Lauren Landis left last November’s Scaling Up Nutrition (SUN) Movement conference in Abidjan, Côte d’Ivoire, energized. Landis, the director of nutrition at the World Food Program (WFP), has been part of the long-standing effort to build a larger network to address malnutrition. The conference seemed to confirm that work is beginning to pay off.
“I really felt that the diversity of players that was at the SUN global gathering – the private sector, civil society, parliamentarians, heads of state – suggested that people are getting it,” she says. “It’s not just nutritionists talking to themselves.”
This followed the November Global Nutrition Summit in Milan, Italy, that saw $640 million in new funding for nutrition from a variety of sources, including from philanthropies actually based in countries that are experiencing some of the worst effects of malnutrition.
Together, experts say, the gatherings seemed to signal an expanded commitment to tackling malnutrition at both an international and domestic level.
If 2017 was the year global attention began to coalesce around nutrition, this year the community is focusing on consolidating those gains and building partnerships with overlapping sectors, identifying innovations to help expand and improve the work that is already happening and ensuring that everyone – but especially the most vulnerable – are included.
Experts are quick to caution that there is a lot of work needed to translate this interest into actual policies and additional funding. For Landis, though, what is critical is that, emerging out of 2017, a broad range of practitioners from a variety of sectors were invested in improving nutrition. The goal for this year, then, is to find explicit ways they can do so.
The nutrition community has been dogged by worries that its efforts are happening in a silo, despite the ways improving nutrition clearly overlaps with other development priorities – improving maternal and child health, increasing access to clean water and creating sustainable food systems.
That has started to change – a result both of the advocacy by community members and the introduction of the Sustainable Development Goals (SDGs) in 2015. One of the underlying purposes of the SDGs is to identify the linkages between 17 different international priorities and to emphasize that efforts to achieve them must be interconnected.
As the nutrition community looks to continue to strengthen collaborations with other sectors, the SDGs offer an obvious entry point.
The new SDG2 Advocacy Hub highlights the ways the nutrition community will try to do this in the coming year. Incubated by WFP and launched last year, the hub is looking to facilitate greater collaboration within the nutrition sector, whose main interests are reflected in SDG 2: ending hunger, achieving food security and improved nutrition and promoting sustainable agriculture.
The hub is also looking to identify linkages and work across sectors to build support for SDG 2.
“We’re starting to think about how do we talk about nutrition in other spaces and get nutrition talked about in other sectors,” says Paul Newnham, who is coordinating the hub.
Experts are also eyeing the EAT Stockholm Food Forum in June for evidence that will emphasize the importance of more cross-sectoral collaboration. The forum, organized by the EAT Foundation, which has a focus on reforming the global food system, will build on new scientific targets from an EAT-Lancet Commission report arriving later this year that is attempting to define how to achieve a healthy diet within planetary boundaries. The process of translating those findings into an agenda should guide a closer collaboration between the agriculture and nutrition sectors.
New partnerships and new funding will only get countries so far toward achieving nutrition goals, though.
“It’s not enough to scale up what we know,” says Katharine Kreis, the director of strategic initiatives for international development at PATH, the global health innovation nonprofit. “It’s a start and it’s having an impact, but it’s not good enough. There’s a need for a concerted effort for nutrition innovation.”
The nutrition sector does not have the same history of innovation as other public health communities, she said. But as the field has garnered more attention, it has also brought pressure to deliver results – and the increasing realization that the standard ways of doing things are not going to achieve them.
Because there has been a paucity of innovation in the past, there are now opportunities across all aspects of malnutrition to both harness technological innovations, but also to refine simple, existing tools to make them easier to use across a range of settings.
Kreis pointed to efforts underway to change how straightforward measurements are done to determine if a child is experiencing wasting.
The Georgia-based biomedical device company Body Surface Translations is developing AutoAnthro – a technology that can scan a child and derive key measurements used to determine if a child is malnourished: length and head circumference, as well as mid-upper arm circumference (MUAC), which is currently one of the standards for determining severe acute malnutrition. The technology could solve not only the problem of getting accurate measurements, but also help gather the kind of large-scale data that is currently missing from malnutrition interventions.
At the same time, two efforts are underway to improve the simple MUAC tape measure, which has long been the basic tool for determining malnutrition. One is attempting to address concerns that the strap’s thickness can result in inaccurate measurements and the other to make results easier to read.
Kreis said it is an important moment for innovations across all steps of a process that begins with tracking and predicting malnutrition to targeting interventions and introducing programs that can help prevent it from appearing in the first place. And while it is hard to predict which advances will ultimately take hold in 2018, she expects it to be a year of innovation.
“I don’t think there’s going to be a silver bullet for nutrition,” she says. “But there are a bunch of things we could be looking at. What are the big issues? How can we address them and how do we think about new solutions in a more concerted way?“”
Even as partnerships and innovations move forward, experts say it is critical to make sure everyone is benefiting from improved nutrition. Women and girls are disproportionately affected by malnutrition. Half a billion women of reproductive age suffer from anemia, contributing to an estimated 20 percent of maternal deaths worldwide. And they generally suffer higher rates of both undernutrition and obesity. Yet there are few programs tailored specifically to their needs.
This is despite mounting evidence that empowering women – both specifically around household resources, including food, but also more broadly – contributes significantly to improvements in malnutrition. A project that CARE International ran in Bangladesh that achieved dramatic reductions in stunting indicated that women’s empowerment was the single factor that had the most impact in that reduction.
“Going forward, we are making sure that the women’s empowerment aspects of every nutrition program is very big,” Jennifer Orgle, the program director for CARE International’s Nutrition at the Center program, tells Malnutrition Deeply. But CARE is not limiting their efforts only to their own projects.
In 2018, they are launching the “Collective Impact” approach, which will bring together a variety of organizations working in a country to encourage them to adopt the most advanced approaches for addressing malnutrition, including women’s empowerment programming. Orgle says CARE will start with a pilot in two countries – Bangladesh and Benin – but plans to expand to several more before the end of the year.
“There’s a lot more to be achieved,” she says. “We want to increase the impact. We want to reach larger numbers.”