December 2023

iNTERNATIONAL DEVELOPMENT COMMITTEE INQUIRY – THE UK GOVERNMENT’S WORK ON ACHIEVING SDG2: ZERO HUNGER

wRITTEN EVIDENCE SUBMISSION BY THE uNITED kINGDOM cOMMITTEE FOR unicef (unicef uk)

Summary:

1. UNICEF, the United Nations Children’s Fund, is mandated by the UN General Assembly to uphold the UN Convention on the Rights of the Child (UNCRC) and promote the rights and wellbeing of every child. UNICEF works in over 190 countries and territories, focusing special effort on reaching the most marginalised and excluded children.
2. UNICEF is also the global custodian for children in the Sustainable Development Agenda and works with governments, partners and other UN agencies to help countries ensure the SDGs deliver results for and with every child – now and for generations to come.
3. The UK Committee for UNICEF (UNICEF UK) is a UK registered charity that raises funds for UNICEF’s emergency and development work around the world and advocates for lasting change for children worldwide. Through our ongoing ‘Futures at Risk’ campaign, we advocate for policies to improve child health and nutrition globally.
4. UNICEF UK welcomes this inquiry and makes this submission with the aim of helping to drive renewed action to tackle the global hunger and malnutrition crisis, achieve SDG2, and save the lives of millions of children around the world.
5. Achieving SDG2 is crucial to ensuring children’s rights can be realised. Good nutrition underpins children’s health, ability to access education, and future economic outcomes. The global picture, however, is deeply troubling. Nearly half of all deaths of children under five are a result of undernutrition. Yet only 1% of ODA goes to malnutrition.
6. Historically, the UK Government had been a global leader in the fight against malnutrition. However, the ODA cuts in 2020 diminished this role, resulting in a large reduction in spending on nutrition programmes, including those of UNICEF, with devastating impacts on health outcomes for children.
7. The UK has a unique and essential role to play in tackling child hunger and malnutrition and achieving SDG2. Using its historic leadership, expertise and connections to key finance institutions, the UK can help to increase sustainable financing for nutrition.

8. Q1: The effectiveness of the FCDO and UK Government’s approach to achieving SDG2 in countries eligible for ODA, including:

8.1.      Relevant strategies, aid spending and programming, and other work.

8.1.1. The UK Government’s approach to nutrition has been largely positive since it organised the first Nutrition for Growth Summit in London in 2013. The Department for International Development (DFID) became a global leader on nutrition policy and programming, and one of the world’s largest donors to nutrition for several years. In this period, its nutrition work was well respected by the development and humanitarian sector and international partners.

8.1.2. In 2020, the creation of the FCDO and the announcement that ODA would be cut from 0.7% of GNI to 0.5% led to substantive changes, with UK spending on nutrition dramatically reduced. Cuts to nutrition were disproportionate - had the aid cuts been applied evenly across themes, the 2021 disbursements would have been approximately $732.2 million, whilst the actual disbursement of $389.4 million[1] represents a huge shortfall. This had a significant impact on the programmes it was supporting and progress towards the UK’s objectives on SDG2. The UK’s global leadership was compromised at a time when the combination of climate change-driven crises, economic crises, conflict and the impacts of the Covid-19 pandemic fuelled a rise in hunger and malnutrition.

8.1.3. The UK aid cuts significantly weakened the work of UNICEF and other UN agencies, with a 60% reduction in the UK Government’s core contributions in 2021 to UNICEF, UNDP, UNFPA, UN Women[2]. At the time that these cuts were made, the UN’s leadership was critical in preventing a reversal of progress on the SDGs, young people and women. The effects of the funding reductions were most felt in difficult locations where the most vulnerable and marginalised populations depend on the UN for their survival[3].

8.1.4. The aid cuts had significant impacts in UNICEF’s country programmes – in Syria, Venezuela, Nigeria and Egypt, amongst others, funding was significantly reduced. In 2020, the UK was the main contributor to UNICEF’s nutrition response in Syria, allowing us to conduct nutrition screenings of over 2.7 million children and pregnant women, reaching 1.6 million children and pregnant and lactating women with micro-nutrients and providing life-saving treatment to 17,768 children with severe acute malnutrition. In 2021, UNICEF’s office in Syria was informed that the UK had no plans to fund its programme that year[4]. This funding loss threatens their ability to continue making progress in tackling malnutrition and will result in fewer children and women being reached. In Zambia, UK aid spending on the SUN-II programme (see Box 4 in Annex A) was cut by around £3.28 million (of an expected total of £11.78 million) leading to the complete ending of some of their work and scaling back in other areas.

8.1.5. To achieve the SDG2 targets on wasting and undernutrition, a shift in policy is needed towards increased efforts to prevent all forms of malnutrition. Interventions include infant and young child feeding counselling for caregivers, micronutrient powders for children aged 6-59 months, deworming for children aged 12-59 months, vitamin A supplementation for children aged 6-59 months.

8.1.6. Evidence suggests that investments in the nutrition of children, adolescents and women can improve current and future nutrition, while breaking the intergenerational cycle of malnutrition. It is therefore crucial that intervention policies, strategies and programmes focus on the prevention of malnutrition in women and adolescent girls before, during and after pregnancy. Such preventative interventions include iron and folic acid supplementation and/or multiple micronutrient supplements for pregnant women, balanced-energy protein for pregnant women (context-specific), and nutrition counselling[5]. When prevention fails, treatment for wasting becomes essential, and must be made more readily available and accessible to all. These include strengthening community health worker capacities, making ready-to-use therapeutic food (RUTF) more affordable and sustainable.

8.2.      Approach and work over the short-, medium- and long-term.

8.2.1. Development progress takes years to materialise, so predictable funding is crucial for achieving lasting change. This requires more than single year planning and budgeting. Providing multi-year flexible funding to delivery partners enables them to deliver more effective and targeted sustainable development assistance that benefits all. Through core funding to organisations like UNICEF, the UK enhances the organisation’s ability to plan and implement long-term programmes to advance children’s rights, have the flexibility to address challenging and rapidly changing contexts, and improve operational efficiency by reducing transaction costs.

8.2.2. Flexible core funding supports strengthened and highly responsive humanitarian action and ability to respond to areas of greatest need. It facilitates our work to strengthen systems over the longer term and helps us reach children and families in chronic cycles of poverty and crises which do not make the news headlines. In 2018-2020 the UK was the second largest donor to UNICEF for multi-year core resources, donating a total of $154 million.

8.2.3. Given its historic leadership role, expertise, and connections to key finance institutions, the UK can play an essential role in increasing much needed sustainable nutrition financing. It can scale-up successful models leveraging domestic resources to address nutrition challenges. FCDO-supported pilot projects that led to the UNICEF-led Child Nutrition Fund in 2021, demonstrated the effectiveness of ‘match funding’ to encourage greater domestic investment in nutrition across Africa and Asia. The UK has a unique opportunity to support global efforts in creating a sustainable funding mechanism for this initiative. The UK should capitalise its significant investments in data generation for anticipatory action and famine prevention, to enhance early warning systems or crisis preparedness, monitoring, and response.

8.2.4.        The UK remains a champion, and one of the largest funders of tackling the most severe form of malnutrition in children, wasting, including through UNICEF’s Child Wasting and Innovation Programme (CWIP). Through the programme, UNICEF has been able to support governments in rolling out their Global Action Plan (GAP)[6] country roadmaps to improve the prevention, early detection, and treatment of child wasting and address the persistently high prevalence of child wasting.[7] The CWIP is on track to deliver essential nutrition actions for at least 6 million children by 2025 in 9 countries with high levels of child wasting and periodic exposure to climate shocks. At the Global Food Security Summit 2023 the UK Government committed to providing a top up of £30 million to CWIP. This will help amplify and accelerate progress on child wasting in these countries.

8.2.5. Some examples of the CWIP programme are highlighted in country case studies provided in Annex A. Key lessons from these include the importance of greater national efforts towards building local production of RUTF from a cost reduction and domestic financing perspective, helping to strengthen national and sub-national supply chains. Across several CWIP contexts, FCDO has funded research and trials complimenting the child wasting programs. This FCDO support has helped to increase domestic resource allocation and prioritisation for ending child-wasting across different countries with high prevalence of child wasting and proven a catalyst for positive change and prioritisation of child wasting across low- and middle-income country contexts.

8.2.6. The Global Food Security Summit 2023 launched the UNICEF co-led Child Nutrition Fund. Within this Fund, there is a ‘Match Window’, a catalytic one-to-one matching mechanism that allows national governments to double their investment in essential services and supplies for the prevention, detection and treatment of child wasting.[8] This can multiply and sustain the gains made through leveraging domestic resources towards child wasting. It is this kind of innovative approach that the UK can champion to help address the huge need for sustainable financing to tackle the nutrition crisis.

8.3.    Whether the FCDO sufficiently targets and reaches the most in-need communities.

8.3.1. Figure 1 shows the decrease in targeting of UK ODA towards countries with the poorest populations over the last 5 years. This was further compounded by UK aid cuts. In 2021, the amount of bilateral ODA going to Least Developed Countries (LDCs) was cut by 40%, down to a total of £1.4bn (12% of the total ODA budget of £11.4bn). A significant portion of the UK's aid cuts to health primarily affected Low- and Middle-Income Countries (LMICs). Out of the 100 countries that experienced budget cuts in 2020/21, 53 were LMICs with sub-Saharan Africa bearing the largest impact, accounting for 27 of these countries[9].

Figure 1: UK bilateral ODA by poverty band trends, 2010–2020

Source:  Development Initiatives based on OECD and World Bank PovcalNet[10]

8.3.2. It is encouraging that the Government’s 2023 International Development White Paper has a renewed emphasis on the SDGs and the key principle of reaching those most in need. We welcome the commitment to spend at least 50% of all UK bilateral ODA in the LDCs, and the aim to provide at least 0.2% of UK GNI to LDCs. To ensure this is delivered and built on, UNICEF UK recommends embedding a renewed commitment to eliminate extreme poverty and ‘leave no-one behind’ into the planning, implementation and monitoring of every area of ODA budget spend.

8.3.3. These overall trends are reflected in nutrition spending. Many of the highest rates of malnutrition are found in Fragile and Conflict Affected Contexts (FCAC). Between 2018 and 2021 the UK Government prioritised FCAC with their nutrition funding, with six of the top ten biggest recipient countries in that category between 2018 and 2019, eight in 2020 and nine in 2021. The significant cutting back of nutrition programming following the aid cuts has therefore had devastating impacts in these areas. Sub-Saharan Africa received the majority of FCDO’s nutrition ODA between 2019 and 2021, but this decreased by a huge 65% between 2020 and 2021[11].  Funding for FCAC is essential to provide assistance to those in acute need. Funding for other development related contexts require additional and separate funding streams which will allow for more predictability, accompanied with modified assistance delivery modalities.

Recommendations:

1. Embed a renewed commitment to eliminate extreme poverty and ‘leave no-one behind’ into the planning, implementation and monitoring of every area of ODA budget spend. 
2. Increase budgets year on year so that the UK Government is spending 0.7% of GNI on ODA by 2027/28. 
3. Commit to increasing sustainable and predictable financing for nutrition programmes within the next 12 months, with targeted support for ending child wasting, and investment in maternal and adolescent nutrition, and prevention.
4. Continue financial support of the CNF to enable a sustainable, predictable global response to preventing, detecting and treating malnutrition. Sustain multi-year unrestricted funding to UNICEF as a strong example of good donor practice.
5. Champion and prioritise child-centred multisectoral prevention and treatment programming of child wasting across development and humanitarian agendas.

9. Q3: The way the FCDO assesses its work in tackling hunger and malnutrition and if these measures and markers are adequate.

9.1.      The UK Government can play a significant role in enhancing mutual accountability mechanisms by ensuring transparent reporting on its international development activities. It can support partner countries to strengthen their systems, contributing to global efforts to standardise data collection and reporting methods to ensure development goals are measurable and comparable for informed decision-making.

9.2.      The commissioning of an external agency, Development Initiatives, to analyse and publish data on nutrition spending patterns of UK ODA on an annual basis is very welcome, increasing transparency and enabling more scrutiny and accountability by development partners. Continued championing of transparency, and more consistent use of measures and markers across the agencies involved in nutrition is welcome.

9.3.      As working to end malnutrition cuts across a range of different sectors (health, agriculture, social protection etc.), the establishment and use of strong impact targets is very helpful. In 2015, the UK set itself a target of reaching 50 million people with nutrition services from 2015-2020, building on a target of 20 million in 2011-15. These ‘impact’ or ‘reach’ targets provided a basis for measuring progress, ensuring accountability and raising ambition. ICAI found that the target increased focus on nutrition and helped hold key partners to account, as well as encouraging advisers to proactively consider how different nutrition programmes can achieve greater impact through integration[12]. We would like to see the FCDO announce a new impact target. Not only will this focus attention on results across sectors but it would enable enhanced scrutiny by parliamentary and other actors.

Recommendations:

1. The UK should announce an ambitious target to reach more vulnerable children, adolescents and women – aiming to reach 50 million people over 5 years, from 2024 onwards.

10. Q4: The FCDO or other Government departments’ work with other country donors and multilaterally to work on achieving SDG2 and food security.

10.1.  The UK can, and must, play a leadership role working with other donors and multilateral institutions to achieve SDG2. These are global challenges, requiring coordinated and coherent action and multi-lateral collaboration. We welcome the increased focus on tackling food security and nutrition within the recent Internal Development White Paper, and the positive language on multilateral cooperation.

10.2.  The 2023 Global Food Security Summit was a good example of the UK playing a proactive leadership role convening multiple actors to address SDG2 challenges, and we would like to see this momentum continued, and action resourced.

10.3.  The UK can play a critical role in helping deliver sustainable nutrition financing, through its own resources and working with other governments, diverse donors and institutions. It can scale-up successful models leveraging and incentivising domestic resources, building on their partnerships and expertise. In 2021, FCDO supported a pilot project on nutrition financing that led to the establishment of the UNICEF-led Child Nutrition Fund (CNF) along with The Bill and Melinda Gates Foundation and Children’s Investment Fund Foundation. The CNF supports the Global Action Plan to end child wasting bringing together governments, donors, and partners to support and incentivise country-led efforts to accelerate the scale-up of policies, programs, and supplies to fund the prevention and treatment of child wasting through sustainable and predictable financing[13]. The Fund was inaugurated at the Global Food Security Summit by the Prime Minister, Minister Mitchell and the Deputy Executive Director of UNICEF, where the Government committed another £16 million towards the Fund. This financial commitment to the CNF signalled to wider donors the prioritisation of ending child wasting and collective action to achieve the World Health Assembly targets to reduce the proportion of children suffering from wasting to <5% by 2025 and <3% by 2030.

10.4.  The Global Food Security Summit’s focus on ‘Creating new approaches to ending preventable deaths of children’ helped to cement a global prioritisation of child wasting and bring attention to the need to shift the dial on prevention of child malnutrition. This is necessary to ensure a gradual reduction in the treatment caseload. When children do slip into severe malnutrition, detection and lifesaving treatments must be made available. For all these interventions, sustainable and predictable financing is central to efforts to achieve SDG2.

10.5.  Another positive example of FCDO’s leadership that warrants continued support is the Nutrition for Growth (N4G) summit. The UK has played a convening role in tackling malnutrition since hosting the first N4G summit in London, alongside Japan and Brazil in 2013. This summit enabled commitments from a range of actors and raised £17 billion to combat malnutrition. This commitment was exceeded at the Tokyo Nutrition for Growth Summit in 2021, where $27 billion was committed by donor governments and multilateral agencies demonstrating the influence of the first N4G summit[14]. At the next N4G summit in Paris in 2025, continued coordinated multilateral action to tackle child malnutrition will require the UK Government’s political leadership, diplomatic support and financial commitment.

Recommendations:

1. Lead globally on child nutrition by continuing to engage with and influence governments, diverse donors and institutions, highlighting the importance of nutrition at the upcoming N4G summit, COP28, and the 2024 G7 and G20 summits.
2. FCDO should increase its financial support to nutrition and channel any increases in the ODA budget to investments in nutrition.

11. Q5: The FCDO’s work on achieving food security over the short, medium, and long-term including its work on food systems, climate resilience, and agricultural sustainability.

11.1.  Achieving food security requires work across multiple sectors in a joined up and integrated way. We welcome the UK’s attempts ensure a more coordinated and cohesive approach as outlined in the recent International Development White Paper. It will not be possible to achieve SDG2 without all the elements within it being well supported and invested in.

11.2.  Previously, the UK has made positive strides in tackling malnutrition by taking (at the time) a ‘whole of DFID’ approach. Integrating nutrition thinking, targets and indicators into all programming around agriculture, climate, health, education and social protection remains critical to making progress on ending all forms of malnutrition. This requires making the majority of FCDO’s programming ‘nutrition sensitive’ and increasing the number of high impact nutrition specific programmes[15]. 

11.3.  Food systems are not working to deliver healthy and sustainable diets, with 1 in 3 people malnourished, and malnourishment present in nearly all countries. The changing climate is adversely affecting the quantity as well as quality of food produced, food access, affordability, and as a result the consumption of healthy diets. While good nutrition sets a strong foundation for individuals and communities to be healthier and more shock resilient, efforts to improve climate change adaptation focusing on the poorest and most marginalised are essential to boost resilience and reduce vulnerability.

11.4.  Given this interdependence, we need a climate-smart as well as nutrition-sensitive food system, which ensures that climate mitigation and adaptation strategies take nutrition into account. All future climate investments must focus on building resilience of countries and communities most vulnerable to climate change, and drive simultaneous improvements in nutrition, without which the UK Government’s investments will yield limited progress[16].

11.5.  Climate and nutrition programming should be integrated more strategically, with the interplay between climate and malnutrition acknowledged and examination of relevant systems like water, health, and social protection. There is also a need for programming linking nutrition actors and services to climate risk monitoring and early warning systems at national, sub-national, and community levels. This can help to reduce the effects of hazards on agriculture and food systems which shape food environments and diets.

Recommendations:

1. The FCDO should ensure that their programmes integrate nutrition objectives in projects related to climate change, health, economic development, agriculture, education and WASH.
2. The Government should ensure the essential services upon which children rely, including health and nutrition, are prioritised in adaptation response to climate change.
3. The UK should capitalise its significant investments in data generation for anticipatory action and famine prevention, to enhance early warning systems or crisis preparedness, monitoring, and response.

Appendix A: UNICEF Country Office Case Studies

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