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Meeting the Global Goals for
Malnutrition: How Much Will
It Cost, and Who Will Pay?
Financing for Development July 2015
Stunting Prevalence:
20 -30%
30-40%
>40% 85% of stunting concentrated in 37 countries
162 million children stunted in 2013
Global target: reduce to ~ 100 million by 2025
2
3
Investments in nutrition build
human capital and boost shared prosperity
SCHOOLING
Early nutrition
programs can
increase school
completion by
one year
EARNINGS
Early
nutrition
programs can
raise adult
wages by 5-
50%
POVERTY
Children who
escape stunting
are 33% more
likely to escape
poverty as
adults
ECONOMY
Reductions in
stunting can
increase GDP
by 4-11%
in Asia &
Africa
4
The 1,000 day window of opportunity
• The first 1,000 days
between pregnancy and
a child’s 2nd birthday sets
the life-long foundation
for human capital
• Adequate nutrition in
this 1000-day window is
imperative
• If not, the damage to
future human capital is
irreversible
WELL-NOURISHED
BRAIN CELLS
UNDERNOURISHED
BRAIN CELLS
5
An affordable package of
interventions to reduce stunting
• Improving nutrition for women during
pregnancy
• Improving infant and young child
feeding practices, including exclusive
breastfeeding for the first six months
• Improving child nutrition, including
micronutrient supplementation
• Improving policy coordination,
capacity and evaluation
ANNUAL
ADDITIONAL
COST PER CHILD
UNDER-5
$8.50
$42 billion additional
financing for 37
highest burden
countries over 10 years
$49.6 billion
additional
financing globally
over ten years
$34.0 billion required for 2021-2025$15.6 billion required for 2016-2020
~ 74 million
fewer
children
stunted
in 2025
Nutrition-specific
interventions
* Includes per capita GDP, food availability and diversity, and women’s education, health and empowerment
Cost and impact on child stunting
Underlying determinants
of stunting*
162m stunted
$1 invested in
stunting = ~ $18
economic returns
~100m stunted
 by 40% by 2025
6
Total $49.6 billion over ten years
7
Current spending on stunting is drastically inadequate
1.1
1.6
Households
Donor
2.9
Domestic
0.2
Annual expenditures (USD billions), 2014
Invested by 37 governments
External contributions
Out of pocket spending
Financing for stunting prevention will have to triple to $9
billion a year in 2025, if we are to achieve the global goal
Business as Usual would result in a shortfall of $27 billion,
condemning 40 million children to avoidable stunting in 2025
8
2025
9.0
2.9
0.3
1.4
1.0
2024
8.9
2.9
1.3
0.9
2023
8.8
2.9
1.2
0.8
2022
8.7
2.9
1.1
0.7
2021
8.6
2.9
0.9
0.6
2020
7.5
2.9
0.8
0.5
2019
6.5
2.9
0.6
2018
5.6
2.9
2017
4.6
2.9
2016
3.8
2.9
2015
2.9
2026
BaselineAdditional donorAdditional domesticAdditional householdRemaining gap
Resource gap remains
1.0
1.7
2.3
3.1
3.8 3.7 3.6 3.5 3.4
Scale-up
Maintenance
Increases
due to
GDP
growth
alone
“Global Solidarity” could generate the resources
to achieve the global stunting reduction target
9
2.9
1.6
1.2
2018
5.6
2.9
1.0
0.9
2017
4.6
2.9
0.8
0.6
2016
3.8
2.9
2015
2.9
2023
8.8
2.9
2.0
2.7
0.8
2022
8.7
2.9
2.3
2.3
0.7
2021
8.6
2.9
2.6
2.0
0.6
2020
7.5
2.9
2.1
1.6
0.56.5
9.0
2.9
1.3
3.3
1.0
20242019
0.9
8.9
2.9
1.7
3.0
2025
0.4
Additional householdInnovative sources Additional donor BaselineAdditional domestic
Countries increase
spending to income
group medians
Donors and countries
share remaining gap in
proportion to income
Scale-up phase
Maintenance phase
10
The global resource mobilization challenge to
tackle child stunting is large but achievable
Additional resources needed,
2016-2025
High-burden countries (n=37) 42.2 B
Remaining LIC and LMICs (n=75) 7.4 B
Total to achieve the global
stunting goal
49.6 B
Between 2001 and 2011, AIDS spending in low and middle
income countries grew from <$1 billion to $15 billion annually –
a larger amount of incremental spending and a higher rate of
growth than what is needed to fight stunting
11
What will it take to reach this goal?
POLITICAL
DECISION
MAKING
ADVOCACY
RESOURCE
MOBILIZATION
WIDESPREAD
IMPLEMENTATION
MONITORING &
ACCOUNTABILITY
Leaders
Committing
to increasing
nutrition
investments
Prioritizing
low cost, high
return
interventions
in plans and
budgets
Unlocking
extra
financing
from
domestic &
external, new
& traditional
sources
Accelerating
the pace of
scale-up to
achieve the
stunting goal
by 2025
Making All
Stakeholders
Accountable
through
better
tracking,
analysis, and
reporting

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Meeting the global goals for malnutrition

  • 1. Meeting the Global Goals for Malnutrition: How Much Will It Cost, and Who Will Pay? Financing for Development July 2015
  • 2. Stunting Prevalence: 20 -30% 30-40% >40% 85% of stunting concentrated in 37 countries 162 million children stunted in 2013 Global target: reduce to ~ 100 million by 2025 2
  • 3. 3 Investments in nutrition build human capital and boost shared prosperity SCHOOLING Early nutrition programs can increase school completion by one year EARNINGS Early nutrition programs can raise adult wages by 5- 50% POVERTY Children who escape stunting are 33% more likely to escape poverty as adults ECONOMY Reductions in stunting can increase GDP by 4-11% in Asia & Africa
  • 4. 4 The 1,000 day window of opportunity • The first 1,000 days between pregnancy and a child’s 2nd birthday sets the life-long foundation for human capital • Adequate nutrition in this 1000-day window is imperative • If not, the damage to future human capital is irreversible WELL-NOURISHED BRAIN CELLS UNDERNOURISHED BRAIN CELLS
  • 5. 5 An affordable package of interventions to reduce stunting • Improving nutrition for women during pregnancy • Improving infant and young child feeding practices, including exclusive breastfeeding for the first six months • Improving child nutrition, including micronutrient supplementation • Improving policy coordination, capacity and evaluation ANNUAL ADDITIONAL COST PER CHILD UNDER-5 $8.50 $42 billion additional financing for 37 highest burden countries over 10 years $49.6 billion additional financing globally over ten years
  • 6. $34.0 billion required for 2021-2025$15.6 billion required for 2016-2020 ~ 74 million fewer children stunted in 2025 Nutrition-specific interventions * Includes per capita GDP, food availability and diversity, and women’s education, health and empowerment Cost and impact on child stunting Underlying determinants of stunting* 162m stunted $1 invested in stunting = ~ $18 economic returns ~100m stunted  by 40% by 2025 6 Total $49.6 billion over ten years
  • 7. 7 Current spending on stunting is drastically inadequate 1.1 1.6 Households Donor 2.9 Domestic 0.2 Annual expenditures (USD billions), 2014 Invested by 37 governments External contributions Out of pocket spending Financing for stunting prevention will have to triple to $9 billion a year in 2025, if we are to achieve the global goal
  • 8. Business as Usual would result in a shortfall of $27 billion, condemning 40 million children to avoidable stunting in 2025 8 2025 9.0 2.9 0.3 1.4 1.0 2024 8.9 2.9 1.3 0.9 2023 8.8 2.9 1.2 0.8 2022 8.7 2.9 1.1 0.7 2021 8.6 2.9 0.9 0.6 2020 7.5 2.9 0.8 0.5 2019 6.5 2.9 0.6 2018 5.6 2.9 2017 4.6 2.9 2016 3.8 2.9 2015 2.9 2026 BaselineAdditional donorAdditional domesticAdditional householdRemaining gap Resource gap remains 1.0 1.7 2.3 3.1 3.8 3.7 3.6 3.5 3.4 Scale-up Maintenance Increases due to GDP growth alone
  • 9. “Global Solidarity” could generate the resources to achieve the global stunting reduction target 9 2.9 1.6 1.2 2018 5.6 2.9 1.0 0.9 2017 4.6 2.9 0.8 0.6 2016 3.8 2.9 2015 2.9 2023 8.8 2.9 2.0 2.7 0.8 2022 8.7 2.9 2.3 2.3 0.7 2021 8.6 2.9 2.6 2.0 0.6 2020 7.5 2.9 2.1 1.6 0.56.5 9.0 2.9 1.3 3.3 1.0 20242019 0.9 8.9 2.9 1.7 3.0 2025 0.4 Additional householdInnovative sources Additional donor BaselineAdditional domestic Countries increase spending to income group medians Donors and countries share remaining gap in proportion to income Scale-up phase Maintenance phase
  • 10. 10 The global resource mobilization challenge to tackle child stunting is large but achievable Additional resources needed, 2016-2025 High-burden countries (n=37) 42.2 B Remaining LIC and LMICs (n=75) 7.4 B Total to achieve the global stunting goal 49.6 B Between 2001 and 2011, AIDS spending in low and middle income countries grew from <$1 billion to $15 billion annually – a larger amount of incremental spending and a higher rate of growth than what is needed to fight stunting
  • 11. 11 What will it take to reach this goal? POLITICAL DECISION MAKING ADVOCACY RESOURCE MOBILIZATION WIDESPREAD IMPLEMENTATION MONITORING & ACCOUNTABILITY Leaders Committing to increasing nutrition investments Prioritizing low cost, high return interventions in plans and budgets Unlocking extra financing from domestic & external, new & traditional sources Accelerating the pace of scale-up to achieve the stunting goal by 2025 Making All Stakeholders Accountable through better tracking, analysis, and reporting