1. Ending child hunger and undernutrition initiative1
Ending child hunger and undernutrition initiative
(ECHUI)
Overview (updated)
UN System Standing Committee on Nutrition
Annual Meeting, Rome, 27 February 2007
World Food Programme, Rome, 2006.

2. 2
Global partnership…
to end child hunger and undernutrition within a generation;
to mobilise attention on the causes and known solutions of child hunger.
to focus the world’s attention, will and resources on what is needed.

3. 852 m undernourished people worldwide 3
Global problem
852 m undernourished people worldwide
400 m undernourished children < 18
149 m underweight children < 5
5-6 m preventable U5 deaths per year, (where undernutrition is a key factor)
85 m families in need
(countries where U5 underweight ≥ 10%)
* Approximations and estimates, sources: FAO, WFP, WHO/UNICEF, WFP/UNICEF
* approximations

4. Global distribution 4
Latin America & Caribbean (3%)
Eastern / Southern Africa (6%)
Middle East, North Africa (11%)
South Asia (53%)
West / Central Africa (12%)
73% of the world’s underweight children live in just 10 countries
Top 24 regions in top 5 countries – 55% of these
East Asia / Pacific (15%)

5. 5

6. Dramatic improvements are possible:6
Dramatic improvements are possible:
Between 1960 and 2004, Chile cut its underweight rate from 37% to 2.4%
Thailand reduced malnutrition rates from 36% to 13% in the 15 years to 1990
Brazil decreased its child undernutrition by 67% between 1970 and 2000
Malnutrition in India has declined by about 30% since 1960
Between 1980 and 1990, Tanzania reduced reduce child malnutrition from 50% to 30%
Common factor: national leadership, focus on nutrition
Economic growth is not always associated with improvements in child nutrition – profound achievements have been made even in its absence.
Explicit political priority and an affordable set of interventions can bring dramatic progress
Keys to successful country experience
Strong political commitment
Active engagement of the health, education and water and sanitation sectors
Focus on building the community’s awareness of health and nutritional problems

7. 7
MDGs and ECHUI targets
MDG-1, Target 2, Indicator 4 - halve the 1990 prevalence of underweight children by 2015
Hunger and the other MDGs
The success of five other MDGs depends on bringing an end to hunger:
MDG-2 – education
MDG-3 – gender
MDG-4 – child mortality*
MDG-5 – maternal health
MDG-6 – diseases
* Over half of child mortality from preventable causes has hunger and undernutrition as a contributing cause
Current trend is positive but insufficient to achieve the MDG.
Child undernutrition rates have been decreasing by approx. 1.7%/year
Need to be significantly accelerated (the Initiative aims to double this rate)
TITLE: Goal, target and key impact indicator for the End Child Hunger Initiative. SOURCE: Millennium Summit, September 2000.
Five other MDGs – education, health, child mortality, gender and HIV/AIDS – depend on achievement on the MDG-1 Hunger Target

8. What will the partnership do?8
What will the partnership do?
Raise awareness of CHU and known solutions
Support country-level policies and systems to dramatically reduce CHU
Mobilise the political, financial, technical resources required to reduce CHU
Promote effective packages of interventions
Promote greater consensus on solutions
Bring greater cohesion across all initiatives for child nutrition
Focus on measurable results and learning.
The slightly smaller picture

9. Three strategic approaches9
Three strategic approaches
1. Partnerships: Create and strengthen global partnerships on CHU
2. Operations: Support national capacity to scale-up and deliver evidence-based solutions
3. Advocacy: Promote effective, integrated policies and programmes.
The partnership approach is to forge:
a strong alliance of national and state governments, international agencies, the private sector, the faith-based, technical, medical, educational, communities and other civil society organisations.
linkages across disciplines, institutions, sectors and countries – building solidarity, exchanging experience and mobilising resources towards the ending of child hunger and undernutrition.
The operational approach:
to strengthen national capacities to scale up and deliver essential ‘anti-hunger’ interventions to the most vulnerable, through the most direct channels, ie. schools, health posts, community-based organisations.
by demonstrating on a large scale that coordination and logistics challenges can be effectively addressed in the highest-burden parts of the world and those currently making the least progress, the Initiative will leverage even broader action globally.
The advocacy approach of the Initiative is to promote more effective, integrated policy and programmes for hunger reduction and nutrition, based on evidence of what works.
Advocacy efforts will include a major campaign to increase global understanding of child hunger and undernutrition, the solutions available, and of how progress can be monitored.
It will be complementary to and aligned with other advocacy efforts on behalf of children and mothers, to enhance overall understanding and achievement of all MDGs and to progressively realise the vision for children articulated within the Convention on the Rights of the Child.

10. Six interventions to address child hunger*10
Six interventions to address child hunger*
Health, nutrition & hygiene education (incl. exclusive breastfeeding)
Household food security
Homestead food production
cash transfers
Supplementary Feeding
Micronutrient supplementation
Hand washing with soap
Household water treatment
Parasite control (esp. deworming)
There is now unequivocal evidence that workable solutions to child undernutrition exist and that they are excellent economic investments (World Bank, Repositioning Nutrition at the Centre of Development)
ECHUI focus areas are known to have immediate impact on the well-being of children and mothers, are suited to rapid scale-up at the household and community level, and are not currently supported to the required scale by other initiatives.
* evidence-based, cost-effective, suited to ‘bundle’ and scale up

11. 11
One voice: one message
Activities of ECHUI partners at all levels will be aligned to “speak with one voice” and to deliver “one message”, viz:
ECHUI’s six key evidence-based, cost-effective and scalable interventions should be “bundled” to achieve the maximum impact in the most-affected areas.

12. Global coordination *Inaugural Chair: High Commissioner for Refugees.12
Global coordination
• global-level partnership forum for international actors, donors, civil society, private sector, technical, scientific and academic actors
• high level advocacy, strategic guidance
• monitors results
• oversight and broad direction
• resources Secretariat
currently, includes WFP, UNICEF and Chair and Vice Chairs of Partners Group
• supports Partners Group
consists of personnel from WFP, UNICEF and others
*Inaugural Chair: High Commissioner for Refugees.

13. Regional Strategy: Sahel Alliance (Feb ‘07)13
Regional Strategy: Sahel Alliance (Feb ‘07)
Coordinated effort to “scale up” ECHUI in the Sahel
Triple threat: “Unacceptably high rates of malnutrition, mortality and food insecurity”
UN Country Teams:
UN Res Coord + WFP CD + UNICEF CR + FAO + WHO Regional Officials
Working through UNDAFs, PRSPs and Govt.
Regional Response ↔ National Action Plans

14. Niger: Prevalence of wasting (children 6-59 mo)
Regional progress: Sahel Alliance (Feb ‘07) 14
Niger: Prevalence of wasting (children 6-59 mo)
33% decrease
p < .05
Niger: Prevalence of stunting (children 6-59 mo)
Above results represent progress from the implementation of a package in Niger under the Sahel Alliance – this is where the WFP country director and the UNICEF country representative for the five countries in the northern Sahel — Mauritania, Mali, Niger, Chad and Burkina Faso — joined the United Nations Country Teams, the Resident Coordinators and regional FAO and WHO developed a “gameplan for combating undernutrition in the ‘fragile economies’ of the North Sahel, where undernutrition prevalence rates are extremely severe.
Such a plan was implemented successfully and the results are impressive. The Alliance provided the required leadership and advocacy for undernutrition in the Sahel, strengthened the capacity of governments to plan acute undernutrition programmes, strengthened partnerships, and implemented the two packages of interventions.
13% decrease
p < .05
* Both surveys conducted in Sep-Oct

15. Country level action plans15
Governments, UN, private sector, IFIs, donors, NGOs and national institutions all partnering to:
analyse the problem and identify intervention requirements
identify gaps, obstacles to progress
help develop Government plan to fill gaps
connect global partners with relevant technical & other resources
support more effective policy responses
build partnerships to harmonise and scale-up needed interventions

16. Community level operations16
Map areas of high undernutrition
Identify potential outreach partners
Strengthen linkages between outreach partners and support organisations
Connect and leverage complementary interventions to the same geographic/ demographic focus areas

17. Costing a typical package17
Costing a typical package
Intervention
US$
1. Health, nutrition & hygiene education 6
2. Household food security (average) 50
3. Micronutrient supplementation 11
4. Household water treatment 4
5. Hand-washing with soap
6. Deworming 2
Household Total
$79
$79 per family
Estimated average annual costs.
Global costing model to be further refined
Country-specific costing required
* Note that “one size does not fit all” and must be adjusted and targeted to specific country needs.

18. What will it cost if we do nothing?18
What will it cost if we do nothing?
Economic and social consequences of approx 45 million preventable child deaths by 2015 (at today’s rate of attrition)
approx. 2 to 3 percent of GDP lost annually to undernutrition in high prevalence countries*
$500 billion to $1 trillion in lost productivity and income over the lifetime of today’s undernourished children*
Prospect of achieving other MDGs reduced.
*Sources: UN Standing Committee on Nutrition, World Bank, FAO
The cost of doing nothing:

19. ECHUI: Interested partners19
ECHUI: Interested partners
Save the Children (UK and US)
World Vision International
World Vision US
Caritas International
EuronAid (consortium of 39 European NGOs)
Action Aid
Oxfam
World Economic Forum
Unilever
TNT
Boston Consulting Group
Centres for Disease Control
George Washington University
The Lancet
UN System Standing Committee on Nutrition (SCN)
Archbishop of Canterbury
Gates Foundation
Rockefeller Foundation
UNHCR, FAO, IFAD, WHO,
WFP, UNICEF