Imagine for a moment that you and your family live in a remote village on the edge of poverty. Both you and your spouse work long, often back-breaking days, and there is still barely enough to go around. Then, COVID-19 strikes. Due to lockdowns and school closures, regular work becomes much more difficult. Because of the pandemic, the fruits, vegetables, and livestock in the market are scarcer and more expensive. The only food you can afford lacks the vitamins and micronutrients your children need to grow and stay healthy, and even then, the family has started skipping meals on a regular basis to make ends meet. Soon you are facing the peril of hunger and malnutrition.
Sadly, this is not a hypothetical. Even before the pandemic, most anyone who works in global health could describe the dismal toll that hunger and malnutrition take on families: children stunted and too weak to move, mothers too anemic to survive pregnancy. Poor diets cost the global economy $3.5 trillion a year and loom as the number one risk factor for deaths worldwide, causing one in five maternal deaths and nearly half the deaths of kids under five. As a result of COVID, an additional 265 million people experienced acute food insecurity last year.
That’s why countries, philanthropies, businesses, and NGOs convened this week at the Nutrition for Growth summit, hosted by the Government of Japan, to refocus attention on the power of nutrition to improve health and lives all over the world. For reasons ranging from conflict to climate change to chronic underinvestment, hunger and malnutrition were already getting worse even before 2020. Now COVID-19’s economic effects have sparked a full-blown crisis. And with only eight years remaining to reach the 2030 Sustainable Development Goal to end hunger and malnutrition, the world needs bold, concerted, and sustained action right now to turn things around.
But the good news is, if achieved at scale, better nutrition could be a powerful engine for the economic recovery so many countries need right now in the wake of COVID-19. Every dollar spent on improving nutrition does more than just feed people in need, it serves as a powerful amplifier for local economies.
As an economist and as a woman, I believe women’s nutrition in particular is one of the highest impact areas of global health we know how to address. Yet as a global community we have consistently underinvested in it. I hope we can change that. The impact of women’s nutrition is enormous—both in terms of its toll on women’s and children’s lives when handled poorly and in terms of its potential to radically accelerate progress across the global goals if we get it right.
The fact that women still suffer disproportionately from malnutrition is not just a matter of chance. Its root causes lie in inequity and disempowerment. A World Bank study found that women’s nutritional status is driven more by inequity within households than it is by poverty. Shockingly, some 75% of underweight women live in households where the man was not underweight.
And when the inequities we see at the household level are magnified across health systems, nations, and even our global frameworks—the consequences are devastating. Just take anemia as one example within this broader picture. Like many health issues, anemia disproportionately affects women. It’s too common. It’s under-researched. It’s underfunded. And its impacts can be devastating. For women, it puts their survival of childbirth at risk. For their babies, it can have lasting impacts on growth and brain development.
That’s why I am so excited that my colleagues at the Gates Foundation are taking an integrated approach—across different teams and strategies—to address the persistent and complex problems that lead to malnutrition. By emphasizing innovation and working across food, health, and social protection systems, we can prevent devastating outcomes like anemia.
For example, through our agricultural development portfolio, we are pushing for greater dietary diversity to ensure that nutritious food value chains are supplying to women diets that are rich in iron.
We are doubling down on large-scale food fortification: the simple practice of adding vitamins and minerals like zinc, iron, iodine, folic acid, and vitamins A and D to commonly consumed foods. This ensures that even the poorest households receive staple foods—like flour and rice—that are sources of iron, helping to prevent disease, improve earnings, and enhance work productivity.
Through our health systems work, we’re designing strategies to ensure that women of reproductive age have access to and consume essential nutrition products—like multiple micronutrient supplements, which are critical sources of iron during pregnancy, and balanced energy protein, an innovation designed specifically to meet the needs of malnourished women.
Even with all these interventions in play, we know some women will still need treatment for anemia—and so we’re also investing in IV iron, an injection that helps treat the most severe cases of anemia.
We need these sorts of integrated approaches to address the complexities of malnutrition, and we are humbled to work with so many partners who are equally committed to solving these challenges. I was so pleased to see that more than 70 countries and numerous NGOs and multilateral institutions made commitments at this week’s summit—totaling more than 27 billion dollars—to address malnutrition and food security within their borders and around the world.
These commitments were made by wealthy and low-income nations alike, reflecting both the urgency of the moment and the near-universal desire by countries—even those with very few resources to spare—to see much more investment put toward fighting hunger. And they will allow local organizations and partners all over the world to do the hard work of improving nutrition and diets for families in need, thereby jumpstarting economies all over the world, spurring drastic improvements in over health and well-being, and helping millions avoid hunger and deprivation in the future.
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