The Bill & Melinda Gates Foundation —
the world’s largest private foundation — will spend $776 million over the next
six years to fight malnutrition, a strong signal of support for a historically
underfunded sector, according to the foundation’s leaders.
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A cook
distributes lunch to students at the Young Tajudeen
Agbangudu
Primary School in Nigeria
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Co-chair Melinda
Gates announced the new pledge — and its accompanying new program strategy —
Wednesday at the European Development Days, the European Commission’s
development forum held annually in Brussels, Belgium. In her remarks, Gates
highlighted nutrition’s chronic underrepresentation in global development
budgets and called on other donors to step up their own commitments.
“I know of no
other problem in the world that does so much damage yet receives so little
attention,” Gates said.
Undernutrition
is responsible for more than one-third of global child deaths. One in 4
children are stunted due to malnutrition, which means their bodies and
cognitive functions never fully develop.
In recent
years — and particularly since the food price crisis in 2008 spurred a wave of
global food shortages — health and development experts have raised louder and
louder alarms about a global nutrition problem, and donors have begun to
reorient programming with nutrition interventions in a more central role.
Still, according to Gates, less than 1 percent of global foreign aid spending
goes toward nutrition.
“We have been
no different from most other funders. We never paid enough attention to
nutrition. That is changing today,” Gates said Wednesday.
Gates added
the foundation’s commitment will “unlock even further resources” from a
matching pledge issued by the United Kingdom. At the Nutrition for Growth
conference Britain hosted in 2013, the government committed to match every 2
pounds in new funding for nutrition with 1 pound of its own, up to a maximum
280 million pounds — roughly $430 million.
“We are
planning to take advantage of that commitment today and we encourage other
donors to take them up on the offer, too,” Gates said.
Is nutrition’s identity crisis over?
For years it
has been both a blessing and a curse that nutrition programs operate at the
intersection of a number of different sectors, Shawn Baker, the Gates
Foundation’s director of nutrition, told Devex at the Global Food Security
Symposium in Washington, D.C., in April.
Health,
agriculture, education and others play roles in building working food systems
that deliver nutritious commodities to communities. That means nutrition
programs can be relevant components to a wide range of public services — and
budget lines. Yet while these other sectors are likely to enjoy political
leadership at the national level, a “ministry of nutrition” is not something
countries typically establish.
“If you’re
not very purposeful about making sure that nutrition is an explicit part of
their mandate, agenda and accountabilities, then it always becomes a niche
intervention instead of a mainstream intervention,” Baker told Devex.
Within the
Gates Foundation’s own organizational structure, nutrition programs previously
worked “opportunistically” at the intersections of other programmatic
priorities.
“Institutional
positioning matters at any organization,” Baker said, and the foundation has
made moves to reposition the sector within its programming.
Nutrition was
previously not a director-level position, and Baker described the foundation’s
nutrition portfolio as “one of the smallest program strategies” — significant
since Gates aligns its budgets against its strategies. That changed about 18
months ago when Baker and others undertook a process to scale up the
foundation’s ambition for its nutrition programs, culminating with Wednesday’s
announcement in Brussels.
“Malnutrition
is a quiet catastrophe. You can’t see it in the same way you can see diarrhea
or malaria or pneumonia, or the other health problems that poor children face,”
Gates said.
In many
countries stunting levels are so high it becomes the norm, Baker told Devex.
“Families
don’t recognize it. Communities don't recognize it. Decision-makers don’t
recognize it. If you’re deficient in vitamin A or iron … it’s invisible,” he
said.
The new
strategy will focus initially in five countries where there is “a particularly
large burden of malnutrition” — Gates listed Nigeria as one country where the
foundation will roll out its new programs — and around two major goals: to
increase coverage of proven interventions and to develop new ones through
investments in upstream research.
“One thing
we’re particularly excited about is much more purposeful collaboration with our
agricultural colleagues,” Baker said, describing a joint body of work on
improving food systems, to make food production more intentionally oriented to
better nutrition.
“I think
that’s quite a big shift for the foundation,” he added.
Gates’ new
strategy will also look to improve the evidence base for nutrition
interventions through support for a forthcoming Lancet series on
breast-feeding, for example. The foundation will continue to play an advocacy
role, engaging both with international donors to prioritize investments in
nutrition, and also with high-burden countries to ensure their own domestic
resources target nutrition improvements.
“The end game
is really that domestic resources need to take up more and more of the burden
of addressing these problems,” Baker said.
Food security
and nutrition will be on the agenda this weekend at the G-7 summit in Germany,
and with one month remaining until the Financing for Development Summit in
Addis Ababa, Ethiopia, Gates’ nutrition commitment, advocates hope, will be the
first of many.
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