Global Nutrition Report 2020 calls to step up efforts to address malnutrition in all its forms.

As the COVID-19 pandemic continues to threaten health and food systems around the world, the 2020 Global Nutrition Report calls on governments, businesses and civil society to step up efforts to address malnutrition in all its forms The COVID-19 pandemic has exposed the weakness…

May 14, 2020 - Last update: February 10, 2023

The COVID-19 pandemic has exposed the weakness of food and health systems, disproportionately impacting already vulnerable populations. As inequalities and malnutrition continue to sweep the world, the 2020 Global Nutrition Report stresses that the need to address malnutrition in all its forms by tackling injustices in food and health systems is now more urgent than ever.

Double burden: Most countries in the world must now be equipped to fight both sides of malnutrition at the same time

Progress is too slow. One in nine people are still hungry or undernourished, while 149 million children under 5 years of age are still affected by stunting globally. Meanwhile, our world has transitioned to one in which more people of all ages are obese than underweight, with one in three people either overweight or obese.

Despite these figures, countries are often unprepared to face the global nutrition crisis. Strong government coordination on nutrition is often lacking; lower income countries tend to deprioritise overweight, obesity and diet-related chronic diseases. Financial commitments also don’t match the scale and nature of the issue: increases in domestic resources for nutrition have been marginal at best, and obesity and overweight have been largely ignored in aid allocations.

Gerda Verburg, UN Assistant Secretary General, Scaling Up Nutrition Movement Coordinator and member of the GNR’s stakeholder group, said: “2020 must represent a turning point for nutrition. As we look to reinforce our resilience to global stresses, nutrition must become a key component of any emergency or long-term response. Investing in nutrition, renewing and expanding commitments, and strengthening accountability has now become urgent if we want to prepare our systems for future shocks, and avoid a reversal of gain.”

New perspective: redirecting resources to communities and people most affected is the right and the smartest thing to do

Global and national patterns hide significant inequalities within countries and populations, with vulnerable groups being the most affected. The Report found clear links between levels of malnutrition and population characteristics like location, age, sex, education and wealth, while conflict and other forms of fragility compound the problem.

Differences across communities and at the sub-national level are striking: wasting in children under 5 years of age can be up to nine times higher between communities within countries, four times for stunting, and three times for overweight and obesity.

If no action is taken, the effects of the pandemic will only make it harder for vulnerable populations to protect themselves against malnutrition. Malnutrition affects our immune system, leaving us more susceptible to infection, and the socio-economic impact of the pandemic could in turn drive malnutrition globally.

Gaps in food systems: Poor diets are not simply a matter of personal food choices

The Report calls for a change in food systems. According to the Report, existing agriculture systems still focus on staple grains like rice, wheat and maize, rather than producing a broader range of more diverse and healthier foods, such as fruits, nuts and vegetables.

Fresh or perishable foods are less accessible and affordable in many parts of the world compared to staple grains. In Burkina Faso, egg calories are 15 times more expensive than calories from staples, whereas they are 1.9 times more expensive in the United States. Processed foods, especially ultra-processed food, are available, cheap and intensively marketed, with sales high and growing fast in many parts of the world.

In sub-Saharan Africa, the growth of supermarket chains is diminishing the role of informal traders and has affected people’s food choices. These changes demand policy and planning resources to promote desirable nutrition outcomes.

Solutions have started to emerge across the world and are being implemented by a fastgrowing number of countries such as India, Nigeria, Peru and Thailand, among others.

These include: increased public investment for healthier food products, support for shorter supply chains for fresh-food delivery programmes, use of fiscal instruments such as taxes on sugar-sweetened beverages (now in 73 countries), limiting advertising of junk food, and food reformulation, or the use of front-of-pack labelling (FOPL) to inform consumers and influence industry behaviour adopted by Chile and the UK. However, much more remains to be done.

“The @GNReport rightly points out that poor #diets are not simply a matter of personal #food choices, & that we need to act decisively to change toxic food environments”

Read our latest blog on addressing #nutrition as part of the global #COVID19 response https://t.co/2uue6PgyWR pic.twitter.com/fEoP5vOxMu

— Global Nutrition Report (@GNReport) May 21, 2020

Universal Health Coverage: an opportunity to make nutrition care universally available as a basic, live-saving and cost-effective health service

Malnutrition in all its forms has become the leading cause of poor health and death, and the rapid rise of diet-related chronic diseases is putting an immense strain on health systems. But despite this assessment, nutrition actions only represent a minuscule portion of national health budgets although they can be highly cost-effective or even cost-saving solutions. The recent Transformation of Aspirational Districts initiative in India is one example of successful integration and delivery of equitable nutrition services as part a broader healthcare transformation effort.

In most countries, health checks do not cover diet quality and national surveys rarely comprehensively assess diets and the nutritional status of populations. The distribution of trained nutrition professionals is inequitable, and these experts are not widely accessible. Globally, the median number of nutrition professionals stands at 2.3 per 100,000 people, 0.9 per 100,000 people in Africa, and some countries have none.

Good nutrition is an essential defence strategy to protect populations against epidemics, relieve the burden on our health systems and ultimately save lives. The findings of the 2020 Global Nutrition Report make clear that tackling malnutrition should be at the centre of our global health response

Renata Micha, Co-Chair of the Report and Research Associate Professor at the Friedman School of Nutrition Science and Policy at Tufts University