Bill Gates explains how feeding children properly can transform global health

This is true for almost every issue the Bill & Melinda Gates Foundation works on, from poverty reduction to elementary school enrollment. But nowhere is the contrast more stark or tragic than in health.

Between 2000 and 2020, the world witnessed a global health boom. Infant mortality fell by 50%. In 2000, more than 10 million children died each year, and now that number is less than 5 million. The prevalence of the world’s deadliest infectious diseases also fell by half. Best of all, advances were occurring in regions where the burden of disease had been greatest. Sub-Saharan Africa and South Asia recorded the greatest improvements.

Then Covid-19 hit and progress came to a screeching halt.

Today, the world faces more challenges than at any time in my adult life: inflation, debt, new wars. It also faces the worst child health crisis: malnutrition. Unfortunately, aid falls short of these needs, especially in the places that need it most.

When a child dies, half of the time the underlying cause is malnutrition. Climate change is making the situation worse. Between 2024 and 2050, some 40 million more children will be stunted and 28 million will be wasted as a result of climate change, according to new data from the Institute for Health Metrics and Evaluation. These conditions, the most acute forms of malnutrition, mean that children do not grow mentally or physically to their full potential.

The health and economic impacts are catastrophic. A child who has suffered severe malnutrition before the age of three will complete five fewer years of schooling than well-nourished children, and studies show that people who were hungry as children earn 10% less over their lifetime and have 33% less likely to escape. poverty.

We must invest in global health to protect children from the worst effects of hunger, mitigate the impacts of climate change, and stimulate economic growth. And looking to the past can inspire us on how to reignite progress.

The global health boom had many causes. A new generation of political leaders embraced humanitarianism. Hundreds of thousands of health workers fanned out across the world, bringing the latest medicines to places doctors rarely visited. But one factor often overlooked was a small, yet crucial, increase in funding.

Beginning in 2000, the world’s richest countries began to steadily increase their funding to supplement low-income countries as they increased their own investments in health. During the first 20 years of the century, OECD countries steadily increased foreign aid from an average of 0.22% of their gross national income to 0.33%, with the most generous countries donating about 1%. In 2020, low-income countries received an average of $10.47 per person. It doesn’t seem like much, but that $10.47 made a noticeable difference. It boosted the work of organizations such as Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria, which gave poorer countries access to life-saving vaccines, medicines and other medical advances.

The impact of this generosity was surprising. However, the work is unfinished. Today, more than half of all child deaths still occur in sub-Saharan Africa. Since 2010, the percentage of the world’s poor living in the region has increased by more than 20 points, to almost 60%. Despite this, during the same period, the proportion of total foreign aid going to Africa fell from almost 40% to just 25%, the lowest percentage in 20 years. Fewer resources mean more children will die from preventable causes.

The global health boom is over. But for how long? That’s the question I’ve been wrestling with for the past five years. Will we consider this period as the end of a golden era? Or is it just a brief interlude before another boom begins?

I remain optimistic. I believe we can take global health a second step, even in a world where competing challenges require governments to stretch their budgets. To do this, we will need a two-pronged approach.

First, the world needs to recommit to the work that drove progress in the early 2000s, especially investments in crucial vaccines and medicines. They are still saving millions of lives every year.

We must also look forward. The research and development process is packed with powerful and surprisingly profitable advances. We need to put them to work to fight the most widespread health crises. And it starts with good nutrition.

One of the few failures of the global health boom was that we didn’t understand the importance of nutrition. But in the last 15 years doctors have begun to discover the ways in which the stomach influences all aspects of human health. If we solve malnutrition, we will facilitate the solution of many other problems. We solve extreme poverty. Vaccines are more effective. And deadly diseases like malaria and pneumonia become much less fatal.

This knowledge is now being transformed into surprisingly profitable innovations, such as super-fortified broth and more effective prenatal vitamins. The impact of scaling up these innovations would be staggering. In Nigeria, models show that fortifying bouillon cubes would not only prevent anemia; It would also prevent more than 11,000 deaths from birth defects of the central nervous system, known as neural tube defects. And if low- and middle-income countries adopted the most complete form of prenatal vitamins, called multi-micronutrient supplements, nearly half a million lives could be saved by 2040.

The early global health boom is over. “But for how long?” is a question that is still under the control of humanity. I believe we can usher in a second global health boom by providing children with the nutrients they need to thrive.

Bill Gates is a co-founder of Microsoft and co-chairman of the Bill & Melinda Gates Foundation. A longer version of this article appears in the foundation’s 2024 article.