Presentation by IFPRI senior researcher Lawrence Haddad at 2015 Global Nutrition Report launch event held in New York City on September 22, 2015

1. 2015

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

3. Nutrition driving the SDGs

4. Alive and
thriving
Intergenerational
equity
Human Rights
Economic
Benefits
Why invest in improving nutrition?

5. 40 low and
middle income
countries
What are the
returns to scaling up
nutrition
interventions?
Benefit-Cost Ratio
16:1
IFPRI 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, Togo
What 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

6. Wordcloud of
Draft SDG
Outcome
Document,
12 Aug, 2015
NUTRITION BARELY
REGISTERS IN THE SDGs

7. Progress on Nutrition Status

8. Progress on stunting reduction
19 15
66
60
24 39
2014 2015
On course
Off course,
some progress
Off course, no
progress
Number of countries on course to meet global (WHA) targets
#NutritionReport

9. 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

10. 25 24
19 22
24 24
31
39
2014 2015
On course, good
progress
On course, at risk
Off course, some
progress
Off course, no
progress
Some progress on Under 5 overweight reduction
Number of countries on course to meet global (WHA) targets

11. Exclusive Breastfeeding Rates
Less progress. Not much data. Reversals even.
Number of countries on course to meet global (WHA) targets
32
10
30
6 on course
off course, some
progress
off course, no
progress
off course,
reversal
Countries experiencing a reversal: Cuba, Egypt, Kyrgyzstan, Mongolia, Nepal and Turkey
N=78

12. But… number of countries that
have reduced
adult obesity rates
WHO: 2010-2014

13. 39
Stunting
children under 5
Wasting
children under 5
Overweight
children under 5
Anemia
women aged
15-49 years
Exclusive
Breastfeeding, 0-6
months
Adult Overweight +
Obesity (BMI≥ 25)
Adult Obesity
(BMI≥ 30)
Adult Diabetes
high 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

14. Progress on Nutrition Actions

15. • Make SMART
commitments
• Report on them
• Meet them
Specific
Measurable
Assignable
Realistic
Time Bound

16. 30
70
SMART
not
SMART
Percent of
commitments
The next set of N4G commitments
must be “SMART”-er

17. 42
44
9
10
40
25
10
21
2014 commitments
2015 commitments
met/on course off course not clear no response
Percent of commitments
Too many N4G signatories failed to
report on commitments they made

18. 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 exist
12 “Lancet interventions”
Bhutta et al. 2013

19. How to create a healthy food
environment?
Labeling; Marketing; Economic Incentives; Public Settings;
Position of healthier foods; Raise productivity of pulses, F&V

20. 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

21. Finance

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

23. 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

24. Domestic Budget
Allocations to
Nutrition as % of total
Government Budget
Actual 1.3%
Upper bound 4.1%
% are medians
14 countries
completed the
exercise

25. Donor
disbursements to
nutrition in 2013
Total: $5bn
• Specific: $1bn
• Sensitive: $4bn
Donors? 4% of spending to nutrition

26. but 13 of 29 OECD
Donors spent less
than $1 million on
nutrition specific
interventions in
2013

27. More resources are needed for nutrition
to meet WHA undernutrition targets
Spending on nutrition specific interventions, 2015-2025
x x
Governments
R4D and World Bank estimates for stunting reduction

28. Climate Nutrition

29. 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

30. 190
240
320
340
Vegetarian
Pescetarian
Mediterranean
Global average
diet
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

31. Food Systems
Poor Diet is now the number 1 risk factor
in the global burden of disease
Lancet, September 10, 2015

32. Food
Consumption
Diversity
Health and
Nutrition
Status
Food
Affordability
Environ-
mental
Sustainability
Dashboard for Food Systems
(13 indicators)
Food Systems
How nutrition-friendly are yours?

33. Business

34. Trust
Engage
Which Comes
First?
Business and
Nutrition

35. 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

36. 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…

37. Accountability and Data

38. Each of the 193 countries has a
nutrition profile like this

39. 65 58
9 18
15 4
99 108
2014 2015
4 targets
3 targets
2 targets
1 target
0 targets
Number of
countries that
can track WHA
targets for
WHA Data gaps are closing, but remain large

40. Calls to Action

41. Calls to Action
1. Elevate nutrition across the SDGs
2. Strengthen national accountability on nutrition
3. Strengthen the Nutrition for Growth commitments
4. 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 systems
8. Build a greater shared understanding of the roles and
responsibilities of business in nutrition
9. Identify the data gaps that hinder action—and fill them

42. G
N
R
Want “Designer” Babies?
Invest in Nutrition!

43. Thank You