Why have donors committed so few direct investments to eliminate child undernutrition?

The mandate of most international donors is to reduce poverty, suffering and inequity. Addressing child undernutrition falls within this. However, current donor investment to directly address undernutrition is estimated to be well under half of the resources required.

Most countries have committed to specific international goals to reduce undernutrition, particularly at the World Summit for Children in 1990. However, recent articles in The Lancet and the Food and Nutrition Bulletin show that an alarming level of undernutrition still exists.

The Lancet estimates that donor spending on programmes to reduce undernutrition is US$250-300 million per year. Even under a 'best case' scenario, in which this is perfectly targeted, this is just US$2 per child (aged 0-5 years) per year; effective nutrition programmes require US$5-10 per child.

Increasing donor investment

There are several constraints to increasing investment. These include:

• the lack of effective coordination amongst the key international and state organisations responsible for reducing undernutrition
• gaps in evidence about the impacts of nutrition interventions, including rigorous evaluation of current programmes
• the daunting challenge of insufficient trained people to design, implement and evaluate programmes.

Donor resources are required to address all of these. International nutrition organisations need to agree with donors on the priorities, and the cost and time-frame for addressing them. If achieved, this will be a massive step forward in stimulating the change in investment that is required.

New initiatives

Encouragingly, some new initiatives to increase investment and improve coordination are already underway. Several international agencies are working together to develop a Ten Year Strategy to reduce vitamin and mineral deficiencies. These include the United Nations Children's Fund (UNICEF), the Academy for Educational Development and the Global Alliance for Improved Nutrition (GAIN). They have completed a technical situation analysis (published in the Food and Nutrition Bulletin) and formed working groups to better coordinate their actions, including monitoring and evaluation activities.

Furthermore:

• The Lancet articles, combined with the increasing global awareness of rising food prices, will hopefully lead to an internal review of food and nutrition investment portfolios among key donors.
• GAIN is helping to form national multi-sectoral alliances to better plan and coordinate food fortification programmes in several countries, including Mali, Ghana and Uganda.
• These alliances bring together public, private and civil society organisations, and could be broadened to include other organisations and programmes that seek to reduce undernutrition.

Barbara Macdonald
Performance Measurement and Research, Global Alliance for Improved Nutrition (GAIN), 37-39 Rue de Vermont, Geneva, Switzerland
bmacdonald@gaingeneva.org
www.gainhealth.org