Ending malnutrition by 2020: an agenda for change in the millennium

During the 1990s, major international commitments were made to reduce malnutrition. There was dramatic progress in some areas, but more still needs to be done. This special supplement to the Food and Nutrition bulletin of the United Nations University reviews progress in combating malnutrition to date. It sets out a vision and goals for the future, and outlines the commission’s agenda for change.

The document discusses the impact of poor nutrition throughout the life cycle, and examines societal issues that must be addressed and the challenges for food production, agriculture and the environment. The key issues are condensed in an executive summary. The authors describe the major nutritional challenges that have been identified. Reviewing recent progress and setbacks in overcoming these, they highlight the following elements of the current situation:

• Dramatic progress has been made in some areas, particularly the reduction of iodine deficiency disorders and clinical vitamin A deficiency. The proportion of underweight and stunted children has fallen, though the absolute numbers continue to rise
• Lessons learned from countries that have achieved significant improvements show that there is no single recipe for success. Policies and strategies have differed, but what is required is purposeful action and political commitment
• The social, economic and personal costs of malnutrition are huge. Investing in nutrition makes good economic sense and yields numerous other benefits by improving the physical and intellectual capacity of individuals
• The economic crises of the late 1990s in Asia and Latin America may threaten much if not all of the progress made there earlier in that decade. Life expectancy has also fallen in central and eastern Europe, following the sudden changes in government and national financial management.

To accelerate progress, poor nutrition must be tackled throughout the whole life-cycle from birth to adulthood. Action is needed to address social issues and attitudes to food, as well as to increase food production and manage the associated environmental pressures. As part of their agenda for change, the report’s authors outline the following major strategic tasks:

• An assessment of national policies and plans in the light of new perspectives is required. There is also a need for accelerated action, along with a new UN process to integrate programmes into a cohesive effort
• A new national mechanism should be established for developing coherent policies on diet and physical activity. These National Nutrition Councils should be recognised by the donor community as the focus of international linkages and support
• The elimination of malnutrition must become a major focus of economic and social policy in developing and developed countries
• Donor governments should offer to establish country-by-country agreements with interested governments. These agreements should indicate targets and strategies for accelerated action and the resources required
• The World Bank and IMF should be requested to issue a policy document on maintaining progress toward nutrition goals in countries undergoing structural adjustment programmes and debt repayment
• Support is needed to improve national statistical systems for collection and analysis of data on nutritional status and trends
• Regional task forces should be established to consider outreach and social mobilisation methods to encourage accelerated actions to improve nutrition.