United States - Nutrition

The US is the largest donor to nutrition globally; funding is mainly provided through US global health and food security programs

The US is the single largest donor to global nutrition efforts, disbursing US$3.3 billion in 2017 for both nutrition-specific and nutrition-sensitive interventions (see box), according to the 2020 Global Nutrition Report . This is a 15% increase over 2016, when nutrition spending was at US$2.8 billion. The US Agency for International Development (USAID) leads the US’ nutrition efforts. There are several key documents that guide the US government’s work on nutrition:

  • The Joint Strategic Plan 2018-2022 of the State Department and USAID refers to food security, including nutrition, as a cross-sectoral, cross-agency priority.
  • USAID’s Multi-Sectoral Nutrition Strategy 2014-2025 sets goals across US nutritional initiatives, addresses direct and underlying causes of malnutrition and highlights the importance of linking development and humanitarian assistance to increase the impact of US global nutrition efforts. Broadly, it identifies three priorities in line with the 2025 World Health Assembly Nutrition Targets: 1) decrease chronic malnutrition, measured by stunting, 2) maintain the Global Acute Malnutrition (GAM) below 15%, and 3) decrease malnutrition in women of reproductive age and children under five, with a focus on the 1,000-day window between the beginning of pregnancy and the child’s second birthday.
  • The US Government Global Nutrition Coordination Plan 2016-2021 aims to strengthen the impact of the diverse US nutrition portfolio “through better communication, collaboration, and linking research to program implementation”.
  • The 2016-2025 Food Assistance and Food Security Strategy, from USAID’s Office of Food for Peace outlines two key strategic objectives for the program: 1) improving and sustaining food security and 2) embracing nutritional security. It supports Feed the Future and other US-related strategies and objectives.

    The US government has made several commitments to international nutrition initiatives over the past years. First, the US was integral to the founding of the Global Agriculture and Food Security Program (GAFSP), housed at the World Bank, during the US’ G20 presidency in 2009. According to GAFSP’s own records, the US disbursed US$635 million in total to GAFSP as of December 2017. In 2017 the US announced that it would no longer fund GAFSP and has not appropriated money to it since that time.

    According to data from the Organisation for Economic Co-operation and Development (OECD), the US provided US$132 million in basic nutrition support in 2017, down from US$154 million in 2016. US funding to nutrition increased significantly between 2010 and 2017. This is largely due to elevated attention to nutrition through Feed the Future, a whole-of-government initiative to drive economic and agricultural development and food security (see ‘Agriculture’). In 2018, The Global Food Security Act (originally passed in 2016) was reauthorized, codifying the Feed the Future Initiative through 2021.

    Since 2009, the government has had a nutrition-specific budget line in the State, Foreign Operations, and Related Programs (SFOPs) bill, which provides funding to basic nutrition, channelled bilaterally.

    The FY2020 budget appropriated US$150 million to basic nutrition, up from US$140 million in fiscal year (FY) 2019. President Trump’s FY2021 budget request proposed a 40% cut to nutrition funding. Congress is likely to reject these steep cuts.

    USAID leads nutrition efforts, coordinating a ‘whole-of-government’ approach

    USAID leads the US’ nutrition efforts, which are largely integrated through the agency’s work in global health, food security and assistance, and agriculture. US global nutrition activities primarily occur within the framework of Feed the Future and for food assistance through Food for Peace.

    Three bureaus within USAID are responsible for most nutrition work. The Bureau for Global Health houses the Office of Maternal and Child Health and Nutrition. Following USAID’s internal reorganization (nearly completed as of the time of writing in May 2020; see ‘Policy Priorities’), the newly formed Bureau for Resilience and Food Security (BRFS) now leads on coordination of Feed the Future. It also houses the new Centre for Nutrition. The Food for Peace Office will move to the newly announced Bureau of Humanitarian Assistance (BHA) once operational. Both the BRFS and the BHA will report to an Associate Administrator for Relief, Response, and Resilience (R3 Bureau), supporting cross-coordination of their work. Additionally, for the first time, USAID has named a Chief Nutritionist, who sits within BRFS.

    The Department of Agriculture funds Food for Peace, which USAID implements, as well as the McGovern-Dole International Food for Education and Child Nutrition program. The Department implements the latter through the Foreign Agricultural Service.

    Other US development cooperation programs, such as the Millennium Challenge Corporation and the President’s Emergency Plan for AIDS Relief, also provide some nutrition support both in terms of financing and implementation.

    Congress authorizes, oversees, and funds the US government’s nutrition-specific funding as well as for related programs within Feed the Future through its annual SFOPs. It does not specify an overall funding level for Feed the Future, but rather allocates funds separately for related activities and accounts, including nutrition, global health programs (implemented by USAID), bilateral food security and agriculture activities (implemented by USAID, the Millennium Challenge Corporation (MCC), and other agencies), and related multilateral organizations.