Institute Insights: December 2019


Global Gathering of the Scaling Up Nutrition (SUN) Movement, in Kathmandu, Nepal.

From the Director

As 2019 draws to a close, Institute Insights offers updates on several of the most critical issues in the effort to end hunger and all forms of malnutrition in ways that the world’s people can sustain. Little more than a decade remains before the due date of the Sustainable Development Goals (SDGs), which was set in 2015 when nearly every country in the world adopted the SDGs. That deadline is December 31, 2030.

I returned just recently from a large and energizing gathering of nutrition advocates in Kathmandu, Nepal. This was the Global Gathering of the Scaling Up Nutrition (SUN) Movement. It was so encouraging to be with 1,200 colleagues from dozens of countries, all of whom are working to extend the reach of proven strategies to prevent and treat malnutrition. Research has shown what works—now, advocates in government, civil society, and the private sector need to continue identifying the most effective ways to reach more people at risk. I describe some of my “takeaways” in “Basking in the SUN” in this issue.

Also in this issue: more on how U.S. development assistance enables Kenya to make progress on malnutrition, drawing on this year’s visit by Bread for the World Institute; why 2019 has been a “hot” year for climate in more ways than one; and what U.S. advocates today can learn from the first and only White House conference on food and nutrition, held in 1969.

Also in 2019, U.K. medical journal The Lancet released its report, Food Planet Health: Healthy Diets from Sustainable Food Systems, commonly known as the EAT Lancet report. The motivation for preparing the report is straightforward, as the report explains at the outset: “Food is the single strongest lever to optimize human health and environmental sustainability on Earth. However, food is currently threatening both people and planet.”

The report generated a great deal of discussion, some of it critical, on a wide range of issues. But the following three recommendations for people in the United States are most likely here to stay: Eat less meat, less sugar, and fewer starches.

The holiday season boasts many occasions where elements of a planet-healthy diet could potentially be incorporated. The U.S. population also seems to have a growing awareness of the important reasons to improve the nation’s eating habits. I would be surprised, though, if many people have been taking advantage of this “potential” by adding new recipes—much less taking away old favorites.

Most people would agree that awareness doesn’t necessarily lead to change, especially rapid or dramatic change. But awareness is an essential first step. After all, there can be no lasting change if those who are expected to make the changes see little or no immediate reason for them.

The recent celebration of Thanksgiving reminded us that the American diet has changed considerably. The main meal at the first Thanksgiving, believed to have been celebrated in 1621, may have had about 700 calories and 10 grams of fat—certainly a feast compared to the meals people usually ate, but far less “indulgent” than many of today’s holiday meals. A number of “traditional” foods weren’t served at all since they were not yet either grown locally or imported. Nothing contained butter, flour, or sugar (of course, this means no pumpkin pie), and there were no potatoes, sweet potatoes, or sweet corn. The primary meat served was venison, not turkey, because a local wild turkey provided very little meat. We now have an abundance of enjoyable foods, but too many people are still not able to access the foods that are good for their health, and our food choices are not good for our planet.

This year The New York Times offered an approach to the Lancet’s “eat less meat” recommendation. More accurately, it was an “eat no meat” approach—an extensive vegan Thanksgiving menu featuring beyond-basic-ingredients recipes from appetizers to desserts. Also this year, an Institute colleague participated in one of a growing number of “alternative” celebrations. This one was a vegan potluck at a sanctuary for farm animals—an event known as “Thanksgiving With the Turkeys.”

Thanksgiving in its early years was similar to today’s holiday in its focus on gratitude, family, and friends—but it was generally a three-day celebration. We are grateful for all our partners engaged in the work of ending hunger and poverty and building a more just and peaceful world. Thank you for all that you do. Happy holidays from Bread for the World Institute!

Asma Lateef is director of Bread for the World Institute

Asma Lateef is director of Bread for the World Institute.

P.S. For more on climate change and four other top-priority action areas for the anti-hunger movement, see the 2019 Hunger Report, Back to Basics: How to End Hunger by 2030.

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Children at the Nutrition Rehabilitation Home in Dhangadhi, Nepal, receive their 4 a.m. milk feeding on Monday, April 30, 2012. Photo by Laura Elizabeth Pohl/Bread for the World

Basking in the SUN

By Asma Lateef

In 2011, Nepal became the fifth country to join the Scaling Up Nutrition (SUN) Movement. In November 2019, it proudly hosted the 5th SUN Movement Global Gathering (#SUNGG19), the largest convening in the country’s history with about 1,200 participants. Representing dozens of countries, the delegates work to support SUN’s mission of expanding effective malnutrition prevention and treatment measures so that they reach as many people at risk as possible.

Malnutrition is a tragedy that kills all too many young children and leaves those who survive suffering from stunting, which causes lifelong health problems and developmental delays. Nepal has made significant progress in reducing its stunting rates—from 57 percent of all children under 5 in 2001 to 36 percent in 2016. But there is a long way to go to meet the 2025 World Health Assembly Nutrition Targets. Most of the 61 SUN countries and four Indian states also have a great deal of work ahead of them.

Yet what struck me most about this Global Gathering was the determination, drive, and motivation of the participants, most of whom came to Kathmandu from far-flung parts of Latin America, sub-Saharan Africa, and Asia. Yes, the challenges were very much on everyone’s minds, but there was also a sense of momentum across the board, among SUN country government focal points and their teams, the many parliamentarians, civil society advocates, representatives of the private sector, and donors.

A few reflections:

  • The discussions I observed and participated in involved people wrestling with the right issues, the difficult issues, focused closely on the “how.” There was an enormous thirst to learn from different experiences and approaches: what is working, what is not, and why not.
  • There was a sense of urgency, driven partly by participating youth leaders. They reminded everyone that in 2030, the world is supposed to have ended malnutrition, and they will be in their prime working and parenting years. They emphasized the enormous human costs of malnutrition, especially for women and girls—lives lost and futures compromised.

    High rates of malnutrition also mean that nations are far less able to compete in a complex world—this at a time when climate change is already causing damage and, even if countries act immediately to end greenhouse gas emissions, will get worse before it gets better.
  • There is strong agreement within the Movement that SUN’s approach is difficult but necessary and well worth the effort. Bringing together diverse stakeholders and working across sectors is the most sustainable way to tackle complex issues. But it requires a common language, patience, nurturing, and building trust, and there is a lot more work to be done to truly live into this vision.

    All stakeholders must intentionally work to put aside institutional interests and priorities.  Hierarchies and other structures that prevent some of the best ideas from being heard must be dismantled. The priority should be to create a level playing field—in a world of structural barriers and great disparities in financial resources, access to information, and respect for individual rights. SUN’s first nine years have laid the foundation. More dialogue and more openness to change will accelerate progress.
  • Civil society is up to the challenge! It was exciting to see country civil society alliances not only actively engaged, but leading efforts and piloting innovations. There are now more than 3,000 civil society organizations in the SUN Movement, expanding its reach considerably. Parliamentarians told us that civil society organizations were helping them by educating them about the urgency of ending maternal/child malnutrition, supporting their oversight responsibilities by tracking nutrition expenditures and budgeting, and advocating for a legal framework to support nutrition.

    Civil society alliances have come together in regional groups to learn from and support one another—an approach that is getting attention. Civil society is helping to translate national plans into local languages at the subnational, provincial, and district levels, so that more communities can become engaged in their children’s nutrition. Efforts to build greater understanding and trust with the private sector have begun.

    Civil society groups face a number of challenges: shrinking space in some countries, lack of understanding of their role, and perennial resource challenges. These are disruptive and can put at risk the sustainability of their own efforts and those of the movement as a whole.
  • In less visible yet essential ways, the Movement has matured. The government, civil society, and private sectors of member countries are more confident in taking leadership. Continued efforts to raise awareness and make the case for nutrition are important but no longer the only focus: much progress has been made in laying the foundations and creating the infrastructure at both the national and global levels that is needed to achieve sustainable results. These include, for example, policies, strategies, data collection, monitoring and evaluation, and multi-stakeholder platforms. Efforts to improve these elements must continue, always with a focus on how to speed up implementation—so that no one is left behind as progress against malnutrition continues.  
  • The U.S. government, especially USAID, has a long history of cooperation, collaboration, and support for Nepal’s efforts to reduce malnutrition. It was really encouraging to hear Beth Dunford, the Assistant to the Administrator in USAID’s Bureau for Food Security and the Deputy Coordinator for Development of Feed the Future, reflect on that history, the progress she has seen in Nepal, and her hopes for the future in her remarks at the opening plenary.

This year’s Global Gathering took place at a critical time. The Movement’s tenth anniversary and its next phase and strategy are on the horizon, and preparations are underway for the next Nutrition for Growth summit, which is being hosted by Japan. The gathering in Nepal was an opportunity to reflect on progress, discuss challenges, and begin to identify future directions.

The people of Nepal and Kathmandu have a lot to be proud of. They were amazing hosts and role models. I came away from Kathmandu inspired and energized, hopeful for the future, and with a sense of enormous responsibility. I suspect I was not alone in any of this.

Asma Lateef is director of Bread for the World Institute.

July and September were two of the hottest months ever recorded, including in Europe. Temperatures in Frankfurt, Germany, reached at least 90 degrees (32 degrees Celsius) rather than the typical 70 degrees (21 degrees Celsius). Photo: iStock

A Hot Year for Climate

By Karyn Bigelow

Literally and figuratively, climate change has had a hot year. Throughout 2019, my colleagues and I have written about the immense obstacle posed by climate change to global efforts to build food security and end hunger. Our analysis has emphasized the need for advance planning to help communities survive and recover from increasingly common climate-related shocks, ranging from extremely strong hurricanes to droughts that drag on season after season.

One possible silver lining of 2019’s record-setting temperatures and natural disasters is that more and more people, even in countries that have suffered less impact so far, are aware that climate change is not just a potential problem for future generations, but an urgent problem here and now.

July and September were two of the hottest months ever recorded, including in Europe. Temperatures in Frankfurt, Germany, reached at least 90 degrees (32 degrees Celsius) rather than the typical 70 degrees (21 degrees Celsius). In France, despite a public information campaign urging people to take steps to stay safe during an extreme heat wave, nearly 1,500 people died of heat-related causes. Most recently, the city of Venice suffered extreme flooding. The United States lost 21 people in Chicago to the effects of the polar vortex.

Millions of people in the worst-affected countries have watched their farms turn to dust or their homes be swept away; they don’t have the luxury of thinking that the world can afford to wait. The science agrees with them: the necessary policies to reach zero net emissions by 2030 must be put in place by 2020. Reaching zero net emissions by 2030 is, in turn, a milestone essential to averting a catastrophic increase in Earth’s core temperature, defined as an increase of more than 1.5 degrees Celsius (2.7 degrees F).

Most visible this year has been the mobilization of youth and young adults to demand action on climate change. The Fridays for the Future movement, led by Greta Thunberg, went global. The Friday before the UN Climate Action Summit in September, youth and young adults held demonstrations in more than 150 countries. It has been heartening to see the energy of these younger generations.

In January, the most diverse Congress in U.S. history was sworn into office. There was a new energy on Capitol Hill with many members, new and returning, holding hearings on the impact of climate change in different sectors. Legislation that contained a bold response to climate change was introduced, although it has so far not won bipartisan support. Some members called for the United States to recommit to the Paris Climate Agreement. Earlier this year, the administration announced that the United States will take official steps to withdraw from the agreement, although according to the rules, formal withdrawal cannot take place until late 2020.

At this writing, in late November, the U.S. political environment has so far stymied congressional climate action. But there is still hope for future bipartisan climate action, as shown by the creation of the House Select Committee on the Climate Crisis and the new Senate Climate Solutions Caucus. 2020 will be an eventful year. In the context of climatologists’ warnings that countries must begin implementing a plan to reach zero net emissions this year, measures to garner political and financial support for effective action are more important than ever. Five years after the Paris Climate Agreement was adopted, thousands of people will be in Glasgow, Scotland, in November 2020 for the 2020 U.N. Climate Change Conference (UNFCCC COP 26). COP 26 will focus on securing additional country commitments to cut emissions.

Karyn Bigelow is research associate with Bread for the World Institute.

“The families here are attracted to school by the food,” explains the headmaster of a primary school visited by staff from Bread for the World Institute. “Without the lunch, most of these kids will not be here.” Photo: Todd Post/Bread for the World

A Home-Grown School Meals Program in Kenya

By Todd Post

School meal programs are a vital safety net for children and their families around the world. In few places is this more apparent than in Turkana County, part of arid Northwest Kenya.

The poverty rate in Turkana is 80 percent, the highest level in the country, according to the Kenya National Bureau of Statistics.1 Nearly a million people live in the county, spread over an area slightly larger than West Virginia.

The harsh environment makes it very hard to do much farming. Long dry spells have always been a way of life, but climate change is increasing the intensity of droughts, shortening rainy seasons, and reducing food supplies. Some of the children who eat a hot lunch through the school meal program have nothing to eat when they return home.

The difficult terrain explains why Turkana is a pastoralist society. Like generations before them, most of the population are nomadic herders of goats, sheep, and camels. To find water for the animals, families are regularly on the move, walking long distances from one location to another. The mobility of the families makes it difficult for children to remain in school. School meal programs have given parents an incentive to send their children to school and keep them there.

“The families here are attracted to school by the food,” explains the headmaster of a primary school visited by staff from Bread for the World Institute. “Without the lunch, most of these kids will not be here.”

At lunch time, we follow the children as they run with their bowls to the kitchen, where the school chef, a local woman who seems to love her job, ladles a porridge made of sorghum and cowpeas. Both these foods are drought-tolerant plants that are high in nutritional value and locally grown.

The U.S. Department of Agriculture (USDA) provides support to the World Food Program (WFP) to purchase food from local farmers to supply schools in this and other localities. WFP has been working with the Kenyan Ministry of Education since 1980 to implement school meal programs in Turkana and other high-poverty areas of the country. USDA’s support for school feeding in Kenya is now through the McGovern-Dole Food for Education Program, established in 2004. The program provides training for chefs and school administrators in how to maintain sanitation standards in an institutional kitchen and how to preserve nutrients while cooking.

Areas like Turkana with high poverty rates have low school enrollment rates and, usually, significant underrepresentation of girls.2 School meals have been shown to increase girls’ enrollment and reduce their dropout rates. Educated women have more agency in their own lives, give birth to healthier babies at lower risk of malnutrition, and are in a better position to contribute to public life and the national economy. It is hard to think of investments that do more than school meal programs to end intergenerational cycles of poverty and hunger.

In 2018, the Kenyan government formally assumed responsibility for the school meal program in Turkana and other arid and semi-arid areas of the country. USDA and WFP continue to support the transition to ensure that the government doesn’t encounter unexpected obstacles to providing all 1.6 million schoolchildren served by this program with a hot lunch.3

Todd Post is senior researcher, writer, and editor with Bread for the World Institute.


A farmers market in Takoma/Langley Crossroads. Joseph Molieri for Bread for the World

Looking Back 50 Years, Looking Forward to Better Nutrition

By Tanuja Rastogi

It can sometimes seem as though the United States isn’t getting any closer to ending hunger. More than 40 million Americans live in low-income households that struggle to put food on the table; they qualify for benefits from the Supplemental Nutrition Assistance Program (SNAP) to help pay for groceries. Despite the record low unemployment rates in 2019, this figure has not changed much from that of the deepest point of the Great Recession.

Anti-hunger advocates can draw encouragement from what people were able to accomplish in another era, one marked by rapid changes. It was 1969, and Richard Nixon was in the White House. The civil rights movement, the women’s movement, deep divides over the Vietnam War, and other struggles were the backdrop to growing public outrage over hunger and deep poverty in the United States. Awareness and shock increased as people heard about Robert Kennedy’s famous visits to parts of the United States that simply didn’t match our national self-image, Dr. Martin Luther King Jr.’s Poor People’s Campaign, and startling glimpses of other American realities.

This year is the 50th anniversary of the first and only White House Conference on Food, Nutrition, and Health. Nutrition leaders such as Dr. Jean Mayer and hundreds of researchers, activists, and policymakers came together to elevate hunger and malnutrition as national responsibilities. They wanted to strengthen the government’s infrastructure, its ability to fulfill its responsibilities to all its people.

“Bread Now!” was what activists demanded, and policymakers agreed that the nation needed to transform and scale up its nutrition and food assistance programs to meet the needs of millions of vulnerable children, women, and families.

The Conference was undoubtedly a pivotal moment in the public health history of the United States. It ushered in congressional hearings as well as actions, including the overhaul and scaling up of national safety net programs focused on food and nutrition security. New federally funded programs were established, including the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which now serves half of all babies born in this country. Others, such as school meals and what is now the Supplemental Nutrition Assistance Program (SNAP), were significantly expanded.

The nutrition community came together this October to observe the Conference’s 50th anniversary and reflect on its legacy. The event, held on Capitol Hill, was an opportunity both to praise the unprecedented leadership shown in that era and to once again galvanize the community to tackle the nation’s current hunger, nutrition, and health crises.

One after another, speakers at the gathering—academics, activists, and leaders—reminded the crowd of daunting statistics, such as high national hunger and food insecurity levels (nearly one person in eight) and obesity rates (40 percent of all adults). Brigadier General Allyson Solomon highlighted the links to national security, pointing out that childhood obesity is one reason more than 70 percent of young Americans are not qualified to join the military.

The complexity of current challenges makes them vastly different from those of 50 years ago, and the solutions will require input from all segments and sectors of society. Growing recognition of the strong connection between healthy diets and sustainable food systems means that both a broader lens and a more integrated set of actions are needed. This can begin with government—better policies, legislation, and research—but also calls for new efforts from the private sector and grassroots organizations.

Yet looking back at the White House conference of 1969 offers insights on the ways forward we need now, as well as encouragement. Tufts Professor Johanna Dwyer summed up these takeaways, commending the sense of activism that enveloped the community and the significant progress that was achieved when people of goodwill came together to help solve very difficult problems.

Tanuja Rastogi is senior global nutrition policy advisor with Bread for the World Institute.

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