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Malnutrition is one of the world’s most serious but least-addressed development challenges. Its human and economic costs are enormous, falling hardest on the poor, women, and children. In 2022, 148 million children under five years old were stunted (low height-for-age), which indicates not only a failure to achieve one’s own genetic potential for height but is also a predictor of many other developmental constraints, including cognitive deficits and future economic opportunities, including impeding a country’s ability to accumulate human capital.

Over the last three decades, the worldwide prevalence of stunting declined from 40 percent in 1990, to 22 percent in 2022. However, the health and food systems disruptions caused by the COVID-19 Pandemic have rolled back years of progress on child undernutrition; it is estimated that, by 2022, an additional 9.3 million children will have suffered from acute malnutrition and 2.6 million more children will be stunted. Global rates have plateaued over the past five years, and as we approach the half-way mark to the SDGs, we are drifting further away from the trajectory needed to halve the stunting rates by 2030 (Joint Child Malnutrition Estimates (JME) for 2022). South Asia and Sub-Saharan Africa are the hardest hit, with the latter showing an unfortunate increase of over 2 million in 2022 compared to 2020. But this might not be the full story: as a lagged indicator, the adverse impact of recent crises on chronic malnutrition is likely yet to fully manifest.

Further, the total number of stunted children in Africa increased during the same period as a result of high fertility rates and lower rates of decline in stunting.

Stunting early in a child’s life can cause irreversible damage to cognitive development and has educational, income, and productivity consequences that reach far into adulthood. The economic costs of undernutrition, in terms of lost national productivity and economic growth, are significant— our economy and society is paying US$3 trillion a year in the form of productivity loss, ranging from 3 to 16% (or more) of GDP in low-income settings. Moreover, the global expert consortium, including the World Bank, estimated economic productivity losses equivalent to US$29 billion globally by 2022 as a result of the additional malnutrition burdens attributable to the COVID-19 pandemic.

Fortunately, these losses are largely preventable if adequate investments in proven interventions are made, particularly those that focus on ensuring optimal nutrition in the critical 1000-day window between the start of a woman’s pregnancy and her child’s second birthday. 

At the same time, a global nutrition transition is underway, leading to rapid changes in food systems, environments, and living conditions in many low- and middle-income countries (LMICs). These changes have stimulated a rapid increase in the burden of overweight and obesity, previously considered an ailment of wealthy countries. In fact, over the past 30 years, rates of overweight have risen faster in LMICs than in high income countries, and every region has seen some increase in the prevalence in overweight children under five years. In 2020, 38.9 million children under 5 were affected by overweight and obesity. Overall, it is estimated that overweight and obesity cost US$2 trillion in economic and social expenses globally.

While stunting and wasting receive the most attention, the creeping rise of overweight among children under 5 is often overlooked: a staggering 37 million children are now living with overweight globally--an increase of nearly 4 million since 2000, widening the gap between our current trajectory and the SDG target of reducing overweight to less than 3% by 2030.

Only Europe and Central Asia seems to show a positive trend. Latin America and the Caribbean, East Asia and Pacific, and Middle East and North Africa (MENA) stand as clear priorities demanding immediate action, with MENA leading the charge, with a whopping 1 in 10 children overweight or obese and a reversal of past progress.

Countries are therefore starting to experience the double burden of overweight and stunting. Today, more of the world’s overweight individuals reside in low- and middle-income countries than in high income countries, and there is no evidence that the rise in obesity in LMICs will decline. As countries experience economic growth and achieve middle and upper-middle income status, their poor will experience a greater share of the burden of overweight and obesity, increasing their vulnerability to health and economic shocks. Both obesity and undernutrition are critical to improving human capital, a central driver of sustainable growth and poverty reduction, and can have a significant effect on the human capital index (HCI). There is an urgent need to ensure that the world’s poor have access to the knowledge, resources, and services needed to achieve optimum nutrition.

The world is off-track on both the undernutrition and the obesity targets for 2030 and unless urgent action is taken at scale, global targets will not be achieved. The world must address both undernutrition and obesity simultaneously through comprehensive strategies that include scaling-up high impact interventions, fiscal policies, such as taxes, marketing regulations, and labeling of unhealthy foods such as sugar-sweetened beverages, and nutrition education for consumers. Many countries are already starting to do this (see the Global Sugar-sweetend Beverage Tax Database), but more is needed to foster a healthier and more sustainable future.

Nutrition is also intricately linked to climate change -- Women, being the gatekeepers of household food and nutrition security, are often the first to bear the heaviest burden of climate-related adversities, surging food prices, and inflationary pressures. The most recent available estimates for anemia in women of reproductive age show that in 2019, 30% of women were anemic (an alarming 7 percentage points above the trajectory needed to achieve the SDG target by 2030) and some recent (albeit incomplete) data suggest that anemia rates among women may in fact be increasing.

There is a need to take urgent action linking nutrition and climate change. Financing at scale is key. As domestic budgets and ODA are constrained, leveraging innovative financing, including from the private sector are critical. As we scale up the nutrition agenda, the world needs to aim for more money for nutrition, and more nutrition for the money by ensuring more efficient use of available resources, using tools such as Optima Nutrition, nutrition-responsive budgeting, and nutrition public expenditure reviews.


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Last Updated: Jun 29, 2023

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