Self-financing sustainability by governments is crucial for the prevention of malnutrition

Increasing food insecurity and risk of famine resulting from the compound effects of global warming, the invasion of Ukraine, and other crises are impacting the cost and availability of food supplies and are putting more children at risk of severe wasting.  

Every year, 10 million children suffering from severe wasting go untreated due to a lack of resources. Yet, funding for nutrition supplies and programmes remains unacceptably low. The rising price of ready-to-use therapeutic food (RUTF) used to treat severe wasting increases the risk of death.  

In 2020, over 45 million children suffered from wasting, out of which 13.6 million were severely wasted. Although severe wasting remains one of the top threats to children below five years and contributes to nearly half of child deaths, the global response to the COVID-19 pandemic has diverted donor commitment away from national nutrition programmes.    
 

Supporting self-financing for nutrition programmes  

 
UNICEF and partners are championing innovative ways to support over 3.7 million children under five years of age suffering from wasting using a three-pronged approach:  the nutrition match fund, pre-financing, technical assistance to collaborate with governments around the world to build sustainable self-financing for nutrition programmes.   

In early 2021, UNICEF launched the Nutrition Match Fund (NMF) with support from the UK Government, the Children’s Investment Fund Foundation (CIFF), and further commitment from the Bill & Melinda Gates Foundation.  

By providing a 1:1 match, the NMF makes financing for RUTF and other critical nutrition supplies more predictable and incentivizes governments to make more robust allocations of their domestic resources towards preventing and treating malnutrition. Currently, Mauritania, Nigeria, Senegal, Uganda, and Kenya have subscribed to the NMF. 

“The Nutrition Match Fund is a game-changer, offering demonstrable evidence that with the right support, national governments can play an ever-increasing role in the financing of key commodities to prevent and treat malnutrition.,” said UNICEF Senior Nutrition Advisor, Mr Saul Guerrero Oteyza.  

“In doing so, the NMF will improve our ability to ensure that all women and children have the right nutritional support when and where they need it most,” he added. 

In April 2022, UNICEF and partners delivered more than 36,300 boxes of RUTF to Mauritania to treat over 35,000 children suffering from severe wasting. Half of the total RUTF consignment was paid for by the Government of Mauritania, and the remainder was covered by the NMF. 

These nutrition supplies were part of a consignment of 155,000 cartons ordered in October 2021. They were funded through NMF, and government resources and deliveries are progressing for Mauritania, Nigeria, Senegal, and Uganda. 

“This initiative increases collaboration between UNICEF and Ministries of Health and Finance on budgeting and financing health supplies and also extends partnerships with private sector supply chain services,” said UNICEF Chief of Nutrition in Mauritania, Christian Tendeng.  

“This initiative increases opportunities for national governments to access innovative financing for nutrition commodities to achieve an optimized, efficient, and timely humanitarian response and provides comparative advantages in product sourcing.”   

All countries are eligible to access the NMF. Ideally, however, participating governments already:  

• Integrate overall RUTF needs and costs of treatment into Global Financing Facility investment cases that have been (or are being) developed. 

• Cover a proportion of related costs with domestically mobilized resources. 

• Can demonstrate that their domestic allocation to RUTF does not negatively impact or distort financing of other life-saving health interventions.  

“Nutrition, as articulated in the National Development Plan (NDP 111), plays an important role in the socio-economic development of Uganda. Despite the Government’s progress in reducing malnutrition, over 2 million children are stunted, and about 250,000 suffer from wasting,” said Uganda’s Permanent Secretary at the Ministry of Health, Dr Diana Atwine. 

“The Ministry of Health sees the Nutrition Match Fund by UNICEF as an opportunity to accelerate efforts to address wasting in children by creating a more sustainable funding mechanism for treatment.”  

With the support of the UK Government, UNICEF has also expanded nutrition pre-financing interventions through the Vaccine Independence Initiative (VII), which accelerates access to nutrition supplies to partners who face temporary budget shortfalls. Through the VII nutrition window, countries can subscribe to the VII revolving fund to address recurring needs or to apply for ad-hoc pre-financing to overcome one-off cash flow issues. In 2021, VII pre-financing bridged delays in the disbursement of funds for emergency response in Ethiopia and Haiti, accelerating the procurement of more than 117,000 cartons of RUTF worth $4.7 million. 

Technical assistance supports the public procurement budgeting processes, annual and multi-year planning for nutrition supplies, capacity building in forecasting and budgeting, and evidence-based advocacy. By addressing reasons for insufficient budget allocations, and delays in the disbursement of funds, technical assistance supports countries transitioning from donor reliance for RUTF procurement to self-financing sustainability. 

While UNICEF procures an estimated 75-80 per cent of the global RUTF demand, the available supply only covers 25 per cent of the estimated needs of children suffering from severe wasting.   

Increased budgetary commitment to nutrition supplies by donors and governments has never been more important.  

“These new financing mechanisms present a unique opportunity to transform the way we prevent and treat severe wasting but for that opportunity to be truly realized we need to maximize the contributions of donors and national governments” said Saul Guerrero, UNICEF’s Senior Nutrition Advisor.