Coletta Kemboi, a dairy farmer from Maili Nne, Kenya, is proof of how innovative farming practices can combat malnutrition. After receiving training from the MoreMilk program, she has seen her milk production improve significantly, and her family’s income has grown. “The extra money we are earning goes to the farm and paying my children’s school fees,” she shared.
Her story mirrors the urgent call for action highlighted in the Bill & Melinda Gates Foundation’s eighth annual Goalkeepers report, released on 17th September.
Titled “A Race to Nourish a Warming World,” the report urges world leaders to boost global health spending, focusing on children’s health and nutrition, particularly in the face of the mounting global climate crisis.
Without immediate global action, climate change is projected to push an additional 40 million children into stunting and 28 million into wasting between 2024 and 2050. These are among the most severe and irreversible forms of malnutrition, impacting both the mental and physical growth of children.
In 2023, the World Health Organization reported that 148 million children suffered from stunting, and 45 million from wasting. These conditions leave children weak, vulnerable to diseases, and at greater risk of developmental delays and death. Despite these alarming figures, foreign aid to Africa has plummeted, now representing just 25% of global aid—down from 40% in 2010—even as more than half of all child deaths occur in sub-Saharan Africa.
“Today, the world is contending with more challenges than at any point in my adult life: inflation, debt, new wars. Unfortunately, aid isn’t keeping pace with these needs, particularly in the places that need it the most,” Bill Gates, co-chair of the foundation, wrote in the report.
He added that malnutrition remains the world’s worst child health crisis, made even more devastating by climate change. Gates emphasized the need to maintain global health funding, support the Child Nutrition Fund, and ensure governments fully back effective institutions like Gavi, the Vaccine Alliance, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
“If we do these three things, we won’t just usher in a new global health boom and save millions of lives—we’ll also prove that humanity can still rise to meet our greatest challenges,” Gates stressed.
Economic Costs and Proven Tools
The economic cost of undernutrition is staggering, with the World Bank estimating US$3 trillion in productivity loss annually. In low-income countries, malnutrition can reduce GDP by up to 16%, equating to a global recession at 2008 levels every year. However, solutions to combat this crisis are available, and the report highlights several proven tools.
For instance, new agricultural technologies are producing two to three times more milk and safer milk, preventing millions of cases of child stunting. In countries like Kenya, India, and Nigeria, these advancements could prevent over 109 million cases of child stunting by 2050.
Additionally, fortifying pantry staples such as salt and bouillon cubes with essential nutrients could drastically reduce anemia rates and deaths from neural tube defects. In Nigeria alone, fortifying bouillon cubes with iron and other vitamins could prevent up to 16.6 million cases of anemia and 11,000 deaths from neural tube defects.
Building Resilience to Climate Change
“The best way to fight the impacts of climate change is by investing in nutrition,” Gates wrote. “If we solve malnutrition, we make it easier to solve every other problem. We solve extreme poverty. Vaccines are more effective. And deadly diseases like malaria and pneumonia become far less fatal.”
Research into improving gut health through better understanding of the microbiome is another promising avenue. Studies suggest that improving children’s gut health could boost their ability to absorb nutrients, develop strong immune systems, and thrive in the face of malnutrition and climate challenges.
Voices from the Frontlines
The report also features testimonies from experts and farmers who are working to fight malnutrition in their communities. Ladidi Bako-Aiyegbusi, Director of Nutrition at Nigeria’s Ministry of Health, emphasized the importance of fortifying everyday foods: “Without access to the essential nutrients that children under five need to grow, thrive, and lead healthy lives, they are being robbed of their future.”
Dr. Sabin Nsanzimana, Rwanda’s Minister of Health, shared the success of prenatal vitamin programs: “Prenatal vitamins save lives. That’s why you can find them on grocery store shelves in wealthy nations. But for women in low- and middle-income countries, like Rwanda, they are at once more essential and harder to find.”
As the world faces unprecedented challenges, the Goalkeepers report serves as a stark reminder of the importance of investing in global health, particularly in regions like sub-Saharan Africa, where the most vulnerable children face the greatest threats.