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The Nutrition Challenge

Additional investments in early childhood nutrition are crucial, and should be a high priority for donor and recipient governments, multilateral development organizations, and philanthropic foundations. The case for such spending is clear, and the payoffs will almost certainly be enormous.

EDINBURGH – It’s easy to think of starvation as a challenge that entered the rich world’s consciousness in the 1980s and was largely solved through charity rock concerts. True, the world has made huge progress in combating mass starvation over the past 30 years, largely as a result of improved agricultural practices. Yet, globally, food deprivation still claims a child’s life every three seconds.

A new report from the United Nations warns that the number of hungry people worldwide increased for a third consecutive year in 2018, and now exceeds 820 million. And some two billion people – over one-quarter of the world’s population – lack regular access to safe, nutritious, and sufficient food.

These quiet deaths and silent suffering don’t seize the world’s attention like past famines did. But they should. Although we have made progress against hunger, there is a powerful case to do even more. In particular, improving child nutrition is one of the most transformative investments that governments and donors can make. Research by the Copenhagen Consensus Center think tank shows that each dollar spent on nutrition in the first 1,000 days of a child’s life returns $45 to society by ensuring that he or she has a healthier and more prosperous future.

Such phenomenal returns explain why the US government launched the Feed the Future Initiative in 2010 and the current administration reauthorized it, and why the European Union pledged in 2013 to spend €3.5 billion ($3.9 billion) on nutrition in 2014-2020. It is vital that the United States and the EU maintain these efforts, especially after the upcoming changes at the European Commission, and it is important that other countries step up.

One of the most frequently used nutrition indicators is stunting – basically, whether a child is much shorter than the norm for its age. Unlike being underweight, which mostly indicates short-term malnutrition, being shorter shows that a child has been undernourished for a long time.

Although global stunting has almost halved since 1990, when four out of every ten children were affected, the effects of stunting remain insidious. Chronic undernutrition in children can lead to diminished cognitive and physical development, lower productive capacity, poor health, and an increased risk of chronic degenerative diseases such as diabetes.

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Malnutrition also has an extensive impact on society, with some estimates suggesting it could cost the global economy over $2 trillion per year. In fact, malnutrition continues to be one of the main barriers preventing children, communities, and countries from realizing their full potential.

That’s why, while adequate child nutrition reduces the risk of disease and death, its biggest long-term benefit is perhaps the least recognized: its positive impact on cognitive development. Well-nourished children learn more in school and are much more likely to become highly productive adults. They therefore earn higher wages, which allows them to feed, protect, and educate their own children better, accelerating their country’s development in the process.

This effect has been clearly demonstrated by the world’s longest-running nutrition study, which began in Guatemala in 1969. One community was provided with continuous access to a micronutrient and protein supplement called atole. In addition, health workers visited mothers during pregnancy and provided free medical services. Another community nearby had the same program, except that the micronutrient supplement was provided without protein.

For the children who received atole, the risk of stunting fell by more than one-half. They stayed in school longer, learned more, scored higher on cognitive tests in adulthood, and were more likely to be employed in higher-paying, skilled jobs. Astonishingly, follow-up studies of the adults found that the average income of those who had avoided stunting was 60% higher.

Today, giving one child good nutrition for their first two years costs about $100. This investment will help only a minority of children avoid stunting: most, after all, will avoid it even without the additional nutrition. But because the children who do benefit are helped so much, it is as if the lifetime incomes of each child increased on average by the equivalent of a one-time amount of $4,500 today.

That is how economists show that every dollar spent on child nutrition will create $45 of benefits for society, making it an extremely valuable investment. Moreover, the Guatemala study revealed other benefits that cannot easily be valued: children who avoided stunting were happier and subsequently had more stable marriages, and women had fewer pregnancies and a smaller risk of miscarriages and stillbirths.

The next 12 months will be critical to keeping the spotlight on nutrition and mobilizing the resources needed to make global targets reachable. The World Bank’s Investment Framework for Nutrition estimates that $70 billion is needed over ten years to achieve key World Health Organization targets on undernutrition by 2025. But progress has not been rapid enough to meet the globally agreed nutrition targets in the UN Sustainable Development Goals – in particular, ending hunger and all forms of malnutrition by 2030.

Additional investments in early childhood nutrition are crucial, and should be a high priority for donor and recipient governments, multilateral development organizations, and philanthropic foundations. The case for such spending is clear, and the payoffs will almost certainly be enormous.

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