February 27, 2019 | By Sharada Keats, Greg S. Garrett

Guest Commentary: All Systems Go for Better Nutrition

Editor's Note: As part of our new blog series, Uncharted Waters, the Chicago Council on Global Affairs is inviting a diverse group of experts to explore topics related to water, nutrition, and agriculture in advance of  the 2019 Global Food Security Symposium.  Join the discussion using #GlobalAg, and tune in to the symposium live stream on March 20 and 21.

By Greg S. Garrett and Sharada Keats

844 million people do not have a basic drinking water service. Close to the same number go to bed hungry each night, while some 2 billion lack the right amounts of micronutrients in their diet. 
Water and food are fundamentally linked. Lack of clean drinking water undermines nutritional status through water-borne disease and chronic gut infections. And water is essential for food production and sanitation. Access to safe drinking water  and access to adequate food are fundamental human rights. Here we look at these linkages more closely, through the lens of the Sustainable Development Goals (SDGs) – and discuss efforts of the Global Alliance for Improved Nutrition (GAIN) and our partners to improve nutrition through better access to nutritious foods and clean water.

Meeting the (Food and Water) Sustainable Development Goals

The United Nations’ 2030 Agenda for Sustainable Development, adopted in September 2015, is underpinned by the SDGs. You’ve heard of them: 17 interlinked development challenges with no less than 169 targets – aiming for a transformed world in only 11 years’ time… a world without the extreme poverty, malnutrition, resource waste, environmental degradation, and gross inequalities we see today.
The SDGs are not meant to be tackled each in isolation. Together they comprise  an interlinked system feeding back on each other; see this fascinating guide to SDG Interactions published in 2017 – with largely positive interactions.
Can systems approaches help improve the way we tackle the SDGs, and specifically the food and water targets?


Linking the Food and Water SDGs

At GAIN we work closely with government and industry to make nutritious diets more available and accessible to vulnerable populations. In the food and nutrition sector, we rally around  SDG 2, calling for zero hunger. In the water sector, SDG 6, clean water and sanitation is the main touchpoint. A few of the other SDGs stand out from a food and water perspective as well – notably SDG 12 and SDG 14 – which call for sustainable consumption and production (including target 12.3 to halve food loss), and sustaining marine areas (including a target to end overfishing), respectively.
GAIN’s systems approach in most of the low- and middle-income countries where we concentrate, people’s diets rely heavily on cereals and other starchy staples, while lacking in protein- and micronutrient-rich foods, such as animal source foods like milk and eggs, as well as fruits and vegetables.
GAIN’s mission is to advance nutrition outcomes by improving the consumption of nutritious and safe food for all people, especially those most vulnerable to malnutrition.
Our five-year strategy outlines our aim to help transform food systems to mainstream nutrition. To help achieve this, we take a broad food systems approach. Safe water and its link to food safety is fundamental to the success of our programs and we actively seek partners who can bring their expertise in the area of clean water.  
Virtually everyone buys their food from markets. The private sector – from farmers to small and medium food enterprises (SMEs), to large national enterprises, to ‘big food’ are major pieces in the food system puzzle. And  all need appropriate incentives, support, and regulation to provide nutritious, safe, and affordable food – and water – for everyone.
At GAIN we seek transformation through food system change – by bringing these private sector partners, governments, and civil society together to figure out what works to deliver better nutrition at scale – trialling things and learning from them.
Toddler eating with help from her mother – GAIN’s BADUTA program, East Java, Indonesia © GAIN


Where Does Our Work on Nutritious Food Systems and Water Intersect?

We acknowledge that water and food are fundamentally linked. Lack of clean drinking water undermines nutritional status, and water is essential for food production. Many micronutrient-rich foods, particularly animal-source foods, have a high fresh water footprint. Addressing this need to protect and sustainably manage our freshwater resources (respecting planetary boundaries), while fulfilling people’s nutritional needs, is one of the larger environmental, social, and political challenges of our time.
While we at GAIN do not work on water directly, through our partners, we have current as well as prospective programs which aim to improve water systems. This includes  small-scale industrial systems,  some agricultural systems as well water use at the household level.  
Three examples of our current and prospective work at GAIN on food and water for better nutrition are detailed below.
1. Mother-and-child nutrition: We know there is a strong link between water and sanitation and hygiene (WASH) and nutritional outcomes, particularly for young children. In East Java, Indonesia, we integrated water into our  BADUTA program which improves maternal, infant feeding and care practices.. In partnership with East Java provincial and district health authorities (including the Directorate of Community Nutrition), Save the Children (Netherlands), NAZAVA Water Filters (PT Holland For Water), and Paramitra (a local NGO), BADUTA focused on mother-and-child nutrition for under-twos. This included two water components. Firstly, education on WASH was provided to expectant mothers and caregivers of under-twos. Secondly, access to clean water was improved through the roll out of hire-purchase and sales schemes for water filters for households in areas with inadequate, tainted, or expensive fresh water supply. The project has seen measurable improvements in anaemia and other nutritional outcomes.
2. Water for horticulture: Our Marketplace for Nutritious Foods program is designed to accelerate accessibility, desirability and quality of nutritious foods in low-income countries through supporting local small and medium enterprises (SMEs). It works with SMEs at various stages along the value chain – from production, to processing, to  marketing and retail. It has helped SMEs to address challenges in water supply. For example, in the outskirts of Chimoio, Mozambique’s fifth-largest city, the vegetable production and marketing business of Vegman was hampered a few years ago by limited irrigation ability. The farm's system was unconnected to the electricity grid and reliant on a costly diesel generator. Following support through the Marketplace for Nutritious Foods to install electricity on the farm to improve irrigation, the production of vegetables – including tomatoes, onions, spinach, bananas, sweet potatoes, squash and beetroot – has received a strong and sustainable boost. 
3. Financing safe water enterprises: In our newest program – Nutritious Foods Financing – operating in sub-Saharan Africa, we are helping unlock commercial investments for SMEs which can scale production of nutritious and safe food and water for low-income target populations. We have developed an impact investment thesis and metrics which help identify SMEs and products which can be considered for investments. The program focuses on nutritious foods, but clean water investments also fit the eligibility criteria. In 2019, GAIN is setting up mechanisms to help unlock commercial investments for these SMEs.

All systems go

The challenges facing us in terms of clean water and nutritious foods are immense, with over 800 million lacking access to a clean water source, over 800 million unable to access enough food and approximately 2 billion with an inadequate diet. However, the opportunities are equally immense. On direct economic benefits alone, we know that every dollar spent on nutrition interventions brings $16 in return, while the return on every dollar spent on WASH is over $4. Rising to the challenge and benefiting from the opportunities requires more than a health or agriculture, or humanitarian, or environment, or food safety or climate response. We need private and public sectors, academia and other parts of civil society working together.
For some SDG areas we generally know what levers we need to pull to drive positive change.  But what works in the world of sustainable, scalable, safe and nutritious food is less well-rehearsed. We do know that the strong interlinkages and feedback loops between sectors and goals means we must take a systems approach when designing, implementing, and evaluating strategies and interventions. More effective collaboration, including better alignment of nutritious and safe food and clean water agendas can help us to meet our sustainable development ambitions.
The right to safe drinking water and the right to adequate, nutritious food can be achieved when public, private, and civil society work together to build the understanding of and the will for transformation.
Better nutrition. For all.


The Global Food and Agriculture Program aims to inform the development of US policy on global agricultural development and food security by raising awareness and providing resources, information, and policy analysis to the US Administration, Congress, and interested experts and organizations.

The Global Food and Agriculture Program is housed within the Chicago Council on Global Affairs, an independent, nonpartisan organization that provides insight – and influences the public discourse – on critical global issues. The Council on Global Affairs convenes leading global voices and conducts independent research to bring clarity and offer solutions to challenges and opportunities across the globe. The Council is committed to engaging the public and raising global awareness of issues that transcend borders and transform how people, business, and governments engage the world.

Support for the Global Food and Agriculture Program is generously provided by the Bill & Melinda Gates Foundation.


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