Maternal and Child Nutrition: Building Momentum for Impact Maternal and Child Nutrition Study Group Members: Robert E Black 1, Harold Alderman 2, Zulfiqar A Bhutta 3, Stuart Gillespie 4, Lawrence Haddad 5, Susan Horton 6, Anna Lartey 7, Venkatesh Mannar 8, Marie Ruel 9, Cesar G Victora 10, Susan P Walker 11, and Patrick Webb 12 1 Johns Hopkins Bloomberg School of Public Health 2 International Food Policy Research Institute 3 Aga Khan University 4 International Food Policy Research Institute 5 Institute of Development Studies 6 University of Waterloo 7 University of Ghana 8 The Micronutrient Initiative 9 International Food Policy Research Institute 10 Universidade Federal de Pelotas 11 The University of the West Indies 12 Tufts University

Nutrition: A Massive Unfinished Agenda 2 Since 2008: tremendous increase in political commitment to improve nutrition; yet this has translated into only modest impact. This represents a massive unfinished agenda to address the cause of 45% (3.1 million) of all under 5 child deaths and the 165 million children who are stunted. These 165 million children with stunted growth have compromised cognitive development and physical capabilities, making yet another generation less productive than they would otherwise be.

Global Targets Within Reach The World Health Assembly (WHA) nutrition targets for reducing stunting, wasting, low birth weight, anaemia and overweight, and increasing exclusive breastfeeding in the first six months of life by 2025 will not be achieved at the current rate of modest progress 3 With concerted effort and sufficient support, the WHA targets are achievable With concerted effort and sufficient support, the WHA targets are achievable

Interventions and Programmes 10 proven nutrition-specific interventions could reduce child deaths by 900,000 per year in 34 high-burden countries and stunting by a fifth Some, but not all, programmes in agriculture, cash transfers, early child development and schooling have shown an improvement in nutrition and development Nutrition-sensitive programmes with the most positive effect on nutrition had nutrition goals and actions, reached mothers and children early and for longer durations and targeted the poorest and most undernourished 4

Enabling Environment for Nutrition Investments need to be directed not only to interventions but also to the environments that enable them Requires strategic investment in building commitment, capacity and leadership, timely data on the problem, its causes and programme performance, accountability mechanisms, resource mobilisation and strengthening institutions for sustainable implementation 5

Nutrition Foundational to Development This series furthers the evidence base that good nutrition is a fundamental driver of a wide range of development goals Countries will not be able to break out of poverty and sustain economic advances if so much of their population fails to get the nutrition needed for a healthy and productive life Undernutrition reduces a nations economic advancement by at least 8% (direct productivity losses, losses via poorer cognition, and losses via reduced schooling) The post-2015 development agenda must prioritise addressing all forms of malnutrition at the top of its goals 6

We Must Ramp Up Spending; and the Cost is Affordable New estimates show that an additional $9.6 billion annually in high burden countries could save nearly a million children per year An increase in donor spending is vital if nutrition targets are to be met or surpassed Government spending in LMIC needs to match or exceed this rate of increase Nutrition budget lines need to be established in all high-burden countries 7 The Scaling up Nutrition (SUN) Movement is a critical driver in this effort and support for it must remain strong

Research Needs To develop scalable interventions or improve their effectiveness, especially to prevent fetal growth restriction, stunting, wasting and micronutrient deficiencies and enhance breastfeeding practices To determine the features of nutrition-sensitive programmes that result in nutritional benefits To show how the private sector can best support optimal nutrition To understand the drivers of country success, how to create enabling environments and how to mobilise national resources 8 Each paper includes a list of relevant research needs

NOW is Our Critical Window of Opportunity to Scale Up Nutrition We must work together to seize this opportunity National and international momentum to address human nutrition and related food security and health needs has never been higher 9

Thank You 10