Window of Opportunity

U.S. Secretary of State Hillary Rodham Clinton, speaking at CARE’s annual conference in May 2010, could not have made a stronger case for investing in maternal and child nutrition.

“As governments and organizations search for strategic interventions in the fight against poverty, nutrition represents a ripe opportunity and one that can be addressed from many different angles. Now, whether the primary focus of these programs is agriculture, health, or education, nutrition is the common thread because it’s an issue that cuts across every sector. It’s an economic issue. The World Bank estimates that up to 3 percent of gross domestic product is lost to under-nutrition in the hardest-hit countries. It’s an education issue. Undernourished children struggle to learn and to stay in school, and it is, of course, a health issue.

“Nutrition plays the most critical role in a person’s life during a narrow window of time—the 1,000 days that begin at the start of a pregnancy and continue through the second year of life. The quality of nutrition during those 1,000 days can help determine whether a mother and child survive pregnancy and whether a child will contract a common childhood disease, experience enough brain development to go to school and hold a job as an adult.

“The science of nutrition points to a strategy. If we target that brief critical period during which nutrition has the biggest impact and focus on improving nutrition for expectant mothers, new mothers, and young children, we can accomplish several things at once. We can save lives, we can help children start life on a better path, and we can bolster economic development and learning down the road.

“For the first time, the United States is focusing our investments on that 1,000-day window. We’re identifying millions of young children who need nutritional support and we’re sticking with them for a three-year period to give them a foundation to lead healthy lives…. We’re trying to make nutrition the intersection of two major new policy initiatives—the Global Health Initiative, a six-year, $63 billion effort to strengthen the health systems of our partner countries and Feed the Future, our hunger and food security initiative of at least three years and $3.5 billion to improve agricultural systems from farms to markets.

“Our principal concern [is] our children. Ultimately, that’s who we’re working to protect—the children whose lives and futures are most vulnerable to the dangers and deprivations of poverty. Their health is a leading indicator of a nation’s stability, security, and prosperity. I often tell people as I travel around the world, “If you want to know how stable a country is, don’t count the number of advanced weapons, count the number of malnourished children.”

Reducing and preventing malnutrition is the right thing to do to allow children the chance to reach their potential. Secretary Clinton’s remarks make a compelling case for the central importance of nutrition in all U.S. foreign assistance for international development.

Nutrition assistance in developing countries has been administered primarily in two ways: through health programs in non-emergency settings and through food aid programs in emergency settings. Much more should be done to promote nutrition in health systems and in emergency responses, but also opportunities should not be missed to promote nutrition more widely in agricultural programming. Nutritious foods can be a source of income generation and market development as well as part of trade systems—all means by which households could improve their food security.

A window of opportunity is available now to define how Feed the Future and the Global Health Initiative can join forces to do a better job than past U.S. international development programs to promote maternal and child nutrition. In 2010, USAID and other U.S. agencies planned how to invest the new resources. In 2011, they begin to implement the plans, and we will be able to track how well the investments are leading to improvements in maternal and child nutrition.

Bread for the World and other anti-hunger organizations have urged policymakers to use investments in Feed the Future and Global Health Initiative to improve maternal and child nutrition to the greatest extent possible. Staff is already “at the table” asking questions of policymakers who are making plans now within these initiatives. And at the program implementation stage, Bread for the World Institute will be a watchdog to monitor whether programs are making a real difference for maternal and child nutrition around the world.

Here are some of the key questions we should be asking:

• Can agricultural supply chains—largely focused on the storage and processing of staple crops such as corn, rice, and wheat, and of cash crops such as sugar and cotton—be strengthened not only to add financial value, but also to add nutritional value? That is, can diversity in the food chain be enhanced, for example by promoting foods rich in key vitamins and minerals, such as milk, meat, eggs, vegetables, and fruit?
• Can a diverse diet then be promoted to consumers throughout the country? We know it is possible to improve nutrition outcomes in small programs occurring in isolated situations. The challenge is bringing nutrition programming up to scale.
• Can biofortification programs—in which the seeds of certain foods are vitamin- and mineral-enhanced so the harvested crops are of higher nutritional value—be expanded? Evidence from across the world shows that investments in agricultural research are crucial to reducing hunger. Similarly, research to improve nutrition offers potential to reduce hunger.
• Can U.S. government investments be used to encourage the private sector to invest in food storage and processing techniques so less food is lost in the post-harvest period? In areas without adequate storage systems, for instance, more than half of the harvest may be lost due to spoilage.
• Can the programs be monitored to ensure that women take part in decisions on how household income will be spent? As the secretary said in her remarks at the CARE conference, “All of the research going back decades demonstrates the best development strategies are focused on women; that focusing on a woman, helping a woman get better nutrition, getting access to credit, getting education, improves life for the families.”
• Can we make sure farmers with small or no land holdings whose families are vulnerable to hunger and malnutrition benefit from the Feed the Future and Global Health Initiatives? Despite increasing numbers of people migrating to urban areas, the rural sector remains the epicenter of the global hunger and malnutrition crisis. The worst off are smallholder farmers and landless agricultural workers.

Kathleen Kurz is a senior nutrition and food security specialist with the Academy for Educational Development in Washington, DC.