Cooperate Across Sectors to Improve Neglected Tropical Diseases and Nutrition Outcomes

 

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By Scott E. Bleggi, Sr. International Policy Analyst, Bread for the World Institute

Scott Bleggi is a senior international policy analyst Bread for the World Institute. Bread for the World Institute provides policy analysis on hunger and strategies to end it. The Institute educates opinion leaders, policy makers, and the public about hunger in the United States and abroad.

Controlling neglected tropical diseases (NTDs) is an important part of improving nutrition, and vice versa. Diseases such as schistosomiasis and intestinal worms result in stunting, wasting and micronutrient deficiencies, and poor nutrition increases susceptibility to NTD infection. Cross-sector collaboration – between the health, nutrition, NTDs and WASH communities – is crucial to achieving nutrition and NTD control and elimination targets. 

Nutrition is a foundational element in human development, and a growing body of evidence shows that it is a vital link across international development sectors. Although nutrition was once solely the domain of public health professionals, development assistance practitioners in agriculture, education, gender, and water/sanitation/hygiene (WASH) are realizing that their successful project outcomes can have a direct and positive effect on nutrition.

Does a value-chain project in horticulture or livestock production improve nutrition? What about efforts to keep girls in school an extra year or two before they assume family and village responsibilities? Does improved hand-washing and food preparation hygiene improve nutrition?  The answer to all these questions is a resounding yes!

The number of people in the world affected by at least one of the 17 NTDs listed by WHO is approaching 1.5 billion, and we know now that NTDs can damage a person’s nutritional status at any point in life. Worse, contracting an NTD can cause infection and other problems that cancel out or even reverse efforts to improve nutrition.

As nutrition started to be at the core of development assistance across sectors, it was clear that a comprehensive strategy to coordinate efforts was necessary. In May 2014, USAID announced its Nutrition Strategy. Bread for the World Institute participated in its development, along with other members of the nutrition stakeholder community (advocacy and operational partners of USAID).

The nutrition strategy recognizes the essential role of nutrition in human development (especially during the “1,000 Days” period from pregnancy to age 2). Moreover, the strategy acknowledges that high rates of chronic malnutrition can cause significant losses in a nation’s GDP and impose other economic costs. The USAID strategy also lays the foundation for the development of a comprehensive Global Nutrition Coordination Plan among all U.S. government offices.

The strategy treats nutrition as “multi-sectoral”– meaning that effective nutrition interventions can be made not only in health programming, but also in agriculture, education, and WASH projects. The most important direct nutrition interventions include 11 “essential nutrition actions” and identified as particularly effective in fighting malnutrition in the research published in the Lancet Maternal and Child Nutrition series. Indirect nutrition actions are nutrition-sensitive activities that target the underlying causes of undernutrition, and direct interventions can be complemented by indirect nutrition actions for maximum impact. In fact, combining direct and indirect actions by “bundling” projects that include both has been found to be .

USAID is committed to the World Health Assembly 2025 Nutrition Targets and is developing additional nutrition targets it will use to track and evaluate its development assistance. Included in these is a target in of reducing stunting by 20 percent in five years in regions where this initiative has programs.

Companion legislative bills have been introduced in the Senate and the House that would authorize Feed the Future as the government’s primary program for global food and nutrition security. Despite recent improvements reported by FAO, there are still 805 million chronically undernourished people in the world. With legislation, we can solidify U.S. leadership in fighting hunger and malnutrition, build and improve upon vital work that has been done, and leverage a government approach across all sectors and programs to meet specific goals for progress against global hunger and malnutrition.

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