On 27th September 2016 Generation Nutrition organised a webinar on the topic of the scaling up of aid and domestic financing for nutrition. The webinar was supported by three of our campaign partners, Action Against Hunger, Cesvi and Concern Worldwide. Below is a link to the audio recording and a report of the meeting.
- REPORT OF PROCEEDINGS -
The debate was moderated by Connell Foley of Concern Worldwide.
Ben Hobbs (Generation Nutrition) outlined at the start Generation Nutrition's campaign calls on nutrition funding: a doubling of global aid for nutrition over the next five years; an allocation by African and Asian countries of a minimum of 3% of their national budgets to nutrition; and the organising of a new international funding summit on nutrition in 2017. Full details of the campaign's position could be read in the report, 'Nutrition Funding: The Missing Piece of the Puzzle'.
Mary D’Alimonte (Results for Development) highlighted the huge funding gap that currently existed for nutrition. Results for Development, the World Bank and 1,000 Days had calculated that an additional $70 billion was needed over the next ten years in order to prevent stunting and anaemia, boost levels of breastfeeding and treat severe acute malnutrition in under-fives. The donor share of these increased costs would be higher at the start and then taper off as Southern countries picked up more of the costs. Upper-middle-income countries would be expected to meet all of the additional scale-up costs from the start. The contribution by low-middle-income and low-income would grow over time.
Felix Phiri (Malawian Ministry of Health) explained how Malawi had made strides in recent years on this issue, helped by the high-level of political commitment to nutrition and also an annual vote in Parliament to allocate funds specifically for nutrition (the ‘Nutrition Vote’). These steps had been a factor in bringing down levels of vitamin A deficiency in children from 23% to 7% between 2009 and 2016 and also levels of stunting (47%-37%, 2010-16), according to preliminary survey results. Some of the main challenges encountered were the competing demands on the resources of each ministry, the fact that donors were still funding 80% of the costs of nutrition programmes and the lack of a single, national fund for nutrition, which could pool funds for different nutrition interventions.
Mr Phiri also pointed out that issues of domestic investment for nutrition should not just rest in the hands of government; households, communities and the private sector had an important part to play too.
Patrizia Fracassi (SUN Secretariat) cited some interesting examples of recent funding increases by Asian countries. (These mainly occurred during the 2013-15 period.) There had been an increase in funding for nutrition-specific programmes in Pakistan, Vietnam and Indonesia, with funding coming from a mix of donor and domestic sources. Increases had also been witnessed in several African countries, albeit from a relatively low starting point.
According to Ms. Fracassi, it was also very important not to ignore the issue of actual expenditures for nutrition, which were usually much lower than budget allocations. Therefore civil society should keep an eye on the issue of programme implementation and the need to “follow the money”, in addition to calling for budget increases.
Laura Frigenti (Italian Agency for Development Cooperation) outlined Italy’s three-pronged approach to tackling undernutrition in developing countries: 1) supporting investment in agriculture and giving people economic incentives to remain in rural areas; 2) education on the appropriate use of food and care practices; 3) assistance during emergencies where people's nutrition was at risk. Ms. Frigenti also spoke about Italy’s role as host of the G7 summit in 2017. She confirmed that Italy had proposed nutrition to be one of the priority topics for discussion. In her view there was a need to “revive the agenda” on nutrition. She was not sure whether a financial pledge would be possible at the summit. However, the minimum should be a statement of a “shared commitment” on nutrition.
Nora Coghlan (Gates Foundation) spoke about the discrepancy between the scale of the problem and the level of funding currently allocated to it: despite the fact that nearly half of under-five deaths were linked to undernutrition, less than one percent of ODA was being spent on ‘basic nutrition’ and just one to two percent of national budgets were going to nutrition in developing countries. There was a lack of a multilateral or pooled fund for nutrition, similar to the Global Fund (for HIV/AIDS, TB and malaria) or GAVI. She pointed out that nutrition was a complex issue and achieving results took a long time, sometimes as much as a generation. This meant that the issue could be a harder sell to policy-makers. Finally, Ms. Coghlan highlighted the recent success in relation to the inclusion of nutrition indicators within the Global Financing Facility’s programmes on maternal and child health.
In the debate which followed amongst the panelists, a number of different questions were posed by the moderator. Firstly, how could we make the case to Finance Ministers and Presidents for an increased budget allocation to nutrition? In Malawi’s case, the Finance Ministry liaised regularly with the Health Ministry on this issue; also dialogue was maintained with the Parliamentary committee responsible for nutrition policy. According to Ms. Frigenti, Finance Ministers were already convinced about the importance of the subject, so this was less of a concern. The main sticking point was the restricted fiscal space for donor governments and the high level of competition for resources. Moreover, ensuring that aid or domestic funds were spent efficiently (and with a demonstrable impact) was as important as increasing the budget.
Secondly, what role could be played by the private sector? The panelists agreed that the private sector could be one of the ‘delivery platforms’ at the country level. One panelist suggested they could assist in the fortification of staple foods. Donor aid agencies could strike more partnerships with companies interested in supporting the achievement of the Sustainable Development Goals. The role of governments in this case would be to develop regulatory frameworks that could encourage more inward investment in those countries with high rates of undernutrition.
And thirdly, what strategy could be developed to ensure that nutrition stayed at the forefront of the political agenda and that there was a new funding summit in 2017? Panelists thought that the best way to keep the focus on nutrition was to show how it was a foundation for many different aspects of development. For instance, children can’t learn properly at school if they are malnourished; they are also more susceptible to catching life-threatening diseases. Both these factors are likely to prevent the achievement of governments’ objectives on education and reducing child mortality. We should therefore explain clearly to others that investing in nutrition is a prerequisite to programmes succeeding in other sectors.
Another strategy proposed by Ms. Coghlan and Ms. D’Alimonte was to create an institutionalised process that would allow countries to make funding pledges on nutrition. This would ensure that countries made sustained investments over a long time period. Two other recommendations were for developing countries to be assisted by the Scaling Up Nutrition Secretariat to improve the tracking of their nutrition spending and for donors to improve their reporting and measuring of aid for nutrition through a reform of the OECD’s reporting codes.