Reaching Global Nutrition Targets: Improving Commitments and Accountability in the African Context

From Promise to Impact

ATOR, Accra, October 18,

2016

The Global Nutrition Report

• Independent

• Global

• All Forms of Nutrition

• Data Driven

• Encourages Accountability

Outline

• Key Findings

• Calls to Action

• Takeaways

• What you can do

Key Findings

1. Malnutrition creates ripples of individual and societal challenges & opportunities

Akin AdesinaPresident of the African Development Bank 2016

“We need to invest in gray matter infrastructure.”

“Neuronal infrastructure is quite possibly going to be the most important infrastructure.”

Jim Kim

President, World Bank 2016

We couldn’t have said it better ourselves..

16.5

11.510.3

7.7

6.35.6

3.1

Ethiopia Rwanda Malawi BurkinaFaso

Ghana Uganda Swaziland

(% of GDP)

Annual cost of undernutrition in 7 African countries

AUC/WFP Cost of Hunger Studies

2. Africa is off track to reach global targets—but there is hope.

9Stunting children under 5

Wastingchildren under 5

Overweightchildren under 5

Anemiawomen aged 15-49 years

Exclusive Breastfeeding, <6 months

Adult Overweight + Obesity (BMI≥ 25)

Adult Obesity (BMI≥ 30)

Adult Diabetes(Raised blood glucose)

3465

3

7

1

16

17

23

1

23

34

987

52

312

54

54

53 1

Global Target

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

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

3. Nutrition is central to the SDGs

Nutrition feeds into 12 of the 17 SDGs — and dozens of the indicators used to track the SDGs

1

1

2

2

3

3

3

3

7

7

12

12

Goal 12: Sustainable cons &…

Goal 17: Global Partnerships

Goal 8: Growth & Employment

Goal 16: Peace and Justice

Goal 4: Education

Goal 6: WASH

Goal 10: Reduce Inequality

Goal 11: Cities

Goal 1: Poverty

Goal 2: Hunger and Nutrition

Goal 3: Healthy Lives

Goal 5: Gender Equality

Number of indicators highly relevant to nutrition

Number of indicators not highly relelvant to nutrition

4. There is a gap between current commitments and need

There are not enough SMART targets in African nutrition country plans

75 73

55

45

35

10

Stunting Exclusivebreastfeeding

Wasting Anaemia inwomen

Low birthweight

Under 5overweight

Percent of 40 African Nutrition Plans with SMART Targets for…

Few African Countries have Targets for Diet Related NCDs

Source: Unpublished self-reported data from the NCD Country Capacity Survey, provided by the WHO

Surveillance and Population-based Prevention Unit, Department for Prevention of NCDs. Printed with permission.

%

Percent of 40 countries with targets for…

40

35

15

Obesity Diabetes Salt Reduction

5. SMART Commitments and Targets Matter

Commitment and Impact go hand in hand

• Countries: Nutrition targets & rate of stunting reduction

• Companies: Targets & performance

• Donors: Public commitment & spending on nutrition

Commitment and Impact go hand in

hand

6. We must move beyond talk to action

Coverage of nutrition-specific interventions remains highly variable across African countries

0

10

20

30

40

50

60

70

80

90

100

Exclusivebreastfeeding <6

months

Minimum dietarydiversity (6-23

months)

Zinc treatmentfor diarrhoea (U5)

Iron-Folic acidsuppl. 90+ days

(pregnant women)

Iron suppl. (U5) Vitamin A suppl.(U5)

Salt iodization(household)

7. Today’s nutrition data are not sufficient to maximize investment

Stunting prevalence by region within 34 African countries

0

10

20

30

40

50

60

70

80

Stu

nti

ng

(%)

Lowest stunting region Highest stunting region

Map of stunting rates in Cambodia

Calls to Action

1. Make the political choice to end all

forms of malnutrition

Reject current trends

continuation of current trends

WHA goal

15% by 2025

15% by 2084

Anemia in Women

The ingredients for success are well known… ...and can

lead to rapid improvements in nutrition.Political leadership

& SMART

commitment

Brazil

Ethiopia

Maharashtra

Nutrition-

oriented

development

Bangladesh

Colombia

Ghana

Tanzania

Data

Systems

Guatemala

Indonesia

Peru

Strong

implementation

Argentina

Burkina Faso

Chile

2. Invest more and allocate better

To meet WHA targets by 2025 nutrition specific

funding will have to multiply

Governments x 2

Donors x 3.5

Total x 3

Funding gaps: Substantial but bridgeable

Source: OPM and SUN SMS

More general government expenditure could be directed towards nutrition-

sensitive actions

Budget allocations to nutrition sensitive actions in these countries are relatively low

4.8

2.1

1.5 1.4 1.2 1.2 1.1 1 0.8 0.6 0.6 0.50.1

% o

f G

en

era

l Go

vern

me

nt

Exp

en

dit

ure

s

3. Invest in proven solutions & find new ones

agriculture and food

systems

social protection

women’s

empowerment

WASH

education

There are many ways to support nutrition

Look outside nutrition to affect

nutrition status, e.g. mothers’ age at birth

0

10

20

30

40

50

60

Stu

nti

ng

(%)

Mothers aged <18 at the time of the birth ≥18

4. Tackle malnutrition in all its

forms

25%A quarter of all African countries have serious levels of undernutrition and adult overweight/obesity

Under 5 Stunting

Women’s Anemia

Adult Overweight (BMI ≥ 25)Ethiopia, Rwanda

Ghana, Senegal

Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Comoros, Congo (Republic of The), Côte d’Ivoire, Democratic Republic of the Congo, Djibouti, Eritrea, Gambia, Guinea, Guinea-Bissau, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Niger, Nigeria, Sao Tome and Principe, Sierra Leone, Somalia, Sudan, Togo, Uganda, Tanzania, Zambia, Zimbabwe

Algeria, Gabon, Morocco, Seychelles, Tunisia

Botswana, Egypt, Equatorial Guinea, Lesotho, Libya, Namibia, South Africa, Swaziland

Countries with Multiple

Burdens of Malnutrition

• Develop political strategies for an enabling environment for nutrition improvement

• Build food environments for diverse diets

• Implement interventions before and during first 1000 days

Find “Double Duty” Actions to address multiple forms of malnutrition

Malnutrition is not destiny. Ending it is a political

choice—supported by SMART commitments for

accountability.

Many countries are on course to meet targets.

Many more are on the verge of doing so.

Coexistence of multiple forms of malnutrition is

the new normal. Nutrition stakeholders need to

unite and then grow the nutrition constituency.

Three takeaways

Three things you can do

• Challenge decision makers with evidence onthe slow pace of malnutrition reduction

• Make those essential but challenging alliances for nutrition with those outside your immediate circle

• Make SMART commitments for nutrition and ask others to do the same

Thank you