The United Nations estimates that more than one billion people suffered from hunger in 2009. Worldwide, nearly 250 million children under age five are underweight or malnourished. For children of this age, malnutrition contributes to more than one-third of deaths, about 3.5 million annually. But, despite the best efforts of development and humanitarian organizations, the fight against hunger has been stalled for the past decade. The United Nations Millennium Development Goal of halving the number of underweight children by 2015 is unlikely to be met.
Why is this issue so hard to solve? Let’s examine the heart of the problem: the undernourished child. He or she likely suffers from insufficient food intake, poor hygiene and health, improper dietary practices, or any of several other causes. All these conditions need to be addressed simultaneously in order to achieve success. In practice, however, each tends to be addressed in isolation.
The good news is that proven and cost-effective interventions exist to address these causes. The promotion of exclusive breastfeeding, the treatment of household water, the provision of nutritional supplements, and food fortification, for example, all contribute to the prevention of hunger and malnutrition. Yet most children in need never benefit from these relatively inexpensive, well-studied solutions.
Why? Lack of funding is one problem. The largest challenge, however, is the fragmented landscape of wellmeaning organizations, each pursuing its own agenda. In a country such as Bangladesh, for example, hundreds of organizations are trying to address child malnutrition. Most, however, focus only on particular interventions and operate at a small scale in specific regions. This collection of separate activities provides spotty coverage (See Exhibit 1). By contrast, a comprehensive solution can ensure that several interventions reach each child.
Clear organizational responsibility and accountability are also missing. Within most governments, the responsibility for eradicating hunger and malnutrition is distributed across many agencies, such as agriculture, health, and—depending on the country—social affairs, women’s affairs, disaster management, and fishery. This fragmentation is mirrored in the community of development and humanitarian organizations.
Within the United Nations, for example, at least four key agencies are fighting against hunger as part of their mission: the United Nation Children’s Fund (UNICEF), the World Food Programme (WFP), the Food and Agriculture Organization (FAO), and the World Health Organization (WHO). The problem of malnutrition often falls through the cracks of responsibility.
One potential solution would be to reorganize and rationalize responsibilities among all these parties. But this is unrealistic, given the political realities and the complex landscape of the organizations involved.
The best practical alternative, therefore, is to ensure that all stakeholders collaborate effectively with one another in joint efforts that have the overall well-being of children as their primary objective. But collaboration does not just happen. It is an undertaking that requires resources, analysis, planning, monitoring, stakeholder management, patience, and persistence.