2015 global nutrition report

2015

• Nutrition driving the SDGs• Progress on nutrition status• Progress on actions• Financing and capacity• Climate• Food Systems• Business• Accountability & Data• Calls to Action

Outline

Nutrition driving the SDGs

Alive and thriving

Intergenerational equity

Human Rights

Economic Benefits

Why invest in improving nutrition?

40 low and middle income countries

What are the returns to scaling up nutrition interventions?

Benefit-Cost Ratio

16:1IFPRI 2014

Brazil

What happens when infants are breastfed > 12 months?Income increases by

33% Victora et al. 2015

Malawi

What is the cost of existing stunting?

10% of annual GDP

AUC/WFP 2015

DRC, Mali, Nigeria, TogoWhat are the returns to scaling up nutrition specific interventions?

Compound rates of return >13% World Bank 2015

What % of healthcare expenses go to obesity treatment?

Brazil: 2%, Europe: 2-4%, USA: 5-20% De Oliveira et al. 2015

Wordcloud of Draft SDG Outcome

Document, 12 Aug, 2015

NUTRITION BARELY REGISTERS IN THE SDGs

Progress on Nutrition Status

Progress on stunting reduction

19 15

6660

24 39

2014 2015

On course

Off course,some progress

Off course, noprogress

Number of countries on course to meet global (WHA) targets

#NutritionReport

Some progress on wasting reduction

64 63

59 67

2014 2015

On course

Off course

Number of countries on course to meet global (WHA) targets

25 24

19 22

24 24

31 39

2014 2015

On course, goodprogressOn course, at risk

Off course, someprogressOff course, noprogress

Some progress on Under 5 overweight reductionNumber of countries on course to meet global (WHA) targets

Exclusive Breastfeeding RatesLess progress. Not much data. Reversals even.

Number of countries on course to meet global (WHA) targets

32

10

30

6 on course

off course, someprogressoff course, noprogressoff course,reversal

Countries experiencing a reversal: Cuba, Egypt, Kyrgyzstan, Mongolia, Nepal and Turkey

N=78

But… number of countries that have reduced

adult obesity rates

WHO: 2010-2014

39Stunting children under 5

Wastingchildren under 5

Overweightchildren under 5

Anemiawomen aged 15-49 yearsExclusive Breastfeeding, 0-6 monthsAdult Overweight + Obesity (BMI≥ 25)

Adult Obesity (BMI≥ 30)

Adult Diabeteshigh blood sugar

601579

63

84

8

115

67

39

5

32

63

242224

180

1036

190

193

185 53

Global Target

Missing data Off course, little/no progress Off course, some progress On courseOn course, at risk

Number of countries at various stages of progress against global targets on nutrition

3

Progress on Nutrition Actions

• Make SMART commitments

• Report on them• Meet them

SpecificMeasurableAssignableRealisticTime Bound

30

70

SMART

notSMART

Percent of commitments

The next set of N4G commitments must be “SMART”-er

42

44

9

10

40

25

10

21

2014 commitments

2015 commitments

met/on course off course not clear no responsePercent of commitments

Too many N4G signatories failed to report on commitments they made

3

3

6

Number of nutrition specific

interventions

Undernutrition interventions? We don’t know enough about scaling up

No comparable

national data exist

Comparable national data

exist

Only proxy comparable

national data exist12 “Lancet interventions”

Bhutta et al. 2013

How to create a healthy food environment?

Labeling; Marketing; Economic Incentives; Public Settings; Position of healthier foods; Raise productivity of pulses, F&V

63 %High income

Upper middle 27 %

Lower middle 10 %

Low income 0 %

But few middle-to-low income countries have implemented policies

to improve food environments

Share of 67 countries that have implemented policies, by income level

Finance

Every country will need to increase its spending on nutrition policies & programs

Domes

SUN member countries stepped

up in 2015

Countries: How much of their budgets are allocated to nutrition?

Bangladesh, Benin, Burundi, Burkina Faso, Cameroon, Chad, Comoros, Congo DRC, Costa Rica, Côte d’Ivoire, Ghana, Guatemala, Indonesia, Kenya, Lesotho, Madagascar, Maharashtra, Mauritania, Nepal, Pakistan, Peru, Philippines, South Sudan, Tajikistan, The Gambia, Togo, Uganda, Vietnam, Yemen, Zambia

Domestic Budget Allocations to Nutrition as % of total Government Budget

Actual 1.3%

Upper bound 4.1%

% are medians

14 countries completed the exercise

Donor disbursements to nutrition in 2013

Total: $5bn• Specific: $1bn• Sensitive: $4bn

Donors? 4% of spending to nutrition

but 13 of 29 OECDDonors spent less

than $1 million on nutrition specific interventions in

2013

More resources are needed for nutritionto meet WHA undernutrition targets

Spending on nutrition specific interventions, 2015-2025

x x

Governments

R4D and World Bank estimates for stunting reduction

Climate Nutrition

2005-6

Jan Feb Mar April May June July Aug Sept Oct Nov Dec

Height-for-Age Z-Scores of children under 3 in India

NFHS Data

Lokshin and Radyakin 2012

Nutrition status is already shaped by seasons. What havoc will climate change cause?

0.2 is the median impact of complementary feeding interventions

190

240

320

340

Vegetarian

Pescetarian

Mediterranean

Global averagediet

Approx. per capita lifecycle greenhouse gas emissions; Kg of CO2-ceq/person/year

Source: Adapted from Tilman and Clark 2014, Fig 4.1

Diet Choices Affect Efforts to Mitigate Climate Change

Food Systems

Poor Diet is now the number 1 risk factorin the global burden of disease

Lancet, September 10, 2015

Food Consumption

Diversity

Health and Nutrition

StatusFood

Affordability

Environ-mental

Sustainability

Dashboard for Food Systems(13 indicators)

Food SystemsHow nutrition-friendly are yours?

Business

Trust

Engage

Which Comes First?

Business and Nutrition

Transparency + Monitoring Trust

• Register of PPPs

• Nutrition Transparency Initiative

• Enforcement Litigation Fund

• ATNI-type disclosures

• Public research Initiatives

Opportunities to advance nutrition

• Mobile phones

• Health• Logistics

• Food

but…there is a massive dialogue gap

FAO, UNICEF, WHO and WFP, together with others, should

• establish an inclusive, time-bound Commission

• to develop a shared understanding of the roles and responsibilities of business in nutrition

Once the WHO Framework for Engagement with Non-State Actors (FENSA) is completed in 2016…

Accountability and Data

Each of the 193 countries has a nutrition profile like this

65 58

9 1815 4

99 108

2014 2015

4 targets3 targets2 targets1 target0 targets

Number of countries that can track WHA targets for

WHA Data gaps are closing, but remain large

Calls to Action

Calls to Action

1. Elevate nutrition across the SDGs2. Strengthen national accountability on nutrition3. Strengthen the Nutrition for Growth commitments4. Implement actions to address malnutrition 5. Find more funding for nutrition action 6. Build alliances between nutrition & climate communities 7. Develop indicators for nutrition friendly food systems8. Build a greater shared understanding of the roles and

responsibilities of business in nutrition9. Identify the data gaps that hinder action—and fill them

GN

R

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