1,000 Days

1,000 Days photo by Laura Elizabeth Pohl

The U.N. Millennium Development Goals (MDGs) treat hunger and poverty as interdependent problems. The first MDG—dramatically reducing hunger and poverty—measures progress against hunger by gauging how many children remain chronically undernourished.

“Hunger” seems like a simpler concept than “undernutrition,” but it’s most accurate to say that it’s the effects of undernutrition that kill children or limit their potential for the rest of their lives. Young children need calories to grow and gain weight, but vitamins and minerals matter every bit as much. In developing countries, one-third of all children are stunted or underweight as a result of undernutrition; it is the leading cause of child mortality. Reducing the high rate of undernutrition among children in the developing world is one of the greatest challenges in global health.

The most critical period in human development is the 1,000 days starting at pregnancy and lasting through a child’s second year.¹ Healthy development, particularly brain development, depends on getting the right foods at this critical time. Hunger during this time is catastrophic, because the resulting physical and cognitive damage is lifelong and  irreversible.

Early hunger and malnutrition is associated with later problems such as chronic illness and poor school attendance and learning. As adults, the survivors have lower productivity and lifetime incomes, which costs developing countries an estimated 2 to 3 percent of their economic output (Gross Domestic Product).²

Stunting is Largely Irreversible after Age 2

Until recently, international development programs did not focus much attention on improving the nutritional status of young children. But that has changed since 2008, when a series of reports on early childhood appeared in the leading medical journal The Lancet. The series emphasized the connection between nutrition during the critical 1,000-day window and development outcomes, and showed how practical, inexpensive interventions during this “window of opportunity” can dramatically alter the arc of a person’s life.

The Lancet series appeared at the height of a global hunger crisis driven by dramatic spikes in the prices of staple foods, which forced an additional 100 million people into hunger and led to rioting in a number of countries. In the aftermath, the United Nations formed a High-Level Task Force on Global Food Security. In addition, representatives of the governments and civil societies of dozens of countries came together to prepare a framework for nutrition action based on The Lancet reports. From this effort came the Scaling Up Nutrition (SUN) movement to support the action plan.

During a U.N. summit on the MDGs in September 2010, Secretary of State Hillary Clinton and her Irish counterpart launched the “1,000 Days: Change a Life, Change the Future” initiative. 1,000 Days and SUN seek to make nutrition an integral component of development programs. SUN’s plan for accomplishing this has been endorsed by national governments, multilateral institutions such as the World Bank and other international development banks, civil society organizations, development agencies, academics, and philanthropic bodies.³ During the U.N. event, David Beckmann, president of Bread for the World, and Tom Arnold, CEO of Concern Worldwide, committed to convening a follow-up meeting of SUN. This meeting was held June 13, 2011, in Washington, DC, and drew government and civil society representatives from both SUN countries and developed countries. Bread for the World and Concern Worldwide continue to be instrumental in keeping policymakers focused on SUN and the critical importance of the 1,000-day window of opportunity between pregnancy and age two.

The United States has two development programs, Feed the Future and the Global Health Initiative, that put nutrition front and center. Bread for the World Institute’s 2011 Hunger Report, Our Common Interest: Ending Hunger and Malnutrition, focused on Feed the Future, an agricultural development initiative designed to address the root causes of hunger in developing countries. Feed the Future is the first U.S. global food security program of this magnitude—and the only one to focus both on nutrition outcomes and agricultural development, two issues that are inseparable.

Food aid is another tool the United States uses to respond to hunger crises. Most of this assistance is devoted to supplying food and other essentials directly to people trapped in humanitarian emergencies. Food aid is also used to improve food security in food-deficit countries where people are chronically hungry. While food aid is not a sustainable long-term solution to hunger and malnutrition, it can and should complement agriculture and food security programs such as Feed the Future.