Expositor: Anthony Hehir – Director Programa Mejoramiento de la Nutrición- DSM Seminario Internacional sobre Experiencia exitosas en Nutrición, organizado por el Programa Mundial de Alimentos de las Naciones Unidas (PMA) en Colombia y DSM. 14 y el 15 de mayo de 2015. Bogotá, Colombia.

1. Unlocking human potential
Economic impact through nutrition
Anthony Hehir
Director - Nutrition Improvement Program
Bogotá, 14 May 2015

2. Page 1
Innovative financing & new business models
“No I didn’t attend - I work in research.”
“Not interesting – its not about nutrition.”
“No - nutrition topics are more important.”

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The vicious cycle of income poverty
Source: World Bank
Malnutrition, Micronutrient deficiencies
Income poverty
Low food
intake
Frequent
infections
Hard physical
labor
Frequent
pregnancies
Large
families
Poor cognitive
development
and schooling
= indirect loss
in productivity
Increased health
care costs and
illnesses =
loss in resources
Poor physical
status = direct
loss in
productivity

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The vicious cycle of income poverty

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The vicious cycle of income poverty
4 Darnton-Hill et al, 2005
Percentage of estimated loss in GNP due to iron deficiency

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Copenhagen Consensus
The Copenhagen Consensus exercise started in 2004 and continued
in 2008 and 2012 as a simple but untested idea of prioritizing
global opportunities of the world’s biggest
problems and their solutions.
Imagine you had $75bn to donate to
worthwhile causes.
What would you do, and where
should we start?

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Copenhagen Consensus 2004, 2008, 2012
2004 2008 2012
1 Control HIV/AIDS Micronutrient supplements for
children (A and zinc)
Bundled micronutrient interventions
2 Provide micronutrients The Doha development agenda (lower
trade barriers)
Malaria combination treatment
3 Trade liberalization Micronutrient fortification (iron and
salt iodization)
Childhood immunization coverage
4 Control of malaria Expanded immunization coverage for
children
TB treatment
5 New agricultural technologies to
increase yields
Biofortification R&D to increase crop yields
6 Small scale water technologies for
livelihoods
Deworming and other nutrition
programs at school
Effective early warning systems
against natural disasters
7 Community-managed water supply
and sanitation
Lowering the price of schooling Surgical capacity
8 Rx on water productivity in food
production
Increase and improve girls’ schooling Hepatitis B immunizations
9 Lowering cost of starting new
business
Community-based nutrition
promotion
Low cost drugs for acute heart
attacks in poorer nations
10 Lowering migration barriers for
skilled workers
Provide support for women’s
reproductive role
Salt reduction campaign

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Best long-term investments to fight hunger and malnutrition:
1. Acceleration of agricultural yield
enhancements
2. Market innovations that reduce hunger
3. Bundled Interventions that reduce
micronutrient malnutrition and reduce
prevalence of stunting
Copenhagen Consensus 2012

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1. Accelerating agricultural yield
enhancements
• We need 2100kCal/person/day
• We produce 2796kCal/person/day
8
 Food production
(Research for yields and tolerance)
 Food prices and  affordability
Buffer against climate change
By 2050:
- Rapeseed oil 68% cheaper
- Rice 25% cheaper
- Hunger 63% less
ROI 16 : 1

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Dual approach to improve economic conditions:
• Provide market information
through cellphones
• Reduce barriers to fertilizer access
• 5 countries & 4 companies control >50%
world’s fertilizer production
• Invest in local fertilizer production capacity
2. Market innovations that reduce
hunger
9
• 80% of global hungry live in rural areas
• 50% of those are smallholders
9
ROI 8.4 : 1
ROI 6.5 : 1

11. Page
3. Interventions to fight hunger and
improve education
1. Micronutrient provision
2. Complimentary foods
3. Treatment for worms/diarrhea
4. Behaviour Change Programs
10
Health, schooling &
productivity
Chronic undernutrition in
developing countries36%
ROI 30 : 1

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Best target for nutrition?
14
By 2030, reduce by 40% the number of children who
are stunted, which would return $45 dollars for every dollar
spent.
ROI 45 : 1

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Focus on stunting reduction
Nutrition Physical/ Economic
cognitive potential growth
15
Horton and Hoddinott (2013), based on Hoddinott (2013)

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Focus on stunting reduction
Advantages of the stunting target
16 Horton and Hoddinott (2013)
- Importance of first 1000 days
- Growth also depends on health status, sanitation and reduced infection.
- Growth also affected by quality of care. Nutrition AND health care provide
better outcomes
- Growth is a good indicator of the quality of the early life environment;
- Growth is readily measurable (although it relies on reasonably good age data)
- Child height at age two is a good predictor of achieved adult height.
- Achieved adult height is associated with wages: from a survey of 8 high
income countries (Gao and Smyth, 2010) the median increase of hourly wages
per 1 cm of additional height was 0.55%; and from a survey of 8 low and middle
income countries, the median was 4.5% (Horton and Steckel, 2013).
- Achieved adult height also tracks economic development quite well
(Figures 1, 2 and 3 from Horton and Steckel, 2013, which show that height
tracks the economic “takeoff” for a range of countries).

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Effect of increased height on
wages, developing countries
17
Horton & Steckel, 2013
Height
=
Earning potential

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Guatemala
Hoddinott et al (2008) Longitudinal study
• 1969: Pre-school children given a more nutritionally rich diet
compared to control group (supplements, deworming, better
quality of the diet).
• Followed up 35 years later.
• Results from intervention group:
18
Virtuous cycle of development
Better nutrition in the first 1,000 days has
an overwhelming economic argument.
 Not stunted at age 3
 Stayed in school longer
 Better cognitive skills as adults
 Higher wages as adults

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Bundled interventions
19
Source: Sight and Life

20. Effective nutrition is affordable.
Ineffective nutrition is expensive
Quality is Essential!

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Back up slide – nutrition in
economic terms
22