Policy perspective: how implementation of the SDGs can put an end to undernutrition

In a guest blog,Christelle Huré of Action Contre La Faim discusses how undernutrition plays across the SDGs, and introduces a new advocacy toolkit.

Global levels of undernutrition are still unacceptably high, with 155 million children under five stunted and 52 million threatened by wasting. Over 3 million children still die of malnutrition every year. Factors and pathways leading to undernutrition are diverse, complex, and most often interconnected. In order to address the scourge of malnutrition once and for all, the Sustainable Development Goals (SDGs) need to reflect this complexity whilst considering nutrition as as “both an input to and outcome of the SDGs.”

Compared to the Millennium Development Goals (MDGs), the SDGs are a step in the right direction. In the MDGs, there was only one relevant target for nutrition. Nutrition, which was included under the fight against poverty (MDG 1), was unappreciated as an objective in its own right. The SDGs have rectified this with Goal 2: End hunger, achieve food security and improved nutrition, and promote sustainable agriculture.

However, advancing on Goal 2 solely won’t be sufficient to witness a world free of undernutrition by 2030. Hunger and undernutrition are not the same thing: hunger is associated with the acute crises that we are seeing in the Horn of Africa and Nigeria this year, typified by wasted children. Although undernutrition includes hunger, it extends to slow, often unseen loss of health and potential associated with stunting and anaemia. Ending undernutrition will depend tackling its underlying causes, such as sustainable and healthy diets, better systems of support for mothers and infant care, access to appropriate health care and proper sanitation, to mention a few. This means that, although Goal 2 will be essential for eradicating undernutrition, other SDGs that contain no direct reference to nutrition are just as essential to ending undernutrition.

Action Against Hunger advocates for “nutrition security,” a model that grasps the complex and varied nature of undernutrition and promotes addressing a suite of problems through a variety of sectors —agriculture, water, sanitation and hygiene, education, health, mental health and care practices —to holistically prevent and treat cases of undernutrition.

The SDGs have the potential to reflect this multisectoral approach. Nutrition is most obviously present in Goal 2 (ending malnutrition in all its forms), but Goals 1, 3, 4, 5, 6, and 13 (concerning poverty, health, education, gender, WASH, and climate respectively) all have important ramifications for the fight against undernutrition. Target 6.1 of Goal 6, for instance, aims to “achieve universal and equitable access to safe and affordable drinking water for all.” A good nutritional status cannot be achieved without drinkable water, making this target just as significant as many of those included in Goal 2. A few targets and indicators found in other less directly related goals are also relevant to nutrition. That is not to say that the SDGs have been 100% successful in their multisectoral approach. Goal 3 (Ensure Healthy Lives) is unfortunately weak on nutrition, with no targets on anemia or breastfeeding, even though malnutrition is one of the major underlying causes of child mortality worldwide.

Achieving the targets found in Goal 2 and other nutrition-sensitive SDGs is crucial because it is impossible to achieve other SDGs without profound progress on undernutrition. Again, many of the targets of Goal 3 on improving health and well-being are out of reach unless nutritional status is improved. Target 3.2, which aims to reduce preventable deaths of children under age 5, is inextricably linked to childhood malnutrition. Over 45% of the deaths of children less than 5 years can be attributed to malnutrition, making it one of the key underlying causes of childhood mortality. This makes the fact that there is no reference in Goal 3 to Severe Acute Malnutrition, which affects 17 million children under age 5, particularly egregious. Another example is the link between nutrition and economic growth, a target which features heavily throughout the 2030 Agenda but is particularly highlighted in Goal 8. Some researchers estimate that countries in Asia and Africa with high rates of malnutrition may lose up to 11% of their annual GDP due to productivity losses caused by malnutrition. A $1 investment in nutrition generates $16, a rate of return greater than 10%, making it one of the best buys in development, especially in growing economies. Success on these targets as well as so many others is only achievable if stakeholders in the nutrition community, such as Action Against Hunger, reach out to other sectors to make the case of nutrition and share their expertise, and inversely if knowledgeable actors in other fields push for an SDG implementation strategy that addresses their own sectors as well as nutrition.

Links between nutrition and the SDGs.

As many governments prepare their SDG implementation plans and harmonize their national policies with the 2030 Agenda, the SUN Civil Society Network, in collaboration with Action Against Hunger, has developed an advocacy toolkit on IMPLEMENTATION OF THE SDGS AT THE NATIONAL LEVEL: HOW TO ADVOCATE FOR NUTRITION-RELATED TARGETS AND INDICATORS. This toolkit gives practical recommendations to ensure that the SDGs related to nutrition are well-integrated in national development plans, policies, and strategies. It provides a general overview of what the SDGs are and why they are important for nutrition, ready-to-use key messages, and identifies the targets and indicators that are relevant for nutrition and should be integrated in national plans.

The incredible breadth of the 2030 Agenda is both a tremendous challenge and a tremendous opportunity: we hope that, in partnership with other members of civil society, governments, donors and other actors, we will be able to seize this opportunity.

 Christelle Huré is a nutrition advocacy adviser at Action Against Hunger.