Bill Gates says world leaders must step up the fight against a worsening child nutrition crisis that’s causing-trillions of dollars in economic losses — and that gut bacteria investment and more productive cows can help.

The-billionaire philanthropist — who has said malnutrition tops his list of problems to solve — warned that more needs to be spent on health issues, especially with an ever-more damaging impact from climate change.

The pandemic and debt crises in poorer countries have hit health and education funding at a time when richer nations have curbed aid for Africa, where hunger is most prevalent. That’s putting nutritious food out of reach for many and threatening decades of improvement in child health, while extreme weather increasingly strains harvests.

As the lack of healthy diets for children hurts their mental and physical capabilities later in life, that threatens grave economic consequences. The World Bank estimates that some $3-trillion in productivity is already lost each year globally due to malnutrition.

“The worst case is that the countries, particularly in Africa, stay in a poverty trap” if malnutrition isn’t solved, Gates said. With so little to spend on the health system and improving diets, “a whole generation of kids grow up where their ability to be educated, their mental capacity, is way below its potential.”

The co-chair of the Bill & Melinda Gates Foundation and one of the world’s richest men sees helping those countries escape a poverty trap as a “moral and strategic priority.” He said tackling child malnutrition would also make vaccines more effective and diseases like malaria less fatal.

Cheap solutions that are ready to scale can address much of the problem, Gates said. The foundation’s efforts include expanding access to prenatal vitamins for pregnant women, boosting output and the safe handling of milk in Africa. It’s also backing research on the microbiome — the bacteria living in the gut.

HEALTH OUTLOOK
The United Nations in July warned the world isn’t on track to reach any of seven global nutrition targets by 2030. The economic costs of undernutrition can even reach 16% of GDP in low-income nations, according to the World Bank.

“Few economists think of the malnutrition rate as a critical economic data point - but they should start,” Gates said in the foundation’s annual Goalkeepers report released Tuesday. “Nutritional deficits quickly translate into financial deficits. Nations can’t grow if their people can’t.”

By mid-century, climate change will lead to an extra 40-million stunted children unless immediate action is taken, according to the report. Another 28-million more children face wasting, where they’re too thin for their height.

Malnutrition is the cause of almost half of young children’s deaths, yet it’s one of the world’s most overlooked development challenges, with less than 1% of public aid devoted to nutrition.

TACKLING PROBLEMS
The Gates Foundation has committed $922-million through 2026 for nutrition. It’s the biggest funder of research into the microbiome, according to Gates, who also wants donors and governments to put money into the Child Nutrition Fund.

The foundation is supporting programs to breed cows that are more resilient to heat and produce more milk. Gates recently visited Nigeria, which has long grappled with food-security challenges. Like in many other places in Africa, animal protein products such as milk and eggs are expensive and hard to get.

“We’re trying to get the cost of milk and eggs to be greatly reduced in these countries,” Gates said. “The cow stuff’s very promising.”

More than half of the world population doesn’t consume enough essential micronutrients like iron, calcium and iodine, a recent study in Lancet Global Health journal showed. Adding them to food is an old technology that’s now being expanded.

For example, Ethiopia is testing adding folic acid to salt that’s already iodized, to help eliminate defects that lead to death and stillbirths. Nigeria is working on adding a range of micronutrients to bouillon seasoning cubes that are found in most kitchens there.

Gates is excited about work on the microbiome, where bacteria in the gut can impact how the body absorbs nutrients and fights diseases. Trials are underway to offer probiotics to infants to help them better absorb nutrients and the next step will be to reduce costs, he said, adding that microbiome advances should also aid the fight against obesity in rich countries.

“In the last 10 years we’ve gained a deep understanding of what goes on,” he said. “It’s clear what we need to do to enable these kids to achieve their potential.”