Bangkok — The world's most comprehensive report on nutrition highlights the worrying prevalence and universality of malnutrition in all its forms. In its fifth edition, the Global Nutrition Report provides a concrete overview of progress made and highlights solutions from around the globe calling on all stakeholders to act now to address malnutrition.
The burden of malnutrition is unacceptably high.
Malnutrition is a universal issue that no country in the world can afford to overlook. A third of reproductive-age women are anaemic, while 39% of the world's adults are overweight or obese and each year around 20 million babies are born underweight.
Beyond health, slow progress on malnutrition is also impacting the social and economic development of countries. It is estimated that malnutrition in all its forms could cost society up to US$3.5 trillion per year, with overweight and obesity alone costing US$500 billion per year.
Corinna Hawkes, co-chair of the Report and Director of the Centre for Food Policy, said: "The figures call for immediate action. Malnutrition is responsible for more ill-health than any other cause. The health consequences of overweight and obesity contribute to an estimated four million deaths, while undernutrition explains around 45% of deaths among children under five. The uncomfortable question is not so much "why are things so bad?" but "why are things not better when we know so much more than before?"
Progress to date is simply not good enough.
Significant steps are being made to address malnutrition. Globally, stunting among children under five years of age has fallen from 32.6% in 2000 to 22.2% in 2017. There has been a slight decrease in underweight women since 2000, from 11.6% to 9.7% in 2016. Yet, while there has been progress, it has been slow and patchy.
The 2018 assessment of progress against nine targets reveals only 94 of 194 countries are on track for at least one of the nine nutrition targets assessed. This means that most countries are significantly off-track on meeting all nine targets:
No country is on course to meet all nine targets.
Only five countries are on track to meet four of the nine targets - which is the most any country is on track for.
No country is on track to achieve the adult obesity target for men or women, nor reach the anaemia target.
Only 26 countries are on track to reach the target for women's diabetes.
We are better equipped to end malnutrition.
The 2018 Global Nutrition Report highlights that solutions already exist but finds effective ideas are not being adopted at scale:
We now know more about what people eat, why it matters, and what needs to be done to improve diets. In Mexico, an evaluation of the sugar-sweetened beverage tax found that sales of targeted beverages fell by 9.7% across the population two years after the policy was implemented, compared with expected sales if it had not been.
New data is a game changer and can drive more effective action. Local-level data and action has been particularly effective. In 2012, Amsterdam faced an obesity crisis among young people. The city tracked childhood obesity in different districts and propelled the issue to the top of the agenda. In late 2012 ambitious targets were set. Actions are broken down by prevention (such as healthy urban design), cure (helping those already overweight) and facilitation (such as learning and research), and included: creating public drinking fountains, implementing restrictions on food advertising, and publishing guidance for healthy snacks in schools. Today, overweight and obesity prevalence in the city is levelling off.
We see examples of countries building multisectoral plans to deliver on their targets. In Tanzania a wide range of targets has been adopted - seven in all, including for stunting, anaemia and low birth weight. These targets form part of an ambitious five-year action plan to reduce multiple burdens of malnutrition. The plan was set up under the direct leadership of the Prime Minister's office to reduce all forms of malnutrition associated with both deficiency and excess/imbalances. Its broad goal is to scale up high-impact interventions among the most vulnerable people, including children under five years of age, adolescent girls and pregnant and lactating women. It does this by calling for action across sectors, from social protection to education and food.
Governments are showing commitment and stepping up to lead action. The government of China is facing the second-largest undernourished population, with overweight and obesity levels rising at alarming rates and diet-related non-communicable diseases (NCDs) such as diabetes on the up. To address this, it has developed two plans with the potential to transform malnutrition in China. Healthy China 2030 (2016), with the direct involvement of the President of China, underlines significant political will to enhance the health status of Chinese citizens. A year later the government released a new National Nutrition Plan (2017-2030), with a range of malnutrition targets including stunting, obesity, anaemia, breastfeeding and folic acid deficiency among vulnerable people. The emerging nutrition governance system deserves credit for the political and administrative commitment to food and nutrition security, demonstrating what institutional coordination can achieve.
The world is off track but the opportunity to end malnutrition has never been greater, nor has the duty to act.
To translate solutions into action, the report's authors urge critical steps in the following areas:
Breaking down existing silos to tackle malnutrition in all its forms;
Prioritizing and investing in data to identify key areas of action;
Scaling up and diversifying funding for nutrition programmes;
Immediately taking action on healthy diets by making healthy foods affordable across the globe;
Implementing more ambitious commitments that are designed for impact through SMART targets.
"The 2018 Global Nutrition Report offers forward-looking steps to strengthen the ability of global and national food systems to deliver nutritious, safe, affordable and sustainable diets for children," said Henrietta H Fore, Executive Director, UNICEF. "This paradigm shift - food systems that contribute to prevent malnutrition in all its forms - will be critical for children's growth and development, the growth of national economies, and the development of nations."
"While malnutrition is holding back human development everywhere, costing billions of dollars a year, we are now in a position to fight it. From policies such as sugar taxes, to new data that enables us to understand what people are eating and how we can best target interventions, the global community now has the recipes that work," said Jessica Fanzo, PhD, co-chair of the Report and Bloomberg Distinguished Associate Professor at Johns Hopkins University.
"The information in the Global Nutrition Report goes far beyond facts and figures. What is really behind these tables and graphs are stories of potential: the potential of more babies seeing their first birthdays, of children achieving their potential in school, and of adults leading healthy and productive lives - all on the foundation of good nutrition. The information collected, analysed and shared in the Global Nutrition Report is never an end in itself, but a means that allows us to save lives, change lives and ensure that nobody is left behind," added David Beasley, Executive Director, World Food Programme.
Notes to Editors
The report will be released in Bangkok, Thailand, on 29 November 2018 during the global event 'Accelerating the end of hunger and malnutrition', gathering decision-makers, researchers and practitioners from key organisations such as the Food and Agriculture Organization of the United Nations, the World Health Organisation, the European Union and UNICEF.
The Global Nutrition Report is the world's foremost publication on the status of malnutrition around the world. It acts as a stock-take on the world's nutrition - globally, regionally and country by country - and on efforts to improve it. It tracks progress on global nutrition targets, ranging from diet-related NCDs to maternal, infant and young child nutrition.
The 2018 Global Nutrition Report reviews existing processes, highlights progress in combating malnutrition, identifies challenges and proposes ways to solve them. Through this, the report guides action, builds accountability and sparks increased commitment to furthering the progress that can reduce malnutrition much faster.
It is researched, analysed and written by the chairs of an Independent Expert Group (IEG) of world-leading academics, researchers and government representatives. The IEG is consulted on, inputs into and reviews the report. A wider Stakeholder Group - drawn from government, donor, civil society, multilateral and private sector organisations - provides strategic leadership of the report.
It is backed and supported, among others, by the Bill & Melinda Gates Foundation, the Department for International Development (UK), USAID, Germany's Federal Ministry for Economic Cooperation and Development (BMZ), the Government of Canada, Irish Aid, The Eleanor Crook Foundation and the European Commission.