The 2030 Covenant: Use action to influence and eliminate malnutrition

Among the many challenges facing the international community today, the problem of malnutrition is particularly serious: one third of the world's population is malnourished
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There are many different manifestations of malnutrition: poor growth and development in children; individual weight loss or susceptibility to infection; excessive obesity or high blood sugar, high blood pressure, high blood fat or high cholesterol; lack of important vitamins or minerals
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For the moment, malnutrition and unhealthy diet are the biggest factors contributing to the global burden of disease: all countries are facing severe public health challenges caused by malnutrition
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In Africa and Asia, the annual economic loss caused by malnutrition is equivalent to 11% of the gross domestic product (GDP), and every US dollar invested in preventing malnutrition can bring a return on investment of US$16
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Although countries around the world have reached a consensus on nutrition goals, and some progress has been made in recent years, the world is not yet on the right track to achieve these goals
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This third comprehensive assessment of the world’s nutritional status points the way for reversing this trend and eliminating all forms of malnutrition by 2030
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In the past ten years, the world has maintained a steady development momentum in improving nutrition: In 2012, the World Health Assembly passed the "2025 Global Maternal, Infant and Young Child Nutrition Target"
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The following year, the World Health Assembly continued to adopt non-communicable disease targets including nutrition-related non-communicable diseases
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In the same year, the first "nutrition for growth" (N4G) summit raised a total of US$23 billion in pledged donations to improve nutrition
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With the second International Conference on Nutrition (ICN2) held in 2014 and the resolution of the “2016-2025 United Nations Decade of Action on Nutrition” passed recently, more and more people are beginning to realize the importance of solving all forms of malnutrition
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In 2015, the goal of "eliminating all forms of malnutrition" was solemnly incorporated into the United Nations Sustainable Development Goals, requiring the world to think about and take actions on malnutrition in different ways, focusing on all aspects of malnutrition, and striving to reach 2030 Eliminate all forms of malnutrition for all mankind
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2016 brought a major opportunity to translate this commitment into action
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These opportunities include: countries have adopted national goals related to the achievement of the Sustainable Development Goals; the continuous advancement and deepening of the "nutrition for growth" process; and Japan's increasing leadership in promoting nutrition safety for the 2020 Tokyo Olympics and Paralympics.
Role
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　　"Global Nutrition Report" is the only independent and comprehensive annual assessment report on the world's nutritional status
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It is also a collaborative project carried out by many partners, reflecting our achievements and deficiencies in achieving intergovernmental nutrition goals
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The report also pointed out the progress made at the global level and made recommendations for accelerating this progress
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The Global Nutrition Report aims to be a beacon, providing countries with successful examples and indicating the direction of action
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The theme of this year's report is "Make and measure commitments in line with SMART principles and formulate actions to achieve the goal of eliminating all forms of malnutrition by 2030"
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　　Main findings　　1.
Malnutrition causes a series of personal and social problems, but it also brings opportunities
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　　Malnutrition and unhealthy eating habits are the primary factors contributing to the global burden of disease
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We already know that wasting, child stunting, and micronutrient deficiencies cause an average of 11% of GDP losses in Asia and Africa each year, which is higher than the losses during the 2008-2010 financial crisis
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The report provides new data on the social and personal costs of malnutrition
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For example, in the United States, when one person in the family suffers from obesity, the additional medical expenses that the family has to pay each year are equivalent to 8% of its annual income
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In China, people with diabetes lose 16.
3% of their income every year due to illness
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These data mean that whether you are directly affected by malnutrition or not, malnutrition has become a heavy burden for all mankind
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But at the same time, solving the problem of malnutrition can also bring huge opportunities to improve human well-being and promote economic development
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This report cites many examples to illustrate how some countries have successfully used these opportunities to improve people's livelihood and social health by addressing malnutrition
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　　2.
The world is not on track to achieve nutrition goals, but hope still exists
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　　If we continue to remain indifferent to the status quo, the global nutrition goals adopted by the World Health Assembly will not be achieved
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However, this view obscures significant differences and some surprises: Many countries are steadily achieving goals related to stunted growth, wasting and overweight, and exclusive breastfeeding for children under 5 years of age
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However, almost all countries are off track in addressing female anemia and adult overweight, diabetes and obesity
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Obesity and overweight are on the rise in almost every country and region, and they have now become a huge global challenge
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The number of overweight children under 5 years of age is gradually approaching the number of wasting children
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In addition, regional differences cannot be ignored: except for Africa and Oceania, the number of stunted children under 5 years of age is declining in every region, while the number of overweight children under 5 years of age in Asia is increasing the fastest
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Faced with these unoptimistic data, we still have a 　　reason to have hope : With a little adjustment, many countries can be on the right track to achieve global nutrition goals
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This report
provides an overview of these opportunities
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　　3.
Nutrition is at the core of the Sustainable Development Goals
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　　Among the 17 sustainable development goals, at least 12 goals contain indicators that are highly relevant to nutrition, which reflects the core role of nutrition in sustainable development
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Improving nutrition is a prerequisite for progress in health, education, employment, women's empowerment, poverty reduction and inequality reduction
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Conversely, poverty and inequality, drinking water, sanitation and personal hygiene, education, food systems, climate change, social security, and agriculture all have important effects on nutritional status
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The report shows that women’s rights and status are closely related to nutritional status: mothers under 18 are more likely to have children with developmental delays; and if mothers have secondary education, the children are less likely to have developmental delays
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Therefore, it is particularly important to incorporate nutrition goals into the development and social sectors.
Many governments spend more than 30% of the total budget in these areas
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At the same time, it is also important to measure the nutritional impact of expenditures in these sectors
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　　4.
The current capital investment cannot meet the demand
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　　In view of the severity of the malnutrition problem, the current funding for solving the problem of malnutrition is too low
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The 24 low- and middle-income countries allocate only 2.
1% of their expenditures to reduce malnutrition, while their expenditures on agriculture, education, health, and social security exceed 30%
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Although funding for measures against malnutrition is increasing in other development and social sectors, funding for nutrition-specific interventions has stagnated at US$1 billion
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The investment in nutrition-related non-communicable diseases (NCDs) is also obviously insufficient
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At present, we do not know the amount of money allocated by countries to tackle nutrition-related noncommunicable diseases
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In 2014, all countries spent US$611 million on various types of non-communicable diseases, which is less than 2% of their overall medical expenditures
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Although nearly half of the deaths and disability in low- and middle-income countries are caused by nutrition-related noncommunicable diseases, the new data reported shows that in 2014, donors allocated only the amount of nutrition-related noncommunicable diseases 50 million dollars
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　　5.
SMART commitments and goals are particularly important
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　　The report found that donors and governments that prioritize nutrition are spending more on nutrition
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Companies that have more commitments in nutrition are better able to provide products, marketing strategies and labels that improve nutrition
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Countries that set targets for malnutrition also generally reduce child stunting more quickly
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Nevertheless, most nutrition plans do not include complete global nutrition goals, and when countries set goals, only two-thirds of them meet SMART principles
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In addition, only 30% of countries have targets for reducing obesity, diabetes, and salt intake in their national noncommunicable disease programs
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In terms of "nutrition for growth" (N4G), only 29% of the commitments made in 2013 were in line with SMART principles, and most of the commitments did not specify what types of malnutrition they hope to solve
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　　6.
We must turn words into actions
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　　The report emphasized the need to strengthen the implementation of policies and plans
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The core policies and plans to promote breastfeeding are seriously behind: only 36% of countries have implemented all or most of the provisions of the International Code of Marketing of Breast-milk Substitutes
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Regarding the regulation of the marketing of food and non-alcoholic beverages to children, no country has adopted a comprehensive plan
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Two-thirds of the countries are implementing the three core recommendations of the World Health Organization to promote healthy eating (reduction of salt intake, reduction of trans fat and saturated fat intake, and implementation of WHO’s promotion of food and non-alcoholic beverages to children).
Recommendation) No progress
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Similarly, the promotion of direct programmes against malnutrition has been slow and unequal
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The coordination mechanism of inter-departmental actions is the key to success, but it must be provided with high-level support and human and financial resources
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　　7.
Current data and knowledge are not enough to maximize the use of investment
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　　Report calls for a revolution in nutrition data
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The lack of data makes it impossible for us to determine the real progress at the global and national levels and draw lessons from it
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This also conceals the inequality between countries, making it more difficult for governments to understand the truth, and it is difficult for governments to be fully accountable
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This report recommends disaggregating data to better understand areas with malnutrition: In an analysis of more than 50 countries, the sub-national regions with the highest rates of stunting have the lowest rates of stunting.
3 times as high as the level of the region
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In 13 countries, the rate of stunting in the wealthiest quintile exceeds 20%, which breaks the old notion that high income is equal to good nutrition
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We face a serious data gap, which means that we lack the following relevant data: investment in nutrition-sensitive actions and actions to tackle obesity and nutrition-related non-communicable diseases; the coverage and impact of programs to address all forms of malnutrition; As a result, the nutritional status of the 60 million people displaced; and malnutrition rates and trends in fragile countries
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Finally, we also face a knowledge gap that makes it difficult for us to understand the reasons for success or stagnation, as well as the potential drivers of obesity and non-communicable diseases
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　　Call for action　　1.
Make political choices to eliminate all forms of malnutrition
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　　We are not yet on the right track to achieve our nutrition goals
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For example, the incidence of anemia is falling very slowly.
At the current rate, we will not be able to achieve this global goal until 2130, not 2030
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Obesity and overweight have not fallen, but are on the rise, putting global nutrition security at risk
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But this not optimistic situation can be changed: under the impetus of the government and other organizations and individuals that have made and abided by their commitments, Brazil, Peru, Ghana, and the Indian state of Maharashtra have significantly reduced malnutrition
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Fundamentally speaking, eliminating malnutrition is a political choice that government leaders, donors, social groups, and international, domestic and regional companies need to make
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Making a commitment to improve nutrition in line with SMART principles will help countries around the world get on the right track
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　　2.
Increase investment and optimize distribution
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　　Investing in the elimination of malnutrition is one of the most cost-effective measures that governments can take: investing 1 US dollar in an effective nutrition program can bring benefits worth 16 US dollars
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In order to achieve important global nutrition milestones, governments and donors need to triple their investment in nutrition in the next ten years
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Just like the areas facing malnutrition in the Indian state of Maharashtra, it is achievable to rapidly increase investment and then improve nutrition
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At the same time, governments, social groups, donors, and companies need to take more actions to ensure that different sectors (agriculture, education, food system, sanitation system, social security, drinking water, sanitation, and personal hygiene) allocate more resources for Eliminate all forms of malnutrition
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We need more investment to improve our ability to solve obesity, diabetes and other nutrition-related non-communicable diseases
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And we need to start to view nutrition investment as a means to promote economic growth, rather than view nutrition improvement as the result of economic growth
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　　3.
Collect correct data to maximize the use of investment
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　　Data gaps are a major obstacle to progress in nutrition globally
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Each country has a different nutritional status, and each country should collect the necessary national and regional data in order to understand its own unique nutritional problems
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In the spirit of the Sustainable Development Goals, governments, donors, companies and social groups should track and regularly report their efforts to eliminate all forms of malnutrition (including stunting, weight loss, anemia, exclusive breastfeeding, obesity and non-communicable diseases).
Disease) investment and impact
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　　4.
Invest in implementing effective solutions and identifying new solutions
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　　We currently have enough experience, data and evidence to take action to improve nutritional status
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Successful examples from Brazil, Ghana, Peru and other countries are instructive to other countries
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We understand which interventions can most effectively address malnutrition
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We know which public policies are most likely to effectively reduce all forms of malnutrition
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We have also realized that it is particularly important to work with citizens and social groups and establish cross-sectoral governance mechanisms
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At the same time, governments, funders, and researchers should work together to close the knowledge gap that hinders action: for example, if we lack understanding of the underlying drivers of weight loss, exclusive breastfeeding, obesity, and overweight, we cannot Mobilize resources from departments other than the health department to prevent
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Knowing more about the reasons why some countries can overcome obstacles and achieve high coverage nutrition programs while others cannot, will help overcome bottlenecks
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At the same time, identifying new and more cost-effective ways to use existing regional data and collect new data will help ensure that countries move forward together in the era of the Sustainable Development Goals
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　　5.
Solve all forms of malnutrition
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　　Governments, enterprises, social groups and individuals need to solve all forms of malnutrition
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This means that the governments of low- and middle-income countries must strive to significantly reduce malnutrition before the situation of obesity and nutrition-related noncommunicable diseases becomes more severe
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These countries must incorporate the prevention and control of diabetes and obesity into their nutrition programs and implement policies and interventions that can address malnutrition
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This means that OECD countries must learn from the successful experience of other countries and improve their strategies to deal with obesity and non-communicable diseases
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Donors must recognize the threat that nutrition-related noncommunicable diseases and obesity pose to global nutrition
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This also means that stakeholders need to identify and implement solutions that can solve more than one malnutrition problem at the same time in order to improve the efficiency of investment and policy.

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At the same time, all stakeholders need to work hand in hand to actively respond to the "new normal" of solving all forms of malnutrition, because this is a common challenge faced by nearly half of the countries in the world
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　　Original download: 2030 Covenant: Use action to influence and eliminate malnutrition