Unlocking human potential

Economic impact through nutrition Anthony Hehir Director - Nutrition Improvement Program Bogotá, 14 May 2015

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Innovative financing & new business models

“No I didn’t attend - I work in research.”

“Not interesting – its not about nutrition.”

“No - nutrition topics are more important.”

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The vicious cycle of income poverty

Source: World Bank

Malnutrition, Micronutrient deficiencies

Income poverty

Low food intake

Frequent infections

Hard physical labor

Frequent pregnancies

Large families

Poor cognitive development and schooling = indirect loss in productivity

Increased health care costs and

illnesses = loss in resources

Poor physical status = direct

loss in productivity

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The vicious cycle of income poverty

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The vicious cycle of income poverty

4 Darnton-Hill et al, 2005

Percentage of estimated loss in GNP due to iron deficiency

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Copenhagen Consensus

The Copenhagen Consensus exercise started in 2004 and continued

in 2008 and 2012 as a simple but untested idea of prioritizing

global opportunities of the world’s biggest

problems and their solutions.

Imagine you had $75bn to donate to

worthwhile causes.

What would you do, and where

should we start?

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Copenhagen Consensus 2004, 2008, 2012

2004 2008 2012

1 Control HIV/AIDS Micronutrient supplements for

children (A and zinc)

Bundled micronutrient interventions

2 Provide micronutrients The Doha development agenda (lower

trade barriers)

Malaria combination treatment

3 Trade liberalization Micronutrient fortification (iron and

salt iodization)

Childhood immunization coverage

4 Control of malaria Expanded immunization coverage for

children

TB treatment

5 New agricultural technologies to

increase yields

Biofortification R&D to increase crop yields

6 Small scale water technologies for

livelihoods

Deworming and other nutrition

programs at school

Effective early warning systems

against natural disasters

7 Community-managed water supply

and sanitation

Lowering the price of schooling Surgical capacity

8 Rx on water productivity in food

production

Increase and improve girls’ schooling Hepatitis B immunizations

9 Lowering cost of starting new

business

Community-based nutrition

promotion

Low cost drugs for acute heart

attacks in poorer nations

10 Lowering migration barriers for

skilled workers

Provide support for women’s

reproductive role

Salt reduction campaign

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Best long-term investments to fight hunger and malnutrition:

1. Acceleration of agricultural yield

enhancements

2. Market innovations that reduce hunger

3. Bundled Interventions that reduce

micronutrient malnutrition and reduce

prevalence of stunting

Copenhagen Consensus 2012

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1. Accelerating agricultural yield enhancements

• We need 2100kCal/person/day

• We produce 2796kCal/person/day

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Food production

(Research for yields and tolerance)

Food prices and affordability

Buffer against climate change

By 2050:

- Rapeseed oil 68% cheaper

- Rice 25% cheaper

- Hunger 63% less

ROI 16 : 1

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Dual approach to improve economic conditions:

• Provide market information

through cellphones

• Reduce barriers to fertilizer access

• 5 countries & 4 companies control >50%

world’s fertilizer production

• Invest in local fertilizer production capacity

2. Market innovations that reduce hunger

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• 80% of global hungry live in rural areas

• 50% of those are smallholders

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ROI 8.4 : 1

ROI 6.5 : 1

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3. Interventions to fight hunger and improve education

1. Micronutrient provision

2. Complimentary foods

3. Treatment for worms/diarrhea

4. Behaviour Change Programs

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Health, schooling &

productivity

Chronic undernutrition in

developing countries 36%

ROI 30 : 1

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Best target for nutrition?

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By 2030, reduce by 40% the number of children who

are stunted, which would return $45 dollars for every dollar

spent.

ROI 45 : 1

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Focus on stunting reduction

Nutrition Physical/ Economic

cognitive potential growth

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Horton and Hoddinott (2013), based on Hoddinott (2013)

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Focus on stunting reduction Advantages of the stunting target

16 Horton and Hoddinott (2013)

- Importance of first 1000 days

- Growth also depends on health status, sanitation and reduced infection.

- Growth also affected by quality of care. Nutrition AND health care provide

better outcomes

- Growth is a good indicator of the quality of the early life environment;

- Growth is readily measurable (although it relies on reasonably good age data)

- Child height at age two is a good predictor of achieved adult height.

- Achieved adult height is associated with wages: from a survey of 8 high

income countries (Gao and Smyth, 2010) the median increase of hourly wages

per 1 cm of additional height was 0.55%; and from a survey of 8 low and middle

income countries, the median was 4.5% (Horton and Steckel, 2013).

- Achieved adult height also tracks economic development quite well

(Figures 1, 2 and 3 from Horton and Steckel, 2013, which show that height

tracks the economic “takeoff” for a range of countries).

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Effect of increased height on wages, developing countries

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Horton & Steckel, 2013

Height

=

Earning potential

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Guatemala Hoddinott et al (2008) Longitudinal study

• 1969: Pre-school children given a more nutritionally rich diet

compared to control group (supplements, deworming, better

quality of the diet).

• Followed up 35 years later.

• Results from intervention group:

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Virtuous cycle of development Better nutrition in the first 1,000 days has

an overwhelming economic argument.

Not stunted at age 3

Stayed in school longer

Better cognitive skills as adults

Higher wages as adults

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Bundled interventions

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Source: Sight and Life

Effective nutrition is affordable.

Ineffective nutrition is expensive

Quality is Essential!

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Back up slide – nutrition in economic terms

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