3 ways governments can tackle the global nutrition crisis and keep health for all within reach as budgets shrink

Julia Hanne is the Communications Director at Global Policy Forum Europe (GPFE) and wrote this article for Options Consultancy Services Ltd.

The world faces a hunger and malnutrition emergency. Its scale is the largest seen in nearly a decade as conflicts, climate changes and economic shocks have driven nearly 300 million people into crisis-level or acute food insecurity in 2024 – the highest number ever recorded in the nine year history of the Global Report on Food Crises (GFRC).

Sharp aid cuts, mainly driven by this year’s USAID shutdown, are further unravelling years of developmental progress and leading to humanitarian nutrition programmes facing record gaps – the United States alone accounted for over 40% of the global humanitarian funding in 2024 and up to 70% in Latin America and the Caribbean and the Democratic Republic of the Congo (DRC). After the U.S. withdrawal, several European donors followed suit and slashed their aid budgets due to economic pressures and changing government priorities.

The consequences are dire. The GRFC 2025 September Update warned of catastrophic food insecurity in Sudan, Gaza, South Sudan, Yemen, Haiti and Mali, with projections that reductions in global aid will disrupt nutrition services for 14 million children in low- and middle-income countries. This leaves 2.3 million children without treatment for severe acute malnutrition and could lead to an estimated 369,000 preventable deaths. At the same time nutrition is increasingly recognised as a fundamental component to achieving universal health care (UHC) and progressing human capital development agendas. But as governments face shrinking budgets and rising needs, the gap between their commitment to deliver universal health care and reality risks widening.

Although the recent G20 discussions touched on food security and the debt distress many Global South countries face, it did not address the widespread gaps in nutrition provision that are needed to avert this unfolding crisis or pragmatic strategies that could push forward an inclusive growth agenda – a reminder that progress cannot rely on political moments alone.

The global push for UHC is a critical opportunity to embed nutrition into these systems and enable countries to do more with less amid shrinking budgets and funding shortfalls, and to address malnutrition in all its forms. Failure to do so risks political commitments to UHC becoming “empty promises” for the millions still facing hunger and malnutrition.

The return on investment in nutrition is clear: Why integrating nutrition into UHC matters as global nutrition financing collapses

Essential nutrition services such as wasting treatment, micronutrient supplementation and antenatal care are largely delivered through primary health care systems (PHC). Because PHC is the backbone of UHC, countries’ commitments to UHC directly determine the extent to which these services can be delivered effectively – which makes mainstreaming nutrition services into PHC key to delivering them effectively.

Nutrition investments don’t just save lives, they also save money. Scaling up essential nutrition interventions between 2025 and 2034 has the potential to prevent 6.2 million under-five deaths and reduce 980,000 stillbirths while generating an estimated US$2.4 trillion in economic returns – a cost–benefit ratio of 1:23.

Malnutrition is linked to nearly half of all under-5 child deaths and affects one in three people globally. Chronic undernutrition during the critical first 1000 days leads to physical and cognitive impairments, lower productivity and academic achievement and an increased risk of chronic diseases. These result in economic losses, with estimates suggesting a 10% loss in lifetime earnings for individuals and at least 2-3% GDP reduction in affected countries, proving that a failure to address malnutrition today results in a less healthy and economically productive workforce tomorrow.

Yet despite the overwhelming evidence of its benefits, coverage of nutrition interventions remains far lower than that of other public health areas – governments of 48 mostly low-income countries allocate just US $1.87 per capita on nutrition.

But the good news is that the systems to deliver essential nutrition services already exist, as a recent framing paper highlights. It would require action in these three areas.

1. Strengthen the integration of essential nutrition services into primary health care as part of the universal health care agenda

Nutrition services, including treatment of wasting, micronutrient supplementation, maternal nutrition interventions and counselling, are already primarily delivered through primary health care platforms. But implementation is weak as nutrition is rarely costed or financed within PHC packages, frontline workers often lack nutrition training, nutrition commodities run through parallel rather than national supply chains and nutrition indicators are frequently absent from routine health-information systems.

The paper highlights that embedding nutrition within existing health-system structures, rather than relying on separate, parallel mechanisms, can significantly improve value for money as experience from Kenya, which integrated nutrition commodities into the national health supply chain and achieved a 14 to 42% cost reductions, shows.

Governments should explicitly recognise essential nutrition services as a core component of UHC and include a costed PHC nutrition package. This should be aligned with the World Health Organisation’s (WHO) framework for strong health systems, consisting of six building blocks: Service delivery, health workforce, health information systems, access to essential medicines, financing and leadership and governance. Civil society can help drive and monitor progress while development partners can signal support for embedding nutrition services into PHC delivery platforms to ensure that they become part of routine, everyday care.

2. Protect and mobilise nutrition financing from budget cuts to scale them

Even when governments include nutrition interventions in national health policies, they are often not funded at the scale needed because overall nutrition financing remains limited. Domestic allocations are low and many countries still rely on donor financing, which, as we’ve seen, is increasingly volatile. Combined with nutrition spending often being spread across different sectors, it can become much harder to scale services.

The framing paper highlights three priorities for countries to strengthen their nutrition financing: protecting the funding they already have, increasing domestic investment by putting costed nutrition services into UHC and PHC budgets and integrating nutrition into national health-system financing.

Governments and civil society have been calling for more stable and predictable nutrition financing and for debt distress to be tackled urgently – both of which constrain national budgets and undermine the provision of nutrition services.

Development partners, multilateral banks and intergovernmental bodies such as the G20 should heed these calls. They could, for example, fix the Common Framework, which aims to help low-income countries restructure unsustainable debt and free up fiscal space, add pandemic- and climate-related clauses to debt contracts, scale up innovative debt instruments like sustainability-linked bonds, debt-for-climate swaps or blue bonds and use guarantees more widely to reduce borrowing costs.

Multilateral development banks should prioritise support for PHC nutrition packages and channel their funding through existing government health-financing systems rather than creating parallel or fragmented funding streams.

3. Strengthen leadership, coordination and information systems to integrate nutrition into PHC and UHC

The paper also highlights that nutrition often lacks clear leadership within health systems and across sectors as responsibilities are unclear and split between different ministries and departments, making coordination difficult and leading to fragmented and inconsistent delivery of nutrition services. At the same time, many countries lack routine nutrition data in their health-information systems, limiting their ability to monitor progress or allocate resources effectively.

Governments should encourage governments to clarify where institutional leadership for nutrition lies, improve coordination across sectors and strengthen information systems so essential nutrition data are routinely collected and used to guide PHC and UHC reforms.

The stakes are high

Global nutrition programmes are facing historic funding cuts, leaving millions of children and families at risk of death and lifelong illness and deprived of their future potential.

Countries already have the systems to deliver the nutrition services that save lives every day. What they lack is the political backing and stable financing to keep them going.

Essential nutrition services belong at the core of strong PHC and UHC systems, financing for them must be protected and expanded even amid tight budgets and governments need the coordination and information systems that allow nutrition services to be effectively delivered and monitored.