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Baroness Manzoor
To ask Her Majesty’s Government what action they are taking to improve standards of nutrition for women and girls globally.
Baroness Manzoor (Con)
My Lords, I noted with great interest that 190 noble Lords spoke over the last two days on the European Union (Notification of Withdrawal) Bill, and that the debates did not conclude until nearly midnight on both days—indeed, after midnight on the first day. Therefore, I am particularly grateful to noble Lords for staying late again tonight and for speaking in this debate, for which I thank them.
International Women’s Day will take place next month and last month there was a debate in this Chamber on employment skills for women and girls. This debate is therefore very timely. As someone who has worked extensively in the NHS, I have seen at first hand just how critical good nutrition is for survival, recovery, good health and well-being. Good nutrition is the foundation for development. Without the right nutrients at the right time, none of us would grow to fulfil our physical or, indeed, cognitive potential.
While my contribution to this debate focuses on the urgent need to tackle undernutrition in low and middle-income countries, as that is where much of the burden of undernutrition is in women, girls and children, let us not pretend that, as a rich country, we are immune to these issues. Every country in the world suffers from one or more forms of malnutrition, be it undernutrition, overnutrition or micronutrient deficiencies.
Just as in Pakistan, India or Malawi, without good nutrition our economy suffers, our society suffers, and, as individuals, we suffer too. SDG 2, to which we as a country are signed up, and fully support, states:
“End hunger, achieve food security and improved nutrition”.
Point 2.2 of the goal states,
“by 2030 end all forms of malnutrition, including achieving by 2025 the internationally agreed targets on stunting and wasting in children under five years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women, and older persons”.
Some good progress has been made but despite all the progress we have seen in recent years, sadly, undernutrition, much like poverty, is sexist, given that 70% of the 1.3 billion people in poverty on this planet are women. Of all those who are undernourished worldwide, 60% are women. In 2013, a woman’s life was lost in pregnancy or childbirth every two minutes, with anaemia being a major risk factor impacting around one in five deaths.
I was very fortunate to visit India last year with RESULTS UK. Uttar Pradesh is the largest state in India with a population of 200 million. According to the Rapid Survey on Children, in 2013-14, it was the home of 21 million children under five. Some 50% of the children had stunted growth, 10% had wasted muscles and 34% were underweight. It was also evident that adolescent pregnancy and anaemia contributed to a high prevalence of low birth-weight and subsequently undernourished children. However, I was pleased to note that education and nutritional programmes had been commenced to tackle these issues in the state.
Worldwide, it is estimated that more than 200 million children under five fail to reach their full development potential largely due to malnutrition. Women make up 63% of adults without minimal literacy skills and 18 million girls a year are forced into early marriage. We must not forget older women. Many of the diseases suffered by older people are the result of dietary factors, some of which have operated since infancy. These are compounded by the ageing process. It is noticeable that many Governments have few policies to prevent undernutrition in older women.
Inadequate diet and malnutrition in older women are associated with a decline in their functional status, impaired muscle function, decreased bone mass, immune dysfunction, anaemia, poor wound healing and delay in recovering from surgery and higher hospital rates and mortality. Women suffer 80% of all fractures due to osteoporosis, with diet being a key factor in this. Shocking statistics such as these are not scarce and certainly cannot be addressed without a change in approach. The Food and Agriculture Organization recognises gender inequality as both a cause of, and result of, malnutrition. We must acknowledge this inextricable link if we want to get to grips with the scourge of malnutrition.
I am proud that the UK Government have stepped up to the plate when it comes to championing good nutrition and have set the bar high. They held the Nutrition for Growth summit in London in 2013. I am sure that the Minister will say more about the impact that UK aid is having on nutrition for women and girls but it is crucial that we keep up the pace. Just a one-off N4G event cannot help us end undernutrition in vulnerable and disadvantaged groups. What is key, especially in this current climate of some anti-aid sentiment, is maintaining the political leadership. I am therefore pleased to learn that the Secretary of State for International Development intends to increase spending on nutrition, and I commend her for that. Will the Minister say what the Government’s plans are to increase investment in, and expand programmes for, women’s and girls’ nutrition in 2017? For instance, can we expect a big initiative such as Nutrition for Growth to show our Government’s continued commitment to this issue, and through which they could encourage other Governments to step up their efforts too?
While it is crucial to have the resources to carry out this important work, it is equally important to identify the right places to invest them. Programmes such as Supporting Nutrition in Pakistan, involving food fortification with iron and folic acid, and other efforts in agriculture and sanitation are being led by the World Bank, the Australian Aid agency and NGOs with a strong understanding of this issue, such as the Canada-based Micronutrient Initiative. These are good examples of how the UK is leading efforts on women’s and girl’s nutrition in partnership with other stakeholders. Another superb initiative is the Scaling Up Nutrition movement.
I am sure we all agree that aid alone will not solve this problem. We all want to see countries stand on their own two feet and lead this fight. By bringing together civil society and Governments across 58 of the world’s poorest countries, SUN is developing a unique platform that can facilitate the kind of shared learning that drives country ownership. I saw this first hand when I visited Uttar Pradesh. I would be interested to hear about the Minister’s assessment of SUN and whether his department has plans to scale up support for the movement given the importance of the work it does.
It is also important here to talk about adolescent girls, as they are such a critical link in the cycle of malnutrition and poverty. The aid agencies and NGOs are doing an important job in improving nutrition among other demographics, but there is evidence that adolescent girls are still being left behind. One in three girls aged 15 to 19, in countries where data are available, are anaemic. This is absolutely shocking. How can we expect adolescent girls to attend school—forget excelling —when they are constantly weak, dizzy, lack concentration, and at risk of disease through reduced immunity? I appreciate that there is a huge blind spot in data and in our knowledge of the nutritional status of many of these girls globally. However, this is an area where the UK could lead the way, with much greater outcome-focused programmes and research.
Another area where I see space for greater impact and value for money is through better integration. Given the links nutrition has with other development sectors, such as health, agriculture and education, perhaps more could be done to better integrate nutrition into DfID’s other aid programmes. I hosted a round-table discussion in this House just before Christmas with RESULTS UK, and I was pleased to hear the DfID official in attendance state that steps were already under way to better combine health and nutrition programming. It is crucial that, where possible, DfID includes specific nutrition objectives and indicators in its other programmes that have an indirect impact on nutrition outcomes for girls and women. Perhaps the Minister could share with us a little bit about the progress in this key area.
To conclude, on a more general note, like many noble Lords in your Lordships’ House, I was deeply concerned when I heard about the reversal in the United States of the Mexico City policy, or the gag law, as it is otherwise known. Increasing access to family planning services—I say this as I was a midwife and a health visitor in my early twenties—is one of the most practical solutions to reducing malnutrition in women as well as giving women basic empowerment over their own bodies. Bill and Melinda Gates have already made it clear that,
“this shift could impact millions of women and girls around the world”,
and,
“could create a void that even a foundation like ours can’t fill”.
I echo this concern and ask the Minister what assessment the Government have made of the impact of this policy change on our own aid programmes and how they might be affected.
At times like these, bold UK leadership is more important than ever. As a nation, we have made the decision to leave the European Union, giving us the opportunity to forge a new role for ourselves in the world. Our commitment to the world’s poorest and most vulnerable has seen us, in recent years, become the only G20 country to allocate 0.7% of GNI to overseas aid. We should stand tall and be proud of this commitment, carrying it forward with us as we make the important strategic decisions that lie ahead. Delivering the Conservative Party 2015 election manifesto pledge to improve the nutrition of 50 million people by 2020 is the perfect way to do this, and would demonstrate to the world that Britain is a compassionate and outward-looking global leader, committed to improving the lives of the world’s poorest—better nutrition for better lives.
In conclusion, I put on record my appreciation and thanks to RESULTS UK and Age International for supporting me in the preparation of this debate.
Baroness Thornton (Lab)
My Lords, I congratulate the noble Baroness on bringing this important debate to the Floor of the House. I put my name down to speak in it because I wanted to identify myself and these Benches with this important issue—which my noble friend will also do—and at the end of my remarks I have a few questions for the Minister to consider.
It is inevitable that statistics will be bandied about during a debate like this, and some of them are startling and shaming. Malnutrition is partly responsible for 45% of childhood deaths. It destroys the most human potential on the planet. Children who are stunted are not just below their global peers in height but are behind them in cognitive development, and that will limit these children their whole lives. Nutrition is the biggest missed opportunity in global health, and were it solved, it would unleash waves of human potential. Yet overall, only 1% of foreign aid goes towards basic nutrition. Malnutrition is not starvation; malnourished children can be getting enough calories but not the right nutrients. That makes them more susceptible to conditions like pneumonia or diarrhoea—and more likely to die from them.
Over half of the world’s population lives in cities, a trend that will accelerate more quickly in the coming decades. In many cities, over half the population lives in informal settlements and slums, and rates of malnutrition are exceedingly high. Urban food systems in many countries are not developing rapidly enough to cope with the challenges of a fast-growing population, a factor which increases obesity levels as traditional diets are swapped for snacks and high-energy foods. So in many ways the global food system is broken.
Estimates seem to vary, but GAIN says that in total about 3.5 billion people—half the people on the planet today—are malnourished in one way or another. Each day, 795 million people go hungry. Each year, malnutrition undermines billions of people’s health. It kills probably 3.1 million children under five and leaves 161 million stunted. Rapid population growth and climate change pose new challenges to an already overburdened food system.
It is clearly obvious—I know that the British Government agree with this—that solving these problems can be done only as part of a collective global effort.
There are some simple and some not so simple solutions. Breast-feeding within the first hour and exclusively for the first six months is the first and simplest intervention and has long-term benefits for nutrition. However, of course it needs the mother to be healthy enough to breast-feed, and it requires the culture surrounding her to encourage her and requires her to understand that that is the best start she can give her child. Of course, the noble Baroness is quite right that this is a women’s issue in particular.
Experts are also figuring out how to breed crops with higher nutritional levels and how to get key nutrients in the food supply, in either salt or cooking oil. Those are promising approaches. However, nutrition is still one of the biggest mysteries in global health. Nutrition gets better as a country gets richer, but it does not seem to have any noticeable effects on positive outliers—there are poor countries with almost half their children undernourished.
In exploring some of the solutions put forward in this area, I came across the Nutrition Knowledge Bank—part of the GSMA mNutrition initiative to help tackle malnutrition in Africa and Asia—which is a collection of content on good nutritional practices and includes downloadable factsheets and mobile messages. This is not the complete answer, but it must be part of the solution, which is to do with knowledge and accessibility and using modern technology to improve nutritional practices, particularly for women and the vulnerable groups we have mentioned. I was struck by the work being undertaken by mNutrition in the various places in the world where it works.
The noble Baroness mentioned the targets that the World Health Organization put forward in this area. The Comprehensive Implementation Plan on Maternal, Infant and Young Child Nutrition, which the WHO endorsed in Geneva in 2012, set some very high targets indeed for solving this problem. The plan proposes:
“40% reduction of the global number of children under five who are stunted … 50% reduction of anaemia in women of reproductive age … 30% reduction of low birth weight … no increase in childhood overweight … increase the rate of exclusive breastfeeding in the first six months … reduce and maintain childhood wasting to less than 5%”.
Five action points flow from the World Health Organization’s proposals. I will not go through those in detail, but I ask the Minister whether the British Government are working to the action plan, to what effect and with what resources.
When the British Government were tackling tobacco as a public health issue, one of the biggest drivers of change in governmental practice were the strong rules about discussions with the tobacco industry. What discussions have been had, and what is the relationship, between the Government or DfID and the food industry? Some of the large companies providing food throughout the world that is not nutritious are based in the UK and Europe. Are the British Government thinking about how to deal with this fact? Indeed, is the Minister being lobbied by some of our large food manufacturers? When we were addressing the issue of tobacco, tobacco companies switched their attention from the first world to the third world because that was where they could make their money. That issue occurred to me and I genuinely do not know what the answer to the question is, but it is one that we need to ask. Does DfID have guidelines on this matter?
Has thought been given to how we will continue to be a leader in our aid programmes, particularly on this one, in a world in which we will not necessarily be able to join forces with our European colleagues in a coherent way, given that a lot of our aid work is currently done through our relationships with the European Union? Also, what consideration has the Minister given to the changing attitude of the new Administration in the United States of America to world aid and to the United Nations and its institutions? I accept that it might be too soon to say, but these are things that we need to think about.
Lord Collins of Highbury (Lab)
My Lords, I too thank the noble Baroness, Lady Manzoor, for initiating this debate, which, I think, follows on from Questions. There is a consensus in this House on the 0.7% aid target and enshrining it in law. The reason for that is very practical: it allows the United Kingdom to support long-term sustainable development projects which really make a difference to the lives of the world’s poorest and most marginalised people. The UK’s commitment to improve the nutrition of 50 million people by 2020 is a good example of this, and is the example I would like the Prime Minister to write about in the Daily Mail. It is exactly these issues that we need to be focused on, and I therefore very much appreciate the noble Baroness’s initiating this debate.
As we have heard from my noble friend and from the noble Baroness, Lady Manzoor, good nutrition is the foundation of sustainable development, and of building health and resilience. Twelve of the SDGs agreed in New York have indicators relevant to nutrition. Without strong nutrition, other health interventions are less effective. Nutrition interventions also promote economic development. Every $1 invested in nutrition achieves a $16 return in benefit. That is the key message of our overseas development work, which we should put into the media in order to respond to some of the ridiculous arguments that have been made. Countries lose at least 10% of their GDP because of malnutrition. It stagnates personal, societal and national development. That is why it is so key that we make progress on this. As we have heard, for women and girls, who are often most vulnerable to under nutrition, nutrition interventions are crucial for supporting their full development potential.
The second SDG is to:
“End hunger, achieve food security and improved nutrition”.
Its second target is:
“By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons”,
as the noble Baroness, Lady Manzoor, pointed out. Older women are particularly vulnerable to malnutrition, and attempts to provide them with adequate nutrition encounter many practical problems. Their nutritional requirements are not well defined and ageing affects nutrient needs—some requirements increase while others decrease.
As we have heard, good nutritional status reduces maternal deaths, improves school outcomes, and contributes to delayed marriage and pregnancy. It saves lives, improving potential and promoting progress, alongside intergenerational health and prosperity. The onset of menstruation in adolescent girls results in a much higher demand for nutrients. Not receiving them can lead to anaemia, which compromises growth and causes fatigue, dizziness, weight loss and reduced immunity. The impact of poor nutrition on maternal health is irrefutable: deficiencies of essential micronutrients and energy during pregnancy can cause maternal complications and haemorrhages and, in many cases, as we have heard, mortality. Nutritional deficiencies can also contribute to foetal birth defects and foetal or new-born mortality. There is no doubt that improving nutrition, alongside good antenatal care, can improve these numbers dramatically. Good nutrition is crucial for unlocking the potential of women and girls across the life cycle and for giving them the best opportunity to become active members of their community.
As my noble friend highlighted, around half of under-five deaths can be attributed to underlying malnutrition. Malnourished children are nine times more likely to die from common childhood infections such as pneumonia and diarrhoea, and improved nutrition is key to changing the prospects of many. In low-income countries, 37.6% of children aged under five are stunted. They are likely to grow into stunted adolescents. For girls, this means they face a higher risk of pregnancy-related complications. Stunting is one of the leading causes of death among this demographic. Over 2 billion people suffer from micronutrient deficiencies. Anaemia, often a result of iron deficiency, affects 500 million women of reproductive age and is responsible for nearly 20% of maternal deaths. In 21 countries out of 41 with data on anaemia prevalence, more than one-third of adolescent girls are anaemic. Undernutrition has a devastating impact on the physical and development potential of girls. Malnourished adolescents go on to lose around 10% of their lifetime earnings as adults. This affects the economic development of these countries which is so vital if we are to change and challenge poverty in our world.
As my noble friend Lady Thornton and the noble Baroness, Lady Manzoor, said, we can be proud of the United Kingdom’s leading role in the world in the fight against malnutrition. Certainly, this commitment was renewed in the recent bilateral development review, about which we have spoken in this Chamber, following on from 2013 when the UK hosted the inaugural nutrition for growth conference in London and made financial commitments—£655 million for nutrition-specific interventions and £604 million for nutrition-sensitive interventions until 2020. As the noble Baroness, Lady Manzoor, said, the Government, as part of their 2015 manifesto, pledged to improve the nutrition of 50 million children aged under five, women of child-bearing age and adolescent girls in developing countries by 2020, which is the N4G commitment.
However, despite these commitments, the world is not on track to achieve the 2025 global nutrition targets. We need to fundamentally address these issues. I welcome DfID’s plan to improve the nutrition target by 2020 and I urge the Minister to commit the Government to invest a further £530 million after 2020. DfID should rapidly disburse its 2013 commitments to nutrition and increase its ODA to nutrition, because it is the key to development; £530 million of new money should be invested between 2016 and 2020 because good nutrition, as we know, has a significant impact on improving women’s economic development, as well as on health.
We need an integrated approach which delivers nutrition as part of a package of wider health and poverty reduction intervention and improves the value for money of health investments. I hope the Minister will support the scaling up of nutrition-specific interventions to tackle all forms of malnutrition and the integration of these interventions into the design and delivery of reproductive, maternal, new-born child, adolescent and other health programmes.
In 2015 the Government made a commitment to leave no one behind in their development work. DfID should ensure that nutrition programmes target and improve nutrition for the most vulnerable and hardest to reach. Does the Minister agree that to do this, DfID should produce disaggregated data for prioritising investments, with a focus on high burden irrespective of low/middle-income status, and allocate resources to strengthen national information systems to ensure that we have that proper and adequate data?
The Minister of State, Department for International Development (Lord Bates) (Con)
My Lords, I join other noble Lords in paying tribute to my noble friend Lady Manzoor for securing this debate. The subject is dear to heart. She has devoted her professional life to it and brings that experience into your Lordships’ House. Her convening of the round table before Christmas enabled an exchange of views with the DfID officials who attended and was helpful in shaping our policy in relation to this issue. I also thank the noble Baroness, Lady Thornton, and the noble Lord, Lord Collins, for their thoughtful contributions from the Labour Benches on these matters. They rightly pointed out that nutrition is the basis, the building block, for all other development. It is crucial, not only in the sustainable development goals but as a woman’s issue in the lead-up to International Women’s Day.
As an aside—I hope the House will bear with me—I am particularly disappointed that we have not heard from the Liberal Democrats; in fact there is no one on their Benches. Normally I would not make reference to that but, because I have had some extra information as to why that may be the case, I want to put on record that this is an important issue that is central to development and we should focus on it and make sure our voices are heard.
Malnutrition still affects one in three people globally. It is holding back the growth and development of both people and countries. Women affected by undernutrition are more likely to give birth to small babies, and those babies will be disadvantaged throughout their lives. Undernourished children are more likely to die young, contributing to 45% of all under-five deaths. Children who survive do less well at school, have 10% lower lifetime earnings and are more likely to have undernourished children themselves.
The economic consequences of undernutrition in affected countries represents a loss to GDP of 10% year on year, whereas every pound spent on reducing stunting has an estimated £50 to £60 return in increased incomes and economic growth. Therefore, tackling malnutrition is critical to reaching at least 11 or 12 of the global goals. Eradicating disease, ending extreme poverty and empowering women will happen only if they are free from malnutrition. A healthy, prosperous and stable world is much less likely while malnutrition persists.
Nutrition is a long-term development challenge and an immediate humanitarian challenge. In 2017 the world is facing unprecedented humanitarian needs. A famine in South Sudan was declared today, along with Her Majesty’s Government’s response to it. It is a call to arms for the international community to respond much more effectively and urgently to the challenge already in South Sudan and just around the corner in Somalia, north-east Nigeria and Yemen. The international community must get much more to the forefront of these issues. However, as the noble Lord, Lord Collins, said, we can rightly be proud of the fact that the UK is leading in this area. We support the comments and remarks of the Secretary of State, Priti Patel, made today to the international community.
UK aid on the ground is saving lives. Now we are calling on the international community to step up its support. The longer we wait, the higher the price humanity will have to pay. For all these reasons, improving the nutrition of women, girls and children in general is a top priority for our work in developing countries. It is for these reasons that at the Nutrition for Growth summit in 2013, to which my noble friend Lady Manzoor and the noble Lord, Lord Collins, referred, we pledged to invest more in programmes that address both the immediate and underlying causes of malnutrition. It is for these reasons that in 2015 the Government committed to the nutrition of 50 million people—women, girls and children—globally by 2020.
Delivering this result will be a priority for DfID, with a focus on quality and value for money. I am pleased to say that we are on track to do that, thanks to the work we are doing to scale up on nutrition across the 20 priority countries that we have identified. More broadly, we are far from complacent. In the coming months my right honourable friend the Secretary of State will launch a new UK position paper on nutrition. This will set out further accelerated and intensified action. The noble Lord, Lord Collins, invited me to say a little more about what the financial resource behind that might be. Like me, he will have to be patient to see that coming forward, but I hope that it will be something where, as on so many things, there is cross-party support.
Our new approach will be built on the latest evidence. This shows clearly that there is a basic package of things that need to be done to most effectively tackle malnutrition. This includes vitamin A and zinc supplements for children, maternal micronutrient and calcium supplementation, breast-feeding promotion—which the noble Baroness, Lady Manzoor, referred to—education around complementary feeding, and specific management of severe acute malnutrition, the most life-threatening form of malnutrition.
The evidence also points towards focusing on both girls and boys under five years, as this is when malnutrition is most likely, has the biggest impact on children’s future potential, and can be most easily prevented. It is also increasingly clear that, for maximum impact, we need to focus more on adolescent girls—a point made by the noble Lord, Lord Collins, and my noble friend Lady Manzoor—both for their own benefit and to prevent malnutrition in future generations.
As my noble friend Lady Manzoor articulated so clearly, we need to ensure that the wider DfID portfolio—be it health, water, agriculture, or economic development programmes—is addressing malnutrition at the same time as hitting other objectives. Our recently published Economic Development Strategy commits us to do this very thing, and we are now specifically looking at how we can go further in integrating nutrition into health. This multisectoral approach not only delivers better results; it also represents better value for money. Delivering multiple outcomes through our programmes maximises the impact of every pound spent.
While tackling undernutrition will remain DfID’s primary nutrition focus, failing to consider overweight and obesity will leave many countries with a costly public health problem in the future. DfID will therefore also identify ways to avert overweight and obesity through our work on undernutrition in low-income countries, making the most of UK expertise in this area. Preventing undernutrition itself will play a role, as undernourished children are at increased risk of being overweight, of obesity and of related non-communicable diseases in adulthood.
As I have outlined, nutrition is a top priority for DfID’s work. However, the UK acting alone cannot of course rid the world of malnutrition. The noble Baroness, Lady Thornton, rightly pointed this out and stressed the importance of working with our European partners. At present, we continue to do that through the European Development Fund. In future, we will continue to work with them through the many multilateral institutions in which we have a shared position, involvement and concern.
Inequalities in malnutrition are also increasing. Girls, excluded ethnic groups, children with disabilities and displaced people—some examples of whom the noble Baroness, Lady Manzoor, referred to in respect of her visit to India—and those living in fragile and conflict-affected states are particularly affected. The new UK position paper will therefore also set out our determination to galvanise the international and business communities to follow our own leadership on nutrition. We will specifically ask countries which are home to large numbers of undernourished people to set out quality, multisectoral plans and financial commitments to tackle undernutrition. We will continue to support the Scaling Up Nutrition movement, by contributing to the costs of the secretariat and by providing assistance to Governments within the movement to improve their nutrition programming.
We will seek new commitments from businesses, which have a crucial role in improving both supply of and demand for nutritious food. The noble Baroness, Lady Thornton, raised a good point about potential conflicts of interest within the food industry. We are supporting the development of guidelines to ensure responsible behaviour by businesses on nutrition, working with Access to Nutrition Index to promote improvement in business practice.
We will lobby other potential global funders of work against malnutrition to step forward and step up, including through the Power of Nutrition financing facility. And we will call on our multilateral partners to up their game, focusing more sharply on supporting Governments to develop and implement their own national nutrition plans.
To advance this agenda, the UK will play a leading role in a series of global nutrition events throughout 2017. Starting with a global call to action at the World Bank spring meetings in April, there will be moments for each group of stakeholders to make new commitments at that point.
Lastly, we will invest to ensure there are better data—a point raised in the debate, and the point about disaggregation of data was particularly well-made—to measure the impact of our own and others’ efforts, and to ensure that we and others can be held to account for delivery.
I am grateful to my noble friend Lady Manzoor for raising this timely debate, and for the expertise she brings. I am grateful also for the contributions of the noble Lord, Lord Collins, and the noble Baroness, Lady Thornton, on this crucial issue. We will continue to work with civil society and the private sector, to get the world back on track and make sure we achieve Global Goal 2 by 2030, and leave no one behind.