Recently in Lomé, Togo, I joined partners from across West and Central Africa to reflect on a critical question: how do we move from commitment to action on nutrition and early childhood development? What was evident is that the cost of inaction is no longer theoretical. It is measurable, immediate and significant.

At the regional conference, hosted by the World Bank, leaders and practitioners came together with a shared sense of urgency and a practical focus exploring how countries can operationalize and prioritize nutrition for children under five. This is foundational for child survival and long-term human capital development.

But this was not simply a theoretical conversation. Across the region, the consequences of malnutrition in childhood continue to show up in ways that societies cannot ignore through preventable illness and death, lower learning outcomes, constrained productivity, and long-term economic losses. Nearly one in three children under five is affected by stunting across Sub-Saharan Africa, with far-reaching consequences for health, learning and productivity. These are not just social costs; they translate into real economic losses for countries.

When the earliest years are compromised, countries feel these effects for decades through reduced educational attainment, weaker workforces, and increased health and social costs.

At the conference, I presented the Cost of Inaction Tool, launched by Nutrition International in 2024 in partnership with Limestone Analytics, with funding from the Government of Canada. It’s an evidence-based tool that helps governments quantify the health, human capital and economic impacts of underinvestment in nutrition. By making the costs of inaction visible, the tool supports more informed decisions on policy, prioritization and investment.

What was particularly encouraging in Lomé was the clear shift in focus from broad commitments to execution. Discussions centered on the systems countries need to deliver results, including service delivery pathways, enabling policy environments, sustainable financing, and stronger data and measurement. The emphasis was on translating evidence into action that supports country-led frameworks to guide investment and implementation.

For Nutrition International, this platform was an opportunity to help decision-makers quantify what is at stake and what is being lost when action is delayed.

How the Cost of Inaction tool helps

Nutrition is foundational for development. Yet even where there is strong political will, decision-making often comes down to familiar constraints with limited fiscal space, competing priorities and pressure to invest in what is immediately visible. This is where progress can stall, not because solutions are unknown, but because the consequences of delay are not always clearly understood.

The cost of inaction framing helps bridge that gap. It translates malnutrition and poor early development into the language of decision-making through costs, trade-offs and long-term returns. When governments and partners can clearly see the economic and human impact of delayed action, they are better positioned to make informed policy choices, allocate resources effectively and prioritize investments that deliver the greatest impact.

While the conference focused on West and Central Africa as defined by the World Bank, the investment questions remain deeply country specific. Each context faces its own constraints and requires strong evidence to inform where resources should be directed, how programs are designed and what trade-offs are being made.

The discussions brought together both regional perspectives and country-level insights, highlighting how national averages can obscure the greatest inequities. Investment decisions are most effective when they are targeted, reaching the populations and geographies where the burden is highest and the potential returns are greatest.

The key takeaway is not only that nutrition and early childhood development are essential, but that cost-effective interventions and delivery platforms already exist. Even modest improvements can unlock significant human and economic benefits. As the Cost of Inaction Tool demonstrates, reducing stunting by just 5% could generate more than USD 18 billion in economic benefits across Sub-Saharan Africa in a single year.

The call to action

The conversations in Lomé ultimately centered on commitments and investments. For countries, the priority is to sharpen action frameworks and align investments with evidence. For partners, it is about supporting those efforts in ways that are coordinated, sustainable and impactful.

The path forward is clear. Decision-makers must be supported to:

• Use evidence to guide policy and investment decisions
• Prioritize nutrition as a foundation of human capital
• Strengthen systems for delivery, data and accountability
• Invest early, where the returns are greatest

Although the discussions in Lomé made clear that the cost of inaction is already being paid, it also highlighted the evidence available and the solutions that exist. What is needed now is urgency and sustained commitment.

Because when we fail to act in the earliest years, we compromise the future of our economies and societies. But when we invest in nutrition, we lay the foundation for stronger, healthier and more productive nations.

Albert Kombo is the Regional Director for Nutrition International in Africa.

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