Chronic malnutrition remains prevalent in most countries across Asia, even in those that are seen to be enjoying positive economic growth. The factors causing hunger and malnutrition are multiple – while some causes such as inadequate consumption of nutritious food or disease are direct and have an immediate impact on malnutrition, other causes may be deeper and have an indirect yet still significant impact on malnutrition. These include a lack of adequate hygiene and sanitation conditions, insufficient health services and a lack of nutritious and diversified diets.
Initiatives that respond to the immediate causes of malnutrition are not enough to address the complex multi-sectoral nature of malnutrition in the long run. Panellists from the 5th ARoFIIN Roundtable highlight the importance of encouraging multi-stakeholder collaborations to scale up localised approaches, as well as discuss the role that various stakeholders have to play in both treating and preventing malnutrition in Asia.
1) How do you develop localised approaches for a global problem like malnutrition?
Warren T K Lee, FAO: We first need to understand the food availability, accessibility and affordability, as well as the food culture and risk factors for ill health and malnutrition in the locality. Preventative or interventional measures have to be locally adapted before they are implemented in a local setting. To do this, we require partnerships with local food, health and nutrition workers who have extensive knowledge on the health and nutrition situation. Local community leaders or other key opinion leaders on nutrition should also be included in the conversation for buy-in before launching an action.
Mansharan Seth, Tata Trusts: A multi-sectoral programme approach with nutrition-specific and nutrition-sensitive interventions targeted towards vulnerable geographies and populations is crucial. Leveraging the right data sets for micro-targeting interventions at localized population levels can be a game changer. That is why Tata Trusts, in partnership with the National Institution for Transforming India (NITI Aayog), has set up a data analytics initiative supported by the Institute of Economic Growth (IEG) and Harvard University to leverage the use of data in driving decision making. Some of the work focuses on using multiple data sets to arrive at the level of malnutrition at the level of parliamentary constituencies, enabling ministers to micro-target their interventions.
2) How can impact investors fuel further development in the area of health and nutrition?
Allison Hollowell, AVPN: The Global Impact Investing Network (GIIN) Landscape for Impact Investing in Southeast Asia found that there is very low impact investment in healthcare. Impact investors can invest in early stage impact small and medium enterprises (SMEs) whose success will catalyse new markets and innovations. The AVPN Deal Share has listed 110 Social Purpose Organisations (SPOs) working on health and nutrition that have been endorsed by our members for follow-on support. Just by sheer numbers alone, these SPOs take up approximately one-third of the Deal Share Platform, reflecting the increasing innovative solutions - from last mile health-tech support to scaling up affordable and nutritious alternative food products - developing across Asia-Pacific that is focused on healthcare and nutrition. According to the 2018 Global Food and Agriculture Outlook report by Valoral Advisors, whilst investment towards health and nutrition has been on a steady incline, about 50% of the funds are directed towards North America, while the Asia-Pacific region saw only 6% of all funds.
Impact investors, however, cannot work alone to develop health and nutrition. Philanthropists and governments have to come in to support SMEs, particularly in the seed stages where the financial returns do not compensate for the level of risk. Incubators are also necessary to help build the pipeline of investment-ready social purpose organisations. In Indonesia, the JAPFA foundation leads the nutrition cluster of Filantropi Indonesia and has funded education and training programmes to promote nutrition and healthy lifestyles amongst school going.
3) What do you think is essential to end malnutrition in all forms by 2030?
Allison Hollowell, AVPN: At the recent AVPN Conference, we heard from Ertharin Cousin, former Executive Director of the UN World Food Programme, that there are approximately 821 million people globally who are food insecure, and 150 million children suffering from stunting. Another 1.3 billion people are facing micro-nutrient deficiencies, or ‘hidden hunger’. There is huge ambition to address these challenges, but the capital invested into nutrition is very much lacking, and is unequal in its distribution. There needs to be more intentional global efforts to drive a higher proportion of food and agriculture investments, which have tripled between 2004 and 2013 to more than $100 billion, to the Asia-Pacific region. Government action alone cannot address these systemic challenges, and partnerships across all sectors are needed to invest in the entire food ecosystem.
Warren T K Lee, FAO: With 2030 only 11 years away, swifter action is needed to plan and implement programmes as well as to monitor the progress. Countries must also be supported to prioritise an actionable programme and to provide a tool box with validated methodologies to end all forms of malnutrition.
Mansharan Seth, Tata Trusts: Despite the urgent and pressing need, nutrition is definitely dangerously underfunded. Global spending by donors on high impact interventions to tackle undernutrition amounts to 0.5 per cent of Overseas Development Assistance (ODA). It is important to remember that for every dollar spent in nutrition interventions can deliver a return of up to $35, giving massive returns on investment.
However, reducing the risk of undernutrition and stunting can be inexpensive, as proven by The Power of Nutrition. Formed in 2015 by the Department for International Development (DFID) and Children’s Investment Fund Foundation (CIFF), these founding funders have committed more than $150 million to The Power of Nutrition to date. This investment will enable them to support a growing number of nutrition programmes in countries in Asia and Sub-Saharan Africa with a high burden of undernutrition and stunting, as well as the chance to work with international partners and national governments to take proven interventions to scale.
Investing in proven nutrition interventions, along with policy changes to address underlying causes of malnutrition, would help millions of children to develop into healthy and productive members of society.
This article was originally published on the ARoFIIN website.
The 5th ARoFIIN Roundtable will take place on 1 August in Bangkok, Thailand. This roundtable aims to catalyse stakeholder relationships by bringing together regional experts to create and execute a collective global effort to transform diets and food products and to ensure that they are accessible and affordable for everyone.
More information and the full list of speakers can be found here.