Leading the fight against malnutrition: France’s historic role in the run-up to Nutrition for Growth

Introduction

Malnutrition remains the number one cause of child deaths worldwide, contributing to the deaths of nearly 2 million children under the age of five annually—the equivalent of one child every 11 seconds. This devastating crisis disproportionately affects 400 million children in the world's poorest and most vulnerable populations, exacerbating global inequities and hindering progress towards the UN SDGs. Despite the scale and urgency of the problem, global donors have not made malnutrition a funding or policy priority. It is estimated that less than 1% of ODA is allocated to malnutrition each year by OECD- DAC donors. Moreover, the existing funding is not always directed to the highest impact and most cost-effective areas, neglecting key rapid interventions needed to save lives already threatened by SAM. With the clock ticking down on the 2030 end date of the SDGs, it is widely recognized in France and globally that achieving SDG #2, Zero Hunger, will require dedicated and concerted efforts from leading donors in the field.

The gap between needs and funding for critical nutrition interventions is ever-growing. The World Bank estimates that 90% coverage of the most effective evidence-based nutrition interventions entails an additional US$128 billion in nutritional funding over the next ten years. These investments would prevent 6.2 million deaths of children under five and nearly a million stillbirths over a decade, as well as hundreds of millions of nonfatal negative health complications as a result of malnutrition. Compounding this need, commitments to health assistance have stagnated across the donor landscape since 2020 and the COVID-19 pandemic, signaling an end to the ‘global health boom’ and threatening decades of progress in health and food security. The economic toll of undernutrition is staggering: the World Bank reported that undernourished children across South Asia and Africa will grow up to be less than half as productive as they could be as a result of childhood malnutrition, wasting, and stunting. Each year, nearly US$3 trillion in productivity is lost, as malnutrition hinders both physical and cognitive development. This creates a vicious cycle of poverty, underdevelopment, and malnourishment—when effective SAM treatment costs less than US$1 a day, evidence-driven nutrition interventions represent some of the most cost-effective investments to promote a solid foundation for all aspects of global development, from poverty and health to education and climate change.

France has played a pivotal role in the charge against global hunger and malnutrition throughout history. Through strategic partnerships, innovative solutions, and robust advocacy, France has firmly established itself as a champion of nutrition through leadership, innovation, and policy, tackling one of the most pressing challenges of our time. The AFD has increasingly acknowledged food security as a key element in the countries where it operates, recognizing the foundational nature of secure and stable nutrition for children. Still, French ODA to food aid and commodity assistance has flagged, representing only 0.16% of total bilateral ODA in 2022 compared to more than double that four years prior.

At Nutrition for Growth Summit in March 2025, France will convene global stakeholders to solidify financial and policy commitments and lay the groundwork for achieving UN nutrition goals by 2030. This is a pivotal moment for advocates to push for France to reinvigorate itself as a nutrition champion and make a historic financial commitment to the fight against hunger.

This Donor Tracker Insight traces France’s historic role in the battle against malnutrition in three key sectors throughout history, highlighting how France can build on its legacy to cement itself as a champion of the cause.

France as a nutrition champion

France’s leadership in the nutrition spans almost a half-century, shaping the fight against hunger from nearly the beginning of the modern era of development assistance.

Leadership

ACF, a frontline organization dedicated to eliminating global hunger, was originally founded in 1979 by a group of French academics, scientists, and doctors. It has been a critical player in delivering life-saving nutrition interventions in some of the world's most vulnerable regions. France's longstanding support for ACF has enabled the organization to expand its reach and impact, providing nutritional support, clean water, and sustainable solutions to nearly 28 million people each year. The organization also developed methodologies for measuring malnutrition. These became widely adopted by other humanitarian organizations, an indelible fingerprint shaping global battle against hunger.

Today, ACF is a global organization that works with more than 50 countries and is the only international NGO solely focused on reducing and eliminating hunger and malnutrition. Continuous support of ACF by the AFD underscores France’s dedication to addressing the root causes of hunger and its commitment to humanitarian principles.

Innovation

France has produced not only the leading organization in the battle against hunger, but also key scientific developments to combat SAM, making French innovation a key building block of nutrition advocacy spanning across the last half-century. Nutriset, a French company, has long been at the forefront of developing innovative nutritional solutions to treat malnutrition. Therapeutic milk products F75 and F100 were developed by Michael Lescanne, the founder of Nutriset, in 1993. These products treat children with SAM and medical complications, with F75 acting to stabilize severely weakened children and F100 acting as a key part of the following rehabilitation phase. Pioneered to treat SAM by ACF’s Scientific Committee, UNICEF and leading NGOs have long promoted F75 and F100 to treat severe malnutrition in vulnerable populations. Upon introduction, therapeutic milk helped drastically reduce the mortality rate of severely malnourished children.

The first RUTF, Plumpy’nut, a successor product to F75 and F100, was developed in 1996 by the French doctor André Briend from the Research Institute for Development alongside Lescanne and Nutriset. RUTF is a high-calorie, nutrient-rich peanut paste that aids rapid weight gain in children suffering from acute malnutrition and severe wasting. Portable and non-perishable, it can be consumed by infants older than six months who are not yet able to eat solid foods. While highly effective for children under six months, therapeutic milk faces delivery constraints that were overcome with RUTF. RUTF transformed malnutrition treatment, as it does not require water for preparation and consumption, nor administration by trained healthcare staff, in notable contrast to therapeutic milk. The innovation of RUTF made it possible to use the product in complex settings where access to clean water is limited, which frequently overlaps areas where lifesaving nutritional interventions are needed most. ACF, always a pioneer, was the first organization to test RUTF on the field, with significant support and funding from the AFD. Both therapeutic milk and RUTF contributed significantly to the 44% decrease in child stunting rates between 1990 and 2022.

Advances like RUTF have also been crucial for community-based care, with RUTF’s ease-of-use empowering families to administer care within their own communities. Prior to the turn of the century, malnutrition was typically treated in treatment centers, but much of the most affected population faced barriers to access these centers due to distance and travel time to the centers. Treatment centers were also associated with risks of infection as a result of hospitalization, leading to unnecessary deaths and suboptimal health outcomes. UNICEF and other NGOs currently procure RUTF for community-based treatment of SAM, enabling children to receive critical care at home and reducing not only the costs of travel for caregivers but also the risks associated with hospitalization. Production of RUTF has expanded to include local African producers, helping shorten delivery times and promote locally led solutions to malnutrition.

In 2010, Nutriset developed another key intervention with SQ-LNS, a lipid-based supplement designed to prevent malnutrition in vulnerable populations with nutrient gaps and micronutrient deficiencies, reducing cases of severe wasting by up to 31% and overall mortality by 27%. Combining SQ-LNS with other nutrition essential interventions is key to reducing the risk of malnutrition in areas with limited access to diverse diets. Beyond health improvements, SQ-LNS distribution has been linked to increased health service engagement, as caregivers may be more likely to access health facilities and receive other key services, such as breastfeeding support, vaccinations, and family planning supplies, when supplements are available.

Policy

Beyond international leadership and scientific innovations, over the past decade France has increasingly recognized nutrition as a key part of broader French development policy. In 2011, France released a policy framework paper on nutrition in developing countries, which would go on to form the foundation of French malnutrition action. Stakeholders across the French government collaborated in 2016 on a roadmap to directly address nutritional deficiencies in eight partner countries and across French development assistance by 2020, working closely with the SUN Movement and the UN institutions as well as European and international stakeholders.

France’s International Strategy for Food Security, Nutrition, and Sustainable Agriculture (2019-2024) has the main objective of “reinforcing of France’s action in nutrition” with a focus on investments in the first 1000 days of life. 25% of the funds allocated through the French Muskoka Fund are aimed to be earmarked for nutrition, and France has increased the AFD’s annual commitments contributing to nutrition in priority countries. France’s 2021 Development Law made the fight “against poverty, malnutrition, and global inequalities” one of its three key objectives for French ODA the promotion of human rights, particularly for children, also featured heavily, signaling the recognition that addressing the issue of child hunger is a key foundation for successful development. The AFD launched the “Food in Common” initiative to further this recognition, already observing that France needed to scale up food security initiatives as the compounding effects of climate change and the COVID-19 crisis continued to worsen the global impact of malnutrition.

The French Strategy for Global Health (2023-2027) further prioritizes the promotion of health and wellbeing by strengthening commitments to nutrition and its determinants, particularly for young children as well as pregnant and breastfeeding women. France’s strategic emphasis on childhood nutrition in the first 1000 days of life, in tandem with the Strategy for Global Health’s commitment to prenatal and childhood nutrition, align France’s development goals more than ever with the worldwide need to increase funding to the most impactful and cost-effective ways to reduce childhood mortality, namely RUTF, prenatal vitamins, and childhood supplements, as well as breastfeeding support. This poses France as an actor with great potential to catalyze immediate and significant results on malnutrition with the implementation of its newest food security and global health strategies.

Call to action

Despite France’s rich history of leadership and innovation and modern recognition of the threat of malnutrition to the well-being of future generations, there is still a significant gap between needs and funds worldwide to effectively address nutrition. Hunger has increased worldwide since 2014 despite repeated nominal commitments to nutrition, with the multiple crises of climate change, the COVID-19 pandemic, and conflict and instability causing more and more people to go hungry each year. Additionally, the world is facing a stockout of RUTF, with UNICEF warning that nearly two million children are at risk of starvation as a result of the shortage of this critical intervention. These crises alone would put an increasing number of vulnerable people at risk—but compounded by flagging donor interest and investment in the regions that need it most, malnutrition becomes one of the most serious humanitarian and economic threats facing the next generation.

Advocacy for nutrition-specific, high-impact interventions is more important than ever to directly and immediately address acute hunger. As host of the 2025 N4G Summit, France has a pivotal leadership role to play. By making substantial financial and policy commitments and leveraging its diplomatic influence, France can inspire global action to combat hunger.

The run-up to the summit is a critical moment for development advocates to engage with French stakeholders, raise awareness for an event at risk of being subsumed in wider political turbulence, and push for substantial French commitments to nutrition beyond its role as host. France’s leadership will be key to the success of the N4G Summit. By stepping up with vision and bold action, France can inspire the global community and reaffirm the importance of nutrition as a foundation for progress.