Nutrition issues to watch at the 78th World Health Assembly

Nutrition will take the spotlight at next week’s 78th World Health Assembly in Geneva, Switzerland, with two nutrition-related resolutions set to be presented for adoption. “This WHA needs to be a wake-up call: nutrition is not just a humanitarian issue. It’s a matter of public health, human rights, and global equity,” Caroline Antoine, deputy director of technical expertise and research at Action Contre La Faim, or ACF, told Devex.. The annual meeting of the WHA — the decision-making body of the World Health Organization — will take place from May 19-27, and this year’s theme is “One World for Health.” It takes place during a difficult period for global health amid funding cuts from multiple aid donors. And while nutrition isn’t a specific agenda item, it cuts across all themes at WHA, said Purnima Menon, senior director for food and nutrition policy and acting senior director for transformation strategy at the International Food Policy Research Institute. For example, nutrition is jeopardized during health emergencies, exacerbating health conditions; it is vital for good health and well-being, and it can’t be achieved without universal health coverage, according to WHO. Further investment in nutrition can prevent illness, reduce costs on health systems, and ensure productivity. Despite this, many countries have failed to integrate nutrition interventions into their health budgets, and as of 2024, about 733 million people were estimated to be hungry. The world is also far from eradicating hunger by 2030 as per the U.N. Sustainable Development Goals. Many in the nutrition community are hopeful that two months after the Nutrition for Growth, or N4G, Summit in Paris — which raised $27 billion in political and financial commitments to end malnutrition — the WHA will act as a reminder of the need to invest in the area as a means to improve global health. “How to get nutrition and healthy diets to be central to some of the discussions and resolutions is going to remain a long-range, urgent advocacy agenda,” Menon said. The two nutrition-related resolutions would extend the Comprehensive Implementation Plan on Maternal, Infant, and Young Child Nutrition by five years to 2030, and limit digital promotion of breast milk alternatives. Both passed the vote at the WHO executive board meetings in February and are thus in a strong position to be adopted, said Miski Abdi, senior nutrition policy and advocacy advisor at Save the Children UK. “However, nothing is truly guaranteed, especially given the ongoing discussions around WHO’s 2026–2027 budget and the potential implications these may have on all the resolutions currently on the table,” she added. A new nutrition plan for mothers and infants WHO’s initial implementation plan on maternal, infant, and young child nutrition was developed in 2012 and committed WHA member states to six global nutrition targets to be achieved by 2025. The targets included reducing stunting in children under 5 by 40%; halving the number of women of reproductive age with anemia; reducing the prevalence of low birth weight by 30%; preventing a rise in childhood overweight; increasing the rate of exclusive breastfeeding in the first 6months of life by 50%; and reducing levels of childhood wasting to less than 5%. Those targets helped mobilize action on malnutrition. While the targets on breastfeeding and childhood obesity are on track, according to the WHO's tracking tool, the majority of countries would not have been able to meet the targets this year. This is why several member states, led by Ireland and Ethiopia, have pushed forward a resolution for a more holistic approach to malnutrition — one that aligns with SDG 2.2 on ending malnutrition in all its forms — and to extend the deadline to 2030 to correspond with the timeline for the SDGs. The U.N. Decade of Action on Nutrition was also due to end this year, but was recently extended to 2030. “The extension of the [targets], but also the extension of the [UN Decade of Action on Nutrition] is very crucial and I hope that the members will realize that to keep the momentum on nutrition,” said Trudy Wijnhoven, nutrition officer at the Food and Agriculture Organization. Following on from a WHO consultation on the topic last year, the resolution also suggests amendments to certain targets, and the adoption of new ones on improving dietary diversity, increasing early initiation of breastfeeding, delivering nutrition counseling, ensuring access to iron-containing supplements during pregnancy, and reducing the consumption of sugar-sweetened beverages. At WHA, Save the Children will also advocate for the anemia target to encompass both boys and girls aged 10-14 as opposed to exclusively focusing on women of reproductive age and for the target on wasting to see a reduction of less than 3% rather than 5%, Abdi said. ACF, for its part, wants to see the targets backed by financial commitments from countries. One way they might do that is via N4G’s platform, which is still taking commitments until June. The targets should be complemented with tracking indicators, said Afshan Khan, assistant secretary-general of the United Nations and coordinator of the Scaling Up Nutrition, or SUN, Movement — a coalition of countries working to end malnutrition. The resolution calls for the WHO director-general to report on progress every two years and for member states to “strengthen monitoring and evaluation systems” on the targets. The SUN Movement, alongside World Vision and the governments of Ireland, Ethiopia, Lesotho, and Pakistan, is hosting an event in Geneva on what happens once the targets are extended and how to accelerate progress. Fighting digital advertising for breast milk substitutes The resolution on regulating companies’ digital marketing of breast milk substitutes has been proposed by over 20 countries. Marketing the likes of formula, bottles, and teats “undermine[s] progress in optimal infant and young child feeding,” it says. WHO recommends babies be exclusively breastfed for the first 6 months of life. Breastfeeding can save lives, Khan said. “We know that breast milk substitutes in environments where there's poor sanitation or no good access to clean water can actually kill kids,” she added. The resolution aims to strengthen the 1981 International Code of Marketing of Breast-milk Substitutes, which advocates for formula to be available but not to be promoted. If adopted, it would commit countries to better regulating the promotion of breast milk substitutes and foods, especially online. “In some countries, 80% of breast milk substitutes advertisement exposure happens online, and companies spend as much as 70% of their entire advertising budget on digital tactics,” said Abdi. Only 19% of countries prohibit it online, and only 33 countries actually have laws substantially aligned with the code. The resolution would commit countries to building better systems to identify any such marketing and supporting government agencies to take action. While WHO released a guidance document in 2023 detailing potential regulatory measures that could be used to limit digital marketing of breast milk substitutes, a resolution at WHA would push countries to allocate budget and human resources and ensure deterrent sanctions are routinely applied in response to violations, Abdi said. “It just needs that political backbone to get countries to uphold it, and the easiest way is through resolution.” Separately, Latin American countries may also highlight the issue of marketing ultra-processed foods. Several have mandated the use of warning labels on foods high in sodium or sugar as a means of tackling noncommunicable diseases such as obesity. “I didn't see that on the agenda this year, but I know there will be people from Mexico at the Assembly, and this is a topic that they will continue to push on because it has such serious health implications,” Menon said, adding that an endorsement from WHO would send a message. How funding cuts hurt nutrition The discussions are taking place amid a restructuring at WHO, which faces a $600 million income gap in 2025 and a much-reduced budget for the next two years. The U.N. health agency is scaling back on its work and workforce as a consequence of funding cuts from donors, most significantly the U.S. WHO Director-General Tedros Adhanom Ghebreyesus is expected to propose next steps at the WHA alongside a potential budget outline for 2026-2027. It’s thought that the biggest cuts will be felt in the Geneva headquarters and the Africa regional office. Collectively, cuts from the United States, as well as the United Kingdom, France, Belgium, and the Netherlands, amount to 44% in international nutrition funding, according to Results for Development. “This is our elephant in the room,” said ACF’s Antoine. Her organization, which is partially supported by government grants, is facing $120 million in budget cuts. At the same time, supply shortages of ready-to-use therapeutic foods as a result of the cuts will have a “severe impact on child morbidity and mortality,” Khan said. “The emphasis on procurement systems and how those are shored up is also an important element of the WHA discussions going forward.” All of this means the WHA may take on a “more focused approach on what are the key essential actions that we need to promote when it comes to improving nutrition,” FAO’s Wijnhoven said. Beyond WHA, Khan hopes “this golden thread of how important nutrition is for influencing other health and productivity outcomes” continues into other upcoming and influential discussions — such as the high-level meeting of the U.N. General Assembly on the prevention and control of NCDs in September, the Financing for Development Conference in June, and the World Summit for Social Development in November.