Charity in the Era of Dwindling Development Aid
William Moore: CEO of the Eleanor Crook Foundation and Chair of “Stronger Foundations for Nutrition”
Charity will not replace public aid, but it can be a powerful force if used correctly. With pressure on global development funding, the diversion of European aid budgets toward defense and rearmament, and a reevaluation of foreign aid in the United States, the aid community finds itself in a state of confusion.
So far, reactions have been of two types: calls for charity to fill the gap and moral statements blaming governments for their decline. Unfortunately, the former is unrealistic, and the latter is ineffective. Private donors cannot resolve systemic global challenges on their own, and telling politicians they are morally bankrupt rarely changes their stance. Instead, we need to meet policymakers where they are, sharpen our arguments, and focus on what actually works.
The hard truth is that most government aid is not even designed for effectiveness, as it prioritizes processes over outcomes. Charity has not been immune to this trend. In our early years at the Eleanor Crook Foundation, we funded comprehensive, multi-sector programs attempting to tackle all causes of malnutrition at once. But the results were unsatisfactory. The approach looked good on paper, but it didn’t achieve any measurable improvement in malnutrition.
Learning from that failure, we changed our course. Now, we direct our funding where the evidence is strong and the results more immediate. At the recent “Nutrition for Growth” (N4G) summit in Paris, we announced a commitment of $50 million, alongside $200 million from other donors, to scale up one of the most cost-effective interventions in global health: prenatal vitamins—known as multiple micronutrient supplements (MMS). This funding will go toward a $1 billion roadmap to ensure access to MMS for pregnant women regardless of where they live.
The science in this case is clear. MMS replaces the old iron and folic acid (IFA) tablets that are still given to many pregnant women in low-income countries. With MMS, women receive 15 nutrients instead of just two, leading to a significant reduction in maternal anemia, stillbirths, and low birth weight. The estimated economic returns are substantial—$37 for every dollar invested—and the humanitarian returns are even greater, reducing infant mortality by nearly a third.
Global disparities in maternal health are profound. In London, a pregnant woman has regular access to comprehensive prenatal vitamins. In Lagos, she may receive IFA, or nothing at all. This disparity reflects a gap in will, not in knowledge. Ending such discrepancies does not require a scientific breakthrough but rather greater investment in already proven solutions.
More than two decades of research, three studies published in The Lancet, and many World Bank investment cases have identified around ten nutritional interventions that remain underfunded despite their proven effectiveness. These are not luxury, multi-sector, forward-looking initiatives. They are targeted, evidence-based programs that can be implemented immediately, at scale, to achieve measurable results.
Solutions include promoting breastfeeding, vitamin A supplementation, prenatal vitamins, and ready-to-use therapeutic foods for children suffering from severe malnutrition—a package of interventions that could save at least two million lives over five years if scaled up in nine high-burden countries. The cost of these life-changing results would be just $887 million annually.
Malnutrition is now the leading cause of child deaths worldwide, contributing to the loss of around three million children in 2023 alone. These are not mysterious tragedies. They are predictable and, in many cases, preventable at low cost. In a world that regularly sends tourists into space, it is clear that we can afford to ensure that all pregnant women receive a $2 bottle of vitamins.
This year’s N4G summit may be the last of its kind. It was part of a series of summits linked to the Olympics, which the United States will host next. With signals from the current U.S. administration that it will not continue this tradition, the commitments recently made in Paris take on new significance. Vague pledges and political posturing are no longer sufficient.
At the Eleanor Crook Foundation, we are not asking governments to spend as they did before. Rather, we urge them to look at the evidence and use their remaining budgets for official development aid to scale proven, cost-effective solutions. A simple investment in MMS—which costs less than one week’s worth of defense spending for G7 countries—could save 600,000 lives.
Even with limited budgets, we have the opportunity to save millions of lives. But only if we stop trying to do everything and instead focus on what is the right thing to do.
