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Forman Lecture: Ellen Piwoz’s playbook for the future of global nutrition

When Ellen Piwoz joined the Bill & Melinda Gates Foundation in 2007, the global nutrition field seemed to be struggling. The community “lacked a common narrative and agenda for action,” she said. It was also difficult to engage outsiders who did not understand the nutrition community’s techno-speak, and the field was also critically underfunded with a narrow donor base. 

Over the following decade, the world saw rapid progress on nutrition, Piwoz, a recently retired Senior Program Officer on the foundation’s Nutrition Team, told an online audience for the 30th annual Martin J. Forman Memorial lecture on Dec. 10. The issue gained firmer scientific and programmatic grounding—and a narrative that both policy makers and donors could grasp. Drawing from those experiences, Piwoz laid out a playbook for future action on nutrition for a world now struggling with a global pandemic.

The lecture, focused on the future of nutrition research and policy making, celebrates Martin J. Forman’s contributions to global nutrition as former head of nutrition at the U.S. Agency for International Development (USAID) for more than 20 years.

IFPRI Director General Johan Swinnen welcomed the audience and guest speakers, including Forman’s son Kenan Forman, who thanked IFPRI and all who helped to put the annual lecture together. USAID Chief Nutritionist Shawn Baker said he is “incredibly indebted in this role to Dr. Forman’s legacy.” The lecture not only honors that legacy in global nutrition, Baker said, it highlights USAID’s continuous commitment to global nutrition research and investments.

To frame her argument, Piwoz presented three common truths on the recent history of nutrition action that Forman exemplified: Nutrition is multi-sectoral and context-dependent; it is important to invest in people and organizations to create nutrition leaders; and learning how to navigate organizations is key to accomplishing goals.

Forman “knew the political and bureaucratic levers at his disposal and how to use them,” she said. “No matter where you work or what you do, knowing how to get things done is essential for translating ideas into action.”

When she joined the BMGF, Piwoz said, the field was in a period of drift. “We were a community that largely talked to ourselves, often publicly disagreeing with each other about which problems and interventions should be prioritized. . We had different nutrition subcommunities that did not work together toward a shared set of goals.”

That began to change with the publication of the 2008 Lancet Maternal and Child Undernutrition Series, Piwoz said. It served as a catalyst for change offering a narrative that resonated not only with nutritionists, but also outside stakeholders. It galvanized global discussions that led to the launching of the Scaling Up Nutrition (SUN) Movement. A second Lancet Undernutrition Series was published in 2013, and five years later the World Bank had over $1 billion investment in its nutrition pipeline.

The nutrition community saw “country demand and political commitment grow as a collective result of these actions,” she said—but this momentum was still not powerful enough to raise the funds and resources that the nutrition movement needed overall. 

Such lessons are important for dealing with current crises, she said.

“Sadly, we are living in a profoundly different time—a time when 25 years of progress has been reversed in less than 25 weeks,” Piwoz said. “It is a time when the global economy is contracting, when science is mistrusted, and when misinformation abounds. The COVID pandemic has laid bare common truths about systemic bias and vulnerability. Education, health services, and humanitarian programs have been disrupted. Gender-based violence is on the rise and mental health is stressed everywhere.” 

COVID-19 has disrupted food systems around the world and halted progress on nutrition investment, she noted. At the same time, though,”the pandemic has also brought to light just how integral nutrition and food systems are to health, livelihoods, and the environment.”

“The power of innovation and the adaptive agility of programs to respond to this crisis” have also been on prominent display, she said.

Thus, the current situation offers opportunities for improving food systems and nutrition going forward. The components of Piwoz’s nutrition playbook include:

  • A global financing mechanism dedicated to nutrition. Piwoz emphasized the need for a more robust and innovative approach to global nutrition financing. The current method is to advocate for nutrition funding within health, agriculture, and other sectors’ budgets, but nutrition issues are too interconnected to continue this fragmented approach.
  • Putting evidence into action. The global nutrition community is producing far too many research articles and reports, without direct pipelines to ensure action on their recommendations. To translate nutrition research into action, Piwoz suggested that the community could benefit from the equivalent of an Intergovernmental Panel on Climate Change for food systems and nutrition. 
  • Research that is strategic. Nutrition research should focus more on policy issues and scalable solutions. There is a greater need for implementation-driven research in the future, aligning more closely with policy makers’ interests and capabilities for implementing proposed solutions.
  • Advocacy that unites. Piwoz urged the global nutrition community to advocate on a more unified front, connecting the dots between various nutrition issues rather than pitting them against each other. While healthy debate among researchers is useful, global advocacy efforts for nutrition are far more powerful in greater numbers and more synchronized narratives.
  • The empowerment of future leaders. Piwoz acknowledged Forman’s commitment to this goal, understanding that improving global nutrition is a long-term process. Investing in early and mid-career professionals in the nutrition field is essential, as well as including more underrepresented voices in global nutrition conversations.

During the Q&A segment, Piwoz was asked to elaborate on how the global nutrition community can support local and national nutrition challenges alongside global narratives that may resonate less within countries. Global discussions should make space for local voices and realities, she said. She referenced the idea of “thinking globally, acting locally”—empowering local research groups to adapt global, policy-relevant research to local uses. “Making sure that global research gets translated locally is exceptionally important,” Piwoz said.

Francesca Edralin is a former IFPRI Communications Intern.

Source: IFPRI.org