By Jessica Fanzo and Paul Pronyk
As the world focuses on the ten-year progress made towards achieving the Millennium Development Goals (MDGs) at the MDG Summit in New York City, it is with great hope that nutrition is front and center in the discussions and decision making at the luminous building that sits on the East River at 42nd Street.
One of the targets of the first MDG is to reduce the proportion of people who suffer from hunger by half between 1990 and 2015, with hunger measured as the proportion of the population who are undernourished and the prevalence of children under five who are underweight.
So where does the world stand so far? Unfortunately, many countries have not yet reached this target with some, far off. Some of the progress made has been eroded by the 2007-2008 global food price and economic crises, and potentially more so with the recent Russian wheat crisis. As we enter the final five years to achieve the MDGs, we look upon one of the greatest challenges of our time with one billion people hungry, 129 million and 195 million children underweight and stunted respectively and more than 2 billion people deficient in micronutrients.
Of the 117 countries analyzed by UNICEF in late 2009, 63 are on track to meet the MDG1 target based on the proportion of children underweight. Three years ago, only 46 were on track, which holds some promise of improvements for certain countries. There are standouts or “trailblazers” with many in Southeast Asia and some in Asia. Of the 20 countries classified as not making any progress at all towards the MDG1, most are in Africa, and it is very clear that those falling behind are countries devastated by conflict.
But not all is lost. Recent calls for greater attention to undernutrition highlight the importance of integrating technical interventions with broader approaches to address underlying causes of food insecurity – incorporating perspectives from agriculture, health water and sanitation, infrastructure, gender and education – with a huge focus on smallholder farmers. Such initiatives as the US Government’s Feed the Future and One Thousand Days Initiatives, the UN’s High Level Task Force on Food Security and the new Scaling Up Nutrition (SUN) have put nutrition security back on the map and will be highly visible at this MDG Summit.
We hope that the momentum coming from this Summit will provide the necessary political incentives to prioritize nutrition security. However, to do this, rapid changes need to be made. We need a change towards dedicated policy and visible leadership at the country level with firm nutrition policies within national strategies. There is plenty of evidence to suggest in the absence of clear policy, rapid gains are much more limited. With that leadership comes adequate financing. Many governments under invest in programs and efforts to reduce undernutrition, and fail to provide the minimal and essential domestic public goods and investments in agriculture and health needed for sustained growth. In countries that cannot afford to provide these goods, international development assistance and food aid will remain an indispensible, temporary supplement. Taking steps to redress gaps in budgetary allocations in line with locally relevant priority areas will be essential if gains in reducing undernutrition are to be achieved. We need a change in measuring progress that is accurate and timely. It is imperative that partnerships be developed or continued to support nationally-led, monitoring systems to measure, feedback and appropriately hone and refine program activities. Building this capacity should be the central goal of both national government and donor-funded activities and should be done at the beginning of policy crafting and implementation. This is especially important in high-risk settings, among vulnerable groups, or to assess the effectiveness of programmatic innovations. Lastly, we must support the need for a comprehensive nutrition response to be firmly embedded within the wider MDGs agenda. Durable gains will hinge on steps to reduce poverty, improve access to education, empower women and girls, and facilitate access to basic infrastructure including safe water and sanitation, energy, transport, and communication – all root causes of undernutrition. Working on multiple fronts simultaneously has the potential to catalyze gains that extend beyond those achieved through sector specific programs working in isolation.
Through energetic and engaged national leadership and with the support of dynamic international partnerships, rapid progress in reducing levels of undernutrition by 50% by 2015 is attainable. Accelerating progress towards these targets is less about the development of novel innovations and new technologies and more about putting what is already known into practice. Success will hinge on linking clear policies with effective delivery systems for an evidence-based and contextually relevant package of interventions that can rapidly be taken to scale. Persistent undernutrition remains an inexcusable unfinished agenda and successfully closing the few remaining gaps is a pre-condition for wider global progress towards achieving the MDGs.
Jessica Fanzo is a Senior Scientist of Nutrition at Bioversity International in Rome Italy.
Dr. Paul Pronyk is Monitoring and Evaluation Coordinator for the Millennium Villages Project.