1. ACF Conference : A Decade of CMAM October 17-18th 2013 Carmel Dolan, Jeremy Shoham :ENN Technical Directors Lola Gostelow ENN consultant Financing the Management of Acute Malnutrition at Scale

2. Background CMAM Conference held in Addis in November 2011- issues raised concerning short term financing, sustainability of long term financing ENN undertook review into current arrangements Interviewed government, agencies and key people Visits to Kenya, Ethiopia to construct case studies. Case studies Nigeria, Malawi Meetings with all main donors and foundations Final reports and ODI-ENN publication May 2013

3. 70+ countries are scaling up CMAM 15 % of global SAM is being treated via CMAM ( 2.6 million) Coverage for MAM – approx 15% (4.6 million) WFP, Kenya

4. CMAM is cost-effective Treatment of SAM is expensive: $70-200 per child ACF, Mali

5. RUTF is over 50% of total cost and local production hasn’t markedly reduced cost Valid International, Sri Lanka

6. 2011 cost of CMAM $6.4 million 67,000. UNICEF 54%, WFP 30%, GoK 16% Kenya MoH, Kenya RUTF $21.5 million per year, to treat around 300,000 SAM cases Ethiopia

7. CMAM financing is ad hoc CMAM is financed mostly by humanitarian aid Funding is short term and unpredictable Funding is rarely through government Little by government ACF, Kenya

8. Moving forward 1. Acute malnutrition - a development concern 2. Country level costing and financing vision 3. Multi-year Funding (MYF) and mixed funding for chronic contexts WFP, Pakistan

9. 5. Funding via governments (matched, pooled) 6. UN agency roles - process for establishing responsibilities 7. Donor coordination: technical and funding MoH, Ethiopia