Thursday, June 20, 2024



ADMINISTRATOR SAMANTHA POWER: Thank you so much, Nick [Dyer], thank you for your leadership. And it's always great listening to you because it is clear, you are never mailing it in, that this work is deeply personal for you and just stems from your experience in so many different parts on grounds, places on the ground, where you've seen the impact of nutrition challenges and grave food insecurity. I'm particularly grateful for the United Kingdom as a partner, for Cathy Russell's leadership at UNICEF. It's a great team. And I think what stands out about this meeting, is really having representatives from our newest partner governments here, sharing their experiences, their ambition: Cambodia, Pakistan, Nigeria, Kenya.

You know, your ideas for how innovation can occur, how financing can be deployed more efficiently and effectively where the needs are. Donors bring a geographic emphasis, where, in fact, the challenges are spread much further afield. We do that often by necessity because of the paucity of resources or the fact that resources aren't keeping up with need. But you all being in the driver's seat, helping direct any infusion of resources is really important.

And what we're hearing now more and more is your mobilization of domestic resources, your leaders attention to this challenge, and the kinds of partnerships that grow out of achieving those synergies when, you know, again, your governments are leading and we are following with resources and really taking direction as to where to channel those resources and how it's just so important. And so I think this is our fourth meeting. But we're long overdue to have you with us and look forward to learning from you and shaping our efforts, according to your needs.

You know, I think that this session is important because we do have to find a way to make as big a dent as possible in this global challenge. With the resources we have, even though we're gratified, for example, by the presence of philanthropy, gratified very much by the World Bank's prioritization of these issues.

But, you know, the progress is evident on the ground in treating and in preventing wasting, we have expanded our impact beyond humanitarian settings. And that was a major focus of last year's meeting. But given the state of the world that Kelly and others have spoken to, and the extent of the needs, given UNICEF's report that more than 180 million children under five, or 25 percent of all the world's children are living in severe food poverty, thereby, of course, dramatically increasing their risk of severe malnutrition. We just have to find a way to use our resources as efficiently as possible to leverage them so that we turn $1 into more, but also to deploy them with maximum care.

Obviously, Gaza and Sudan really stand out right now, in terms of the emergency needs. A staggering 90 percent of children in Gaza, not getting access to the nutritious foods that they need to grow. We know that in addition to the loss of life, and the harrowing experience of parents and family members who want to provide for their kids, we know the generational effects of a protracted conflict like this one. And even if these children are able to survive, what the harm will be of going through what they are going through right now.

In Sudan, you're looking at a situation where millions of people are facing a famine that potentially could be worse than the 2011 famine in Somalia. There are about 4 million children under the age of five projected to be acutely malnourished by the end of the year. And the estimates are that without treatment, 730,000 of these kids may well not live to see their sixth birthday. So again, we know our resources are insufficient.

Appreciate so much hearing from our Pakistani colleagues. Again, out of the new and innovative ways they have found to commit more domestic funds for wasting. That leadership is absolutely indispensable. Unfortunately, at least between 2022 and 2023 – development donors have not we have not collectively been able to maintain the sort of surge of resources that we were able to orchestrate in 2022. That was a banner year for fundraising and financial commitments for wasting and thanks to so many colleagues here.

The challenge approach, also in leveraging, again, philanthropic dollars, private money proved very, very effective. But when those numbers went down, you know, the lower 2023 funding levels resulted in a situation where some staff were let go, some projects had to be shut down, and treatment had to be disrupted. And then on top of that, we get, of course, the war in Sudan starting a year ago in April, and then October 7, everything that has ensued in Gaza. And more, of course, in other parts of the world.

So we need more funding, and we need people to fight for the prioritization of this effort, given how foundational it is to development outcomes more broadly. And then, you know, my job here is to talk a little bit about the WHO guidelines because what we think we have in them is a way to make our efforts to end wasting as cost effective as possible. And we think these guidelines are a really important step to helping us achieve that. So a few examples.

First, community health care workers already going door to door, we know through all our other global health, inventions, and above all those of the countries on the front lines, but community health workers are going door to door in communities all around the world providing families with health services like treatment for malaria, screening for TB, family planning resources. Now, with the guidelines, the same health workers with the training, are going to be in a position to treat wasting and malnutrition at home. And this is going to result in fewer trips to clinics and fewer expensive inpatient stays at government facilities, it's really important.

Second, severely malnourished kids who are quickly improving may not need the same amount of RUTF [Ready-to-Use Therapeutic Food] as they recover. And nutritionists agree that gradually reducing the amount of RUTF sooner rather than later is beneficial to a child's long term health. So with all the caveats that we know we have to apply here, the guidelines recommend adjustments in the amount of RUTF needed to treat malnourished children who are quickly improving. And that then, of course, in a world of scarce resources allows us to channel this powerful resource to the children who need it most.

And third, the guidelines allow us to more easily and effectively prevent severe malnutrition. By reaching high risk cases before they spiral out of control and require expensive and intensive treatment to address. Because malnutrition among pregnant mothers and babies less than six months old, are strong indicators for future wasting. The guidelines now recommend regular nutrition screenings and nutritional supplements for pregnant mothers and infants, including regular prenatal supplements for pregnant moms. And hopefully that will put us on a path to preventing more wasting before it can develop. And now when children suffer from moderate levels of malnutrition, the guidelines lay out a strategy to provide more regular and effective treatment. So again, they don't become severely wasted in the first place.

A lot more work is needed to clarify which moderately malnourished children qualify for treatment first. But this guideline is an important step in preventing and reducing rates of severe malnutrition. So these guidelines present opportunities for us to make the most of our stretched resources by strengthening the ways in which we treat wasting and working to prevent it altogether. But we know that there is more still we can do to be even more targeted and efficient in our efforts. And in order to implement newer changes, we need more data that can inform future adjustments and future changes.

So USAID will continue to support efforts to further study how wasting funds can go as far as possible in all of the contexts where they are needed. Whether that is examining how cash transfers can best support children with moderate malnutrition in non humanitarian contexts, or whether that is generating evidence on treatment approaches that best lead to sustained recovery. These guidelines, of course, mean very little unless they are implemented unless we together implement them. And that is why last month, I announced another $200 million in USAID funding to treat and prevent wasting money that will help implement these strategies that in turn will help us stretch our resources further.

Many of the funds that I've announced will be dedicated to purchasing RUTF and other nutrition commodities. But they will also be used to support the World Food Program and UNICEF, as they phase in the changes that these guidelines lay out as they train more community health workers as they expand treatment for moderately wasted children and as they reach more pregnant mothers and newborn babies with nutritional support.

It was a privilege for USAID to be the first to commit funding specifically to phasing in these more cost effective approaches. But we would be immensely grateful if others would join us and invest in what is going to be, you know, a challenging period of operationalizing these guidelines. Again, they're, you know, they're in the abstract they're not going to be making a meaningful difference on the ground, actually making sure that things are changing, and that these are operationalized is one of our collective tests.

We have come together before, we have helped millions of children recover their strength, recover their childhoods, recover, in many cases, their lives, we can help millions more. We just have to come together once again. So thank you so much, thanks to everybody who's contributed and I learned a lot particularly about what's happening in key countries that are on the frontlines of battling this really, really challenging phenomenon worldwide. It is now my pleasure to invite Dr. Francesco Branca who is the Director of the Department of Nutrition and Food Safety at the World Health Organization to deliver remarks.

Samantha Power
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