This World Health Day, we introduce the first part of a blog series on Nutrition and Social Protection, written by our Social Protection Officers Kia Howson and Olivia Claxton. This first blog highlights the multifaceted challenges of malnutrition, from undernutrition to the rise of obesity and diet-related diseases, exacerbated by factors like poverty, inequality, and climate change. Urgent action is emphasised, calling for investment in social protection, resilient food systems, and political commitment to ensure equitable access to nutrition and a sustainable future for all.
Conflict, economic shocks and climate extremes have left nearly all countries grappling with the effects of malnutrition. Whether in the form of undernutrition (wasting, stunting and being underweight), deficiencies in essential vitamins and minerals; or the impacts of overweight, obesity and diet-related non-communicable diseases (NCDs) such as heart disease, cancer, and diabetes, malnutrition means people are more likely to die younger, suffer disability, live in poverty and have impaired physical and cognitive development.1
2030 targets set in the Sustainable Development Goals (SDGs) for undernourishment, child stunting, wasting and mortality are all off track, with nearly half of all deaths among children under the age of 5 linked to undernutrition.2 Severe forms of undernutrition, such as kwashiorkor disease, can impair immune function, cause cognitive deficits, and increase susceptibility to infections in children. The long-term effects of childhood malnutrition are equally alarming, as those who survive may face a heightened risk of developing NCDs later in life due to metabolic changes that occur during periods of severe malnutrition.
Compounding the issue of undernutrition is the growing prevalence of overweight and obesity, driven by the rise of ultra-processed foods and the marketing of nutrient-poor diets. Globally, around 40 per cent of adults and 20 per cent of all children are either overweight or obese.3 Many countries also now face the double burden of malnutrition (DBM): the coexistence of undernutrition with overweight, obesity, and diet-related NCDs. More than one in three low- and middle-income countries grapple with the DBM.4 With less robust healthcare systems to prevent, detect, and manage NCDs, these nations face a looming risk that the future NCD burden linked to the DBM could surpass that of high-income countries.5
The Barriers to Progress: Poverty, Inequality, and Climate Change
The causes of the global nutrition crisis are complex and interrelated. Rising temperatures and extreme weather events have reduced crop yields and global stocks of essential grains. Armed conflicts compound the crisis as a major driver of malnutrition – they disrupt food systems, displace populations, and severely impede access to critical nutrition services. Moreover, the impacts transcend borders – the war in Ukraine, for instance, has caused price surges and supply shortages of fertilizers, leading to reductions in their production and exports. This has resulted in rapidly rising prices for food and fuel, threatening to turn the current crisis of affordability into one of availability. Indeed, decreased harvests of key staples are forecasted to escalate food insecurity further and restrict families’ access to nutritious, diverse diets.6
Poverty and low incomes, driven by widespread low wages and informal employment, are core drivers of malnutrition. The informal economy employs 60 per cent of the global workforce and 90 per cent of workers in low-income countries, where low and precarious incomes are common.7 Many families cannot afford nutritious, diverse diets in countries where most people subsist on low, unstable incomes. This perpetuates a vicious cycle – malnourished populations incur higher healthcare costs and reduced productivity, eroding economic growth and entrenching poverty further.8
Income inequality itself exacerbates the malnutrition-poverty trap. Even amid economic growth, many countries still grapple with widespread poverty and high levels of malnutrition. This disconnect arises because income disparity breeds health inequality – as income gaps widen, so do disparities in nutritional status and overall well-being.9
The Urgent Need for Action: Investing in Social Protection and Food Systems
Global evidence demonstrates the positive impact of social protection on malnutrition rates.10 When families are provided with regular and predictable income transfers, parents tend to increase the number of meals per day, diversify their diets and reduce negative coping mechanisms, such as reducing household food intake or taking children out of school to support income generation. Good quality social protection systems address the risks individuals face across their lifecycles, protecting citizens from both individual shocks and large-scale crises that threaten access to adequate nutrition. For example, a child benefit could help with the added costs and unpaid care duties associated with a new family member, which often leads mothers to take time away from paid work.
Today, we stand at a critical juncture in the fight against malnutrition. Despite the global commitment to “end all forms of malnutrition” (SDG 2.2) progress remains unacceptably slow. The persistent gap between political commitments and the mobilization of resources has led many countries to rely on nutrition-specific interventions that focus on the treatment of undernutrition, rather than the prevention of malnutrition.11 Social protection systems often fail to target the multiple burdens of malnutrition in an integrated way across health, education, and other critical services, hindering our ability to address the root causes and achieve long-lasting, transformative change. As the climate crisis presents an ever-growing threat to food security and livelihoods, it is more crucial than ever for political commitment to translate into greater investment in social protection, climate resilience, food systems, and other key services. Only by upholding everyone’s right to food can we build a more equitable, sustainable future for all.
1 World Health Organisation. (2020). Food security | Nutrition]. Available at: http://www.emro.who.int/nutrition/food-security/; International Food Policy Research Institute. (2017). Global nutrition report. Washington, DC: International Food Policy Research Institute.
2 WHO (2023). Malnutrition: factsheet; UNICEF. 2023. Undernourished and Overlooked: A Global Nutrition Crisis in Adolescent Girls and Women. New York; FAO, IFAD, UNICEF, WFP and WHO. 2023. The state of food security and nutrition in the world 2023. Urbanization, Agrifood Systems Transformation and
3 Global Nutrition Report. (2021). Global Nutrition Report: The state of global nutrition. Bristol, UK: Development Initiatives. Available at: https://globalnutritionreport.org/reports/2021-global-nutrition-report/; World Health Organization. (2021). Overweight and Obesity. Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight..
4 Popkin BM, Corvalan C, Grummer-Strawn LM (2020). Dynamics of the double burden of malnutrition and the changing nutrition reality. Lancet; 395: 65–74
5 Shrimpton R, Rokx C (2012). The double burden of malnutrition: a review of global evidence. Washington DC: World Bank; Donohue, James F et al. (2023). “Bridging the “Know-Do” Gaps in Five Non-Communicable Diseases Using a Common Framework Driven by Implementation Science.” Journal of healthcare leadership vol. 15 103-119.
6 WFP (2023). A Global Food Crisis. Available at: https://www.wfp.org/global-hunger-crisis#:~:text=Conflict%2C%20economic%20shocks%2C%20climate%20extremes,people%20are%20facing%20chronic%20hunger.
7 OECD (2024), Breaking the Vicious Circles of Informal Employment and Low-Paying Work, OECD Publishing, Paris, https://doi.org/10.1787/f95c5a74-en.
8 WHO (2023).
9 Siddiqui, Faareha et al. (2020). “The Intertwined Relationship Between Malnutrition and Poverty.” Frontiers in public health vol. 8 453.
10 De Groot et al (2017); Manley et al (2012; 2020) and Olney et al (2021).
11 Nisbett, N., Salm, L., Roelen., K. et al. (2022). Social Protection Pathways to Nutrition Synthesis Report, Brighton, UK: IDS, WFP and IFPRI.