Category: Region

1,000 Days Statement on Senate Finance Committee Paid Leave Hearing

Senate Finance Committee Holds Hearing on Paid Leave

This week, the Senate Finance Committee held a hearing on paid leave, highlighting the critical need for family and medical paid leave and how our current patchwork of paid leave policies falls short of supporting all infants and families. It also confirmed the importance of paid leave for workers, businesses, and the country.

While there have been some gains in paid family leave over the past five years, the Bureau of Labor Statistics shows that only about 1 in 4 employees (27 percent) in the private sector workforce have access to paid family leave. Access to paid family leave is lower among those receiving lower wages or working part-time. People of color also have less access to paid family leave than their white counterparts.

This lack of paid family leave means parents are often forced to choose between taking time off from work to care for their young children and earning the income they need to support their families. It means that 1 in 4 women in America return to work just 2 weeks after giving birth, putting their health and that of their infant at risk. Policies that enable parents to spend time nurturing and caring for their babies—particularly in the early weeks after birth and for babies that are born pre-term, low birthweight or with illness—are critical to the healthy cognitive, social, and emotional development of children.

We applaud state, local and business-level efforts to increase access to paid family leave, but it is not enough to address this public health crisis. We need a national paid family and medical leave program that is comprehensive and covers all workers, including small business employees and the self-employed. Paid leave is the biggest obstacle to working women in the U.S. in the 1,000-day window and can reduce racial and ethnic health disparities. Our 2020 qualitative paid leave report highlights real stories from families without access to paid leave and the detrimental impacts it had on their family, including their health and the health of their baby.

We appreciate the Senate Finance Committee’s thoughtful attention to this issue. We call on Congress to take the next step, moving legislation to enact a comprehensive national paid leave policy that supports mothers and families and ensures children get the strongest start to life.

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.

Nutrition is a Feminist Issue

Nutrition only featured in three of the 75+ sessions and events of the Women Deliver conference which brought over 6,0000 advocates, activists and decisionmakers to Kigali, Rwanda, last week. But what Women Deliver demonstrated is that nutrition is part of a much bigger framework, and an integral component of the feminist agenda. Here are three reasons why maternal nutrition is a feminist issue:

  1. The gender nutrition gap is real, widening, and solvable:  It is the political failure to meet the unique nutritional needs of women and girls and ensure their access to nutritious diets, nutrition services, and nutrition care. More than 1 billion adolescent girls and women worldwide suffer from undernutrition, including detrimental lifelong effects of the consequences of wasting and stunting, micronutrient deficiencies, and anaemia, according to UNICEF’s Undernourished and Overlooked: A Global Nutrition Crisis in Adolescent Girls and Women report. Malnourished mothers give birth to small and vulnerable newborns with immediate and long-term consequences for individual and societal development and growth. Today, approximately 20 million infants are born with low birthweight globally.  Cultural norms, social roles, economic disparities, and discriminatory practices create and sustain this gender nutrition gap. 1,000 Days was among 40+ organizations to launch Closing the Gender Nutrition Gap: An Action Agenda for Women and Girls. It aims to unite stakeholders in the nutrition, health and gender communities to take specific actions that improve women’s and girls’ nutrition while advancing maternal, newborn and child health and gender equality. The Action Agenda prioritizes actions for healthy diets, access to healthcare and social protection, gender equality and creating an enabling policy environment.
  • Adequate nutrition and breastfeeding are part of a woman’s right to bodily autonomy,  which UNFPA defines as  ‘the power and agency of individuals to make choices about their bodies without fear, violence or coercion’. While the concept is often used to advocate for reproductive justice, it goes beyond sexual and reproductive health and services and encompasses access to the wide range of care and services necessary to keep our bodies, minds and spirits healthy and whole – including nutrition – as per the Positive Women’s Network framework. UNFPA announced the Kigali Call to Action: United for Women and Girls’ Bodily Autonomy  for accelerated investments and actions, with women-led organizations and the feminist movement at the centre. Bodily autonomy is a strong platform to call for the right to breastfeed, as well as access to diverse and nutritious foods for all pregnant and lactating women, babies and toddlers. It is also a powerful aggregator to build a solidarity front against regressive forces. 
  • Maternal health is divisive and divided: As advocates calling attention on specific aspects of a woman’s health and wellbeing, we risk positioning women as a set of issues to be solved and competing for attention and space.  This does not only diminish our voice and reduce our impact, but it also leaves a vacuum for the opposition to fill, with clear, unified anti women’s rights messages.  Calling for reproductive justice, access to antenatal care, newborn and child health, respectful care, nutrition services, exclusive breastfeeding are not competing agendas, but all contribute to redressing the systemic inequalities that women face and that prevent them from reaching their full potential. Feminism, as a social justice movement, provides a larger and stronger platform to join forces and advance women’s nutrition, including nutrition for pregnant and lactating women.

Bills We are Watching this Children’s Week

As we kick off the 2023 Children’s Week, we feel a mixture of excitement for the opportunities to improve children’s nutrition and concern about policy and funding proposals that undo progress to protect the health and wellbeing of children and their families in their 1,000-day window.

The nutrition that people receive leading up to and throughout their pregnancy, as well as the nutrition their babies receive in the earliest years of life, has a profound impact on a child’s ability to grow, learn, and thrive. In honor of Children’s Week, 1,000 Days is highlighting some legislation that we support focused on children, mothers, and birthing people. It is our hope that with these bills enacted, moms, babies, and their families will receive the support and resources they need to begin to build a healthier future.

The Wise Investment in Children Act of 2023 (WIC Act of 2023) (H.R.3364/S.1604) expands eligibility to receive benefits under the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). This would extend the certification period for infants to up to two years and increases the certification time under the program for postpartum women to a period of up to two years.

Modern WIC Act of 2023 (H.R.2424/S.984) would build on lessons learned during the pandemic and modernize WIC to allow remote access. The remote flexibility implemented during the public emergency contributed to a 12% increase in child participation since 2020.

WIC Healthy Beginnings Act (H.R.3151/S.974) requires USDA to make information on infant formula procurement under WIC publicly available. This increases transparency and promotes competition within the sole-supplier model.

Black Maternal Health Momnibus Act (H.R.3305/S.1606) will address the maternal mortality crisis in the U.S. through historic investments that comprehensively address every driver of maternal mortality, morbidity, and disparities in the United States. The Momnibus Act includes twelve individual bills that among other actions will make critical investments in social determinants of health that influence maternal health outcomes, like housing, transportation, and nutrition and extend WIC eligibility in the postpartum and breastfeeding periods.

The Family Act (H.R.3481) would provide employees a family and medical leave insurance monthly benefit payment of two-thirds of the employee’s regular pay, limited to a maximum of $4,000, for no more than 60 days of qualified caregiving. The bill also established the Office of Paid Family and Medical Leave within the Social Security Administration.

No Surprise Bills for New Moms Act (H.R.3387) would automatically cover newborns with health insurance for the first 30 days and create a standard for enrollment after that period. It eliminates confusion for new parents by establishing a uniform 60-day enrollment period after that first month. The bill would also have all health plans and insurers notify parents if they receive a bill for an uncovered newborn.

We also continue to remain focused and engaged in the appropriations process for FY2024. Non-defense discretionary programs, which disproportionately serve young children, families, and those most in need across the country, will face the brunt of spending caps and cuts. We must protect programs that support children and families and build off the recent successful increased investments in the first 1,000 days. In doing so, we are letting our children and our nation’s future the opportunity to thrive. How well or how poorly mothers and children are nourished and cared for during the 1,000-day window has a profound impact on a child’s ability to grow, learn and thrive.

Unpacking the Joint Child Malnutrition Estimates 2023 Edition

On May 18, 2023, UNICEF, the World Health Organization (WHO), and the World Bank Group released the Joint Child Malnutrition Estimates, which are published every other year. The new report examines progress to reach the 2025 World Health Assembly (WHA) global nutrition targets and Sustainable Development Goal (SDG) target 2.2 to end all forms of malnutrition. Specifically, the 2030 target is to reduce the number of children under 5 who are stunted by 50% and to reduce and maintain childhood wasting to less than 3%. Given the crises that low- and middle-income countries are experiencing, including conflict, disasters from climate change like severe droughts or flooding, and lasting impacts from the COVID-19 pandemic, it is not surprising, but still alarming, to see that tens of millions of children are affected by stunting and wasting:

  • Stunting impacted 148.1 million children under 5 globally in 2022, or 22.3%.
  • Wasting threatened the lives of 45 million children under 5 globally in 2022, or 6.8%.

Unfortunately, at the midpoint of the SDG period, the stunting target will not be met if the current trajectory of progress continues. The assessment of progress is not even possible for about one quarter of countries as only about one third of all countries are ‘on track’ to halve the number of children affected by stunting by 2030. Similar to stalled levels on stunting but more severe, an assessment of progress towards the wasting target is not possible for almost half of the countries.

The disparities of stunting and wasting and lack of progress lies predominantly in Africa and Southern Asia. In 2022, more than half of all children under 5 affected by stunting lived in Asia and two out of five lived in Africa. Additionally, 70% of all children under 5 affected by wasting lived in Asia and more than one quarter lived in Africa. If the current trajectory continues, an estimated 128.5 million children will be stunted in 2030, with about half of those living in Western and Middle Africa.

Globally, the annual average rate of reduction (AARR) for stunting based on the current trend from 2012 to 2022 is only 1.65 percent per year. But an AARR of 6.08 is required from now to 2030 to achieve the global target of reducing the number of children with stunting to 88.9 million. This rate of reduction is almost four-fold higher than what has been achieved in the last decade.

As countries move further away from the targets, and investments in critical nutrition interventions continue to be limited or reduced, the child malnutrition targets will become more challenging to achieve. Work must now be accelerated to catch up to the lack of progress which in turn is more costly. To compound this issue, the report also highlighted the dire need for addressing reporting and data gaps in countries and regions to measure and indicate progress on child malnutrition.

The report underscores the importance of reminding  decisionmakers, like legislators and policymakers, and program implementers that all forms of malnutrition are preventable and that it is not too late to get countries and regions on track to meet these critical targets. Nutrition interventions are relatively inexpensive to implement and have an extremely high return on investment (ROI), with every $1 invested yielding up to $35 in economic returns. As malnutrition costs the world $3.5 trillion in lost productivity and healthcare costs each year, smart investments in global nutrition now would support billions of children to reach their full potential and help end the cycle of poverty and malnutrition once and for all. By ensuring all children and families have access to nutritious foods and essential health and nutrition services through proven nutrition interventions, substantial progress can be made to reduce and prevent stunting and wasting.  

https://data.unicef.org/resources/jme-re 1

Undernourished and Overlooked: A Global Nutrition Crisis in Adolescent Girls and Women

Photo credit: Paula Bronstein/Getty Images/Images of Empowerment

Published: March 2023 

Publication: Undernourished and Overlooked: A Global Nutrition Crisis in Adolescent Girls and Women 

Authors: United Nations Children’s Fund (UNICEF) 

Background: 

In the 12 hardest-hit countries, the number of pregnant and breastfeeding women and adolescent girls suffering from acute malnutrition has soared from 5.5 million to 6.9 million – or 25 per cent – since 2020.  

More than 1 billion adolescent girls and women worldwide suffer from undernutrition which includes underweight and short height, micronutrient deficiencies, and anemia.  

Globally, 51 million children under 2 are stunted. Almost half of all stunting early childhood originates during pregnancy or in the first six months of life – a time when children are entirely dependent on their mothers for nutrition.  

Summary: 

The report analyzes the current status, trends and inequities in the nutritional status of adolescent girls and women of reproductive age (15-49 years), the barriers they face in achieving a nutritious diet, utilizing essential nutrition services, and benefiting from nutrition and health-focused practices. Data were analyzed from more than 190 countries and territories, representing more than 90% of adolescent girls and women from around the globe. 

Findings: 

  • Progress on addressing adolescent girls’ and women’s nutrition is not advancing quickly enough and has been deprioritized. The current global food and nutrition crisis may slow progress even further and no region is on track to meet the 2030 global targets to reduce anemia in adolescent girls and women by half and low birthweight in newborns by 30%. 
  • Prevalence of undernutrition and anemia is highest in the lowest income regions and disadvantaged adolescent girls and women are more likely to experience it. The prevalence of underweight among adolescent girls and women belonging to the poorest households is double the prevalence in the wealthiest households (14% v. 7%). 
  • Poor nutrition is generational. The nutritional status of a mother, including weight, height, and low birthweight, are consistent predictors of stunting and wasting in early childhood. Child undernutrition is concentrated in the same regions as maternal undernutrition.  
  • The global food and nutrition crisis is worsening the health and nutrition in adolescent girls and women. Adolescent girls and women have been disproportionately impacted by the COVID-19 pandemic and its impact on livelihoods, income, and access to nutritious food. They are also disproportionately impacted by conflict, climate change, poverty, and other economic shocks.  
  • Diets of adolescent girls and women are not diverse enough to meet nutritional needs. Fewer than 1 in 3 adolescent girls and women have diets meeting the minimum dietary diversity in the Sudan, Burundi, Burkina Faso, and Afghanistan. In other countries, the percentage of women being able to access nutritionally adequate, diverse diets, continues to fall.  
  • Gender and social inequalities have further slowed progress on improving nutrition in adolescent girls and women. Child marriage and adolescent pregnancy have profound negative impacts for nutrition in adolescent girls and their children. Often, women do not have the ability to make their own decisions, including those that would enhance their education and employment opportunities. 
  • The nutrition programs and services designed to address undernutrition have not reached the number of women or adolescent girls impacted or has not met the full nutritional needs of these populations. Only 2 in 5 pregnant women benefit from iron and folic acid supplementation for the prevention of maternal anemia and only 29 low- and middle-income countries provide multiple micronutrient supplements, or prenatal vitamins. Conflict and humanitarian crises like the one in Afghanistan, have made these gaps in coverage grow even larger. 
  • There are policy gaps in addressing undernutrition in adolescent girls and women. Of the eight key policies reviewed that address adolescent girls’ and women’s nutrition, only 8% of countries have all of the policies while 39% have only four or less. 

Governments, development and humanitarian partners, the private sector, civil society organizations, and research and academia sectors must work together to strengthen nutrition governance, activate the food, health and social protection systems, and transform harmful social and gender norms to deliver nutritious and affordable diets, essential nutrition services and positive nutrition and care practices for adolescent girls and women everywhere. 

Key Quotes: 

“Women and girls need access to nutritious and affordable diets, including fortified foods, and essential nutrition services before and during pregnancy and while breastfeeding.” 

House FY24 Agriculture Appropriations Bill will Stall Progress, Decrease Access for Families in Need

1,000 Days is dismayed by the House Appropriations Committee’s fiscal year 2024 Agriculture Appropriations bill released today. This bill under delivers in providing nutrition assistance to those in need and rolls back successful program improvements implemented during the pandemic. Of concern, the bill would reduce funding levels for WIC below current levels, with proposed funding $800 million below the FY24 President’s Budget request. This would result in fewer women and children being served, and possible waitlists for those that qualify for the program. The proposed House Agriculture Appropriations bill ends the increased fruit and vegetable benefits that have been provided to families since April 2021, further reducing nutrition benefits provided to WIC participants. These benefits have had multiple benefits, especially for young children, including increased fruit and vegetable consumption in WIC toddlers and a broader variety of fruit and vegetable purchases by parents. The bill also undermines the science-based review process for the WIC food package, preventing USDA from updating the foods provided to include more fruits, vegetables, seafood, and whole grains.

The proposed bill is short-sighted, cutting benefits to pregnant women, infants and children when investment in the 1,000 days between pregnancy and a child’s 2nd birthday sets the foundation for all the days that follow. How well or how poorly mothers and children are nourished and cared for during the 1,000-day window has a profound impact on a child’s ability to grow, learn and thrive. Research has proven that WIC saves lives. WIC reduces fetal deaths and infant mortality; reduces low birthweight rates and increases the duration of pregnancy; and it improves the growth of nutritionally at-risk infants and children. We call on Congress to fund WIC at $6.35 billion in fiscal year 2024, providing essential nutrition services during this critical timeframe.

Advocating for Nutrition, Maternal and Child Health Funding

From left to right: Dorothy Monza (RESULTS), Stephanie Hodges (1,000 Days), Andrew McNamee (Food for the Hungry), John Goetz (Legislative Correspondent for Sen. Tim Scott), Daren Caughron (Bread for the World)

Each year, there is an appropriations process that determines the budget for the federal government and the programs that it carries out. The President releases a budget, which provides insight into an administration’s priority, but ultimately, it is up to Congress to draft and pass the budget for the federal government each fiscal year. 1,000 Days, an initiative of FHI Solutions, raises awareness of this process and engages every year to advocate for robust funding to support and promote maternal, newborn, and child health and nutrition.

In partnership with the Maternal, Newborn, and Child Health Roundtable (MNCH RT), and representing the 1,000 Days Advocacy Working Group (AWG), 1,000 Days led and attended Hill meetings in both the House and Senate to advocate for funding increases for the Maternal and Child Health Account and the Nutrition account within the United States Agency for International Development (USAID). We conducted nearly 40 meetings and secured sign-ons to Dear Colleague letters from Democrats and Republicans in the House and Senate supporting these funding increases.

In FY23, the nutrition account was funded at $160 million, and the maternal and child health account (MCH) was funded at $910 million. To address the malnutrition crisis and to meet the moment of increased health and nutrition needs, our International Non-Governmental Organization (INGO) community is requesting $1.15 billion for the MCH account, which includes $340 million for Gavi, the Vaccine Alliance, and $300 million for the nutrition account within USAID. 

These additional investments can help close the food and nutrition insecurity gaps and pick up the pace on progress toward ending malnutrition which has slowed over the past 12 years. In 2021, 5 million children under age five died from mainly preventable and treatable diseases, with malnutrition as the underlying cause of roughly half of these deaths. Additionally, 300,000 women die annually of preventable causes related to pregnancy and childbirth. 

The Nutrition account within USAID supports nutrition programs for women and children, focusing on the 1,000-day window, the time between pregnancy and a child’s second birthday. It is crucial to reach children and their caregivers early in life with interventions like breastfeeding support and vitamin A supplementation to prevent malnutrition. When children are malnourished, early detection and access to therapeutic foods can save lives. Severely malnourished children are much more likely to have weakened immune systems and are at risk of permanent physical and mental stunting, which prevents them from reaching their full educational, social, and earning potential. Malnutrition costs the world $3.5 trillion in lost productivity and healthcare costs each year. The current global food crisis, fueled by conflict, climate shocks and the threat of a global recession, continues to threaten the lives of women and children globally. Full funding of the nutrition account is critical for saving lives and reaching USAID’s goal of ending preventable child and maternal deaths.

As Congress establishes budget levels for FY24, we urge them to include the increased funding levels for USAID and we will continue to advocate for these funding increases. If investments are not made in preventing and treating malnutrition and improving maternal and child health, we will continue to see backsliding of the progress made and lives lost. Now is the time to act to ensure mothers and children have the health and nutrition supports they need within the first 1,000 days and beyond.

 

Lifting Up the Powerful Role of Nutrition for Policymakers and Advocates

Good nutrition before, during, and after pregnancy has a profound impact on the health of both a mother and child. This National Nutrition Month (NNM), and as part of our global #March4Nutrition campaign, 1,000 Days is highlighting some of the nutrition-related regulations and legislation that we support to ensure every child can grow, learn, and thrive. Much of this legislation also shapes the future for mothers, pregnant, birthing and postpartum people. This Spring, we are focused on advocating for regulatory updates, legislation that supports nutrition for families here in the U.S. and around the world, and additional funding to support all these programs. This year’s NNM theme of “Fuel for the Future” highlights the importance of ensuring families are well nourished to support healthy futures.

Updated Regulations for Maternal & Child Nutrition

WIC Food Package Updates

The United States Department of Agriculture (USDA) has proposed several regulatory changes to strengthen nutrition programs and improve maternal and child nutrition. The agency is currently updating the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages, that would impact over 6 million WIC participants which include moms, babies, and young children. The updates, which are science-based and align with the most recent Dietary Guidelines for Americans and the 2017 National Academies (NASEM) report, increase fruit and vegetable vouchers, promote greater flexibility to accommodate cultural food preferences and dietary needs, strengthen support for breastfeeding, and increase access to under-consumed, nutritious foods, like seafood with lower levels of methylmercury.

Child Nutrition Program Updates

USDA also proposed updated nutrition standards to school meals that would more closely align the standards recommended in the Dietary Guidelines for Americans to provide children with nutritious and delicious meals. The proposed updates do include some changes to the Child and Adult Care Food Program (CACFP), which serves young children, including those in their 1,000-day window, at childcare. Changes in the CACFP program would support more nutritious meals and snacks by reducing added sugar content and allowing more plant-based meat/meat alternate options.

Dietary Guidelines for Americans

While not specific legislation or regulations, the Dietary Guidelines for Americans (DGA) form the basis of nutrition policy in the U.S. and are a critical component of improving maternal and child nutrition. Co-developed every five years by USDA and the Department of Health & Human Services (HHS), the basis of the guidelines is a science-based report developed by the Dietary Guidelines for Americans Advisory Committee (DGAC) which includes nutrition researchers, physicians, and Registered Dietitians. The DGAs have a broad impact ranging from WIC food packages and child nutrition programs to food labeling and nutrition education programs. The guidelines include dietary recommendations for pregnant and lactating people and birth to age 2, which were included for the first time in the 2020-2025 DGA. The next iteration of the guidelines is currently underway as the DGAC is reviewing evidence and drafting conclusion statements which will ultimately lead to dietary recommendations and guidelines for Americans, including mothers, babies, and young children.

2023 Farm Bill

Every five years, Congress reauthorizes the Farm Bill which is a robust, multiyear law that authorizes food and agricultural programs. Although the name may imply that most of the bill is focused on farming and agriculture, nutrition spending makes up an overwhelming majority of the legislation. In 2018, the nutrition title (Title IV) made up about 76% of total Farm Bill spending, and for the 2023 Farm Bill, it is projected to be as much as 85%. The Supplemental Nutrition Assistance Program (SNAP), formerly known as “food stamps,” is authorized in the Farm Bill which is the reason for the large amount of spending for nutrition in the bill. When children have access to SNAP, from birth through early childhood, their risk of developing high blood pressure, heart disease, diabetes, and other poor health outcomes later in life greatly decreases. Children on SNAP can immediately experience a reduction in food insecurity. As Congress works to reauthorize the 2023 Farm Bill, it is imperative that they ensure families have access to the food and nutrition assistance they need through SNAP benefits as nearly half of all people who participate in SNAP are children.

In addition to domestic nutrition programs, the Farm Bill also reauthorizes international food aid programs in Title III. These programs include Food for Peace Title II, the McGovern-Dole Food for Education Program, Food for Progress, and the Bill Emerson Humanitarian Trust. These programs are primarily focused on improving food security. As Congress works to reauthorize the 2023 Farm Bill, we urge them to further consider how the programs can incorporate nutrition interventions to address both food and nutrition insecurity and prevent malnutrition. Robust funding will be needed to address the current malnutrition crisis and to build resilience in communities globally.

Implementation of the Global Malnutrition Prevention & Treatment Act

In October 2022, the Global Malnutrition Prevention & Treatment Act (GMPTA) was signed into law to bolster the federal government’s efforts to address global malnutrition and build resilience. It authorizes the United States Agency for International Development (USAID) to advance targeted interventions to prevent and treat malnutrition around the world while requiring a robust monitoring of interventions to ensure effective use of funding. As USAID works to draft the implementation plan and coordinate efforts, we look forward to working alongside them to ensure all activities address the nutritional needs of families in their first 1,000 days.

Fiscal Year 2024 Appropriations

Addressing nutrition security in the U.S. remains a critical need. 1,000 Days joins the National WIC Association and the broader maternal and child health community in urging funding of $6.35 billion for WIC in FY 2024. This amount will ensure adequate funding to support WIC’s growing caseload and address rising food costs in WIC food categories. We also support increased funding to strengthen FDA’s food safety and nutrition capacity, especially for infants and young children.

While reductions in global mortality rates for women and children are two of the biggest success stories in international development, progress has slowed over the past 12 years. There remain significant gaps that additional investments can help close. In 2021, 5 million children under age five died from mainly preventable and treatable diseases, with malnutrition as the underlying cause of roughly half of these deaths. Additionally, 300,000 women die annually of preventable causes related to pregnancy and childbirth. 

As Congress determines funding levels for FY2024, it is critical that funding meets the moment to address the malnutrition crisis. 1,000 Days as part of the 1,000 Days Advocacy Working Group (AWG) and the Maternal, Newborn, Child Health Roundtable (MNCH RT), is requesting $300 million for the nutrition account and $1.15 billion for the maternal and child health (MCH) account within USAID. Malnutrition costs the world $3.5 trillion in lost productivity and healthcare costs each year. The current global food crisis, fueled by conflict, climate shocks and the threat of a global recession, continues to threaten the lives of women and children globally. Full funding of the nutrition account is critical for saving lives and reaching USAID’s goal of ending preventable child and maternal deaths.

President’s FY2024 Budget Meets the Moment for U.S. Families, Misses the Mark for Foreign Investments in Nutrition

The Biden Administration’s FY 2024 budget proposal includes significant funding for several of 1,000 Days’ domestic key policy priorities. The proposal reflects priorities of the 2022 White House Conference on Hunger, Nutrition, and Health and opportunities identified in the American Journal of Public Health series to unlock the untapped potential of this critical time by closing data gaps, enhancing promising programs, strengthening policies and uniting around this powerful window of growth. It includes:

  • $6.3 billion to fully fund the 6.5 million individuals expected to participate in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
  • $325 million to establish a national, comprehensive paid family and medical leave program plus $10 million to help states expand access to paid leave benefits, including creation of a Technical Assistance Hub to share best practices among states.
  • $471 million to support implementation of the White House Blueprint for Addressing the Maternal Health Crisis to strengthen maternal health initiatives. Additionally, the budget requires all states to provide continuous Medicaid coverage for 12 months postpartum, eliminating gaps in health insurance at a critical time.
  • Increased funding for early care and education programs to increase childcare options for more than 16 million young children and lower costs so that parents can afford to send their children to high-quality child care.

While we celebrate increases across domestic nutrition programs, the proposals for global programs missed the mark. We welcome the topline increases for the State Department and USAID, but the Administration’s proposal to provide no increases to current investments in global nutrition and maternal & child health fall short in addressing growing the need. This past week, a report released from UNICEF shed light on how dire the malnutrition crisis is, particularly among adolescent girls and women. The number of pregnant and breastfeeding mothers suffering from acute malnutrition has soared from 5.5 million to 6.9 million – or 25 percent – since 2020 in 12 countries hardest hit by the global food and nutrition crisis. 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.

As rates of hunger and malnutrition continue to climb around the globe, it was disappointing to see that Global Health accounts within the United States Agency for International Development’s (USAID) budget for the Nutrition and Maternal & Child Health (MCH) did not receive funding increases in the President’s Fiscal Year 2024 budget. Within the proposal, the nutrition account is flat funded at $160 million and the MCH account is flat funded at $910 million. The NGO community has called for no less than $300 million for the nutrition account and $1.15 billion for the MCH account. The released budget is world’s apart from these needs-based community asks to address the ongoing health and nutrition crisis.

Ultimately, these funding levels will be decided by Congress and we urge Congress to fund State and Foreign Operations accounts at a level that meets the moment, including $300 million for the Global Health Nutrition account, $1.15 billion for the Maternal and Child Health account.