It is two years since the formation of N4D when a small group of like-minded nutrition practitioners came together to ‘try and make a difference’ in nutrition. Although the three N4D founding partners had all travelled different career routes, each with 30-40 years of experience, we seemed to have arrived at the same place in our view and understanding of the current nutrition ‘ecosystem’ and how certain fault lines continue to slow down, and at worst, impede real progress in addressing global malnutrition. At this late stage in our careers, it is interesting to reflect on what we used to hear from our nutrition mentors and gurus when we were ‘starting out’. Visionaries who ran the nutrition master’s course at the London School of Hygiene and Tropical Medicine like (the late) Erica Wheeler, Philip Payne and John Rivers, helped shape a paradigm shift away from a belief in ‘a magic technical bullet’ approach to solving global malnutrition to a far more sophisticated understanding of the need to think and act multi-sectorally as well as socio-politically. In our view, these influencers would have applauded the numerous developments and progress in international nutrition, but they would probably have been disappointed by other recurring features of the ecosystem.
In what feels like two ‘short’ years, N4D have undertaken an enormous range of work at country and global level. It always feels like a privilege to be invited by governments to directly lend support to national efforts to combat malnutrition and to have the opportunity to learn about the socio-political reality of working within a given country context. Our work in Vietnam, Ethiopia and Yemen have provided numerous insights into some of these profound challenges. These include addressing the nutrition needs of marginalised ethnic minorities, difficulties with working multi-sectorally, with strengthening entrenched nutrition information systems which benefit some interests and not others and the need to ‘right-size’ humanitarianism in contexts that are fragile and conflict affected (FCS) in order to transition from cyclical emergency response.
Our recent work at global level with the SUN Movement, the Global Nutrition Report and with Nutrition for Growth shine a light on significant progress and potential but also, on challenges, many of which are sadly not unfamiliar to us. These include the resistance to a more country relevant, decentralised institutional architecture and the tendency of institutions to control an agenda according to their own priorities and interests.
At the end of all our assignments, we seem to return one question – namely how well global actors adequately understand, identify and respond to national needs. Clearly there are many examples of where this is the case. For example, the SUN Movement’s third phase focusses on aligning with country priorities through a regionalised approach and the GNC Technical Alliance is increasing its capacity to provide country relevant technical support. At the same time, we need to be honest and acknowledge that even where national priorities and needs are clearly identified, we haven’t always been that successful in aligning our technical or financial support to these needs. The lack of progress with localisation and strengthening the humanitarian and development nexus (HDN) are good examples of this.
Through our work over the past two years, national actors have expressed their dissatisfaction with elements of the global support system including the disparity in resources being channelled through international agencies compared to national entities, competition between large international agencies driven by a bureaucratic imperative, and lack of progress with localisation and HDN. There is also a pervasive sense amongst some national actors that agency agendas can sometimes feel imposed or at odds with national priorities and plans.
N4D’s current country-based work is supporting the Government of Yemen to operationalise their national Multi-Sectoral Nutrition Action Plan, developed with facilitation through the (then) global technical support mechanism MQSUN+. It is a privilege to be asked to support such an important process which should culminate in greater alignment and investments in its implementation. We firmly believe that the sustainability of multi-sectoral actions to tackle malnutrition requires much greater local and national ownership.
More broadly we also believe that this is the right time to take a look at the nutrition ecosystem in terms of how well it is meeting country needs. It is 14 years since the Lancet 2008 Nutrition Series which did this so well and in the intervening years, there have been a myriad of positive institutional and policy developments. N4D approach to this work will draw heavily on the perceptions and experiences of national actors across a range of countries and focus on four key domains – international and national nutrition financing, leadership and stewardship in nutrition policy and implementation, and capacity strengthening and research.
We are in the run up to the all-important 2025 WHA targets at a time when we are witnessing more conflict, food, economic and climate related crises which are threatening hard-won nutrition gains. Over the next two years, N4D will continue to work with our colleagues to help bolster processes at country level to deliver more sustainable and impactful multi-sectoral actions led by local actors.