Category: Global

15 Years of Change: Opening the Window of Opportunity for Mothers and Children 

This year, 1,000 Days celebrates 15 years of advocacy, impact, and progress. We’ve spent a decade and a half protecting the first 1,000 days—a window of opportunity that shapes lifelong health and equity. Read through our timeline of key moments and big wins in nutrition advocacy and celebrate with us.  

2008

2010

  • 1,000 Days, the organization, is born.  

2012

  • The World Health Assembly sets six targets to accelerate global action on malnutrition. 1,000 Days goes on to partner with the World Bank to promote these targets through a series of iconic images and infographics.

2013

  • The first Nutrition for Growth Summit (N4G) is held in London. 100 stakeholders endorse the Global N4G Compact and pledge more than $23 billion.
  • In a landmark follow up to its 2008 publication, The Lancet releases an updated series on maternal and child nutrition, revealing that malnutrition is responsible for nearly half of all child deaths each year—3 million children under age 5—and is the single greatest threat to child survival.
  • What to Expect® creator Heidi Murkoff teams up with 1,000 Days to raise awareness and advocate on behalf of women and children worldwide.

2014

  • 1,000 Days launches The International Coalition for Advocacy on Nutrition (ICAN) to mobilize more and better resources and policies for nutrition while also holding N4G commitment makers, especially donor countries, accountable for their pledges.
  • The Global Nutrition Report (GNR) is established to track progress against global nutrition targets and the commitments made to reach them. 1,000 Days goes on to help produce the GNR in the years to come.  

2015

  • 1,000 Days expands its focus to include issues that impact the nutrition and well-being of mothers, babies and toddlers in the United States.
  • 1,000 Days hosts nutrition leaders and advocates, including Melinda Gates, on Capitol Hill to “light the torch” for nutrition in advance of the 2016 Summer Olympics in Brazil. 

2016

2017

2018

  • We launch our first set of parent education videos in partnership with the CDC on infant and toddler feeding, reaching millions of parents across the country.

2019

2020

  • We join FHI 360, an international nonprofit working to improve the health and well-being of people in the United States and around the world.
  • For the first time ever, the 2020-2025 Dietary Guidelines for Americans provide advice by life stage, including specific recommendations for infants, toddlers, and pregnant and lactating women in the first 1,000 days.
  • 1,000 Days, Bread for the World, and The Chicago Council on Global Affairs host a virtual dialogue on the impact of COVID-19 on global malnutrition.  

2021

2022

2023

  • 1,000 Days surveys and interviews 224 Black pregnant and postpartum moms in the United States to better understand the perceptions and attitudes around the nutritional information they receive before, during, and after pregnancy.

2024

  • 1,000 Days and FHI 360 launch Closing the Gender Nutrition Gap: An Action Agenda for Women and Girls, a global framework of concrete actions to improve women and girls rights, advance gender equality, and improve their nutrition.
  • 1,000 Days co-hosts Lasting Nutrition for Moms and Babies, a congressional briefing focused on how the U.S. Government and its global partners are coming together to improve nutrition outcomes and uplift mothers and babies around the world. 
Image of parents with infant

2025

  • Global leaders come together at the Paris Nutrition for Growth Summit to pledge action towards the challenge of malnutrition and pledge almost $28 billion in nutrition funding.  
  • 1,000 Days celebrates 15 years of advocacy, impact, and progress. We’ve spent a decade and a half protecting the first 1,000 days—a window of opportunity that shapes lifelong health and equity. We’re excited to see what we can accomplish next!

Support Breastfeeding, Nourish the Future

Breastfeeding lays the foundation for child health and development, offering lifelong benefits for babies and mothers. Yet, despite its proven benefits, breastfeeding rates remain low both in the U.S. and around the world.

As we mark World Breastfeeding Week and National Breastfeeding Month (U.S.), 1,000 Days honors the strides made in supporting breastfeeding families and recognizes the ongoing need for stronger policies, resources, and community support to ensure every family has the opportunity to begin and continue breastfeeding.

We all have a role to play in supporting breastfeeding, and we hope you’ll join us in celebrating breastfeeding this week and month online by visiting our 2025 Breastfeeding Inspiration Guide.

Why Anemia is Holding Women Back

This year, the world will come together to celebrate International Women’s Day under the theme: “For ALL women and girls: Rights. Equality. Empowerment.” This year’s theme is a powerful call to action, urging us to unlock opportunities and champion a future where no one is left behind.

At 1,000 Days, we believe achieving this vision starts with one fundamental pillar: good nutrition. And yet, for one in three women and girls, anemia—a condition primarily caused by poor nutrition—continues to stand in the way of their health, economic potential, and empowerment.

Anemia: A silent barrier to women’s health and potential

Anemia affects half a billion women of reproductive age worldwide, with iron deficiency being the most common cause. This condition is not just about feeling tired—it weakens immune systems and increases risk of infections. During pregnancy, anemia has been associated with poor outcomes for both mothers and babies, including premature birth, low birth weight and maternal mortality. Women suffering from severe anemia during pregnancy are twice as likely to die during or shortly after pregnancy than non-anemic women, and anemia is the cause of 20% of maternal deaths worldwide.

Anemia is not only a health issue; it’s a barrier to women’s and girl’s potential too. Anemia causes extreme fatigue and poor concentration, hindering learning potential, educational attainment, and productivity. Women and girls, particularly those in low-income and marginalized communities, often face more significant obstacles in accessing the iron-rich foods, supplements, and healthcare they need. These barriers perpetuate cycles of malnutrition and poverty, preventing women from fully participating in society and the economy.

Addressing anemia accelerates change

When we invest in tackling anemia, we invest in stronger women, healthier families, and more resilient economies. The benefits of addressing anemia are profound:

  1. Healthier Pregnancies & Babies: Anemia in pregnancy increases the risk of preterm birth by 30% and low birth weight by 40%. Ensuring pregnant women have access to iron and folic acid can save lives and improve newborn health.
  2. Stronger Women:  Adolescent girls with anemia often struggle in school due to cognitive impairments linked to iron deficiency. Research has proven that anemia negatively impacts work performance and productivity. When women and girls have access to the nutrition they need, they can achieve their potential, participate fully in society, and build security for their families.
  3. Better Economic Outcomes:  Research from the World Bank estimates that anemia reduces work productivity by up to 17%, costing some economies more than $70 billion annually in lost productivity. Addressing anemia means stronger economies and stronger women in the workforce.

How we can accelerate change

Fighting anemia requires urgent, multisectoral action. Here’s how we can make an impact:

  1. Expand access to Multiple Micronutrient Supplementation (MMS): Governments and health systems must ensure women and adolescent girls have access to essential nutrition interventions, including multiple micronutrient supplementation and prenatal care. According to UNICEF, scaled-up MMS can drive country-level progress towards global goals and targets to improve anemia, low birth weight, wasting, and stunting.
  2. Scale food fortification: Investing in food fortification—adding iron to staple foods like flour, maize flour, rice, and oil—can effectively reduce anemia rates for just pennies. Countries like India have seen success by fortifying staples with vitamin B-12, iron and folic acid, providing a cost-effective solution to widespread deficiencies.
  3. Prioritize Girls’ & Women’s Health in Policies: Nutrition must be integrated into national health and gender equality plans. Governments, nonprofits, and the private sector must work together to eliminate obstacles for women and children to good nutrition.
  4. Educate & Empower Young Women: Young women and adolescent girls must be equipped with nutrition knowledge to advocate for their health and futures. Schools and communities play a vital role in ensuring this education reaches those who need it most. Studies show that nutrition education programs have increased iron intake among adolescent girls.

A future where no one is left behind

This International Women’s Day, we can take bold action to ensure every woman and girl—regardless of income, geography, or status—has the right to the nutrition she needs to thrive. 

Anemia is a solvable challenge. By investing in solutions today, we are building a future where all women and girls can rise, lead, and shape a more just and equal world.

Join us in advocating for change. Together, we can make anemia a thing of the past and build a future where women’s health is never a barrier to their rights, equality, or empowerment.

Take Action: Share this message. Advocate for maternal and adolescent nutrition. Support policies that expand access to essential nutrition services. Because when women are strong, we all rise.

National Nutrition Month: A Time to Connect

March is our favorite time of year: it’s National Nutrition Month®!

At 1,000 Days, we believe that every family, everywhere deserves the opportunity to have a healthy 1,000-day window and beyond – and that starts with access to good nutrition. Decades of research has shown that nutrition plays a foundational role in a child’s development and her country’s ability to prosper.

This year is extra special as we focus on food as a connecting factor for all of us – connecting us to our cultures, our families, our babies and our friends.

Follow #March4Nutrition on Facebook, Instagram, LinkedIn, and Twitter/X all month long and join the conversation.

Find our social media toolkit here.

Making strides towards nutrition and gender equality in Nigeria

By Lilian Okafor, CS-SUNN

In Nigeria, malnutrition not only affects individuals, but also stunts economic growth and human development. The Women and Girls’ Nutrition Project is a collaborative effort implemented by the Civil Society-Scaling Up Nutrition in Nigeria (CS-SUNN), in partnership with FHI360, Alive & Thrive, 1,000 Days, and Intake, supported by the Bill & Melinda Gates Foundation. The project aims to empower women and girls to achieve optimal nutrition and stand as crucial pillars for progress.

The project partnered with federal Ministries, Departments, and Agencies relevant to nutrition to develop a cross-cutting Action Agenda for women and girls’ nutrition in Nigeria that delivers healthy diets, care, gender equality, and a multi-system enabling environment as priorities for a thriving female from girlhood. These include:

  • Support the nutrition department of the Federal Ministry of Women Affairs and Social Development to develop national guidelines on women and girls’ empowerment for optimal nutrition by September 2024.
  • Secure commitments of Federal Ministries, Departments, and Agencies (MDAs) relevant to nutrition (Ministry of Health, Ministry of Women Affairs & Social Development, Ministry of Education, Ministry of Finance, Budget and National Planning, Ministry of Agriculture and Rural Development) to increase the number of women in decision-making positions by at least 10% by 2024.
  • Increase gender equity in the access and utilization of public economic empowerment schemes by at least 10% nationally by 2024.
  • Increase awareness of professionals at the federal level, who have the potential to become champions, on the benefits of girls staying in school beyond basic education and the impact on nutrition outcomes.

Milestones Achieved:

The journey towards this transformative vision has been marked by a series of significant milestones:

  • National Workshop on Women and Girls Nutrition: Leveraging momentum towards the pursuit of gender-inclusive nutrition, the National Workshop on Women and Girls Nutrition proved a pivotal event, uniting stakeholders from across Nigeria in a shared mission. Over two days, a dynamic blend of in-person and online participation brought together 167 virtual attendees with 30 enthusiastic on-site participants. Through a diverse array of activities spanning presentations, group discussions, and brainstorming sessions, participants collaborated to create an advocacy goal and four strategic objectives tailored to Nigeria’s unique context. Following this workshop, the coalition then agreed crafted a comprehensive advocacy strategy delineating actionable pathways towards achieving project objectives and engaging stakeholders across key sectors.
  • National Guideline for Women and Girl’s Nutrition for Optimal Nutrition: CS-SUNN successfully achieved the primary objective of the Women Nutrition Project by supporting the Federal Ministry of Women Affairs and Social Development to develop a National Guideline on Women and Girls’ Empowerment for Optimal Nutrition. This involved convening a crucial gathering of nutrition stakeholders, including government ministries, agencies, and partners, to review and shape the guidelines content and framework. The resulting guideline, spanning six key sections, addresses critical aspects of empowerment principles, program initiatives, policies, coordination mechanisms, and implementation strategies. The Guidelines were recently validated and has been adopted by the  key stakeholders including the Federal Ministry of Women Affairs, representing a key step towards empowering women and girls nationwide. It will be launched before the end of 2024.
  • Women In Power Conference: In May, the coalition hosted the Women in Power Conference for Nutrition, convening women from various spheres of society, including governor’s wives and accomplished professionals. The conference served as a platform to spotlight the pivotal roles women play in driving advancements in women and girls’ nutrition at the state level. Encouragingly, there is strong enthusiasm to establish this conference as an annual fixture in Nigeria, serving as a forum to evaluate the progress and commitments made by governor’s wives in advancing the nutrition agenda.
Governors’ Wives at the maiden Women in Power Conference for Nutrition
  • Media Engagement: Leveraging the power of media, CS-SUNN organized media roundtable sessions to raise awareness, secure media support, and promote discussion on policy actions required on women and girls’ nutrition. The events garnered extensive coverage across prominent media, amplifying the discourse on this critical issue. With series of social media campaigns like; Women and Girl’s Nutrition: Why it Matters, gender equity in accessing public economic empowerment schemes, alongside the importance of girl-child education beyond basic schooling, CS-SUNN elevated awareness and advocacies for empowering women. Collaborating with partners such as Bridge Connect, wcyheIN, and Womenadvocate and leveraging visually appealing social cards and hashtags like #NutritionTuesday, #Nutri4Women, and #Nutri4Girls, trackable metrics underscored the campaigns’ impact, with significant reach and engagement rates observed across platforms.
Media roundtable hosted by CS-SUNN
  • Community Empowerment: Recognizing the importance of grassroots engagement, community town hall meetings were conducted to mobilize support from and empower local leaders. These interactions fostered commitments by community leaders to set up committees headed by cabinet members to sensitize households within their communities on the need to empower women and the girl child through access to quality education and livelihood support.

Looking Ahead

The Women and Girls’ Nutrition Project stands as a testament to the power of collaboration, innovation, and determination. Building on the momentum generated, the project will drive lasting change by: addressing cultural barriers through community involvement; educating mothers on the importance of girl-child education; introducing media study circles to deepen media coverage on women’s nutrition; and shifting an advocacy focus to implementation, ensuring that advocacy efforts translate into tangible policy changes and action.

Through concerted efforts and unwavering commitment, we move closer to a future where every woman and girl in Nigeria has the opportunity to thrive and to contribute to a healthier, more prosperous nation.

From Food Security to Nutrition Security: Bridging the Gap for a Healthier World

Photo: K. Trautmann via Flickr

“Fighting global food insecurity means more than feeding the world – it also means nourishing the world. Calories alone are insufficient to increase individuals’ well-being, fuel economic growth and build resilient, prosperous communities.”

– 2023 Feed the Future Snapshot

After more than 3 years of worst-case scenario hunger headlines, this year’s plateau in global food insecurity was, relatively, a breath of fresh air. Global hunger remained relatively unchanged this year, and we saw the gender gap in food insecurity, which got worse during the pandemic, decrease by 37%.

But despite these positive-seeming signs, we are not yet out of the woods. Global food insecurity remains far worse than it was in 2019, with 122 million more people facing hunger in 2022 than in 2019. Ongoing conflict, as well as climate and economic shocks, threaten to tip the scales and send food insecurity numbers surging again. In this crisis, it is easy to view the quality of calories as less important than the quantity, but there are millions of vulnerable people who cannot sustain themselves on calories alone. Experts estimate that over half of preschool-aged children and two-thirds of non-pregnant women of reproductive age worldwide have micronutrient deficiencies. Even if we fed every hungry person today, millions of women and children would still be malnourished, jeopardizing their wellbeing and limiting countries’ overall potential and growth. As we focus on the monumental task of addressing these sky-high rates of global hunger, we must ensure achieving nutrition security is a fundamental component of our food security strategy.

Nutrition security means making sure people not only have enough to eat, but that they have sufficient nutrients to ensure they are not malnourished. It means moving beyond solutions focused merely on providing hungry people with starchy staples that may be able to sustain life but are insufficient to meet their nutritional needs. It means ensuring people have access to diverse diets that include fruits, vegetables, legumes, and animal-sourced foods. When healthy diets are unavailable, it means providing stop-gap nutrition interventions, like specialized food supplements and fortified foods, and screening and treating severely malnourished children promptly with ready-to-use therapeutic foods (RUTF).

Nutrition is often sidelined as a secondary component of food security efforts, but for vulnerable groups, it is often the difference between life and death or a barrier to a child developing to their full potential. The most vulnerable of these groups are children in the 1000-day window between pregnancy and a child’s second birthday for whom even a short bout of malnutrition can cause lifelong physical and cognitive consequences leading them to perform less well in school and earn less as adults. We also know that in times of food insecurity, women often bear the brunt of the hunger burdens for their families, eating last and least to help food stretch further. We must ensure these women get the nutrition care they need, both for their own sakes and because malnourished mothers often give birth to malnourished babies, perpetuating an inter-generational cycle of malnutrition.

To build true food security, we must draw from models that build resilience across vulnerable communities. One such model is the U.S. Department of State’s Vision for Adapted Crops and Soils (VACS) which focuses on developing climate-resilient varieties of nutritious, indigenous crops with the potential to diversify diets and reduce rates of malnutrition. Similarly, initiatives that strengthen and embed nutrition interventions into national health systems build community resilience to food shocks by ensuring nutrition care continues even when food availability diminishes.

In the coming years, the world will face numerous threats to global food security, the most serious of which is likely the growing threat climate change poses to the quantity and quality of food that is available. Increasingly frequent climate shocks will make crops harder to grow and livestock harder to raise which will ultimately decrease food supply and incomes for agricultural workers. The food that does grow will be less nutritionally dense. In the face of these challenges, we will need to take concrete steps to shore up global food security. Clear plans to address malnutrition along with hunger will be key to any successful strategy.

This IWD, #InvestInWomen by Closing the Gender Nutrition Gap

Around the world, more than a billion adolescent girls and women suffer from undernutrition, micronutrient deficiencies and/or anemia. Malnutrition is robbing women of their earnings and energy, adolescent girls of their educational opportunities, and young girls of the chance to grow up to reach their full potential. Without tackling malnutrition, we will never reach gender equality.

The Nutrition for Growth (N4G) Summit is a global pledging moment that brings together governments, philanthropies, businesses, and NGOs to accelerate progress against malnutrition. The next N4G Summit will take place in early 2025 in Paris, France and will be a critical opportunity to spotlight women and girls’ nutrition.

This International Women’s Day, we are calling on governments and donors to prioritize women and girls’ futures by investing in closing the gender nutrition gap at N4G 2025.

Here are five key nutrition issues threatening women and girls, and some concrete solutions governments and donors can pledge to scale at the next N4G summit:

1. Women and adolescent girls face unequal burdens of micronutrient deficiencies, especially anemia.

Anemia is the number one threat to the long-term health of adolescent girls and afflicts almost one-third of women of reproductive age. Progress against anemia lags other nutrition achievements, and only one country (Guatemala) is on track to meet the globally agreed 2030 target on anemia. Meanwhile, deficiencies in vitamin and mineral status, particularly of folate, iron, vitamin A, and zinc, affect 67% of all women of reproductive age (WRA) worldwide. Micronutrient deficiencies can be life-threatening and cause extreme fatigue and poor concentration, hindering learning potential, educational attainment, and productivity. By scaling interventions that target anemia, we can cure millions of women and girls of this debilitating condition.

    Here are two actions that can help: 

    • Fortify staple foods with essential nutrients to prevent, reduce, and control micronutrient deficiencies at the population level.
    • Supply all pregnant women with multiple micronutrient supplements (MMS) with a focus on increasing adherence through improving availability combined with nutrition counseling in ANC services and mid and mass media communications.

    2. Climate change poses a disproportionate threat to women’s nutrition and food security.

    Climate change is increasing extreme weather events like heat waves, droughts, and floods, which impact food quantity, quality, and diversity. These climate shocks will put growing stress on food and nutrition security in the years to come. The food that does grow will be less nutritionally dense, which can lead to deficiencies in certain vitamins and minerals. Women are most likely to bear the brunt of this climate-related food insecurity. Not only are women more susceptible to micronutrient deficiencies, but women and girls are more likely to reduce their food intake and eat last and least in their households. Additionally, poorer regions and disadvantaged adolescent girls and women already bear the brunt of undernutrition and anemia and will be least equipped to respond to the climate impacts likely to hit many of these same regions the hardest. By investing in strategies to build resilience to climate-related malnutrition, we can mitigate some of these effects.  

      Here are two actions that can help: 

      • Promote long-term, climate-resilient food and nutrition security and protect the livelihoods of woman farmers by developing diverse, climate-resilient crop varieties. Contribute to initiatives like the Vision for Adapted Crops and Soils (VACS) Multi-Donor Fund hosted by IFAD.
      • Expand conditional cash transfers (CCTs) targeted to women to allow for greater flexibility in the face of humanitarian emergencies like natural disasters.

      3. Every year, millions of girls miss out on the opportunity to grow, learn, and earn to their full potential because of malnutrition they experience in early childhood.

        As we strive to address inequities in adult women’s nutrition, we must keep in mind the life-changing impact good nutrition can have on young girls today. Girls who are well-nourished are healthier, more productive, and more likely to finish and excel in school, be economically independent, and have healthy babies. Targeted nutrition interventions are a cost-effective way to give girls today a bright future and boost their chances of overcoming poverty and reaching their educational goals.  

        Here are three actions that can help: 

        • Protect large-scale Vitamin A supplementation to prevent vision problems, illness, and death.
        • Ensure children and their parents have access to quality nutrition counseling to promote dietary diversity and the consumption of animal-sourced foods.
        • Expand access to specialized foods (eg. RUTF and SQ-LNS) to prevent and treat child wasting 

        4. Women who choose to breastfeed often face workplace barriers and lack the support they need to be successful.

        Breastfeeding provides numerous benefits to both mothers and their babies. Breastfeeding gives all children the healthiest start in life and promotes cognitive development and acts as a baby’s first vaccine, providing critical protection from disease and death. It also reduces the burden of childhood and maternal illness, lowering health care costs, creating healthier families, and strengthening the development of nations. Family-friendly workplace policies promote gender equity and women’s economic participation, while strengthening the economy. By giving women the information and space they need to breastfeed successfully, they can be empowered to make an informed choice about how to feed their children.  

        Here are three actions that can help: 

        • Enact and promote adequate paid family leave, including maternity and parental leave, and breastfeeding breaks for women who chose to breastfeed.
        • Support breastfeeding mothers with one-to-one and group breastfeeding counseling.
        • Promote greater male engagement in infant and young child feeding (IYCF) to lessen the care burden for mothers.

        5. Commitments made at large pledging moments often lack accountability mechanisms.  

        Large pledging moments are critical for raising the profile of nutrition interventions, but they can only be truly successful if governments, philanthropies, businesses, and NGOs are held accountable for the commitments they make. This accountability requires commitment makers to invest in clear, quality data on spending, outputs, and outcomes.

        Here are three actions that can help:

        • Invest in strong nutrition data systems that ensure routine collection of data on girls and women to support effective policies and programs and to advocate for nutrition investment across sectors.
        • Improve accountability by tracking how global and national actors are currently investing in nutrition data and information systems.
        • Invest in global nutrition financing tracking system to improve coordination, resource mobilization, and resource allocation and regularly track progress on commitments made in the Nutrition Accountability Framework.

        Maximizing Potential: The Impact of Multiple Micronutrient Supplementation (MMS) for Improved Maternal and Child Health

        In the quest for improved maternal and child health and gender equality, we often overlook a fundamental intersection with the importance of good nutrition. The unique biological needs of women, gender disparities in access to food and services, and harmful social norms contribute to an ever-growing gender nutrition gap. During pregnancy, increased nutritional needs due to physical changes and the needs of a growing baby further exacerbate this gap. Micronutrient deficiencies during pregnancy put both mothers and babies at risk of birth complications, small vulnerable newborns, and even death, and the lack of nutrients in this critical period can prevent children from reaching their full physical and mental potential. Multiple Micronutrient Supplementation (MMS) during pregnancy provides a transformative solution to mitigating a wide array of harmful micronutrient deficiencies. During #March4Nutrition, we want to highlight MMS as a proven solution to meet the increased nutritional needs of women during pregnancy and further children’s growth, learning, and overall well-being.

        World Health Organization Releases Guidelines on the Prevention of Acute Malnutrition

        World Health Organization Releases Guidelines on the Prevention of Acute Malnutrition

        In November 2023, the World Health Organization released updated guidelines on the prevention of acute malnutrition, also known as wasting. The guidelines followed the release of guidelines specific to the management and treatment of wasting and nutritional oedema that the organization published in July 2023.

        Preventing malnutrition is key to long-term growth, development, and positive economic outcomes. Nutrition interventions, including those that prevent malnutrition, are some of the best buys in global development. Ensuring children have access to good nutrition when it matters most is one of the most powerful and cost-effective ways to create brighter, healthier futures. Leading economists consistently rank nutrition interventions among the most cost-effective ways to save and improve lives around the world with every $1 invested yielding up to $35 in economic returns.

        Malnutrition continues to be one of the leading drivers of child death and disability. Malnutrition is the greatest threat to child survival worldwide and is the underlying cause of half of preventable child deaths. That is roughly 3 million children dying before their fifth birthday every year. Those who do survive severe malnutrition in early childhood are much more likely than their well-nourished peers to suffer from lifelong illnesses and disabilities.

        We continue to see unprecedented rates of malnutrition and nutrition insecurity as the result of conflicts, climate shocks and stressors, and lingering impacts of the pandemic. New child malnutrition estimates from UNICEF released in May 2023 found that stunting (too short for their age) impacted 22.3% of children under 5 (148.1 million) globally and wasting (too thin for his or her height), the deadliest form of malnutrition, threatened the lives of 6.8%, or 45 million children under 5 globally.

        1,000 Days welcomes the two new recommendations specific to the prevention of wasting and nutritional oedema as well as the two new good practice statements:

        • Recommendation 1: In areas of, or during times of high food insecurity, in addition to infant and young child feeding counselling, specially formulated foods (SFFs), including medium-quantity lipid-based nutrient supplements (MQ-LNS) or small-quantity lipid-based nutrient supplements (SQ-LNS), may be considered for the prevention of wasting and nutritional oedema for a limited duration for all infants and children 6-23 months of age, while continuing to enable access to adequate home diets for the whole family; and in areas of, or during times of high food insecurity, children living in the most vulnerable households should be prioritized for SFF interventions through a targeted approach. However, when targeting is not possible, these SFFs may need to be given to all households through a blanket approach for infants and children 6-23 months of age, while continuing to enable access to adequate home diets for the whole family and providing infant and young child feeding counselling. (Conditional recommendation; Grade: Low certainty evidence)
        • Recommendation 2: In contexts where wasting and nutritional oedema occur, multiple micronutrient powders (MNPs) should not be given to infants and children 6-23 months of age for the specific purpose of preventing wasting and nutritional oedema. (Strong recommendation; Grade: Moderate certainty evidence)
        • Good Practice Statement 1: In contexts where wasting and nutritional oedema occur, preventive interventions should ideally be implemented through a multisectoral and multisystem approach (i.e. food, health, safe water, sanitation and hygiene, and social protection systems). These interventions should include access to healthy diets and nutrition and medical services as appropriate, counselling (breastfeeding, health and nutrition related, especially helping families use locally available nutrient-dense foods for a healthy diet), should address maternal and family needs, and should involve psychosocial elements of care to ensure healthy growth and development.
        • Good Practice Statement 2: Infant and young child feeding counselling must be provided as part of routine care especially in contexts where wasting and nutritional oedema occur. In order for this counselling to have the most benefit for the prevention of wasting and for other child health and nutrition outcomes, personnel carrying out the counselling should have comprehensive training and be supervised regularly, with dedicated resources and time within health system strategic planning for this intervention.

        In both the recommendations and in the practice statements, we were pleased to see mention of a multi-sectoral and family approach to these interventions to prevent wasting and nutritional oedema. It is key to provide access to nutritious foods and nutrition support, including breastfeeding counseling and complementary feeding, to whole families to address maternal, infant, and child nutritional needs. The guidelines note that prevention requires a package of interventions to be implemented together rather than focusing on one single intervention. We also support the recommended psychosocial elements of care to ensure healthy growth and development as preventing malnutrition early in life impacts long-term health.

        These guidelines provide organizations with the tools necessary to prevent, manage, and treat malnutrition. WHO also notes that further research is needed for many of the recommendations outlined in the guidelines to be most effective in efforts to prevent and treat wasting. The guidelines provide a critical opportunity to advocate for the essential resources to support good, life-long nutrition, particularly among vulnerable populations, including those in the 1,000-day window.

        World Food Day 2023 Highlights an Opportunity for the US to Lead on Preventing & Treating Malnutrition

        World Food Day 2023 looks similar to recent past food days as the world continues to grapple with high rates of food and nutrition insecurity due to long lasting impacts of the pandemic, climate shocks and stressors, conflict, and inflation. Although much attention has been paid to rising rates of malnutrition, unfortunately, in 2023, malnutrition continues to impact tens of millions of children around the world. New child malnutrition estimates from UNICEF released in May 2023 found that stunting impacted 22.3% or 148.1 million children under 5 globally and wasting threatened the lives of 6.8%, or 45 million children under 5 globally.

        To meet the Sustainable Development Goals related to food security and nutrition, targeted interventions and significant investments must be made to reverse the current malnutrition trends and speed up progress. Due to the compounding crises impacting malnutrition, it is estimated that to stay on track with reaching global nutrition targets, at least $10.8 billion each year from 2022 to 2030 is needed.

        A new study published just last week in The Lancet shows how dire nutrition needs are, specifically within the 1,000-day window. These new data from WHO, UNICEF, and the London School of Hygiene and Tropical Medicine found that 1 in 10 babies worldwide are born early, with major impacts on health, survival, and eventual economic impact. Since prematurity is the leading cause of death in children’s early years, there is an urgent need to strengthen prenatal care for mothers that protect both mom and baby, focus on malnutrition prevention in early life, and provide postpartum care that nurtures mom and supports breastfeeding.

        In addition to the efforts to treat malnutrition, further attention should be paid to prevention of malnutrition in the first place. Over the last year, USAID has not only released the implementation plan for the Global Malnutrition Prevention and Treatment Act (GMPTA), but also released a position paper on child wasting in June 2023 which outlined specific, actionable steps on how the USG will continue its investments and commitments to reduce and prevent malnutrition globally. Some of these steps include: strengthening nutrition as part of primary health care, building a better understanding of the specific pathways through which food systems can most effectively and efficiently prevent child wasting, improving access to RUTF for treatment and SNFs for prevention, supporting the development of sustainable financing strategies for health systems and the procurement of SNFs, and conducting joint cross-sectional and cross-bureau analyses and/or implementation research in nutrition priority countries.  

        Necessary investments would help to close the nutrition insecurity gaps seen in the most vulnerable populations, including women and children. Our advocacy community continues to seek additional monetary investments from the US Government to improve nutrition security. Malnutrition is the underlying cause of nearly half of all childhood deaths under 5, however, it only received under 1.5% of US global health funding in FY2023 while AIDS, malaria, and tuberculosis collectively netted roughly 72%. For FY24 funding requests, our global nutrition advocacy community requested $300M for the nutrition sub-account which would save the lives of 30,303 children annually according to the World Bank’s Nutrition Investment Framework. Efforts to reduce funding for this account undermine progress made to address malnutrition and will put lives at risk.

        As Congress continues to draft FY24 appropriations bills ahead of the November 17th continuing resolution deadline, we urge them to protect and defend investments aimed at improving the health and nutrition of vulnerable populations, like women and children, particularly in the first 1,000 days. In addition, FY25 budgets and appropriations bill should include investments that both prioritize preventing and treating malnutrition. To accelerate progress on preventing and treating malnutrition, Congress and the US Government must solidify their role as a leader in putting health and nutrition first.