Children in the town of Didiévi, Ivory Coast, lining up to wash their hands before they receive food Credit: Scaling Up Nutrition Movement

By Afshan Khan
GENEVA, Dec 23 2025 (IPS)

In my more than 30 years with the United Nations, I’ve seen enormous change, collaboration and progress towards improving human development. But I’ve also seen how history has a way of repeating itself to entrench some of the most intractable global challenges.

In no area is this more evident than in the fight against malnutrition. Early in my career with Unicef, I learned to appreciate how crucial nutrition is to a child’s future, and the cascade of problems that follow when nutrition falters. The effects ripple through learning outcomes, health, economic opportunity, and long-term stability.

The 2008–09 food price crisis brought the issue of malnutrition sharply into focus. When nutritious diets suddenly became unaffordable for many millions, global leaders recognised the need for a different approach, inspiring the creation of the Scaling Up Nutrition (SUN) Movement.

Fifteen years on, we stand at a crossroads on nutrition. 2025 has seen a dramatic fall in overseas development assistance (ODA), especially for nutrition, which even in good years is below 1% of total ODA. And, there is no end in sight to humanitarian crises. The United Nations has appealed for US$23 billion to save the lives of 87 million people facing acute crisis, while more than 135 million people worldwide now require humanitarian assistance. In an increasingly constrained aid environment, the UN is forced into triage, deciding not where needs are greatest, but where limited resources can stretch the furthest. Beyond emergencies, a global cost-of-living crisis is pushing healthy diets further out of reach for millions more. Taken together, these pressures make one outcome tragically predictable: without urgent action, malnutrition will rise.

In Nigeria, hospital admissions of severely malnourished children have surged by 200 per cent in some states, and hundreds of children have already died from malnutrition, just in the first half of this year. In Sudan, the destruction of food factories and aid disruption amid a years-long civil war has left millions of people trapped in a never-ending, ever-worsening nutrition emergency.

Against a bleak backdrop of humanitarian crises at country levels, global trends project that more than half of the global population will be overweight by 2035 — the outcome of a food environment where convenient, low cost foods high in transfats, sodium and sugar are more affordable than nutritious foods.

And yet, now — just as renewed commitments to the principles that inspired SUN’s creation seem most crucial — high-income nations are reducing their spend on overseas development assistance (ODA) while SUN countries struggle with dwindling resources, regardless of their commitments to improving nutrition.

The world cannot afford to forget nutrition. To do so would invite a future marked by widespread chronic disease, overstretched health systems, lost educational and economic potential, and diminished quality of life for millions.

Meeting today’s reality demands a fundamental shift in how we plan and invest to solve the problem. We must move beyond short-term thinking, break down divides between humanitarian and development work, and coordinate efforts across food, health, education, climate, and social policy.

Only by building long-term resilience across governments, economies and communities can we hope to reverse current trends and safeguard the next generation against the nutritional challenges of the future.

This is the thinking behind the SUN Movement’s renewed approach — a joined-up, global effort built around three simple ideas: build resilience against shocks, work across sectors, and diversification of finance for sustainability. ODA alone cannot fuel progress against the World Health Assembly malnutrition targets.

First, resilience. The past few years showed that conflicts, climate disasters, and economic emergencies can quickly wipe out national nutrition gains. Resilience to such shocks is necessary to avoid human capital loss leading to longer term national decline. SUN will focus on helping countries build food and healthcare systems to withstand shocks and prevent emergencies turning into disasters.

Second, sustainable financing. Today, the world faces a $10.8 billion annual nutrition funding gap. Until we close it, countries will continue to face the same cycle of progress followed by setbacks. Countries need to be able to draw on more than one pot of money, and SUN will help them to diversify across national budgets, responsible business, philanthropies, development banks, and climate funds.

Third, addressing the changing face of malnutrition. Overweight and obesity now affect almost 400 million children, a tenfold increase since 1975. What is more, 70 per cent live in low- and middle-income countries, where populations are growing fastest. SUN’s renewed approach has put obesity prevention and healthy food environments alongside its long-standing focus on undernutrition.

Finally, integration. Malnutrition does not exist in isolation, so neither can our response. Policies across health, agriculture, education, social protection, climate adaptation, and humanitarian response matter. The Global Compact for Nutrition Integration — already supported by over 80 countries and organisations — is showing what true collaboration can look like. The Compact brings together governments, funds, development banks, UN agencies, civil society and business around a shared goal: aligning support with countries’ needs and providing a common framework to ensure nutrition objectives are embedded in policies, programmes and financing across all relevant sectors.

My career has taught me that global progress is never guaranteed. Moreover, I have learned that the gains we fight hardest for are often the most fragile and must be cultivated, invested in, and protected.

Two things are clear: no country is immune from the malnutrition crisis, and if we continue to rely on fragmented, short-term responses, this crisis will only deepen.

SUN is on a journey to help the world chart a different course. As I step back from this work, my hope is that global resolve only grows stronger, and in fifteen years time, we will have found new solutions for seemingly intractable problems.

Afshan Khan is UN Assistant Secretary-General and coordinator of the Scaling Up Nutrition (SUN) Movement

IPS UN Bureau

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A baby hangs on a scale during a community health check-up and vaccination in Akosombo in the Eastern Region, Ghana, on April 28, 2022. Credit: Gavi/2022/Nipah Dennis

By Afshan Khan and Sania Nishtar
GENEVA, Aug 7 2024 (IPS)

From 11-year-old Chinese skateboarder Zheng Haohao to 16-year-old American gymnast Hezly Rivera, several children have reached the pinnacle of world sport at the Paris 2024 Olympic Games.

Yet at the same time, millions of other children worldwide are denied the chance to unlock their full potential simply because of a lack of access to basic nutritious diets and vaccines that prevent disease.

As young athletes impress and inspire global audiences, the Games are the perfect moment to reflect on how to level the playing field for all children. Integrating nutrition and immunisation as the cornerstones of healthy development can be a game-changer, ensuring every child is able to reach their full potential in whatever field they choose.

The conditions for healthy development include both the absence of disease and presence of adequate nutrition, creating a virtuous cycle that allows children to thrive. Vaccines trigger the strongest immunity in children who have healthy diets, while those who are malnourished are more susceptible to infectious diseases.

Unconscionably, in this day and age, both malnutrition and preventable infectious disease claim the lives of millions of children every year.

Globally, more than 14 million children are un- or under-vaccinated – an increase of 2.7 million compared with pre-pandemic levels – while almost a quarter of children under five were stunted in 2022 as a result of inadequate diets.

Yet, immunisation and nutrition interventions are proven to be amongst the most cost-effective approaches to help children survive and thrive. One dollar invested in nutrition gives a rate of return of US$16, rising to US$35 for exclusive breastfeeding, while the return on investment of immunisation in Gavi-supported countries is estimated at between US$21 and US$54 per US$1 spent.

This is especially important for low- and middle-income countries where immunisation rates are lowest, malnutrition is prevalent and resources are stretched thin. The latest UN figures show more than half of unvaccinated children live in 31 countries exposed to conflict and other vulnerabilities, disrupting access to nutrition and health services.

The same children often miss out on both nutritional supplements and essential vaccines, meaning that integrated health services would solve two problems at once.

Integrated nutrition and immunisation can be achieved either in the same clinic or community health facility, or through the same health worker.

Uganda is one country that has taken proactive action towards integration, and plans to shift to integrated provision of nutritional supplements and vaccines based on learnings from several pilot programmes.

Meanwhile, Action Against Hunger and partners in Somalia mounted an integrated campaign to address rising levels of malnutrition and disease during the prolonged drought in 2022, which affected 7.8 million people.

The campaign reached more than 200,000 children with measles vaccines, deworming treatments and vitamin A supplementation, and screened more than 185,000 children under five for wasting. Among the referral sites for severe acute malnutrition, the average cure rate was 83 per cent and malnutrition decreased significantly over the period of the campaign.

If more governments were able to adopt and scale such levels of integrated service delivery as part of primary health care, more countries could achieve Universal Health Coverage to reduce preventable deaths, ill-health and malnutrition in children.

As the world celebrates the remarkable achievements of young Olympians, the international community also has a window to transform the future of millions of children worldwide.

From the 2024 Games to Gavi’s replenishment and the 2025 Nutrition for Growth Summit, which has followed the Olympics since 2012, world leaders have the chance to invest in research and partnerships to integrate nutrition and immunisation as the fundamental components of healthy development. This is the winning formula for more children to succeed – on the track, field and pitch, and in life.

Afshan Khan, UN Assistant Secretary General and Coordinator of the Scaling up Nutrition (SUN) Movement

Sania Nishtar, CEO of GAVI, the Vaccine Alliance

IPS UN Bureau

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