The Bill and Melinda Gates Foundation has urged world leaders to increase global health spending where it is needed most to boost children’s health and nutrition, especially in the face of the global climate crisis.
The foundation stated this in its eighth annual goalkeepers’ report released today.
The goalkeepers’ report, “A Race to Nourish a Warming World,” projects that without immediate global action, climate change will condemn an additional 40 million children to stunt and 28 million more to waste between 2024 and 2050.
Scaling up solutions now can avoid this outcome, while also building resilience to climate change and spurring much-needed economic growth.
In 2023, the World Health Organization estimated that 148m children experienced stunting, a condition where children don’t grow to their full potential mentally or physically, and 45m children experienced wasting, a condition where children become weak and emaciated, leaving them at much greater risk of developmental delays and death.
These are the most severe and irreversible forms of chronic and acute malnutrition.
According to the report, at the same time, as global challenges intensify, the total share of foreign aid going to Africa has decreased. In 2010, 40 per cent of foreign aid went to African countries.
But that number is now down to just 25 per cent, the lowest percentage in 20 years, despite more than half of all child deaths occurring in sub-Saharan Africa.
This trend leaves hundreds of millions of children at serious risk of dying or suffering from preventable diseases and threatens the unprecedented progress the world made in global health across Africa between 2000 and 2020.
“Today, the world is contending with more challenges than at any point in my adult life: inflation, debt, new wars.
“Unfortunately, aid isn’t keeping pace with these needs, particularly in the places that need it the most,” writes report author Bill Gates, co-chair of the Bill & Melinda Gates Foundation.
“I think we can give global health a second act—even in a world where competing challenges require governments to stretch their budgets.”
According to Gates, malnutrition is the world’s worst child health crisis, and climate change is only making it worse.
Amidst this crisis, Gates calls for maintaining global health funding; immediately addressing the growing threat of child malnutrition by supporting the Child Nutrition Fund, a new platform that coordinates donor financing for nutrition; and governments fully funding the established institutions that have proven effective at protecting millions of lives each year.
These institutions include Gavi, the Vaccine Alliance, which is due to hold its next funding replenishment in 2025; and the Global Fund to Fight AIDS, Tuberculosis and Malaria, which is expected to also hold its replenishment next year.
“If we do these three things, we won’t just usher in a new global health boom and save millions of lives—we’ll also prove that humanity can still rise to meet our greatest challenges,” Gates writes.
The report also shines a light on the catastrophic economic costs of malnutrition and highlights solutions that can help mitigate them.
According to the World Bank, the cost of undernutrition is US$3trn in productivity loss every year, because malnutrition stunts people’s physical and cognitive abilities.
In low-income countries, that loss ranges from 3 per cent to 16 per cent (or more) of GDP, which amounts to a permanent 2008-level global recession every year.
“The best way to fight the impacts of climate change is by investing in nutrition…Malnutrition makes every forward step our species wants to take heavier and harder,” Gates writes.
“But the inverse is also true. If we solve malnutrition, we make it easier to solve every other problem. We solve extreme poverty. Vaccines are more effective. And deadly diseases like malaria and pneumonia become far less fatal.”
The report highlights proven tools that are helping solve malnutrition, building people’s resilience to the worst impacts of climate change, and further driving down childhood deaths. They include:
New agricultural technologies that are producing up to two to three times more milk and safer milk, can prevent millions of cases of child stunting by 2050.
Modelling shows that in India, Ethiopia, Kenya, Nigeria, and Tanzania, these technologies can prevent 109 million cases of child stunting by 2050.
Efforts to scale up new ways of fortifying pantry staples, such as salt and bouillon cubes, can reduce millions of cases of anaemia and prevent deaths due to neural tube defects.
In Ethiopia, a new process to fortify salt with iodine and folic acid could lead to a 4% reduction in anaemia and could eliminate up to 75 per cent of all deaths and stillbirths due to neural tube defects.
In Nigeria, fortifying bouillon cubes with iron, folic acid, zinc, and vitamin B12 could avert up to 16.6 million cases of anaemia and up to 11,000 deaths from neural tube defects.
Efforts to provide a high-quality prenatal vitamin for pregnant women could save almost half a million lives and improve birth outcomes for 25 million babies by 2040.
Adopting multiple micronutrient supplements (MMS) costs as little as $2.60 for an entire pregnancy in all low- and middle-income countries.
The report also highlights how promising new research into the microbiome can improve people’s health. Studies indicate that better gut health can help children absorb nutrients, develop strong immune systems, and grow as they should to thrive.
A deeper understanding of gut health, Gates writes, has the potential to change not just how the world treats malnutrition but also overnutrition, which impacts wealthy countries.
