2020 Global Nutrition Report Action on equity to end malnutrition 1 st July 2020 UNSCN | FAO | 2020 GNR Online Event Professor Renata Micha, RD PhD FAHA Co-Chair, Independent Expert Group of the Global Nutrition Report
About the Global Nutrition Report
About the Global Nutrition Report The world’s leading independent assessment of the state of global nutrition The Global Nutrition Report was conceived following the first Nutrition for Growth (N4G) Summit in 2013 as a tool to track stakeholders’ commitments and inspire action. Its vision is A world free from malnutrition in all its forms. Its mission is To drive greater action to end malnutrition in all its forms. 2020 Global Nutrition Report
Nutrition Accountability Framework The Global Nutrition Report as a key accountability mechanism Stakeholders Accountability Priority setting Data Reporting Advocacy Governments collection Businesses GNR Data storage Civil society Philanthropic Data organisations analysis
Covid-19 and the 2020 Global Nutrition Report
The 2020 GNR in the context of Covid-19 Urgent need for equitable, resilient and sustainable food and health systems The way forward Covid-19 does not treat us equally ► Coordination Covid-19 exposes the vulnerability of our food systems ► Financing Covid-19 exposes ► Accountability deadly healthcare disparities 2020 Global Nutrition Report
Why action on equity to end malnutrition?
Nutrition inequity: our defining challenge Injustices in food and health systems hold people back from healthy diets and lives Social determinants are drivers of inequity… … that can lead to inequalities in nutrition outcomes Basic Underlying determinants determinants Globally, 1 in 9 Globally, 1 in 3 people is hungry people is overweight Socioeconomic and or undernourished or obese Everyday political context circumstances and norms Human capital or potential Environments Social position Processes of unfairness, injustice and social exclusion start at the basic level and extend to the underlying level
Nutrition equity: our defining opportunity Healthy diets and quality nutrition care are not simply a matter of personal choices Food systems and health systems need to be transformed Fully integrate nutrition in Address inequities in health systems and make food systems and make nutrition care – preventive healthy, sustainable food the and curative – universally most accessible and available affordable choice for all 2020 Global Nutrition Report
Who is most affected?
The state of global nutrition Progress towards global nutrition targets is too slow and deeply unfair Maternal, infant and young child nutrition targets Anaemia Exclusive Low birth breastfeeding weight In 2016, anaemia affected 613.2 In 2018 , 42.2% The latest estimate million women of of infants 0 – 5 (2015) is that there reproductive age, months were are around 20.5 35.3 million of whom exclusively million children with SOME SOME OFF COURSE were pregnant. breastfed. low birth weight. PROGRESS PROGRESS Childhood Childhood Childhood stunting wasting overweight In 2018, 149.0 In 2018, 7.3% In 2018, 5.9% million children of children were of children were were stunted. wasted, equivalent overweight, to 49.5 million equivalent to 40.1 OFF COURSE OFF COURSE OFF COURSE children . million children . 2020 Global Nutrition Report
The state of global nutrition Global patterns hide significant inequalities between and within countries Diet-related noncommunicable disease (NCD) targets Salt Raised blood Adult Adult intake pressure obesity diabetes In 2017, the global In 2015, 597.4 million In 2016, 284.1 million men In 2014, 217.8 million mean salt intake men and 529.2 million and 393.5 million women men and 204.4 million were obese – 677.6 was 5.6 g per day . women had raised blood women lived with pressure – 1.13 billion diabetes – 422.1 million adults in total . adults in total. million adults in total. OFF COURSE OFF COURSE OFF COURSE OFF COURSE 2020 Global Nutrition Report
The double burden of malnutrition Underweight mainly affects children, while overweight and obesity are rising across all ages Children and adolescents (5 – 19 years) Adults (18+ years) Underweight Overweight Underweight Overweight 39.2% 37.0% 40% 31.6% 31.7% 38.5% 30% Prevalence 19.2% 29.6% 29.7% 20% 25.9% 11.5% 10.3% 9.4% 17.5% 10% 11.1% 10.3% 8.6% 0% 2000 2004 2008 2012 2016 2000 2004 2008 2012 2016 2000 2004 2008 2012 2016 2000 2004 2008 2012 2016 Male Female 2020 Global Nutrition Report
Inequalities within countries and populations Vulnerable and poorest groups are often the most affected 2020 Global Nutrition Report
How can we make our health systems more equitable?
Leadership and governance are central Countries must be prepared to fight both sides of malnutrition at the same time Percentage of countries with actions related to 72.0% 72.0% global nutrition targets 70% in health sector plans 66.7% 66.7% 60.0% 60.0% 60% 56.3% 56.3% 55.6% 55.6% 55.6% 55.6% 53.8% 53.8% 52.0% 52.0% Low-income 50% 46.2% 46.2% 46.2% 43.8% 43.8% 42.3% Lower-middle-income 40.7% 40% 37.0% 34.6% Upper-middle-income 31.3% 31.3% 29.6% 30% 26.9% 26.9% 25.0% High-income 18.8% 20% 12.0% 10% 6.3% 4.0% 4.0% 0% Anaemia Exclusive Childhood Childhood Adolescent and adult Diabetes breastfeeding stunting overweight overweight 2020 Global Nutrition Report
Poor diet: #1 cause of poor health globally Greatly exceeding burdens attributable to traditional risk factors Source: Global Burden of Disease, 2017 18
Critical actions to change health systems Universal health coverage is our opportunity to mainstream nutrition, save lives and reduce healthcare spending Integration of nutrition within health systems Across each of the health system building blocks Leadership Health Access to Health Health Health and systems essential services information workforce governance financing medicines delivery systems Full integration A greater Alignment of Inclusion of Integration of Inclusion of of nutrition number of costed nutrition nutrition care nutrition into care into equitably nutrition care products in in health health records national health distributed plans with essential service delivery, and public sector plans nutrition healthcare medicines' lists regularly health professionals monitored financing and use of surveillance technologies systems plans 2020 Global Nutrition Report
How can we make our food systems more equitable?
Processed food is available, cheap and intensively marketed Sales are rapidly increasing in upper- and lower-middle income countries 2020 Global Nutrition Report
Food policies add years of healthy living and save billions Volume based tax Tiered sugar content tax Absolute sugar content tax Taxing sugary drinks based on sugar content in the US could save: ► 1.8 million CVD cases ► 0.5 million diabetes cases ► $140.7 billion in societal costs Source: Food-PRICE initiative; Lee Y, Micha R Circulation 2020
Critical actions to change food systems Solutions already exist to make healthy, sustainable food the most accessible, affordable and desirable choice
What investments are needed to improve nutrition?
The state of nutrition financing Financial commitments do not match the scale and nature of the issue 9.7 9.5 9.3 9.1 10 9.0 Additional 0.4 0.4 0.1 0.4 funds needed 0.1 0.4 0.1 0.4 0.1 0.1 to meet specific 7.5 2.1 8 MIYCN targets 2.6 0.3 3.1 0.1 (US$ billions) Additional domestic 3.5 3.9 Additional donor 6 3.5 Additional household 2.8 4 Innovative sources 7.1 6.4 5.7 5.1 4.5 2 3.5 2.9 2.2 1.5 0 2020 2021 2022 2023 2024 2025 2020 Global Nutrition Report
Financing for diet-related NCDs Disbursements rose to US$ 39.8 million in 2017, which need to be scaled up Disbursments Commitments Disbursements % of total ODA 2020 Global Nutrition Report
Coordination, financing and accountability Direct resources and programs to communities and people most affected Data Situational International Dialogue Global Domestic financing systems assessment spaces accountability financing Conduct situational Establish support Increase Invest in data Establish a global Increase domestic assessment to spaces for open international nutrition information systems, framework to hold financing, covering identify bottlenecks dialogue on financing, targeting aligned with stakeholders undernutrition and and remove barriers coordinated action those most in need national priorities accountable diet-related NCDs 2020 Global Nutrition Report
How can we achieve nutritional well-being for all?
Strategic steps to achieve nutrition equity Transform systems and target resources for faster and fairer progress Invest in nutrition, Build equitable, especially in resilient and communities most sustainable food and affected health systems Renew and expand Focus on joint efforts commitments and – global challenges strengthen show how vital this is accountability 2020 Global Nutrition Report
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