Well, that was quite an event: David Cameron, MIchel Temer, Bill Gates, Kofi Annan, Joyce Banda, Enda Kenny, Justine Greening, Anjelique Kidjo, Tony Lake, Ertharin Cousin, Graziano De Silva, Raj Shah, etc. And very well conceived and executed.
But ultimately it was a story of hedges, pledges and edges.
Hedges, because the Children's Investment Fund Foundation (CIFF) funded by profits from the TCI Hedge Fund surprised everyone (and perhaps themselves) by pledging $700 million to nutrition over the next 7 years. Phenomenal for a Foundation that is only 10 years old.
Pledges, because despite everyone saying it is about more than the money, the money is a big part of it.
$4 billion was pledged by the Donor government and Foundation donors. But just how significant is that?
This is not an easy question to answer.
Try this (and let me know if I have done something obviously wrong).
- Assumption 1: say economic growth will take care of about half of stunting (this is what the evidence says). So, assume economic growth continues in the high burden countries
- That means we need about an extra $10bn a year on nutrition specific programmes (the Lancet estimates) to take care of just under a quarter of stunting
- Assumption 2: I would guess an increase of $15bn/year (who knows?) classified as nutrition sensitive programmes is also needed to take care of the remaining quarter. Note this will probably show as zero or a small marginal costs as it is mostly about making existing potentially nutrition sensitive programmes actually nutrition sensitive.
- Assumption 3: so the total 7 year bill is $70bn. The assumption of donors is that they will cover 30% of that cost (and where were India and Indonesian pledges?) which puts their bill at $21bn.
- So we can almost eliminate stunting by 2020 for $21bn of donor funds if the high burden countries find $49bn and economic growth continues. Phew.
- Assumption 4: however, we probably don't have the capacity to spend that step increase sensibly so assume half of that envelope is scaled up over the 7 years, which is $10.5bn for donors and $24.5 bn for high burden countries
- Assumption 5: so an increase of $4 bn (if the donor pledge is realised) to 2020 looks to cover just under 40% of the donor gap. This is probably an underestimate of the gap covered given the matching element of the pledges risks some double counting.
- $4bn at 40% of the gap to 2020 seems like a very positive result, albeit with very favourable assumptions (continued economic growth, high burden country financing materialising, zero marginal costs on nutrition sensitive interventions, new pledges being kept). With less favourable assumptions the $4bn looks much smaller.
- Another way of looking at it is that a $4bn increase over 7 years is an average of about $570k/year extra on top of an annual $400k of nutrition specific + $4bn of nutrition sensitive (rough estimate from donor work in April) or about a 13% increase on average, but will be a lot higher as a % by 2020 as this will be backloaded.
- But even if the pledges do represent 40% of the gap, that still leaves $6bn for the donors to find, $4bn of pledges to materialise and be spent sensibly, donor fatigue not to set in and SUN to help civil society in high burden countries encourage/pressure their governments (esp India and Indonesia) to find the $24.5 bn of domestic resources.
So, not bad at all with the rosy scenario. Less good with the more realistic scenarios. But as I said, it is very murky.
Edges, because whatever the scenario, we now have to be hard edged and hold funders (donor and domestic) to their commitments and to find additional funding commitments to end stunting and other forms of undernutrition.
Brazil 2016 is a future staging post for new additional commitments and we need a few additional staging posts between now and then.
Hedges, Pledges and Edges. We need to make it work for the world's most vulnerable children.