Putting an end to the current nutrition crisis by 2030 is possible, but only if nutrition is embedded within a post-2015 development framework. Undernutrition continues to afflict 170 million children worldwide and is responsible for nearly 3 million child deaths each year. The life-long and wideranging effects of undernutrition cannot be overstated – brain damage, immune system malfunction, weaker schooling attainment, lower workforce productivity, greater poverty and a greater susceptibility to chronic disease later in life. A new development framework must seek to establish a much clearer and stronger set of nutrition targets and indicators than exist within the current Millennium Development Goals (MDGs).
This policy brief concludes with the following recommendations:
- Replace the underweight (low weight for age) indicator with a stunting (low height for age) indicator. Stunting is a much more precise marker of the negative consequences of undernutrition.
- A new development framework must support and complement the work of the SUN movement and the new WHA targets established in 2012, which propose six targets, including a 40 per cent reduction in the number of stunted children from 171 million in 2010 to 100 million in 2025.
- The nutrition community should lobby for nutrition to be located as part of a food and nutrition goal. Alternatively, it could be located as part of the poverty or health goals. However, there is a lot of pressure for the poverty goal to be more geared towards job creation and this is not such an easy fit for stunting (the job consequences of stunting being large but 20 years delayed). Any single health goal is likely to be crowded. The Rome-based UN agencies that include the World Food Programme (WFP), the FAO and the International Fund for Agricultural Development (IFAD) represent a committed set of institutions to take nutrition forward in partnership with food security, and so nutrition is probably best housed here. But there is a key caveat: nutrition must not be subservient to food. Undernutrition is linked to but different from hunger, and they are both of equal importance.
- Nutrition-relevant indicators should be embedded across all goals. These indicators can be thought of as a ‘horizontal’ goal (see Table 2). This would represent a purposeful and joined-up set of dashboard indicators for nutrition.
- Nutrition relevant indicators should be thought of as ‘nutrition-specific’ and ‘nutrition-sensitive’. Nutrition-specific indicators operate at a proximate level (e.g. stunting, wasting and exclusive breastfeeding coverage). There needs to be five to six nutrition-specific indicators included in the final set of post-2015 indicators. The current MDG framework contains one nutrition-specific indicator (underweight) out of 48. In addition, nutrition-sensitive indicators relating to food security, women’s empowerment and water and sanitation need to be included and must serve both as indicators for these goals as well as for nutrition.
- The nutrition community quickly needs to identify its priorities for nutritionspecific and nutrition-sensitive indicators and how these should be embedded across the new goals. For instance, nutrition could play a strong role in any potential child goal, with its ‘getting a good start’ narrative given the focus on the first 1,000 days after conception. In this way, the current high commitment to nutrition can be locked in for the next generation.