Hunger Food Security and Nutrition in the Post 2015 Development Agenda

Statement by Mark Suzman, ManagingDirector, International Policy, Programs & Advocacy

Bill & Melinda Gates Foundation[1]

to

High Level Consultation on Hunger, FoodSecurity and Nutrition in the Post-2015 Development Agenda

in

Madrid, Spain, April 4, 2013

Introduction:

The Millennium Development Goals (MDGs) have become a central frameworkto guide global development efforts. Endorsed by every UN member state, theyhave helped align actors and focus donors and developing countries on many ofthe basic ingredients needed to improve the lives of the poorest. The deadline associatedwith the goals, the specific targets attached to each goal to measureachievement, and the “compact” that both rich and poor nations have coordinatedroles to play in achieving the MDGs, have led to a degree of public awarenessand support, and a seriousness of effort on poverty reduction, that isunprecedented. 

Given this success, the foundation is pleased to see such stronginterest in the post-2015 agenda and the robust discussion about how to ensurethat people are healthy and productive.  Thecentrality of food insecurity, hunger and extreme poverty in the MDG frameworkwas clearly recognized when they were placed first in the set of eight goals.

The triple challenges of hunger, malnutrition, and povertyremain central today, but the context for development has experiencedsignificant changes since the Millennium Summit in 2000. 

The financial context has changed. Many countries aresuccessfully growing their economies, moving into or higher within middleincome status, though still with large pockets of extreme poor. Domesticresource mobilization is increasing in most developing countries, though notalways translating into pro-poor investments. New donors—public and private—havejoined the landscape, while fiscal constraints in traditional donors pose bigthreats to a significant source of support for global development programs. 

Some issues have risen to greater prominence. Resourceconstraints and environmental threats are an increased concern as globalenvironmental negotiations have stalled and failed to catalyze significantchanges in production and consumption patterns. This has particular relevancefor food and agricultural systems, given their immediate proximity to theenvironment and the imperative of feeding a growing global population. Theimportance of political leadership and good governance is even more apparent aswe learn both from good performers and those that are failing to turn theirassets into productive investments for the well-being of all.

We need to find ways to better address these challenges. Thismeans utilizing and re-animating the existing forums we have to addressclimate, biodiversity, trade, investment rules, and so on. This is challenging asthe political context has also changed. The world is more multi-polar andlong-standing models for forging political momentum (e.g. the G8) no longer holdas much sway. Global agreement will be more difficult to secure, particularlyon issues that impose real costs. Governments will be paying keen attention towhat they are endorsing. 

How do we moveforward?

Since the MDGs have garnered universal endorsement, there isa temptation to use the post-2015 discussion as the platform to move forward onthese global concerns without critically examining: What is the purpose of agreeing to goals, andare time-bound, specific goals and targets the right tool to tackle all of theseissues? 

Addressing extreme poverty, hunger, malnutrition and themain factors that contribute to their reduction should be our first order ofbusiness, the global community’s top priority. The MDGs helped advance thisagenda. The purpose of agreeing to successor goals after 2015 is to extend and finish this agenda,  setting specific outcomes to significantlyreduce extreme poverty, hunger, malnutrition and their contributing factors andmanifestations (such as lack ofagricultural productivity or higher stunting rates), particularly among thepoorest and most vulnerable populations, that the global community collectivelysets its will to achieve. The overall vision for what the goals themselves willcontribute to can be laid out in an overall framework or vision statement. TheMillennium Declaration in 2000 helped set the overall vision for the world wewant, encompassing wider issues of peace, security, human rights, and goodgovernance that set out the wider context in which the more concrete MDGs,which sought to measure progress in specific areas of development, were to besituated.    

The resulting global goals are a time-bound, limited set of themost critical priorities that require (and can secure) global cooperation andfor which concrete targets could be set and progress could be measured throughclear indicators. Their simplicityand clarity have also resonated with the public, both making them an effectiveadvocacy rallying cry and making it easier to track and push for governmentalaccountability for their achievement. Weneed to preserve these core principles for the next goals – as the Issues Paperrightfully recognizes[2]–while also coming up with a system that allows countries, or groups ofcountries, to customize their own additional national or regional priorities, goals,and targets.  Global goal-setting isn’ tmeant to preclude this, but rather to set shared global priorities that requireaction from many countries and actors, and for which these actors can be heldaccountable to deliver. 

Post-2015:Poverty, Hunger, and Malnutrition

Today, three quarters of the world’s poorest people get their foodand income by farming small plots of land. Despite considerable success inmeeting the poverty reduction target ahead of 2015, nearly one billion peopleworldwide are still affected by poverty, severe hunger, and diets that do notprovide for their minimum nutritional requirements[3], mostof whom are in Sub-Saharan Africa and South Asia. If we are to help them on thepathway to prosperity and food and nutritional security, we must focus on helpingfamily farms—most of whom are led by women—sustainably increase theirproductivity. When farmers grow more food and earn more income, they are betterable to nourish their families, send their children to school, provide fortheir family’s health, and invest in their farms.[4]The post-2015 agenda needs to take into consideration their needs andchallenges.

With the global population set to increase by a billionpeople between now and 2030, it is estimated that the world will need toincrease food production by at least a third to keep up with demand and changingdietary preferences.[5] Adding tothis complexity, farmers face increasing environmental degradation andconstraints on land and water that pose serious challenges to gains inproductivity. It is estimated that climate change could reduce agriculturalproductivity in Africa between 17% – 28% by 2080.[6]With a dwindling amount of uncultivated land—much of what little remains is inAfrica—farmers will have to grow more with less land, water, and other inputswhile preserving natural resources for future generations.

Thefoundation recommends the inclusion of an agricultural productivity target inthe post-2015 development framework, with a strong focus on small-holderfarmers and sustainability. Tackling extreme poverty and hunger were placedat the top of the MDG list. However, agricultural productivity—one of theclearest pathways to reduce both poverty and hunger—was never an explicittarget in the MDG framework. Historyhas shown that growth in the agriculture sector is shown to reduce poverty twoto three times faster than any other sector in the economy.[7] Higheragricultural productivity results in greater food availability—the  necessary condition to combat hunger—and  when coupled with interventions to optimizediet and health care practices is key to reducing stunting and other forms ofundernutrition.

Without agricultural productivity increases, led bysmall-holder farmers in South and East Asia during the ‘Green Revolution’, itis unlikely that we would have seen the Asian economic transformation.[8]The Green Revolution doubled food production and saved hundreds of millions oflives, but also produced unintended consequences, notably to the environmentand a rise in rural inequity. Sub-Saharan Africa, a region that missed theproductivity gains of the Green Revolution, has seen higher rates of poverty,hunger, and malnutrition. In the last decade however, Africa’s agriculturaloutput has helped fuel overall economic growth, which is a result of effectivepolicy, investment and partnership with donors and private sector. An ambitious, but achievable, productivitytarget can help focus greater attention and resources to agriculture to sustainfood production increases in the region.

Any post-2015 agricultural productivity target would need tobe aimed toward small-holder farmers, who account for a large portion of globalproduction as well as poverty. To achieve substantial reductions in poverty andpromote inclusive growth, such a focus would be essential. Equally important,the environmental consequences of agricultural intensification need to beaddressed proactively.

Addressing the Unfinished Nutrition Agenda

The face of malnutrition is changing. While significantprogress in reducing underweight has been achieved in many regions of theworld, this condition is still the leading cause of death and disability amongchildren under five.[9]Notably, since 1990, stunting has surpassed underweight as the most prevalentnutritional challenge, affecting 165 million children worldwide. Stuntedphysical growth goes hand in hand with stunted brain and cognitive development,hampering nations’ abilities to grow and transform economically.

The foundation recommends inclusion of a stunting reduction targetin the post-2015 developmentframework, with consideration of other nutritional targets withinhealth-specific development goals.  Reducingmalnutrition in all its forms will contribute to eliminating preventablematernal and child deaths and to building smart, strong and resilientindividuals, families, communities, and populations. This unfinished agendarequires greater focus and attention in the successor framework to the MDGs.

Although global rates of stunting havedeclined by 36% over the last 25 years, the number of stunted children is risingin sub-Saharan Africa.[10]In addition, today there are 52 million children suffering from wasting, withreduced numbers in Asia but increases in Africa, yielding little improvementglobally since 1990. Low birth weight, sub-optimal breastfeeding, and anemiahave remained relatively stagnant, while the number of overweight children hasdoubled since 1990, reaching 43 million in 2010.^[11]  

It is now recognized that we do not live in two worlds, thewealthy suffering from overweight and the poor from undernutrition. Today, itis often the same households, families, and at times the same individuals whosuffer from multiple forms of malnutrition. Exposed to poor andmicronutrient-deficient diets, children stunted in early life are at heightenedrisk of becoming overweight, with subsequent increased risks for numerousnon-communicable diseases later in life.[12] Furthermore, evidence has emerged in the lastdecade firmly establishing that adequate nutrition in the 1000 days fromconception through 2 years of age is a key driver of economic and socialdevelopment and not solely one of its outcome measures.[13] 

The post-2015 development agenda also provides an opportunity to recognizelinkages across the nutrition and agriculture sectors, and the potential ofcoordinated approaches that are highly effective in combating multipledevelopment challenges. Nobel Prize-winning economists agreed in the 2012Copenhagen Consensus, for the second time, that nutrition—bundled with agricultureinterventions such as bio-fortification of crops and improving householdconsumption practices—was  the toppriority investment for policy-makers. [14] Thus addressing agricultural productivity,nutrition, and effectively exploiting the links between both can help furthercatalyze progress against extreme poverty, hunger, and malnutrition in thepost-2015 development agenda.  

What mightagricultural productivity and nutrition targets / indicators look like?

 Targets should be ambitious, but technically feasible, aswith the current MDGs. Whileambitious, to varying degrees the current targets were set within reach at theglobal level.[15] This made the MDGs different: they are not pie-in-the-sky aspirationaltargets of the kind the UN was too often prone to embrace in the past withlittle hope of achievement, but are concrete and at the global level, largelyachievable.   

Governments feel accountable for achieving the MDGs.  That is what has led to many developing countriesactively allocating resources against “MDG priorities” in their budgets,adopting target acceleration frameworks to try to achieve the goals, andsometimes even adding their own additional goals. Purely visionary targetswithout a chance of achievement would have been much easier for governments toignore – and indeed have routinely ignored over the decades. This is somethingwe should keep in mind as we assess proposals for goals, targets and indicatorsfor agriculture, nutrition, hunger, and food security.

For agriculture, anambitious but achievable global target is a doubling of the rate of sustainableproductivity growth by 2030. Such a target would help ensure enough foodavailability for a growing global population in the context of several constrainingfactors, such as the negative consequences of climate change on agriculture,limited arable land and the like. It would also help catalyze dramaticreductions in extreme poverty and hunger, under the right conditions.

The global productivity target would need to account forgeographic variation at the regional and national levels. For Sub-Saharan Africa, the regional target would need to be a triplingof the rate of sustainable productivity growth by 2030, since nearly 60percent of the global population increase will occur in that region, requiringsubstantially higher rates of food production. A specific set of indicatorsthat are measurable, and if achieved, would track to higher agriculturalproductivity can be developed to ensure greater accountability and moreeffective monitoring. For instance,investments in agricultural research have consistently been shown to providehigh rates of social and economic return.[16] 

There are several ways that nutrition could be addressed in thepost-2015 framework. Although many mayargue for a standalone hunger, nutrition and food security goal, we believethat the best approach is a ‘horizontal one’ that incorporates key nutritionindicators into health, hunger, and poverty reduction goals. This approach recognizes the foundationalrole that nutrition plays in human health and cognitive development, as well asthe contribution other sectors to improved nutrition. 

Amongpotential indicators of malnutrition, childhood stunting is the highest impactindicator, based on its power to capture inequity and chronic conditions ofpoor health, diet and caring practices during the crucial 1000 days frompregnancy through age 2 of a child’s life. An ambitious but achievable target would be a 40% reduction in thenumber of stunted children by 2030. This would require a nearly 4% reduction instunting per year, a rate that has already been achieved by countries makingsignificant investments in agriculture, health, sanitation, and nutrition. Country-specific annual rate of reductiontargets will be required to meet this target and devising country-specificstrategies has already begun through the Scaling up Nutrition (SUN) movement.  Other important indicators could be consideredsuch as those endorsed by the 2012 World Health Assembly, with targets that areachievable with scale up of proven interventions:

• 50% reduction of anemia in women of reproductive age
• 30% reduction of low birth weight
• No increase in childhood overweight
• Increase the rate of exclusive breastfeeding in the first 6 months up to at least 50%
• Reduce and maintain childhood wasting to less than 5%

 As with stunting,country-specific plans are required to put nations on the pathway to achievingthese targets, which if met would represent significant improvement in thelives of billions around the world.

Fine-tuningpost-2015 goals: customization,disaggregation, and indicators

Customization: New global targets that aggregate progress atthe regional and national levels are needed to rally the global community. However, learning from the current MDGs,where global targets were de facto applied to all regions and countriesregardless of starting points, there should be more explicit customization andtailoring for regional and national contexts. This could be done through a transparent process at each level. The UN and other development actors couldprovide technical help and for example, work with countries and regionalgroupings to assess and learn from the high-performing countries that startedfrom similar rates, or had similar income, spending, or capacity levels, tohelp fine-tune ambitious but realistic national targets. One such opportunity will arise next yearwhen the African Union renews its Maputo pledges around the ‘Year of AfricanAgriculture’. This will be a crucialmoment for the UN system, led by the Rome Based Agencies, to work with the AUto endorse the regional productivity target and a robust results framework thatcan help achieve it.

The need to customize and move away from “one size fits all” targets also raises challenges with visionary absolute targets that call forthe elimination  of hunger and stunting  that all countries would be expected toachieve. For worse-off countries, thetargets are not realistic and if interpreted to apply to them, will set them upas failures, even if they make dramatic absolute or relative improvement fromtheir starting point. Indeed, the top 20best performers in terms of absolute progress on the MDGs include 10sub-Saharan Africa countries, while just three make the top 20 relativeperformers list.[17] 

Disaggregation: As others have noted, MDG progress is basedon averages, and much valuable research has shown that vulnerable and excludedgroups (this includes rural communities, ethnic minorities, the poorestquintiles, farming families) have typically not experienced progress in thecurrent MDG period.[18] In the next development goals’ time frame,the global community needs to find ways of ensuring that the most vulnerablebenefit. As most of the vulnerable andthe poorest tend to live in rural communities, an agricultural productivitytarget that focuses on small-holder farmers, will help ensure greater equityand enhance the prospects of inclusive growth.  That is the reason why the foundation would like to stress appropriatedisaggregation of productivity growth among various food producers – fromsmall-holder farmers to large-scale commercial farms. 

At the level of indicators, there is also fine tuning that can bedone once the overall goal and target architecture is agreed. The foundation’s program teams look forwardto helping inform that discussion when it moves forward. As an early input, some guiding parametersmight include:

• Flexibility and customization. The tools and tactics we use to address agriculture and nutrition outcomes will change as we learn what works and as new tools become available. They may also be country-specific.
• Focus. Focus on those indicators for which we have and can get good data, and that best reflect the output and outcome we seek to achieve. Recognize that a long list of indicators can put enormous monitoring burdens on countries, so they should focus effort on the most illuminating indicators.
• Smart proxies. Include measurable indicators that are good proxies for sustainable productivity, such as partial measures like yields per input unit or adoption of high yielding varieties. These in turn also form one impact pathway toward the productivity target that can help achieve hunger and poverty goals. The same holds true for nutrition.

Conclusion:

The MDGs succeeded in part because they did not pretend to be the“sum total” of development. They are aset of specific goals with bold targets that the global community set its mindand will to collectively address.  They are deliberately ends rather than means,and as such are not the blueprint for development.  Nor do they fully represent the set of issuescritical for sustainable development. This distinction is critical as we look to agree on a successorframework to the MDGs. There is a dangerthat in trying to create the perfect framework that fully encapsulates globaldevelopment challenges, we lose the power of the goals as a global collectiveagreement to address some of the most egregious contributions to and manifestationsof extreme poverty in the world, including preventable disease and death. 

I welcome this opportunity to offer these views on the post-2015framework and the critical space for agriculture and nutrition within it. The foundation looks forward to working withall of you to ensure that development and health keeps its deserved space onthe global agenda and to crafting goals and targets that will accelerate ourmomentum to ensure that all people can lead productive and healthy lives.