On the Horizon: Prioritizing Nutrition within the Covid-19 Context

The COVID-19 pandemic will be a history-altering event. But where will it take us? In “On the Horizon,” a new CSIS series, our scholars offer their insights into the fundamental changes we might anticipate for our future social and economic world.

Proper nutrition—that is, access to an adequate quantity and quality of food that provides sufficient energy for growth and daily activities—is a crucial component of global health. Well-nourished mothers are more likely to have healthy pregnancies; well-fed newborns and infants have a better chance to grow and survive childhood illnesses; and the elderly may be less likely to succumb to cancer or other chronic diseases if they can access appropriate food and nutritional supplements.

Yet nutrition, linked to access to food, and by extension, to agriculture, water security, and trade, is often seen as separate from health services, and instead as the primary responsibility of other sectors, such as social protection.

The Covid-19 outbreak, which the World Health Organization (WHO) declared a pandemic on March 11, has focused the world’s attention on the challenges of responding to a novel infectious disease for which there is neither a vaccine nor widely available treatment. While there is still a great deal about Covid-19 that is unknown, reports from several world regions suggest that well-nourished populations may have a greater likelihood of resilience in the face of measures imposed to limit transmission of the disease, such as shelter-in-place orders and limits on trade and transportation. And yet those same preventive measures, and their social and economic impacts, may imperil recent progress on addressing global nutrition challenges.

Thanks in part to the galvanizing impact of the Millennium Development Goals, the first decades of the twenty-first century saw notable progress in raising the political profile of malnutrition and undernutrition in the lowest-income countries. In 2012, the World Health Assembly set ambitious global targets for improving maternal, child, and newborn nutrition—with a goal of reaching them by 2025. And in 2015, the Sustainable Development Goals called the world’s attention to nutrition, emphasizing that improved access to energy-, mineral-, and protein-rich foods can serve as a foundation for advancing health, education, employment, women’s empowerment, and poverty reduction. In 2016, the UN General Assembly declared the period from 2016 to 2025 the Decade of Action on Nutrition to stimulate increased funding for nutrition activities in key countries.

The U.S. government has been a leading donor to global nutrition programs over the last two decades, with support channeled through food security, health, and water and sanitation programs. For the past decade, the U.S. government has supported nutrition improvements through its global health investments, as well as Feed the Future, which was launched in 2010. U.S. support is channeled through the Economic Support Funds, Development Assistance accounts, and global health programs, but nutrition still only makes up 1 percent of U.S. overseas global health spending.

Even before the WHO declared the outbreak of Covid-19 to be a pandemic, there were worrying signs that progress toward global nutrition goals was off-track. The number of people considered to be hungry or undernourished had risen over the past five years as a consequence of drought and conflict across diverse regions, including sub-Saharan Africa, western Asia, and Latin America. Global funding for nutrition programs appears to have plateaued, as well. The United States, along with Canada and Germany, has historically been among the leading donors to nutrition programs, yet funding for U.S. programs has stagnated in recent years, with the 2020 level of $150 million little higher than 2017’s $148 million.

Recognizing these challenges, and in order to rejuvenate global consensus around nutrition as a political priority, the global nutrition community had anticipated building on this progress through several events planned across 2020. The Nutrition for Growth Summit was to have been held in Tokyo in December, following a “Goalkeepers Kick-Off Event” originally scheduled to take place prior to the opening of the Olympic Games in July. Organizers had anticipated that world leaders would make commitments in three core areas: making nutrition integral to the global goal of universal health coverage, building food systems that promote health diets and nutrition, and addressing malnutrition effectively in fragile and conflict-affected contexts.

For now, these global events have been postponed until at least 2021, and the Scaling Up Nutrition Joint-Assessment, an annual event that enables participants to monitor progress on improving nutrition, identify new goals, and elaborate plans, was delayed for several months to allow countries time to shift to an online reporting format and respond to Covid-19.

In the meantime, several donors have pledged new support for global food and nutrition programs. At the June 27 Global Goal event organized by the European Commission and Global Citizen, Spain pledged nearly $12 million to the Global Agriculture and Food Security Program, and Belgium, Finland, and Switzerland committed funds to the World Food Program.

The United States has taken several actions to support global nutrition within the Covid-19 crisis, including renewing trade policies to strengthen food security and markets; making credit available to farmers and small businesses, particularly those run by women; promoting safe continuation of supply chains, markets, and transborder commercial activity; and sustaining production and distribution of nutrient-rich foods.

More broadly, the United States has directed more than $1 billion to Covid-19 relief activities, including through emergency activities for global health and development assistance that indirectly affect nutrition, including water, sanitation, and hygiene activities in overcrowded camps for displaced peoples and refugees.

These are helpful steps, but there is more that can be done. In supporting countries’ responses to Covid-19, the United States has an opportunity to ensure nutrition issues are an integral component of plans related to health system support and can encourage other partners to strengthen their own work on nutrition as they assist hard-hit populations in responding to the pandemic. Ensuring that nutrition projects are fully integrated into U.S. development and health system support for Covid-19 response can alleviate hunger and help protect vulnerable populations from the most severe consequences of the pandemic while promoting healthier and more resilient communities in the longer term.

Katherine Bliss is a senior fellow with the Global Health Policy Center at the Center for Strategic and International Studies in Washington, D.C.

Commentary is produced by the Center for Strategic and International Studies (CSIS), a private, tax-exempt institution focusing on international public policy issues. Its research is nonpartisan and nonproprietary. CSIS does not take specific policy positions. Accordingly, all views, positions, and conclusions expressed in this publication should be understood to be solely those of the author(s).

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Katherine E. Bliss
Senior Fellow and Director, Immunizations and Health Systems Resilience, Global Health Policy Center