View
5.044
Download
0
Embed Size (px)
Citation preview
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
Want “Designer” Babies? Invest in Nutrition!
Thank You