Achieving the MDG target – halving the proportion of underweight children between 1990 and 2015 – will involve efforts at micro, meso, macro and global levels, as well as partnerships among all sectors of society.
The time to act is now
Millions of children’s lives will be transformed if the MDG target to reduce hunger is fulfilled in 2015. This is by no means a far-fetched scenario. Much is known about what can make a difference in child nutrition. Food as well as access to health services and good care, especially in early childhood, is important.
The drive for nutrition will also involve working across sectors, recognizing that water, sanitation and HIV/AIDS, for example, are inextricably connected with child health and nutrition. It will involve efforts that span the micro level up to the macro level (see chart) and will require every level of society to work in partnership.
The priority of nutrition interventions must be children under two years old, when they are most vulnerable to disease and mortality. Early childhood offers a window of opportunity; nutrition-related interventions during this period have the greatest impact.
In addition, interventions need to focus on women – before they become pregnant, while pregnant and when lactating – through antenatal care and other opportunities, because mothers deprived of good nutrition are likely to give birth to underweight babies.
The health and nutrition needs of children in complex emergencies must remain a priority. But there is, further, an urgent need to focus on the major causes of death and undernutrition in ‘silent’ emergencies – outside camps, in stable environments and in communities affected by HIV/AIDS, particularly in southern Africa.
New evidence39 indicates that if high-impact health and nutrition interventions such as breastfeeding, complementary feeding and vitamin A and zinc supplementation are scaled up, they will have a synergistic impact on growth and development, as well as survival.
Even countries with low per capita incomes can make significant progress if appropriate policies are matched by political will. As the World Bank advocates in its recent publication, nutrition needs to be repositioned in national development if the MDGs are to be achieved.40
The time to act is now. To begin with, the MDGs have been adopted by United Nations Member States – already a big step forward for children and humankind. And in the push towards the MDGs, the battle against poverty has moved to centre stage.
The world is certainly capable of getting on track to meet the MDGs on child nutrition and health. There can be no excuses if another generation of children is allowed to fall by the wayside.
39 See, for example, The Lancet series on child survival (2003) and neonatal survival (2005); The World Bank, World Development Report 2004: Making services work for poor people, The World Bank, Washington, D.C., 2003; World Health Organization, The World Health Report: Make every mother and child count, WHO, Geneva, 2005; Copenhagen Consensus 2004 reports accessed at <http://www.copenhagenconsensus.com>; UN Millennium Project, Investing in Development: A practical plan to achieve the Millennium Development Goals, UNDP, New York, 2005, and other Millennium Project reports accessed at <http://www.unmillenniumproject.org/reports/index.htm>.
40 The World Bank, Repositioning Nutrition as Central to Development: A strategy for large-scale action, Directions in Development, The International Bank for Reconstruction and Development/The World Bank, Washington, D.C., 2006.