Peer-reviewed article
Global, regional, and national progress towards the 2030 global nutrition targets and forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2021.
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Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tracks progress toward six global nutrition targets set by the World Health Assembly in 2012, covering low birthweight, exclusive breastfeeding, child wasting, stunting, overweight, and anaemia in women. Using data from 204 countries between 2012 and 2021, the analysis shows that while some progress has been made in reducing the burden of malnutrition, few countries are on track to meet the targets by 2030. The study projects that child overweight is increasing in most countries, while child wasting and stunting are declining in some regions faster than expected based on economic development alone.
Key points
- In 2021, only five countries had met the exclusive breastfeeding target, four had met the stunting target, 96 had met the child wasting target, and no countries had met the targets for low birthweight or anaemia in women
- Child overweight prevalence increased in 201 countries and territories between 2012 and 2021
- Sub-Saharan Africa showed faster-than-expected reductions in child stunting and wasting compared to countries at similar development levels
- By 2030, only 94 countries are projected to meet one target and 89 countries are projected to meet no targets at all
- While attributable burden of low birthweight, stunting, and wasting decreased faster than prevalence in most low-income and middle-income countries, anaemia in women of reproductive age has remained stagnant
Limitations
This is a modelling and forecasting study based on aggregated data from global surveillance systems, so it cannot explain the specific drivers of progress or lack thereof in individual countries, nor can it evaluate the effectiveness of particular interventions. The projections to 2050 are based on extrapolation of past trends and assume continued patterns of development and policy effort.
Abstract
BACKGROUND: The six global nutrition targets (GNTs) related to low birthweight, exclusive breastfeeding, child growth (ie, wasting, stunting, and overweight), and anaemia among females of reproductive age were chosen by the World Health Assembly in 2012 as key indicators of maternal and child health, but there has yet to be a comprehensive report on progress for the period 2012 to 2021. We aimed to evaluate levels, trends, and observed-to-expected progress in prevalence and attributable burden from 2012 to 2021, with prevalence projections to 2050, in 204 countries and territories. METHODS: The prevalence and attributable burden of each target indicator were estimated by age group, sex, and year in 204 countries and territories from 2012 to 2021 in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, the most comprehensive assessment of causes of death, disability, and risk factors to date. Country-specific relative performance to date was evaluated with a Bayesian meta-regression model that compares prevalence to expected values based on Socio-demographic Index (SDI), a composite indicator of societal development status. Target progress was forecasted from 2021 up to 2050 by modelling past trends with meta-regression using a combination of key quantities and then extrapolating future projections of those quantities. FINDINGS: In 2021, a few countries had already met some of the GNTs: five for exclusive breastfeeding, four for stunting, 96 for child wasting, and three for child overweight, and none met the target for low birthweight or anaemia in females of reproductive age. Since 2012, the annualised rates of change (ARC) in the prevalence of child overweight increased in 201 countries and territories and ARC in the prevalence of anaemia in females of reproductive age decreased considerably in 26 countries. Between 2012 and 2021, SDI was strongly associated with indicator prevalence, apart from exclusive breastfeeding (|r-|=0·46-0·86). Many countries in sub-Saharan Africa had a decrease in the prevalence of multiple indicators that was more rapid than expected on the basis of SDI (the differences between observed and expected ARCs for child stunting and wasting were -0·5% and -1·3%, respectively). The ARC in the attributable burden of low birthweight, child stunting, and child wasting decreased faster than the ARC of the prevalence for each in most low-income and middle-income countries. In 2030, we project that 94 countries will meet one of the six targets, 21 countries will meet two targets, and 89 countries will not meet any targets. We project that seven countries will meet the target for exclusive breastfeeding, 28 for child stunting, and 101 for child wasting, and no countries will meet the targets for low birthweight, child overweight, and anaemia. In 2050, we project that seven additional countries will meet the target for exclusive breastfeeding, five for low birthweight, 96 for child stunting, nine for child wasting, and one for child overweight, and no countries are projected to meet the anaemia target. INTERPRETATION: Based on current levels and past trends, few GNTs will be met by 2030. Major reductions in attributable burden for exclusive breastfeeding and anthropometric indicators should be recognised as huge scientific and policy successes, but the comparative lack of progress in reducing the prevalence of each, along with stagnant anaemia in women of reproductive age and widespread increases in child overweight, suggests a tenuous status quo. Continued investment in preventive and treatment efforts for acute childhood illness is crucial to prevent backsliding. Parallel development of effective treatments, along with commitment to multisectoral, long-term policies to address the determinants and causes of suboptimal nutrition, are sorely needed to gain ground. FUNDING: Bill & Melinda Gates Foundation.