work, we don’t think back to whether we were breast-fed for long enough.
But the reality is that 159 million children around the world are stunted physically, emotionally and cognitively because of malnutrition early in life. This can limit academic achievement throughout a child’s school life and can have longer term consequences for adult earning potential. Imagine what that means for countries where 30 percent of the population of children under 5 years old are stunted. A whole generation of stunted children can limit national earning potential (measured by gross domestic product), by up to 11 percent in some regions of the world, including my home, Africa.
But over the past year, I’ve also learned a lot about what can be done to reverse the negative impact of stunting on children and societies, and how we can set the stage for a generation of healthier, stronger children and growing, thriving societies. A lot of this work has been led by a surprising ally: World Bank President Jim Yong Kim. In his role, President Kim has looked beyond the institution’s usual role of building roads and bridges, to building a different kind of infrastructure — grey matter infrastructure. Through a new initiative focused on “Investing in the Early Years,” the World Bank aims to help low- and middle-income countries, particularly those burdened with high rates of stunting, prevent childhood stunting.
It is too early to tell if this initiative is working, but here are some of the key lessons I’ve learned from watching this program and ones like it.
1. We know what it takes to scale up nutrition interventions to prevent childhood stunting.
Researchers all over the world have scrutinized the impact of interventions focused on reducing malnutrition, and have agreed that key interventions are the most effective in ensuring proper nutrition for pregnant women and children worldwide. These interventions were first reviewed in The Lancet, a preeminent international public health journal in 2008, and again in 2013. They include micronutrient fortification for infants, pregnant women, women of reproductive age, exclusive breast-feeding for infants under 6 months, and complementary feeding for children between 6 and 24 months, among others. These interventions can prevent the nearly 3.1 million child deaths a year caused by childhood stunting, wasting and micronutrient deficiencies, and an additional 800,000 neonatal deaths per year caused by maternal undernutrition.
2. We know how much it costs.
Thanks to analysis work done by the World Bank, Results for Development and 1,000 Days Projects last year, we know now more than we ever have before about what it costs to scale up interventions directed at reducing malnutrition. We know that in addition to the $3.9 billion a year given by public and private donors, the world needs at least $2.2 billion to scale a priority package of interventions on nutrition, or $7 billion per year to result in 3.7 million child lives saved, 65 million fewer stunted children, and 265 million fewer women suffering from anemia. These additional funds need to come not only from public and private donors, but also from countries with high burdens of malnutrition themselves.
Investing $7 billion per year, or $70 billion over 10 years, may sound like a lot of money, but actually, investing in nutrition has proven to be one of the highest impact investments. For every $1 invested in nutrition, a country can expect between $4 and $35 in economic returns, making nutrition a clear development “best buy.” We also know what it costs to ignore the problem. Because undernutrition has been shown to lead to lower physical and mental capabilities, lower wages, and more days away from work due to illness, failing to address undernutrition can cost developing countries an estimated $149 billion in lost productivity each year.
When competing priorities or political issues come forward, it is always the health and nutrition of our children that suffer.—
3. We have support of leaders, but it’s uncertain whether we have the political will.
Today, we cannot claim that decision-makers are unaware of the importance of investing in nutrition. Over the past year, I have met with ministers of health, finance, economic development, members of parliament and directors of institutions like the World Bank on this issue. They all agree that investing in nutrition is a critical priority to ensure health, wealth and future progress for their countries and the world over. But when it comes down to it, when competing priorities such as the emergence of epidemics or political issues such as corruption come forward, it is always the health and nutrition of our children that suffer. This cannot go on. We must take the evidence we have and put it to use!
Governments of high-burden countries must develop budget lines for nutrition where they do not already exist, come up with aligned, multisectoral and comprehensive plans to address malnutrition, and commit to investing in nutrition at home. Donor countries must continue to invest in nutrition and scale up investments, particularly in countries where clearly set priorities are laid out in country plans. Institutions such as the World Bank and the African Development Bank must do more to prioritize nutrition in their grant and lending mechanisms, including through innovative financing mechanisms, such as the Global Financing Facility for Every Woman Every Child. Jim Kim’s push to put stunting on the global agenda has been commendable, but we have yet to see that translate to increased funding on the ground.
There are multiple moments between now and 2020 for leaders to show their dedication to this issue and make concrete, measurable, political and financial commitments. I call on all leaders, and especially leaders of African countries, to move past the talk and take action. Our children, and our future, depend on it.
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