Chapter Thirteen

169

The Evolving Worldof Nutrition

Saskia de Pee
Technical Advisor Nutrition and HIV/AIDS, WFP,
Adjunct assistant Professor Friedman School of Nutrition Science and Policy,
Tufts University, Boston, USA
Visiting Assistant Professor, Wageningen University, the Netherlands

“He who has health has hope, and he who has hopehas everything.”
Arabian Proverb

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Key messages• Almost everyone plays a role in nutrition
through taking care of their own diet andhealth, as well as through involvement in
the food system in one way or another.
• Nutrition is multi-disciplinary, ranging
from agriculture to medicine to behavioral
science and economics.
• Throughout the 20th century, knowledge
and approaches for addressing
malnutrition developed within therespective disciplines, but there waslimited cross-disciplinary coordination,even with other players in the food andhealth systems.
• Understanding the forms andconsequences of undernutrition, being able
to cost the economic impact ofundernutrition, and having examples ofwhat is required and what works to prevent
undernutrition, including good governance,
has generated the strong momentum
behind nutrition that exists today.

Nutrition is everybody’s business
Everyone deals with nutrition – individuals who are looking
after their own diet and health; mothers and fathers whoare caring for their families; farmers who grow food forthemselves and others; medical doctors, teachers, sports
coaches and others who support people in understanding
the importance of health and nutrition; food processors
who produce, preserve, package and distribute foods; andcommunity leaders, politicians and business owners, who
impact other people’s ability to access an affordable, healthy
and nutritious diet. Food systems around the world arediverse, increasingly industrial, commercial and global, andmany of us play an active role in shaping them.
However, while we affect our own and other people’s
nutrition every day, directly or indirectly, there are manydifferent ways in which nutrition and health are
understood, and our ability and decisions to actively
influence them, either by ourselves or by seeking assistancefrom others, ranges widely. Furthermore, as the preceding
chapters discuss, many factors that impact on the healthand nutrition of individuals and populations are beyond the
direct influence of the individual, as these are determined bytheir environment and circumstances.

Silvopastoral cultivation, in which livestock live in wooded areas
Source: CIAT

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Early discoveries in nutrition
Throughout the centuries, there has been a growing
understanding of the relationship between diet and health andabout how poverty and related living circumstances affect a
population’s health, for a substantial part through the diet.
In the late 19th and early 20th centuries, scientists in the fields
of chemistry, biology and medicine started conducting animal
experiments in which they supplemented basic diets consistingof carbohydrates, fat and protein, with specific foods or foodcomponents such as milk and butter to determine which
components made the animals live or die. While doing so, theyobserved conditions in the animals that were comparable tosymptoms that had been described in humans, such as inrecords from naval medicine in the 19th century.

Vitamin

Alternative nameVitamin A

Over the course of a few decades, the various vitamins wereisolated and named, and their deficiency states described.
For several of the deficiencies, the ultimate consequence wasdeath. It was realized that severe deficiencies could occur
without starvation, and that many people were probably
affected by nutritional deficiencies. To address vitamin A
deficiency, some European countries and the US introduced
school milk distribution schemes (fortified with vitamin A inthe case of skimmed milk) as well as encouraging, or evenenforcing, consumption of butter and/or cod liver oil in the
1920s–1940s.

Discovery

Isolation

Structure

Synthesis

Retinol

1909

1931

1931

1947

Provitamin A

β-Carotene

1831

1831

1930

1950

Vitamin D

Calciferol

1918

1932

1936

1959

Vitamin E

Tocopherol

1922

1936

1938

1938

Vitamin K

Phylloquinone

1929

1939

1939

1939

Vitamin B1

Thiamin

1897

1926

1936

1936

Vitamin B2

Riboflavin

1920

1933

1935

1935

Vitamin B3

Niacin

1936

1936

1937

1994

Vitamin B5

Pantothenic acid

1931

1938

1940

1940

Vitamin B6

Pyridoxine

1934

1938

1938

1939

Vitamin B7

Biotin

1931

1935

1942

1943

Vitamin B9

Folic acid

1941

1941

1946

1946

Vitamin B12

Cobalamin

1926

1948

1956

1972

Vitamin C

Ascorbic acid

1912

1928

1933

1933

From November 1944 to December 1945, 36 conscientious
objectors participated in the historical Minnesota Starvation
Experiment, which was designed to study the physiologicaland psychological effects of severe and prolonged dietary
restriction and the effect of dietary rehabilitation strategies,
as was a reality for many people in Europe during theSecond World War. This work, led by Ancel Keys, provided

key insights into nutrition, including the understanding thatstarvation dramatically alters personality and that nutrition
directly, and predictably, affects mind as well as body.
During that first half of the 20th century, undernutrition was
primarily of interest a) as a medical condition with specificsymptoms characterizing specific nutrient deficiencies, and b)
as a problem of lack of food resulting in starvation.

Chapter Thirteen | The Evolving World of Nutrition | Saskia de Pee

Different worlds of nutrition
Between the 1940s and 1970s, the medical field evolved
dramatically, and after the Second World War, the economic
development of Western Europe and North America
increased access to a more nutritious diet for a large part ofthe population, while living circumstances such as hygiene
and education continued to improve substantially. Together,
these developments resulted in lower child mortality,
increased life expectancy, and a marked reduction ofnutrient deficiency diseases (e.g rickets and night blindness).
With these developments, the momentum behind nutritionin Europe and North America from the early part of the20th century was not sustained, as undernutrition was not
perceived to be much of a problem anymore. The attention
for the role of nutrition in health continued in developing
countries and among international agencies, and regained
strength globally when case reports and survey data on
health and nutrition started to be reported from more andmore developing countries from the early 1970s.
In the period following the Second World War, most of theattention regarding diet and food was focused on ensuringthat there would be enough food for the growing world
population, and on making sure that protein deficiency wasprevented or treated (see the chapter in this volume byVictoria Quinn on the ‘protein fiasco’). This meant that
agriculture was largely focused on the production of cereals(green revolution, increase of scale) to ensure that caloric
requirements were met, and on cash crops for income.

Women farmers in East Africa
Source: CIAT172

The signs of undernutrition from developing countries thatdrew attention from professionals in the biomedical field wereparticularly those related to micronutrient deficiencies, which
could be solved by a medical-type intervention, such asproviding supplements of vitamin A, iron, iodine and/or zinc.
Meanwhile, it was also realized that the causes of nutrition
problems were rooted in poverty, and that, besides being
related to food, they were also related to water, hygiene,
sanitation and caring practices, and that approaches foraddressing malnutrition therefore had to be multidisciplinary. Due to this, social and behavioral scientists
also became involved in nutrition, and there was anincreasing sense that individuals and communities should be
able to rely on their own resources and means, including
food production, to achieve adequate nutrition.
The UNICEF Conceptual Framework of causes ofmalnutrition, which was developed at the time of the Iringa
project in Tanzania in the early 1980s, clearly illustrated themulti-factorial causes of malnutrition and indirectly assigned arole for many disciplines for addressing malnutrition.
However, for a couple of decades, there was limited focused
attention on addressing malnutrition, because thecomprehensiveness of the framework indicated that there weremany factors involved but at the same time it was not clear
which one(s) to prioritize where and who should take which
action. There was also limited awareness of the consequencesof not tackling the problem, and several signs of undernutrition
were not yet properly understood.

Women have a key role to play in improving the nutritional status of theworld’s population
Source: The Gates Foundation

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Momentum for concerted action on nutrition
Fortunately, the past ten years have seen a marked increaseof attention as well as momentum for action on nutrition,
due to several coinciding developments:• Advances of our knowledge of the consequences ofundernutrition, which goes beyond the signs andsymptoms of specific deficiencies on the one hand andstarvation on the other, to lifetime consequences of
inadequate nutrition in early life in terms of early morbidity
and mortality, as well as impact on cognitive ability
affecting performance in school and income-earningpotential, and non-communicable diseases later in life suchas cardiovascular disease and diabetes;• Increased understanding of the biology ofmalnutrition, including the relationship between two
apparently different forms of malnutrition, i.e.,undernutrition and overnutrition, that are actually very much
related (both include micronutrient deficiencies, both are
related to poverty – the world’s wealthier and well-educatedpeople have the healthiest diet, and undernutrition in early life
predisposes to overnutrition and non-communicable disease
later in life);• Evidence of effective nutrition interventions,
including their cost-benefit ratio. Also, the Copenhagen
Consensus 2012 expert panel of economists, which
included four Nobel laureates, identified that the smartest
ways to allocate money to respond to ten of the world’s
biggest challenges is by fighting malnourishment. Nobel
laureate economist Vernon Smith said: “One of the mostcompelling investments is to get nutrients to the world’s
undernourished. The benefits from doing so – in terms ofincreased health, schooling, and productivity – are tremendous”;• The observation that economic development andlarge-scale production of cheap, convenient fooddoes not lead to better health but instead is related toan epidemic of obesity and related non-communicablediseases, has led to people’s rethinking of food systems
and healthy and sustainable diets (it has become
everybody’s problem);• Increased ownership of nutrition and collaboration
by a wide range of disciplines, including biomedical,
behavioral, agricultural, and economics;• Increased access to information through media such
as Internet and mobile-phone technology, which increases
the awareness as well as the ability to act and hold politicians,
companies and others accountable for their actions;• A more connected world where heads of state agree on
mutual goals (Millennium Development Goals, post-2015
development agenda), low-income countries evolve to
become middle-income countries and grow from being therecipients of donor funding to being donors themselves,
and the private sector becomes involved in solving the
problems of the most vulnerable.

The first Lancet series on Maternal and Child Nutrition,
which was published in 2008, summarized the magnitudeand consequences of the nutrition problem, and provided
evidence of a number of proven and low-cost solutions.
This publication galvanized substantial action on multiple
fronts, and not only the questions of ‘why to address
undernutrition, by doing what, and where’, but also thequestion of ‘how to do it’ received attention. Moreover, thishappened at a time when it was realized that everyone has arole to play, including, for example, the private sector,
which had previously been regarded by some as mainly
contributing to the problem rather than building a path tothe solution. It also showed convincingly that poor fetal
growth or stunting in the first two years of life leads toirreversible damage, including shorter adult height, lower
attained schooling, reduced adult income, and decreased
offspring birth weight. This very much focused everyone’s
attention on the prevention of stunting and on prioritizing
nutrition during the first thousand days from conception
until two years of age.
Furthermore, in May 2012, the 65th World Health
Assembly (WHA) endorsed six global nutrition targets to beachieved by 2025 as part of WHO’s comprehensive plan onmaternal, infant and young child nutrition, including
reducing by 40 percent the number of children under age 5
who are stunted from 171 million in 2010 to 100 million
by 2025. This means that there is very broad commitment
to these goals, as the WHA is the forum through which
WHO is governed by its 194 member states and it iscomposed of health ministers from these states.

Chapter Thirteen | The Evolving World of Nutrition | Saskia de Pee

Malnutrition remains a serious impediment to the progress
towards achieving the Millennium Development Goals. Yet
many of the nutrition challenges that have persisted for
decades can be resolved within our generation.
Recognizing that accelerated global action is needed toaddress the pervasive and corrosive problem ofmalnutrition, the World Health Organization (WHO)recently identified a set of global targets designed toreduce the unacceptably high burdens of disease and deathcaused by poor nutrition, particularly during the critical
1,000 days between a woman’s pregnancy and a child’s
second birthday.* By aligning the glocal community
behind six targets aimed at improving the nutritional
status of mothers, infants and young children andcommitting to a decade of investement to expand
nutrition interventions, we can prevent the deaths of one
million children per year and help to build the foundations
for healthier and more prosperous societies.

GLOBAL TARGET 1

GLOBAL TARGET 3

GLOBAL TARGET 5

By 2025, reduce by 40% thenumber of children under age 5
who are stunted.

By 2025, achieve a 30% reductionof the number of infants born withlow birth weight.

By 2025, increase to at least 50%
the rate of exclusive breastfeedingin the first six months.

Problem:
Stunting is the irreversible result of chronic
nutritional deprivation during the mostcritical phase of child development - the1,000 days between a woman’s pregnancy
and her child’s 2nd birthday. Stunted
children have weaker immune systems
making them more likely to die from
common illnesses and disease, and sufferfrom impaired brain development making
them less able to learn in school and earn agood living as an adult.

Problem:
An infant’s weight at birth is a strong
indicator of his or her chances for survival,
growth, and long-term health anddevelopment. In the developing world, lowbirth weight stems primarily from poormaternal nutritional status before conception,maternal short stature due mostly toundernutrition and infections during childhoodand poor nutrition during pregnancy.

Problem:A non-breastfed child is 14 times more likely
to die in their first six months of life than achild who is exclusively breastfed. Thoughbreastfeeding is the single most effective
nutrition intervention for saving lives, global
breastfeeding rates have stagnated or
dropped in most regions of the world to an
estimated 37%.

Results:
3.9% relative reduction in the number of
infants born with low birth weight per year.

Results:
2.3% relative increase per year would leadto approximately 10 million more children
per year being exclusively breastfed until six
months of age.

GLOBAL TARGET 2

GLOBAL TARGET 4

GLOBAL TARGET 6

By 2025, achieve a 50%
reduction in anemia in womenof reproductive age.

By 2025, ensure that there is no
increase in the number of children
who are overweight.

By 2025, reduce and maintainchildhood wasting to less than 5%

Problem:Anemia in women increases the risk of dying
during childbirth and increases the risk ofbabies being born with low birth weight. Iron
deficiency anemia affects 1/3 of all womenof reproductive age throughout the world.

Problem:
Obese children are likely to grow into obese
adults, have an increased risk of diabetes
and liver disease, and have poorer
economic prospects later in life.

Results:
A reduction in the number of stunted
children from 171 million in 2010 toapproximately 100 million.

Results:
A reduction in the number of anemic,
non-pregnant women from 468 million toapproximately 230 million.

Results:
The number of overweight children underage 5 would not increase from current levelsof 43 million to forecasted levels of
approximately 70 million.

Problem:Commonly used to indicate the severity of afamine of food crisis, wasting is the result ofgrave disease and/or deprivation of nutritious
food at a specific point in time and is seen
as an early warning for future increases inchronic undernutrition. The proportion ofchildhood wasting rose in the second half ofthe last decade, likely as a consequence ofthe dramatic spikes in food prices.
Results:
Current global prevalence of wasting of
8.6% should be reduced to less than 5% by2025 and maintained below such levels.

*These targets were endorsed by the 65th World Health Assembly in May 2012 as part of WHO’s comprehensive plan on maternal, infant and young childnutrition. Sources: Black, R. et al “Maternal and Child Undernutrition” The Lancet, January 2008; Save the Children “The Child Development Index
2012”; UNICEF, “Committing to Child Survival: A Promise Renewed” Progress Report 2012.

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The second Lancet series of 2013 has reaffirmed thefindings of the first series and particularly emphasizes theimportance of adequate nutrition for pregnant and lactating
women as well as for adolescent girls (before they become
pregnant). It also highlights the potential for nutritionsensitive fields and programming to contribute topreventing undernutrition and/or deliver some nutritionspecific interventions.

Conclusion
The world of nutrition has evolved substantially over thelast century and a half, reaching a high level of knowledge,
convergence and momentum, especially during the past ten
years. This should result in more sustainable and nutritious
diets and in better health and life chances for children beingborn in the next few decades.

The current momentum in nutrition is particularly
coordinated through the SUN (Scaling Up Nutrition)
Movement, to which more than 40 countries have now
committed themselves. They have committed to
implementing nutrition-specific and nutrition-sensitive
action, and have joined a movement that is coordinated bya special representative to the UN Secretary-General andhas been endorsed by more than 100 organizations.

My personal view
Saskia de Pee

Technical Advisor Nutrition and HIV/AIDS, WFP
Adjunct assistant Professor Friedman School of Nutrition
Science and Policy, Tufts University, Boston.
Visiting Assistant Professor, Wageningen University, theNetherlands

Having worked in the field of
nutrition for almost 20 years, I findthis time very exciting because of thegreat momentum to improve
nutrition and health worldwide andthe increased understanding andcommitment among a very wide
range of stakeholders and experts.
The involvement of so many is essential, and while
everyone should focus on what they are good at, there isa great deal of cross-disciplinary work to be done in atarget-oriented manner.
It is important to develop context-specific solutions
based on the global body of knowledge and expertise,
and to monitor, evaluate and share these experiencesusing the information and communication technology
available today.

Further reading
Bloem MW, de Pee S, Semba RD. How much do data
influence programs for health and nutrition?
Experiences from Health and Nutrition Surveillance
Systems. In: Semba RD, Bloem MW (eds). Nutrition
and Health in Developing Countries (2nd ed).
Totowa, NY: Humana Press, 2008.
Copenhagen Consensus. http://www.
copenhagenconsensus.com/projects/
copenhagenconsensus-2012/outcome
Food and Agriculture Organization. The State ofFood and Agriculture. Rome: FAO, 2013.
Kalm LM, Semba RD. They starved so that others bebetter fed: Remembering Ancel Keys and theMinnesota Experiment. J Nutr 2005;135:1347–1352.
Sight and Life. Micronutrients, macro-impact: Thestory of vitamins and a hungry world. Basel,
Switzerland: Sight and Life, 2012.
The SUN Movement website: www.
scalingupnutrition.org

Chapter Thirteen | The Evolving World of Nutrition | Saskia de Pee

Table 1: Progress in Micronutrient Science and Policy
1975

Formation of International Vitamin A Consultative Group (IVACG)

1991

Ending Hidden Hunger: The Montreal Micronutrient Conference, Montreal, Canada

1992

Helen Keller International Bellagio Meeting on Vitamin A Deficiency and Childhood Mortality

2002

UN General Assembly special session on children
Creation of GAIN (Global Alliance for Improved Nutrition)

2006

Creation of Micronutrient Forum

2007

World Bank report Repositioning Nutrition as Central to Development

2008

Lancet Series, Maternal and Child Undernutrition
Copenhagen Consensus places micronutrients center stage
World Economy Forum formed the Global Agenda Council (GAC) on Food Security

2009

Castel Gandolfo Declaration
Private Sector Declaration and United Call to Action on Vitamins and Mineral Deficiencies during
Micronutrient Forum, Beijing
Creation of Amsterdam Initiative for Malnutrition (AIM)
Obama administration signals its commitment to addressing hunger
International Congress on Nutrition in Bangkok – Nutrition Security for All
G8’s $20 billion commitment on Food Security and Nutrition
Scaling Up Nutrition (SUN): A Framework for Action – up-scaling of 13 highly cost-effective interventions

2010

G20 pledge additional $5.0 billion over the next five years towards achieving MDGs 4&5
African Union summit places safe motherhood and child health high on Africa’s agenda
SUN Framework and Roadmap launched
Feed the Future (FTF), the new US government global hunger and food security initiative, is launched
The Global Strategy for Women’s and Children’s Health launched by UN Secretary-General
UN Secretary-General includes nutrition security and the importance of nutrition at the MDG summit
Nutrition included in the 2010 MDG outcome document
1,000 Days Partnership: Change a Life, Change the Future launched by Hillary Rodham-Clinton,
the United States Secretary of State, and Irish Minister of Foreign affairs, Micheál Martin
African First Ladies sign a call for action to put nutrition at the heart of development.

2011

High-level event on Scaling Up Nutrition at UN Headquarters, New York (September)

2012

Copenhagen Consensus – bundled nutrition interventions ranked highest
Hunger Summit at Olympic Games, London

2013

Hidden Hunger Conference, Hohenheim, Germany
Launch of Lancet Series on Maternal and Child Nutrition
Nutrition for Growth meeting, London - $4.1 billion new funding for nutrition-specific actions and$19 billion for nutrition-sensitive activities
International Congress on Nutrition in Granada – Joining Cultures Through Nutrition
Report of the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda

Source: Amended after Micronutrients, Macro-Impact: The story of vitamins and a hungry world, Sight and Life, 2012. Copyright Sight and Life.

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Table 1: Important Milestones in Nutrition Policy Development
Year

Organization

Purpose

Goals

Achieved in Moving theAgenda Forward

2002

The
International
Vitamin A
Consultative
Group (IVACG)
Annecy Accord

Leading the campaign
against vitamin A
deficiency disorders(VADD)- Provide a forum to exchange new ideas, todiscuss research findings and their policy
implications, and share experiences with programinterventions.

Comprehensive
recommendations for theassessment and control ofvitamin A deficiency (VAD) were
rigorously reviewed and revised
by a working group andpresented for discussion at the
XX International Vitamin A
Consultative Group meeting in
Hanoi, Vietnam.

- Provide technical guidance through state-of-theart publications on VADD.
- Collaborate with international organizations indeveloping and establishing policy guidelines fordiagnosis, treatment, and prevention of VADD.

2007

2008

2008

The World
Bank; ReportonRepositioning
Nutrition as
Central toDevelopment

Provide a global
framework for action
and to complement thesimilar analyses
undertaken by theWorld Bank’s regional
units for Africa andSouth Asia.

- Reinvigorate dialogue regarding what to do about
malnutrition;

Lancet Series;
Maternal andChild
Undernutrition

Given that that nutrition
is a major risk factor for
disease, the Lancet
series sought to gather
scientific evidence about
the importance ofmaternal and childnutrition and aimed to fillthis gap in global publichealth and policy action.

- Catalogue the long-term effects of undernutrition;

Copenhagen
Consensus

To set priorities amonga series of proposals forconfronting thefollowing global
challenges: Air
Pollution, Conflicts,
Diseases, Education,
Global Warming,
Malnutrition and
Hunger, Sanitation andWater, Subsidies andTrade Barriers,
Terrorism, Womenand Development.

The panel was asked to address the ten challenges
by considering the question, “What would be thebest ways of advancing global welfare, andparticularly the welfare of the developing countries,
illustrated by supposing that an additional $75
billion of resources were at their disposal over a four
year initial period?”- Encourage the development community toreevaluate the priority it gives nutrition;- Facilitate an agreement on new ways forstakeholders to work together;

This report highlighted theburden of malnutrition andimportance of addressing it,
thereby justifying the increased
funding for nutrition from theWorld Bank.

- Scale up proven interventions for tackling
malnutrition.
- Identify proven interventions to reduce
undernutrition;- Call for national and international action to
improve nutrition for mothers and children.

Provided objective evidence that
there are effective interventions
to reduce stunting andmicronutrient deficiencies andthat improved governance isdesperately needed to scale up
nutrition interventions, monitor
and evaluate those plans, andimplement laws to enhance therights of women and children.
Among all the worlds challenges
identified at Copenhagen, thepanel ranked malnutrition very
highly, given the tremendously
high benefits compared to costs.
The expert panel ranked fighting
malnutrition as follows, providing
tremendous clout to our cause:
1. Micronutrient supplements forchildren (vitamin A and zinc);3. Micronutrient fortification (ironand salt iodization);
5. Biofortification;
6. Deworming and other nutrition
programs at school;
9. Community-based nutrition
promotion.

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Year

Organization

Purpose

Goals

Achieved in Moving theAgenda Forward

2010

SUN: A
Framework for
ActionLabeled as the‘forgotten’ Millennium
Development Goal, theprimary objective of the
SUN Framework is tocatalyze actions tomove undernutrition
toward the center stageof international politicaland economic
discourse.

The policy brief hopes to provide both the following:

The SUN brief concluded that the
MDGs cannot be achieved
without urgent attention to
nutrition. SUN is a call to action
for increasing high impact
interventions that address
undernutrition, with more than
100 organizations having
endorsed the Framework to date.

- An outline of the emerging framework of key
considerations and priorities for action to address
undernutrition;- Mobilize support for increased investment in
nutrition interventions.

2010

A Road Map
for Scaling up
Nutrition

Provides the principles
and direction forincreased support for
countries as they scale
up efforts to tackle
undernutrition across a
range of sectors. It
encourages multistakeholder platforms
that promote synergizedactions and simplify
coordination of support.

To serve as a resource for countries wanting toinclude nutrition within the context of nutritionfocused development policies

Galvanizing countries to takenutrition seriously and include itin their development agenda.

2013

LancetSeries 2

An update of issues
dealt with in Lancet 1(2008)

Re-evaluation of the problems of maternal and childundernutriiton and also examination of the growing
problems of overweight and obesity and theirconsequences in low- and middle-income countries

Its aim is to offer evidence-based
consensus recommendations onwhat to do about the continuing
problem of undernutrition.
Particular attention is paid tocosting actions of direct nutritioninterventions in the context ofnutrition-sensitive interventions.

Source: Amended after Micronutrients, Macro-Impact: The story of vitamins and a hungry world, Sight and Life, 2012. Copyright Sight and Life.

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List of key organizations
Centers for Disease Control andPrevention (CDC)

Food and Agriculture Organization of
the United Nations (FAO)

Health Protection – Health Equity

For a world without hunger

Founded: 1946

Founded: 1945

Headquarters: Atlanta, GA, USA

Headquarters: Rome, Italy

Website: www.cdc.gov

Website: www.fao.org

Collaborating to create the expertise,
information, and tools that people andcommunities need to protect theirhealth – through health promotion,
prevention of disease, injury anddisability, and preparedness for new
health threats.

Achieving food security for all is at theheart of FAO’s efforts – to make surepeople have regular access to enoughhigh-quality food to lead active,
healthy lives

GAIN (Global Alliance for Improved
Nutrition)
Canadian International
Development Agency (CIDA)
Founded: 1968
Headquarters: Gatineau, Quebec,
CanadaWebsite: www.acdi-cida.gc.ca/home

Leads Canada’s international efforts to
help people living in poverty.

UK Department for International
Development (DfID)
UK Government Department
responsible for promoting
development and the reduction ofpovertyFounded: 1997
Headquarters: London and East
Kilbride, Glasgow, UK
Website: www.DfID.gov.uk

DfID’s mission is to eliminate global
poverty by making a greater impact onachieving the Millennium
Development Goals.

Founded: 2002
Headquarters: Geneva, Switzerland
Website: www.gainhealth.org

GAIN is committed to accomplishing
the global health goals which are
related to its vision of a world
without malnutrition.

Helen Keller International (HKI)HKI is a non-profit organization
dedicated to preventing blindness andreducing malnutrition worldwide
Founded: 1915
Headquarters: New York City, NY, USA
Website: www.hki.org

HKI’s mission is to save the sight andlives of the most vulnerable anddisadvantaged. It combats the causes
and consequences of blindness andmalnutrition by establishing programs
based on evidence and research invision, health and nutrition.

International Food Policy ResearchInstitute (IFPRI)
Sustainable solutions for ending
hunger and poverty
Founded: 1975
Headquarters: Washington, DC, USA
Website: www.ifpri.org

Bill and Melinda Gates Foundation(Gates Foundation)

To provide policy solutions that reducepoverty and end hunger andmalnutrition.

All lives have equal value
Founded: 1994
Headquarters: Seattle, Washington,
USA
Website: www.gatesfoundation.org

To increase opportunity and equity for
those most in need.

International Fund for Agricultural
Development (IFAD)
Founded: 1977
Headquarters: Rome, Italy
Website: www.ifad.org

The goal of the IFAD is to enable poor
rural people to improve their food andnutrition security, increase their incomesand strengthen their resilience. IFAD
also acts as an advocate for poor rural
women and men. The multilateralorientation provides a strong global
platform for discussing rural policy
issues and increasing awareness of why
investment in agriculture and ruraldevelopment is critical to reducing poverty
and improving global food security.

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Micronutrient Initiative (MI)United Nations World Food Program (WFP)

World Health Organization (WHO)Solutions for hidden hunger

Fighting Hunger Worldwide‘Working for Health’

Founded: 1997

Founded: 1963

Founded: 1948

Headquarters: Ottawa, Canada

Headquarters: Rome, Italy

Headquarters: Geneva, Switzerland

Website: www.micronutrient.org

Website: www.wfp.org

Website: www.who.int

To develop, implement and monitor
innovative, cost-effective andsustainable solutions for hidden
hunger, in partnership with others.

WFP is the food-assistance agency of theUnited Nations system. Food assistanceis one of the many instruments that canhelp to promote food security, which isdefined as access of all people at all
times to the food needed for an active
and healthy life. The policies governing
the use of WFP food assistance must be
oriented towards the objective of
eradicating hunger and poverty. Recently,
WFP moved its focus from food aid tofood assistance, using different modalities
to improve food security and nutrition of
their beneficiaries.

WHO is the directing and coordinating
authority for health within the United
Nations system. It is responsible forproviding leadership on global healthmatters, shaping the health research
agenda, setting norms and standards,
articulating evidence-based policy
options, providing technical support tocountries and monitoring and assessing
health trends. In the 21st century, healthis a shared responsibility, involving equitable
access to essential care and collective
defense against transnational threats.

Program for Appropriate Technology in
Health (PATH)
A catalyst for global healthFounded: 1977
Headquarters: Seattle, Washington,
USA
Website: www.path.org

PATH’s mission is to improve thehealth of people around the world byadvancing technologies,
strengthening systems, andencouraging healthy behaviors.

The World Bank (World Bank)

United States Agency forInternational Development (USAID)

Working for a world free of poverty

Founded: 1961

Headquarters: Washington, DC, USA

Headquarters: Washington, DC, USA
United Nations International Fund
(UNICEF)‘Unite for Children’
Founded: 1946
Headquarters: New York, NY, USA
Website: www.unicef.org

UNICEF is mandated by the United
Nations General Assembly to advocate
for the protection of children’s rights,
to help meet their basic needs and to
expand their opportunities to reach
their full potential.

Website: www.usaid.gov

The US Agency for International
Development (USAID) is anindependent agency that provides
economic, development andhumanitarian assistance around theworld in support of the foreign policy
goals of the United States.

Source: Micronutrients, Macro-Impact: The story of vitamins and a hungry world, Sight and Life, 2012.
Copyright Sight and Life.

Founded: 1944
Website: www.worldbank.org

To fight poverty with passion andprofessionalism for lasting results. To
help people help themselves and theirenvironment by providing resources,
sharing knowledge, building capacityand forging partnerships in the public
and private sectors.

World Vision International
Founded: 1950
Headquarters: Monrovia, USA
Website: www.wvi.org

World Vision is a global Christian relief,
development and advocacy organization
dedicated to working with children,
families and communities to overcome
poverty and injustice. World Vision
serves all people, regardless of religion,
race, ethnicity, or gender.