PANEL 2.1 NUTRITION AND THE SUSTAINABLE DEVELOPMENT GOALS— NO ROOM FOR COMPLACENCY
MICHAEL ANDERSON A
s discussions continue on the design of the forthcoming global Sustainable Development Goals (SDGs), momentum is growing for new nutrition goals. In 2012, the full World Health Assembly (WHA)—the deci- sionmaking body of the World Health Organi- zation—set a strong precedent by adopting six nutrition targets known as Global Targets 2025 (WHO 2012b). Also in 2012, the United Nations secretary-general launched the Zero Hunger Challenge (United Nations 2014), which includes one goal on stunting. In 2013 the High-Level Panel on the Post-2015 Devel- opment Agenda (2013) proposed an illustra- tive goal on food security and good nutrition, including targets on food security, stunting, wasting, and anemia. And three pan-African regional bodies endorsed a goal including “adequate nutrition for all” (UNECA 2013). These are positive signs, but much could change before the UN member states agree
on final SDGs in September 2015. Because the SDGs will not be legally binding, their power will derive mainly from their ability to inspire, excite, and guide. To be effective, the goals will have to be simple, clear, and compelling, and they will have to lead to action. Vague aspira- tions or too much technical detail will lose the audience and dampen momentum. This pres- ents a challenge for nutrition: terms like “stunt- ing” and “wasting” are not well understood outside the nutrition and health community, yet these terms are worth keeping because of their specificity and analytical power. It will be up to the nutrition community to explain them in simple and compelling terms. Another risk is that nutrition goals may get lost in a long list of wide-rang- ing aspirations. In July 2014, the UN Open Working Group recommended 17 goals and 169 targets, including a wide range of tar- gets on sustainable food production. The
recommendations contained only one pro- vision on malnutrition that made reference to two of the WHA targets (on stunting and wasting in children younger than five years old). Arguably, this is not a bad outcome as long as the world pays attention to the details of the WHA targets.
A related risk is that the SDGs may reduce good nutrition to a matter of cutting hunger, particularly if participants in the September 2015 summit are looking for goals with max- imum political appeal. Hunger is understood everywhere. Unfortunately, the idea that nutri- tion is purely a matter of access to enough food remains one of the most stubborn myths impeding good policy among political leaders. Instead, nutrition should be seen as requir- ing the right nutrients at the right time, along with strengthened health care and social pro- tection, especially during pregnancy and the first two years of life.
should the 2030 targets be an extrapolation of the 2025 targets? In other words, has any new information come to light since 2012 to challenge our sense of the rate of progress?
We argue that several factors should make everyone more ambitious about meeting and exceeding some of the WHA targets by 2025 and therefore more ambitious about the 2030 SDG targets.
First, the Government of India has produced a new national survey on children. WHO and UNICEF have not yet reviewed the survey’s data and methodologies, and the survey results thus do not yet appear in the WHO’s Global Database on Child Growth
TABLE 2.3 WORLD HEALTH ASSEMBLY NUTRITION TARGETS WHA target
40% reduction in the number of children under five who are stunted
and Malnutrition, but if the finalized rates of undernutrition are close to the preliminary reported rates, they should make us more optimistic about our ability to meet the global WHA goals (Panel 2.2).
Second, there is a new statewide survey from Maharashtra in India (Haddad et al. 2014). In the Maharashtra case study (Panel 2.3), it took only seven years to reduce child stunting by one-third, from 36.5 to 24.0 percent, for an annual average rate of reduction of 5.8 percent. Stunting declines resulted from a combination of nutrition-specific interventions, improved access to food and education, and reductions in poverty and fertility.
Baseline year(s) 2012
50% reduction of anemia in women of reproductive age (pregnant and nonpregnant) 2011 30% reduction in low birth weight No increase in childhood overweight
2012
2008–2012 2012
Increase the rate of exclusive breastfeeding in the first six months up to at least 50% 2008–2012 Reduce and maintain childhood wasting to less than 5%
Source: WHO (2014a).
Baseline status 162 million 29% 15% 7%
38% 8%
Target for 2025 ~100 million 15% 10% 7%
50% <5%
ACTIONS & ACCOUNTABILITY TO ACCELERATE THE WORLD’S PROGRESS ON NUTRITION
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