2020 Global Nutrition Report: Action on equity to end malnutrition
The 2020 Global Nutrition Report discusses inequity in food and health systems, and its relationship to malnutrition. The report has been written and compiled by the Independent Expert Group of the Global Nutrition Report, which includes academics, researchers and government representatives from around the world. The publication was supported by the Global Nutrition Stakeholder Group and the UK-based Development Initiatives Poverty Research Ltd.
Nutritional wellbeing has become increasingly
important in the face of the coronavirus pandemic, especially for the
marginalised. This report highlights the need for integrating nutrition into
universal health coverage to improve diets, save lives and reduce the burden on
The report suggests measures to end malnutrition
globally by examining it through an ‘equity lens’. Its analysis reveals that global
and national patterns hide inequalities like the urban-rural divide. The report
proposes a conceptual framework to address nutrition inequities through the various
socio-economic and political contexts that determine it.
The 172-page publication contains six chapters:
Introduction: towards global nutrition equity (Chapter 1); Inequities in the
global burden of malnutrition (Chapter 2); Mainstreaming nutrition within
universal health coverage (Chapter 3); Food systems and nutrition equity (Chapter
4); Equitable financing for nutrition (Chapter 5); Ensuring equitable nutrition:
a collective responsibility (Chapter 6).
The report states that one in nine people – 820 million worldwide– are hungry or undernourished. These numbers have been rising since 2015, particularly in Africa, West Asia and Latin America. Around 113 million people across 53 countries experience acute hunger due to conflict, food insecurity, climate shocks and economic turbulence. At the same time, more than a third of the world’s adult population is overweight or obese, with an increase in this trend over the past two decades.
Member States of the World Health Organization adopted the 2025 global nutrition targets in the 65th World Health Assembly held in Geneva in May 2012. The Global Nutrition report categorises the progress made by countries towards the 2025 targets as ‘on-course’, ‘some progress’ or ‘no progress or worsening’ for maternal, infant and young child nutrition indicators, and as ‘on course’ or ‘off course’ for diet-related non-communicable disease targets.
The report indicates that countries have made some progress towards reaching the 2025 nutrition targets. For example, childhood stunting (impaired growth and development) has dropped globally from 165.8 million people in 2012 to 149 million in 2018.
The world is ‘off course’ when it comes to meeting the maternal, infant and young child nutrition targets. About 613.2 million (32.8 per cent) adolescent girls and women between 15 and 49 years suffer from anaemia. Cases of anaemia are substantially higher in pregnant women (40.1 per cent) than non-pregnant adolescent women and girls (32.5 per cent).
Globally, 20.5 million or 14.6 per cent of newborns have a low birth weight – well below the level required to achieve 2025 targets. Stunting affects 149 million (21.9 per cent) children under five years of age, and wasting affects 49.5 million (7.3 per cent) of them.
Globally, 1.13 billion (22.1 per cent) adults have raised blood pressure. This comprises more men (597.4 million, 24.1 per cent) than women (529.2 million, 20.1 per cent). About 677.6 million (13.1 per cent) adults are obese worldwide, with more women being obese (393.5 million, 15.1 per cent) than men (284.1 million, 11.1 per cent).
The report notes that 106 countries with available data are ‘on course’ to meet at least one global nutrition target, with an additional 28 showing ‘some progress’ in at least one target.
Only 143 – 0f the 194 countries assessed in the report – had comparable and sufficient malnutrition data. Of these, 124 countries experienced high levels of at least two forms of malnutrition – 56 reported high anaemia and obesity rates; 28 faced anaemia and stunting; and three countries experienced high levels of obesity and stunting. As many as 37 countries – many of which are in Africa – recorded high levels of all three forms of malnutrition.
Corruption or healthcare fraud poses a major threat to universal healthcare coverage. The report points out that more than $500 billion in health resources are lost annually due to corruption worldwide.
In India, one in two women of reproductive age is anaemic, one in three children under five years is stunted, and one in five children under five years is wasted (low weight-for-height). The prevalence of stunting is 10.1 per cent higher in rural areas compared to urban areas.
The high cost of several nutrient-dense foods is a major barrier in tackling malnutrition. A key objective of food policies should be to ensure that nutrient-rich foods are affordable. This can be achieved through targeted income support for the poorest households, as well as lowering prices through economic policies in trade and agriculture.
A key objective of pro-equity, nutrition-sensitive food policies should be to ensure that nutrient-rich foods are affordable, both at the level of the whole economy and for the poorest households in particular.
The report proposes that food systems should ensure that healthy and sustainably produced food is the most affordable, accessible and desirable choice among people. Systems devoted to healthcare must work together to provide nutrition as a basic healthcare service. Various sectors must work in collaboration to develop funding and accountability mechanisms which help in directing resources towards communities that are most severely affected by malnutrition.
The upcoming years – notes the 2020 report – have several events that could be opportunities to rethink policies and systems. These include the government of Japan’s Tokyo Nutrition for Growth Summit in 2021, as well as the United Nations’ conferences on climate change and food systems in 2021. With only five years left to meet the 2025 global nutrition targets, governments, businesses and civil society organisations must focus action on areas with the greatest need.
Focus and Factoids by Khushi Mehrotra.
PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.
Independent Expert Group of the Global Nutrition Report
Venkatesh Mannar and Dr. Renata Micha
Development Initiatives Poverty Research Ltd., Bristol, UK
12 May, 2020