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INTRODUCTION T
HE CHALLENGE OF IMPROVING NUTRITIONAL STATUS IS A QUINTESSENTIALLY 21ST-CENTURY ENDEAVOR. IT IS A CHALLENGE THAT RESONATES THE WORLD OVER: nearly every country in the world experiences a level of malnutrition that constitutes a serious public health risk. Between 2 and 3 billion people are malnourished—they experience some form of undernutrition, are overweight or obese, or have some sort of micronutrient deficiency.1
The faces of poor nutrition are many: from children living under famine conditions who appear to be made of skin and bone, to adults who have trouble breathing owing to obesity, to infants who do not live to see their first birthday as a result of a combination of poor diets, poor infant feeding practices, and exposure to infectious disease.
It is a challenge that requires effective action across a number of sectors and areas (food, health, social welfare, education, water, sanitation, and women) and across a number of actors (government, civil society, business, research, and international development partners). Strong alliances for action are much more effective than silver bullets, and the multiple causes of malnutrition often represent multiple opportunities to improve nutrition in a sustainable way.
Lastly, poor nutrition is a challenge that casts a long shadow: its consequences flow
throughout the life cycle and cascade down the generations affecting everyone— especially children, adolescent girls, and women—and include mortality, infection, cognitive impairment, lower work productivity, early onset and higher risk of noncom- municable diseases (NCDs), stigma, and depression.
KEY POINTS 2
1. The challenge of improving nutrition shares many characteristics with other 21st-century develop- ment challenges: global prevalence, long-term consequences, and the need to work through broad alliances of sectors and actors.
2. Improvements in nutrition status will be central to the sustainable development agenda: nutrition improvements are inherently sustaining throughout the life cycle and across generations, and they contribute directly to most of the proposed Sustainable Development Goals.
3. The features of nutrition outcomes and actions—their short- and long-term effects, the invisibility of some consequences of malnutrition, and the need for alliances—make the process of identifying commitments, and then monitoring them for accountability, more complex than for many other development issues.
4. This report is one contribution to strengthening accountability in nutrition.
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