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(Blog was originally submitted to the Sabin Vaccine Institute and the Global Network for Neglected Tropical Diseases in support of their policy brief Toward a Healthy Future: Working Together to End Neglected Tropical Diseases and Malnutrition, endorsed by 22 global health organizations)
Nutrition is a foundational element in human development, and a growing body of evidence shows that it is a vital link across international development sectors. Although nutrition was once solely the domain of public health professionals, development assistance practitioners in agriculture, education, gender, and water/sanitation/hygiene (WASH) are realizing that their successful project outcomes can have a direct and positive effect on nutrition.
Does a value-chain project in horticulture or livestock production improve nutrition? What about efforts to keep girls in school an extra year or two before they assume family and village responsibilities? Does improved hand-washing and food preparation hygiene improve nutrition? The answer to all these questions is a resounding yes!
The number of people in the world affected by at least one of the 17 NTDs listed by WHO is approaching 1.5 billion, and we know now that NTDs can damage a person’s nutritional status at any point in life. Worse, contracting an NTD can cause infection and other problems that cancel out or even reverse efforts to improve nutrition.
As nutrition started to be at the core of development assistance across sectors, it was clear that a comprehensive strategy to coordinate efforts was necessary. In May 2014, USAID announced its Nutrition Strategy. Bread for the World Institute participated in its development, along with other members of the nutrition stakeholder community (advocacy and operational partners of USAID).
The nutrition strategy recognizes the essential role of nutrition in human development (especially during the “1,000 Days” period from pregnancy to age 2). Moreover, the strategy acknowledges that high rates of chronic malnutrition can cause significant losses in a nation’s GDP and impose other economic costs. The USAID strategy also lays the foundation for the development of a comprehensive Global Nutrition Coordination Plan among all U.S. government offices.
The strategy treats nutrition as “multi-sectoral”-- meaning that effective nutrition interventions can be made not only in health programming, but also in agriculture, education, and WASH projects. The most important direct nutrition interventions include 11 “essential nutrition actions” articulated by the World Health Organization and identified as particularly effective in fighting malnutrition in the research published in the Lancet Maternal and Child Nutrition series. Indirect nutrition actions are nutrition-sensitive activities that target the underlying causes of undernutrition, and direct interventions can be complemented by indirect nutrition actions for maximum impact. In fact, combining direct and indirect actions by “bundling” projects that include both has been found to be the most effective development investment a country can make.
USAID is committed to the World Health Assembly 2025 Nutrition Targets and is developing additional nutrition targets it will use to track and evaluate its development assistance. Included in these is a target in Feed the Future of reducing stunting by 20 percent in five years in regions where this initiative has programs.
Companion legislative bills have been introduced in the Senate and the House that would authorize Feed the Future as the government’s primary program for global food and nutrition security. Despite recent improvements reported by FAO, there are still 805 million chronically undernourished people in the world. With legislation, we can solidify U.S. leadership in fighting hunger and malnutrition, build and improve upon vital work that has been done, and leverage a government approach across all sectors and programs to meet specific goals for progress against global hunger and malnutrition.
Posted by Scott Bleggi on October 28, 2014 in Africa, Agriculture, Asia, Climate Change, Data to End Hunger, Development Assistance, Economic Development, Food Aid, Food Prices, Foreign Aid Reform, Gender, Global Hunger, Good Governance, Hunger Hotspots, Hunger Report, Latin America, Malnutrition, Maternal and Child Nutrition, Millennium Development Goals, Success in Fighting Hunger, Weblogs | Comments (0) | TrackBack (0)
Photo by Joseph Molieri/Bread for the World
The child migration surge is out of the headlines and the number of children reaching the U.S. border has decreased dramatically, but the three nations of Central America’s Northern Triangle continue to grapple with violence and poverty. It may be only a matter of time until history repeats itself, because the root causes of unauthorized migration for both children and adults remain unchanged.
At the height of the crisis, Congress granted U.S. government agencies such as the Department of Homeland Security’s Customs and Border Patrol and the Department of Health and Human Services’ Office of Refugee Resettlement increased flexibility in spending previously allocated funds to respond to the crisis. So far, however, Congress has not approved Obama administration requests for additional funding, either for services at the border or for development assistance in the child migrants’ home countries of Honduras, Guatemala, and El Salvador.
Some congressional policy makers continue to seek long-term legislative solutions to the poverty and violence driving migration through increased and more effective U.S. foreign development assistance to the region. Bread for the World supports integrating migration issues into U.S. development assistance, including targeting programs to high-propensity migration regions in Central America and other regions that are sources of many immigrants.
In addition to congressional efforts to build momentum for a comprehensive solution to the root causes of migration from Central America, country-led solutions to reduce insecurity and poverty in the region are emerging. Multilateral organizations such as the Inter-American Development Bank are also involved in these discussions.
One of the plans emerging is the "Plan of the Alliance for Prosperity in the Northern Triangle." This plan was announced in late September 2014 by Secretary of State John Kerry and the foreign ministers of Guatemala, Honduras, and El Salvador during the UN General Assembly meeting in New York. It includes a plan by Central American governments to boost economic growth in the region and reduce unauthorized immigration to the United States.
So far few details of the plan have been made public, but the focus on the “root causes” in migrants’ nations of origin is a promising first step -- both in responding to the poverty and violence that drive child and adult unauthorized migrants from Central America to the United States and in engaging all countries involved in doing their part. It will take the engagement of both the United States and Central American nations to help solve the socioeconomic problems driving immigrants north.
On November 24, which is the Monday of Thanksgiving week, Bread for the World Institute will launch our 2015 Hunger Report: When Women Flourish … We Will End Hunger. Just before Thanksgiving is when we launch each new edition of the report. What better time of the year in the United States to draw attention to hunger?
In the coming weeks, as the launch approaches, I plan to preview the report on this blog. I’ll share a little of what’s in the report and offer some personal reflections. I write most of the report, but I don’t get the opportunity within it to discuss how writing it has affected me.
When Women Flourish is about women’s empowerment, and why women’s empowerment is so important to ending hunger. The last several editions of the Hunger Report also had plenty to say about women’s empowerment, but this is the first one where we’ve put the issue front and center.
Hunger persists mainly because poverty persists. To really eradicate hunger, you have to address the root causes of poverty, and discrimination is the most fundamental of all root causes. Discrimination defines who we think people are and what we believe they are worth. It determines the limited aspirations that too many parents have for their daughters. If girls are seen as an economic burden to a family, for example, it is not surprising that they die in greater numbers than boys as a result of underinvestment in their health -- including the share of food they receive.
Ending hunger ultimately depends on working with and through women: in the developing world, women work predominantly as subsistence farmers, and subsistence farming is the backbone of community food security. In addition, at the household level, women are responsible for preparing the food that nourishes children and other family members. (This holds true for the most part in rich countries, too).
Yet we did not want to instrumentalize women – seeing and talking about them only as foot soldiers in the fight against hunger. Empowerment is about much more than food production and preparation.
Similarly, discrimination is about more than just gender discrimination. Race, ethnicity, religion, caste, and other drivers of social exclusion also figure into who goes hungry and who doesn’t. We could have done a report focused on race, ethnicity, or any other layer – they all interact. But in this report, we start with gender.
The report looks at three fundamental topics: improving women’s bargaining power in the economy and in the household; reducing the burden of unpaid domestic work and sharing it more equitably between men and women and between families and government; and strengthening women’s collective voice by increasing their political representation and leadership in civil society. I’ll write more about each of these in the coming weeks. For the remainder of this blog post, I’d like to offer a personal reflection.
I learned a great deal while working on the 2015 Hunger Report, as I do on each edition, but on this report there were some real jaw droppers. Let me single out child marriage. When I learned that one out of nine girls around the world becomes a child bride – that’s 39,000 per day -- it was a moment when amazement doesn’t seem too strong a word.
Why was I so surprised? Maybe because child marriage isn’t a big issue here in the United States. I was already aware of the grotesque levels of gender-based violence, the one in three women who will experience it during their lives. Gender-based violence, on the other hand, is also common right here in the United States as elsewhere, so even though the statistics are still disturbing and I wouldn’t say I’ve become indifferent, there’s a certain degree of numbness that sets in after time.
The child marriage figure one in nine is for the whole world, so when you zero in on the countries where this is a common occurrence, you find statistics like three out of four girls in Niger, two out of three in Bangladesh, and one in two in India. Most countries where child marriage is prevalent have laws against it, but changing cultural norms is not as simple as changing laws.
Five years ago, I was in Bangladesh visiting an agricultural program and talking with beneficiaries. The program officer brought me to the farm of probably the most successful farmer in the village. She was not only an able farmer but clearly had charisma. She was probably no more than 30 at the time, and her daughter, a girl about half her age, walked with us by her mother’s side. Behind us was a much older man, over 60 at least, possibly beyond 70. He had trouble keeping up. Only when we stopped and she described what she was doing on each part of the farm did he catch up, standing quietly off to the side until we charged on ahead again. He was her husband. The word marriage doesn’t seem to fit this situation, though. Given the age of their daughter, the farmer could have become this man’s wife when she was as young as 12 or 13. Find out more about child marriage and the damage it does here.
Posted by todd post on October 24, 2014 in Africa, Agriculture, Data to End Hunger, Development Assistance, Economic Development, Global Hunger, Hunger Report, Inequality, Latin America, Malnutrition, Maternal and Child Nutrition, Millennium Development Goals, Religion and Hunger, U.S. Hunger | Comments (0) | TrackBack (0)
This year's World Food Day focuses on supporting and strengthening the 500 million smallholders growing food in developing countries, including Joao, a maize farmer in Mozambique. Photo by Kate Raisz.
Over the past few years, most lists of global problems have come to include climate change -- along with older concerns such as hunger, poverty, limited resources, and population growth. It often appears to be simply another challenge on the list. But although our mission of ending hunger requires facing and overcoming a number of challenges, climate change is different from other problems.
We can't make an "apples to apples" comparison between climate change and longstanding human problems. Climate change is much more like an apple tree than simply an apple among other apples. If we don't find ways to prevent further damage to Earth's climate and to mitigate the impacts that poor communities in particular have already been suffering for years, it will not matter nearly as much what we do about individual apples. Responding effectively to the dangers of climate change (improving the health of the tree, if you will) is a precondition for responding effectively to any other development challenge.
As we mark World Food Day (and, bracketing today, the three-day Borlaug Dialogue in Des Moines, Iowa), I've been thinking about the concept that language shapes our reality. What people think about the importance and urgency of climate change depends partly on how we talk about it. For example, when the administration launched its Global Alliance for Climate Smart Agriculture last month, it said that climate change poses "a range of unprecedented threats to the livelihoods of the world’s most vulnerable people..." [emphasis added]. By definition, "unprecedented" can only be used once for any given category of events -- otherwise, it's just hyperbole. It's a word that should catch people's attention, information overload notwithstanding.
The evidence shows that human activity is causing the changes in the world's climate that are now so readily observable. Climate change must be an urgent global priority for the foreseeable future if we are to contain the damage we have already caused to the planet that sustains us.
One pressing need is for communities to be able to access data on climate issues specific to them, so that they can make informed decisions at the local level. This is a relatively neglected middle ground between global- and continent-level data, and a myriad of anecdotal accounts from people who are witnessing climate change firsthand.
Three U.S. agencies, including the National Aeronautics and Space Administration (NASA), are making available higher-resolution elevation datasets based on information collected by sensors on the U.S. space shuttle. Datasets for Africa have been released and are available at the USGS’s Earth Explorer website. Datasets for Latin America are to follow in the coming months.
Designed "to empower local authorities to better plan for the impacts of severe environmental changes," the data resolves to 30 meters (compared to the 90 meters that was the clearest previously available) and will be used to "improve environmental monitoring, climate change research including sea-level rise impact assessments, and local decision support."
Of course, better data alone will not enable local leaders to solve a global problem with roots in faraway developed countries. But equally obviously, informed decision-making requires information. Climate change is enormously complex. Distilling what is happening in particular locations will help support country ownership of a global problem.
Photo by Laura Elizabeth Pohl/Bread for the World
Two years ago, on the eve of the first-ever United Nations Day of the Girl, 15-year-old schoolgirl Malala Yousafzai was in the hospital. We reported here on Institute Notes on her courageous advocacy for girls' education in Pakistan -- advocacy that so angered conservative Taliban forces that, in a now world-famous act of barbarism, they shot her in the head at point-blank range.
Tomorrow, October 11, we celebrate the third Day of the Girl. Things have changed. Malala Yousafzai has just been named a a Nobel Peace Prize laureate. Her work has galvanized support for adolescent girls denied the right to go to school. World outrage greeted the abduction of nearly 300 Nigerian schoolgirls by another reactionary armed group, Boko Haram. The global rate of girls' enrollment in secondary school is catching up to boys' enrollment, at between 97 and 98 girls for every 100 boys.
Also in recent years, there has been an intensified global campaign against child marriage, an all-too-common form of gender-based violence. An unwitting activist even younger than Malala published a book about her story, I Am Nujood, Age 10 and Divorced. Media coverage of girls who have fled marriage has become more frequent. Numerous education and advocacy campaigns have helped communities understand that the poverty that often leads them to arrange for their young girls to marry much older men is only being perpetuated by child marriage, and have supported them in finding alternatives.
Poor communities cannot afford the waste of human potential when a 13-year-old becomes a mother rather than studying algebra in a junior high school. She has a much higher chance of dying in childbirth --as a girl under 15, her risk is five times that of a woman older than 18. She and her surviving children are far more likely to be malnourished than women who married as adults. As we have said many times here on Institute Notes and in our other materials, education for girls is the factor that has made the biggest difference to child malnutrition -- it has helped more than having more food available.
They don't seem to get much attention, even on the Day of the Girl, but girls of 13, 14, 15 who are married are girls just as much as their peers who are closing those secondary school enrollment gaps. Very few (estimates are 2 percent) continue to attend school once they are married, and even they drop out once they become pregnant. Prevention of child marriage is, of course, an urgent necessity. So are efforts to help married girls and young women who were married as children regain hope for a better life.
Very often, they are the most isolated from their communities. One way to reach them is through the health sector as they come in during complications of pregnancy and childbirth and afterwards -- for example, with conditions caused by giving birth at an age when a person's body is not yet mature, such as obstretric fistula. Another time when community services can reconnect with married girls is when the teenagers bring their babies and young children in for vaccinations and medical care.
Programs can build on those contacts to put girls in touch with other community services and with each other in support and self-help groups, as well as with programs such as bridge schools that allow them to resume their education to some degree. These efforts exist, but are far more rare than they should be given the world's tens of millions of child wives. On this Day of the Girl, the world should recommit to helping teenagers whose lives, though marred by child marriage, are not over. Barriers can be removed so that they may yet take their places as empowered contributors to their societies.
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