79494 April2010 High-Level Nutrition Event World Bank-IMF Spring Meetings Washington, D.C. The Governments of Canada and Japan, the United Up Nutrition. The framework carries the endorseme nt States Agency for International Development (USAID), of more than 80 multilateral, bilatera l, academic, and and the World Bank co-hosted a high-level meet- civi l society agencies and institutions (see pages 8-9). ing on "Scaling Up Nutrition" during the World Bank- IMF Spring Meetings. With malnutrition causing the Senior members of delegations, includ ing severa l deaths of as many as three million mothers and young minist ers of finance from client count ries with the children every year, ministers, heads of development highest ma lnutrition burden, high- level representa- agencies, and civil society organizations attending the meeting appealed to governments worldwide to in- vest more in halving the rate of malnutrition (MDG 1c). 2010 Spring Meeting features: The primary objective of the meeting was to mobilize Agenda P.l buy-in from country clients and global development Highlights for the Meeting P.3-7 partners on an inclusive approach to country owner- Endorsements for the P.S-9 ship and action for scaling up nutrition investments Scaling Up Nutrition for sustainable development. The meeting capital- (SUN) Framework ized on the current window of political opportunity SUN Framework News P.10 by bringing together senior representatives from global partners across many sectors to define strate- Participants P.11-14 gic ~ommitments and partnerships for nutrition. The Nutrition Country Profiles P.15 meeting also offered an opportunity to share the new "Let's Grow Together" video P.15 multi-partner global Framework for Action for Scaling 1+1 Canadian International Development Agency Agence canadienne de developpement international ® USAID !ft'i"'i! . Government of Japan FROM THE AMERICAN PEOPLE THE WORLD BANK High-Level Meeting on Scaling-up Nutrition Co-hosts: Canada, Japan, USAID, and the World Bank April 24, 2010 ~ Welcome Moderator: Phil Hay, Communications Advisor, World President, Bank World Bank World Bank's Commitment to Scaling Up Nutrition Robert B. Zoellick, President, World Bank Bolivia, The Honourable Viviana Caro Hinojosa, ~ Canadian International Development Agency: Minister of Development Planning Achieving Nutrition Results Ethiopia, Dr. Kesetebirhan Admasu Birhane, Director- The Honourable Beverley J. Oda, Minister of lnterna- General for Health Promotion and Disease Preven- tional Cooperation, Canada tion, Federal Ministry of Health ~ Perspectives from Country Partners: ~ Catalyzing the Nutrition Movement Dr. David Nabarro, Special Representative of the UN Rwanda, The Honourable John Rwangombwa, Secretary General for Food Security and Nutrition Minister of Finance and Economic Planning (via VC) Guatemala, The Honourable Juan Alberto Fuentes Knight, Minister of Public Finances ~ Moderated Discussion ~ USAID's Renewed Thrust in Scaling Up Nutrition DFID: The New South Asia Food and Nutrition Dr. Rajiv Shah, Administrator, United States Agency Security Initiative for International Development Nemat (Minouche) Shafik, Permanent Secretary, United Kingdom Department for International Development ~ Perspectives from Development Partners: ~ Japan's Support to Scaling Up Nutrition United Nations Perspective Nobumitsu Hayashi, Deputy Director-General, Inter- Josette Sheeran, Executive Director, World Food national Bureau, Ministry of Finance, Japan Programme ~ Moderated Discussion Civil Society Perspective David Beckmann, President, Bread for the World ~ Closing Remarks/Adjournment Graeme Wheeler, Managing Director, World Bank Private Sector Perspective Venkatesh Mannar, President, Micronutrient Initiative Video: Investing in Nutrition: Let's Grow Together ~ Perspectives from Country Partners: ~ Reception Canadian International Development Agency Agence canadienne de developpement international ® USAID Government of Japan tives from civil society organizations, development everyone in the room for being a part of the these partners, bilateral donor governments (including important scale-up efforts. G8 members), and the media participated in the meeting. In a press release before the event, Mr. Zoellick said "Malnourishment not only means children have to suf- Opening the meeting, Robert B. Zoellick President fer, but it also makes them less-productive adults. We of the World Bank spoke about nutrition as a "for- need to break the vicious cycle of poverty and malnutri- gotten MDG." "For all of you who know your UN liturgy, tion to give people opportunity and to achieve sustained you know that nutrition is a sub-goal of the first goal economic growth. The new multi-partner Framework for dealing with poverty." He called nutrition "the criti- Action represents a united call to action for this 'forgot- cal multiplier Millennium Development Goal, because tenMDG."' if you fell short on nutrition, it was going to hurt ev- ery one of the other goals-with critical/inks to child Canadian Minister of International Cooperation, mortality, to maternal health, obviously the ability of the Honourable Beverley J. Oda reiterated the re - children to learn, and of course to poverty... [but] if you newed commitment of the international community compare the resources for malnutrition, they fall far to nutrition. She stated, "As a leader in micronutri- short." Mr. Zoellick stated, "The evidence now is clear ent investments, Canada welcomes renewed interna- that the effects of malnutrition sadly will last a life- tional attention to nutrition as a development priority. time. About 80% of the brain is hardwired by age five, We have been working hard with our global nutrition so if [a child] does not get proper nutrition, it will hold partners to build this momentum and will champion back a child his or her whole life." He quoted a study nutrition as part of the maternal and child health ini- from Guatemala that shows how boys who benefit- tiative at the GB Summit in June:' She said, "Not only ted from an early childhood nutrition program were does improved nutrition significantly reduce child and earning 46% more as adults. Speaking of the need maternal mortality, it also improves educational out- to build synergies across sectors, he said "we need to comes, increases productivity and economic growth ... figure out how to use some of these common platforms and... the prevention of undernutrition is therefore a for multiple purposes because sometimes there just long-term investment that greatly benefits both pres- isn't enough money to have huge programs for each ent and successive generations." Ms. Oda emphasized of these. And nutrition is a wonderful one to build on the importance of nutrition indicators across sectors: because it cuts across all others." He spoke about the "Going forward, we must place our focus on achieving Bank's strengthened staff capacity for nutrition, and optimal nutritional results based on validated indi- the potential fo r scale-up using IDA resources, including the expanded use of the new IDA crisis-response window. He also added that no sin- gle actor can accomplish what needs to be done alone, saying, "What we have clearly identified (and that's why this meeting is so important to us), is that the likelihood of success is much greater if we have a multi-partner framework." Mr. Zoellick ended by reiterating the need for countries to be in the drivers' seat, and to make this happen, "we need to try and build country capacity- and this is where Japan and the UK have stepped up." He noted with appreciation how Canada, as host of the G8, and South Nobumitsu Hayashi Hon. Beverley J. Oda Korea as the G20 host, were trying Permanent Secretary, Deputy Director-General, Minister of International to support the agenda, and thanked DFID Intern ational Bureau, Japan Cooperation, Canada In a press release, Dr. Shah said "For too long, nutri- tion has been separated from agricultural practices and food policy. We must strive to make fortified foods more available and step up proven ways to change women's and young infants' feeding and caring be- havior, where needed, through community-based programs. The approach that we're working out today marks a turning point in the way we see how agricul- ture and nutrition policy interact." USAID is working with governments in Africa, Asia, and Latin America to develop comprehensive, multisectoral plans to invest in food security and nutrit ion. Josette Sheeran, Executive Director for the World Food Programme spoke about the "burden of knowl- edge" that the global community is now faced with Hon. Viviana Caro Hinojosa Minister of Development Planning, Bolivia regarding nutrition in that we know how important good nutrition is for development and how to com- bat malnutrition effectively. She also spoke about "the cators. We are promoting incorporating real time re- convening power [the World Bank has] brought together sults tracking of nutrition outcomes in agriculture and in the diverse group ofpeople [here] shows that this issue health programs. Canada supports using a cost-effec- is really moving in to a new era." She said, "We all have tive, evidence-based approach to guide investments a huge opportunity-a historic opportunity-to bring in nutrition and to focus on high-impact activities that the food security community together with the nutrition produce sustainable results." community," adding WFP's policy stance about the need for not just supplying enough food, but the right USAID Administrator, Dr. Rajiv Shah especially kind of food, at the right time. thanked the Finance Ministers for participating in the event, saying "it is the planning and finance and According to Minouche Shafik, Permanent Secretary high-level political leadership that will successfully for the U.K. Department of International Develop- bring all of this together over time': He spoke in sup- ment (DFID). "The development community dropped port of the new Framework for Action, about how the ball on nutrition, but we've received a wake-up call the health sector needs to focus on the window of opportunity between minus 9 to 24 months of age, and how USAID's Global Health Initiative will be refocused on maternal and child health (instead of a disease-oriented approach). He also called on the de- velopment community to use nutri- tion outcomes and indicators such as stunting for measuring progress in related sectors such as water and sani- tation and agriculture-a suggestion that was supported by many other participants. Likewise, he suggested that the health sector begin to use agriculture-based indicators such as dietary diversity, access to vegetables, Hon. Juan Alberto Fuentes Knight Dr. Rajiv Shah Robert B. Zoe! and access to animal protein as core Minister of Public Finances, Admini strator, President, health indicators. Guatemala USAID World Bank in the last year:' She said the global community could no longer ignore the "burden of evidence that investing in nutrition is one of the most cost-effective development interventions we can make:' She added, ·: .. we're thrilled to see the level ofpolitical commitment around this agen- da. And we are particularly grateful to the World Bank, to the UN agencies, and to all the development partners around the table for coming together on this." She also announced the South Asia Food and Nutrition Security Initiative (SAFSNI), which will support work in Afghani- stan, Bangladesh, India, Nepal, and Pakistan. The joint DFID/ World Bank initiative aims to improve food secu- rity and nutritional outcomes across the South Asia re - gion, which will be accomplished through improving the evidence base, increasing awareness, and build- ing country-level capacities. She spoke about the new Hon. John Rwangombwa DFID nutrition strategy that wants to deliver better nu- Minister of Finance and Economic Planning, Rwanda trition outcomes for at least 12 million children over the next five yea rs across six countries where DFID will focus support and the need to use several policy levers countries and communities will be stronger and more to improve nutrition outcomes- social protection, resilient in the face of future shocks such as the food, fuel, agriculture, gender, water and sanitation, governance and financial crises." and education- an issue that was reiterated by many others in the room. Ms. Shafik ended on an optimistic Senior officials (including ministers of finance and note: "We're very keen to make up for the neglect of past planning from Rwanda, Guatemala, Bolivia, and Ethio- years and try and make really fast progress on nutrition in pia), spoke of the importance of tackling malnutrition the period ahead." and building country programs to address the issue. The Honourable John Rwangombwa, Minister of Nobumitsu Hayashi, Deputy Director-General, Finance and Economic Planning, Rwanda empha- International Bureau, Ministry of Finance, Japan, sized how his government was looking at nutrition as welcomed the new Framework for Action for Scaling a health issue, but also as a long-term development Up Nutrition and noted that it was critical to enhance goal for the country. He spoke about the need to en- capacities and political commitment in the client sure that the kind offood people are able to access ful- countries in order to put this ambitious framework fills their nutritional needs, and innovative programs into action. In this context, he spoke about the Japan such as kitchen gardens and distribution of dairy cows Trust Fund for Scaling up Nutrition Investments, anini- to provide a diversity of food at the household level. tiative to build operational capacities for nutrition in- The Honourable Juan Alberto Fuentes Knight, Min- terventions in high-burden countries in order to boost ister of Public Finances, Guatemala talked about the investments through the International Development World Bank-supported program that uses innovative Association (IDA)/World Bank. He noted that Japan systems to expand coverage of basic services to about hopes that this would "catalyse the establishment of two million children in the most remote communities a common platform for the international community in Guatemala. He also referred to the new conditional to boost necessary resources for enhanced service de- cash transfers program initiated in 2008 following in- livery [for nutrition]." Discussing the global economic ternational best practices as a mechanism to address recovery, he said, "What matters is how this economic malnutrition in Guatemala. He stressed that "a call recovery or the capital increases will help us to reach the for the commitment and coordination such as the one poor and the vulnerable, or how we listen to the voices proposed by the new Scaling Up Nutrition Framework is of those over three million infants and mothers that are highly welcome. We believe this framework can improve dying every year because of malnutrition:' Mr. Hayashi the coordination of existing resources, ensure targeting noted in a press release, "By addressing the multiple fac- of the most vulnerable populations, and guarantee the ets of undernutrition in the youngest children of today, use of most cost-effective measures needed to reduce World President David Beckmann. "That provides a solid, politically attractive basis fo r action:' Venkatesh Mannar, President of the Micronutrient Initiative, spoke on behalf of the private sector, sum- ming up that "The challenge before all of us therefore is to come to the hope we can channel the capacities of the private sector and the huge potential for good in a con- structive and responsible manner:' With 2010 marking the five-year countdown to achiev- ing the 2015 MDGs and evidence that food prices are rising again in developing countries, Dr. David Na- barro, Special Representative of UN Secretary Gen- eral Ban Ki-Moon for Food Security and Nutrition, spoke about the recent MDG meeting that noted the very slow progress on MDG 1c (the Millennium Devel- opment Goal that refers to hunger and malnutrition) and stressed the need for "nutrition-sensitive develop- ment.""/( we are going to help children in their first 1000 Robert B. Zoellick Nobumitsu Hayashi days of life, from conception to the age of two, we have President, World Bank Deputy Director-General, to be sensitive to the challenges faced by women, par- International Bureau, Japan ticularly when they are juggling childcare and trying to earn an income. Working on nutrition is not easy. The undernourished are frequently undetected in society chronic malnutrition." The Honourable Viviana Caro and even in the home. Once children are more visible, for Hinojosa, Minister of Development Planning, Bo- example when they are in school, much of the damage livia brought up the need for health systems reforms has been done. And so, what is needed now is a really to effectively implement nutrition programs, as well strong movement to address the challenge of undernu- as Bolivia's vulnerability to recurrent shocks, and the trition, to scale up nutrition, to champion the effort, but need to manage natural resources effectively to in- most importantly to bring multiple actors together in crease resilience among the rural agricultural popula- a movement." He said, "The Scaling Up Nutrition-or tions. Dr. Kesetebirhan Admasu Birhane, Director SUN-Framework has the potential to mobilize all of us General for Health Promotion and Disease Preven- behind a smart new approach for vastly better develop- tion, Ethiopia discussed Ethiopia's National Nutri- ment outcomes." He ended by saying on behalf of the tion Program, developed in 2008 and implemented UN family, " We wish to lend all our weight to this new through the Health Extension Program, which em- movement that is being launched today." ploys a vast cadre of health extension workers to de- liver "preventive, promotive, and basic curative services Representatives from the Bill & Melinda Gates Founda- at the community and household level :' He spoke about t ion, G8 member countries (France, Germany, Spain), how "The centerpiece of the Health Extension Program is the European Commission, FAO, UNICEF, and World newborn child health and nutrition." Vision all issued strong statement s in support of the SUN Framework for Action and the scale-up efforts, Country delegations from finance, health, planning, engaging civil society and other actors at all levels agriculture, and social protection-as well as civil so- in this multi-partner framework, and harnessing the ciety organizations and bilateral partners, highlighted power of both direct and multi-sectoral actions. Not- achievement and challenges to scaling up effective ing that France had adopted a new nutrition strategy approaches to address undernutrition. "Many civil so- last year, Sujiro Seam, Ministry of Foreign and Eu- ciety groups around the world are thrilled that there is ropean Affairs, reiterated the need to act at all levels, now international consensus about the most effective from the community upwards. Saad Houry, Deputy strategy to tackle undernutrition;' said Bread for the Executive Director, UNICEF spoke about the impli- cations of these discussions for the next installment of the MDGs-to ensure that human development is- sues are tackled in a serious manner, and noted how nutrition embodies the complexity and the inter-relat- edness of these issues. Mr. Bayartsogt, State Secre- tary for Finance from Mongolia reiterated that this initiative will help developing countries to address poverty and undernutrition. Akol Rose Okullu, Mem- ber of Parliament from Uganda and chairperson of the budget committee voiced her President's commit- ment to improving nutrition outcomes through both direct and indirect strategies. Noting that Ireland will co-host, with U.S. Secretary of State Clinton, a nutrition event at the MDG Sum- mit in September, Peter Power, Minister of State, Department of Foreign Affairs, Ireland, who was unable to attend, wrote in a letter distributed to participants: "There is an urgent need to fast-track Venkatesh Mannar President, Micronutrient Initiative progress toward meeting the Millennium Develop- ment Goals and to push for a truly comprehensive approach to eliminating hunger; one that delivers the common goal of improving nutrition outcomes for trition plans as key elements of their human capital poor people." strategies, Graeme Wheeler, Managing Director at the World Bank closed the meeting with the com- Observing the level of support, consensus and en- ment that "This is a historic meeting. It's the first time in thusiasm from all constituencies present, and the the history of nutrition that the global community has compelling stories from ministers from developing rallied around a common message and a common call countries about the emphasis they are placing on nu- to action." Capturing the timeliness of the meeting, he said, ''This meeting could not have happened three years ago... but in the last two or three years, we've seen some excellent empirical work that's been undertaken on the scale of the problem, on the linkages, and on the cycles of poverty in terms of malnourished mothers producing malnourished children who are more likely to die. And, if they are fortunate enough to survive, the children will likely be less productive as adults, and perpetuate cycles of poverty and malnutrition, yet again:' He ended with the note that "we have the solutions in our hands," and that there is now "tremendous opportunity" in front of the development community to act at scale to ad- dress malnutrition. "The Framework for Action has over 80 signatories-it is truly a multi-partner effort and for us in the Bank, we're just a small part of it, but hopefully an important part. We're very proud to be a part of this scale-up effort." The meeting ended with a viewing of the newly re- leased video, Investing in Nutrition : Let's Grow Together David Beckmann (www.youtu be. com/ watch ?v=yysyFtjcgzf) . President, Bread for the World Endorsements for the Sea lin Nutrition {SUN) Framewor ~- @l ~ BILL & MELINDA GATES foundation Connecting People > Creating Change ADRA W' Mllllt.»>MIIJITI()N$0CilTI ... Universi ti! 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