Nutrition and the post-2015

Development Agenda

Meera Shekar, PhDLead Health and Nutrition Specialist

World Bank, Washington DC

Launch of the Global Nutrition Report

Guatemala, April 2015

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Where are we coming from - nutrition and the pre-2015

development agenda

The Millennium Declaration (2000): 8 Millennium

Development Goals

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• Underweight – prevalence of children under 5 who

are underweight

• Undernourishment – proportion of the population

below minimum level of dietary energy consumption

Nutrition buried in MDG1 on poverty and hunger

• MDGs1C: “Halve, between 1990 and 2015, the proportion of

people who suffer from hunger.”

Indicators:

MDGs and nutrition: an unfinished & incomplete agenda

Goal not reached

MDG agenda for nutrition is incomplete:

• Mostly health sector focus

• In accurate indicators & focus on quantity rather than quality of

• Not inclusive of multiple aspects and burdens of malnutrition

3Source: MDG Progress Report 2014

26 52 13 4 8 35

Insufficient

data

Seriously off target Moderately

off target

Insufficient

progress

Sufficient

progress

MGD met

Progress toward achieving the nutrition MDG (prevalence of undernourishment), by number of

countries:

Overlapping burdens of malnutrition: 20 countries with highest

absolute burden and 17 countries with highest prevalence

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Overlapping burdens of malnutrition: 20 countries with

highest absolute burden

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Iraq

Sri LankaSouthSudan

NigerMaliChad

MadagascarMozambique

Uganda

Myanmar

Vietnam

RussiaJapan

Uzbekistan

Thailand

Iran

Turkey

USABrazil

Myanmar

Mexico

Yemen

DRC

Kenya Ethiopia

Sudan

India ChinaPhilippines

Indonesia

Egypt

Tanzania

Bangladesh

Pakistan

Nigeria

Algeria

Ukraine

South AfricaSouth AfricaColombiaMoroccoSyriaANEMIA

WASTING

STUNTING

BREASTFEEDING

Post-2015 – Sustainable Development Goals (SDGs)

Oct. 2013 UN :adoption of a post-

2015 development agenda

September 2014 – UN Open

Working Group recommended 17

SGDs & 169 targets

SDGs will be finalized & adopted at

the UNGA September 2015

Indicators will be finalized by the UN

Statistical Committee by March 2016

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169 proposed targets

17 Sustainable Development Goals

(SDGs)

Up to 2 proposed indicators per targets

Nutrition and proposed SDGs

SDG 2: “End hunger, achieve food

security and improved nutrition, and

promote sustainable agriculture.”

Target 2.2: “By 2030 end all form of

malnutrition, including achieving, by

2025, the internationally agreed

targets on stunting and wasting in

children under 5 years of age, and

address the nutrition needs of

adolescent girls, pregnant and

lactating women, and older persons.”7

Nutrition mentioned explicitly (unlike MDGs)

Need to ensure that it is not limited to hunger and food quantity but also addresses

nutrition quality

WHA nutrition targets

Only 2 out of 6 WHA targets currently included

Nutrition and proposed SDGs (cont.)

3 Key recommendations for

revising SDG 2 and Target 2.2:

• Include all 6 WHA nutrition

targets

• Add dietary quality indicator–

Minimum Dietary Diversity for

Women (MDD-W): % of women

15-49 who consume at least 5 out

of 10 defined food groups.

• Measure of political

commitment – percentage of

overall national budget allocated

to nutrition.8

Area Recommended Indicator

Global WHA

Nutrition

Targets

Prevalence of stunting in

children <5yrs

Prevalence of wasting in

children <5yrs

% infants <6mo who are

exclusively breast fed

Percentage of women 15-

49 with anemia

Prevalence of overweight

in children <5yrs

% of infants born with low

birth weight

Dietary

Diversity

% women 15-49 who

consume at least 5 out of

10 defined food groups

Political

Commitment

% national budget

allocated to nutrition

WHA Nutrition Targets

Adopted at the 65th World Health Assembly in 2012

To be achieved by 2025

Current WHO proposal to extend the targets to 2030 to harmonize

with the SDGs 9

40% REDUCTION IN THE

NUMBER OF CHILDREN

UNDER-5 WHO ARE

STUNTED

50% REDUCTION

OF ANAEMIA IN WOMEN OF

REPRODUCTIVE AGE

30% REDUCTION IN

LOW BIRTH WEIGHT

NO INCREASE IN

CHILDHOOD VERWEIGHT

INCREASE THE RATE

OF EXCLUSIVE

BREASTFEEDING

IN THE FIRST 6 MONTHS UP TO

AT LEAST 50%

REDUCE AND MAINTAIN

CHILDHOOD WASTING

TO LESS THAN 5%

Informing discussion on nutrition and development:

SDGs and beyond

Key opportunities to inform the discussion:

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• Financing for Development conference, Addis Ababa,

July 2015 – placing nutrition at the center of the

development agenda

• Civil Society consultations – reinforcing the position of

nutrition

• UN General Assembly, September 2015 - adopting the

SDGs

• Global nutrition summit in Rio de Janeiro – securing

development funding for nutrition

Phase 1

Draft outputs

for:

Addis FfD

July 2015

Rio Nutrition

Summit

June 2016

Others

Phase 2

Phase 3(Potential)

Estimating the costs and financing required to meet the

WHA targets: 3 phases

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Stunting Breastfeeding

WastingAnemia

Low birth weight Overweight

Partnership:

Approach:

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Estimate

Costs and

potential for

impact

Estimate

current

financing

Estimate

resource

gaps

Identify

potential

future

financing

pathways

Estimate

impact on

nutrition

outcomes

under

different

scenarios

For scale-up

of evidence-

based

interventions

across all

targets

From all

sources:

• Domestic

• Donor

• Private

Subtract

available

financing from

costs

Estimate

under

different

financing

scenarios &

assumptions

Estimate

impact of

scale-up per

scenario

1 2 3 4 5

Flat-lining of

funds

Max.

effortWHA

targets

achieved

Slow

progressResource

Gap

Costs Available Financing for

Nutrition

Costing methodology

We will cost the highest possible impact that can be modelled using LiST (20-30% reduction in stunting, rather than 40%).

• At 90-100% scale up and/or at a more realistic level

• Estimate the impact of the scale-up on stunting using LiST

• Estimate the cost of the scale up

Overlay these impacts with secular trends in underlying determinants of stunting

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Maximum scale up of

interventions

Estimated impact on stunting

Cost of scale up

Financing and fiscal space analysis methodology

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Estimate baseline

financing for nutrition

Assess the

funding gap

Analyze future

financing pathways

Objectives

Understand baseline nutrition

financing by source:

• Domestic spending

• Donor spending

• Household

contributions

Understand nutrition specific &

sensitive financing contributions

Link stunting

cost estimates

with baseline

stunting

financing

estimates

Predict possible future

financing scenarios that

could close the gap &

achieve the desired impact

on stunting

1 2 3

Informing discussion on nutrition and development:

SDGs and beyond

Key opportunities to inform the discussion:

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• Financing for Development conference, Addis Ababa,

July 2015 – placing nutrition at the center of the

development agenda

• Civil Society consultations – reinforcing the position of

nutrition

• UN General Assembly, September 2015 - adopting the

SDGs

• Global nutrition summit in Rio de Janeiro – securing

development funding for nutrition

THANK YOU

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