United States - Nutrition
At a glance
The US is the largest donor to nutrition globally and funding is mainly provided through US global health and food security programs
Global nutrition is a priority of US development efforts. There are several key documents that guide the US government’s work on nutrition, which is led by the US Agency for International Development (USAID):
- 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 Global Nutrition Coordination Plan 2021-2026, which coordinates the work of 12 US agencies and departments to scale up proven nutrition programs.
- 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 is the single largest donor to global nutrition efforts according to the 2021 Global Nutrition Report. The US disbursed US$3.7 billion in 2017 (latest data available) for nutrition-sensitive interventions (see box). This is a 16% increase over 2016, when nutrition spending was at US$3.2 billion.
Data from the Organisation for Economic Co-operation and Development (OECD) shows that the US provided US$143 million in basic nutrition support in 2019, up from US$135 million in 2018 (projects that are reported to the OECD Creditor’s Reporting System database under the ‘basic nutrition’ purpose code). US funding to nutrition increased significantly between 2010 and 2017, largely due to elevated attention to the issue through Feed the Future (see sector: ‘Agriculture’). Funding for basic nutrition has stagnated somewhat since 2017, leveling off between US$130 and US$150 million.
Since 2009, the US government has had a nutrition-specific budget line in the State, Foreign Operations, and Related Programs (SFOPs) bill, which provides funding to basic nutrition, channeled bilaterally.
The FY2021 budget appropriated US$150 million to basic nutrition, level from FY2020 up from US$140 million in FY2019. The FY2022 budget proposal would keep nutrition funding steady.
In August of 2021, the US Senate Appropriations Committee approved the FY2022 Agriculture Appropriations bill, authorizing funding for two international food assistance bills: the Food for Peace program and the McGovern-Dole child education and nutrition program, both of which help combat malnutrition and hunger around the globe. The Food for Peace program (PL 480 Title II) was funded at a slightly higher level (US$1.8 billion) than the House-passed level of US$1.7 billion and above what President Biden had proposed (US$1.8 billion), which should ensure that final funding levels will be equal to or above FY2021 levels. The McGovern-Dole program was approved at US$274 million: US$15 million above both the President's request and FY2021 enacted levels.
In September of 2021, at the UN Food Systems Summit, the US pledged US$5.0 billion over five years for the Feed the Future (FTF) program, the US government's global hunger and food security program, which works with partners in the private sector and local actors. FTF aims to achieve “inclusive and sustainable agriculture-led economic growth”; “strengthened resilience among people and systems”; and a “well-nourished population, especially among women and children”. A further US$1.0 billion will be invested in the next five years in combatting food insecurity and bolstering agriculture.
In December of 2021, at the Tokyo-based Nutrition for Growth Summit, the US pledged US$11.0 billion over three years to fight global malnutrition. The commitment is subject to Congressional appropriations. The funding will go toward programming efforts to expand data, address wasting, scale-up breastfeeding for maternal and newborn care, and enhance food fortification efforts for better nutrition.
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 (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 Center 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 and 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 (PEPFAR), also provide some nutrition support both in terms of financing and implementation.
US 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, and other agencies), and related multilateral organizations.