Addressing Malnutrition in Pakistan: The Role of Civil Society Alliance for Scaling up Nutrition

Malnutrition is one of the most persistent development challenges facing Pakistan. Decades of poverty, food insecurity, and weak health systems have left millions of children stunted and many mothers anaemic. Government programmes alone have struggled to reverse the trend, which is where organised civil society steps in. The Scaling Up Nutrition Civil Society Alliance (SUN-CSA) emerged as a coalition that brings together doctors, nutritionists, activists, and community groups under one banner to push nutrition up the national agenda. This case study explains how the alliance was formed, what it does, and why it matters for understanding the role of civil society in South Asia.

The scale of malnutrition in Pakistan 🔗

To understand why SUN-CSA exists, it helps to grasp the size of the problem. Pakistan carries one of the heaviest malnutrition burdens in the world, and the numbers are stark. The National Nutrition Survey 2018 found that roughly 40 percent of children under five were stunted, meaning they were too short for their age due to chronic undernutrition. Around 17.7 percent were wasted, or too thin for their height, and nearly 29 percent were underweight.

The crisis is not limited to children. According to the Global Alliance for Improved Nutrition, the same survey revealed that 42.6 percent of women of reproductive age were anaemic and 46.9 percent of pregnant women were iron deficient. These figures matter because maternal malnutrition feeds directly into child malnutrition, creating a cycle that passes from one generation to the next.

Researchers describe Pakistan as facing a triple burden of malnutrition, where undernutrition, micronutrient deficiencies, and rising obesity coexist. The survey itself noted that stunting, wasting, and micronutrient deficiencies have profound effects on the immunity, growth, and mental development of children. The poorest provinces, including Sindh, Balochistan, and Khyber Pakhtunkhwa, record the worst indicators.

The global SUN movement and its civil society arm 🔗

The Scaling Up Nutrition movement is a global effort launched in 2010 that unites governments, donors, businesses, and civil society around a shared goal of ending malnutrition. Rather than imposing a single model, it is built on the principle that nutrition efforts should be country-led. Pakistan joined the movement in 2013.

How civil society fits into the structure 🔗

Within each member country, nutrition-focused organisations come together under a structure called a Civil Society Alliance, or CSA. As the SUN Civil Society Network explains, these national alliances are part of a wider global network of local and international organisations that share resources, build relationships, and coordinate advocacy. The logic is straightforward. Governments may set policy, but civil society brings the grassroots voice to the table and holds officials accountable for delivering on their promises.

The formation of SUN-CSA Pakistan 🔗

The idea of a national alliance took shape through a broad consultation process. As documented by Scaling Up Nutrition, key civil society organisations and networks from across the country met in Islamabad in June 2014 to begin forming the SUN-CSA for Pakistan. A membership drive followed to register interested groups.

The alliance was formally launched on 23 December 2014 during a two-day national conference on the state of nutrition in Pakistan, according to SUN Punjab. The launch was marked by the adoption of a Civil Society Declaration on Nutrition and Food Security, which set out the shared commitments of member organisations. The alliance positioned itself as an overarching body for organisations either already active in nutrition or interested in nutrition-related issues, with a mandate to monitor the national situation and advocate for legislative reform and effective programme implementation.

Who makes up the alliance 🔗

SUN-CSA Pakistan is a coalition rather than a single organisation. It draws together health activists, doctors, nutritionists, child rights groups, women’s organisations, and research bodies. Its membership has grown steadily over time. The network expanded from its founding members to 164 organisations by September 2019, and reporting from 2024 placed the figure at more than 250 civil society organisations spanning all federating units of the country. This breadth is one of the alliance’s defining strengths, because it allows nutrition messages to reach communities through many different channels at once.

What SUN-CSA actually does 🔗

The alliance works mainly through advocacy, awareness, and capacity building rather than direct service delivery. Its activities target the people who shape and implement nutrition policy.

Policy advocacy and budget reviews 🔗

A core function of the alliance is pushing for stronger nutrition policy and bigger budgets. The SUN Civil Society Network profile notes that the alliance advocates for the implementation of multi-sectoral nutrition strategies, demands enhanced budgetary allocations, and presses for the enforcement of relevant rules and laws. It also built the capacity of its own members on nutrition budget advocacy so that the coalition can engage with public finance debates in an informed way.

Engaging parliamentarians and the media 🔗

SUN-CSA understands that lasting change requires winning over decision-makers and the public. Over a three-year period, the alliance sensitised more than 200 parliamentarians on the value of investing in nutrition and oriented over 250 journalists to highlight the impacts of malnutrition. By working with lawmakers and the press at the same time, the alliance builds pressure from both above and below, making it harder for governments to ignore the issue.

Developing a strategic plan 🔗

The alliance did not operate in an ad hoc manner. In 2015 it undertook an extensive consultative exercise to formalise a five-year strategic plan, which was approved by its General Body and Executive Council. The plan was designed to align with both Pakistan’s national commitments and the wider SUN Movement strategy, giving the alliance a clear direction and measurable goals.

The #InvestInNutrition campaign 🔗

Awareness campaigns are among the most visible outputs of the alliance, and the #InvestInNutrition campaign stands out as a flagship success. The campaign used the hashtag to draw public and political attention to the human and economic cost of malnutrition, with a particular focus on children and pregnant women, who are the most vulnerable groups.

The results were tangible. According to the SUN Civil Society Network, a campaign run by the Pakistani alliance gained mass media coverage and influenced the government to allocate a multi-year budget towards nutrition. This is a concrete example of advocacy translating into financial commitment. Later reporting confirms the scale of such commitments. In early 2024, Scaling Up Nutrition reported that Pakistan approved a three-year national multi-sectoral nutrition plan allocating 30 million US dollars to fight child malnutrition and promote healthy dietary practices.

Campaigns of this kind are often timed around moments of high public attention, such as World Food Day, when nutrition naturally rises on the public agenda. By concentrating messaging and coordinating member organisations around these events, the alliance amplifies its reach far beyond what any single organisation could achieve alone.

Collaboration with the global SUN movement 🔗

SUN-CSA Pakistan does not work in isolation. It is firmly embedded within the global SUN Civil Society Network, which connects thousands of local and international organisations across dozens of country alliances. This connection gives the Pakistani alliance access to shared resources, technical assistance, and a platform for learning from other countries.

The relationship runs in both directions. Pakistani civil society leaders have taken on prominent roles within the global movement. For instance, a representative from the SUN Civil Society Alliance in Pakistan has chaired the global Steering Group of the SUN Civil Society Network, which is responsible for network-wide decision-making. This shows that the alliance is not merely a recipient of global support but an active shaper of the movement’s direction.

Why this case matters for civil society in South Asia 🔗

The SUN-CSA case illustrates several broader lessons about how civil society operates in South Asia. First, it shows the power of coalitions. By uniting hundreds of organisations under a single platform, civil society can speak with a louder and more credible voice than fragmented groups acting alone.

Second, it demonstrates that civil society’s most effective role is often complementary rather than oppositional. SUN-CSA works alongside the government, recognising official leadership while still pushing for stronger commitments. In 2025 the alliance, by then a coalition of over 170 organisations, adopted a joint declaration reaffirming its support for national nutrition goals, as reported by the Daily Independent. This collaborative posture allows civil society to remain influential without being shut out.

Third, the case highlights how advocacy can produce measurable outcomes. The shift from awareness campaigns to actual budget allocations and a national nutrition plan shows that sustained, organised pressure from civil society can move policy. For students of South Asian politics, SUN-CSA offers a clear model of how non-state actors can fill governance gaps and strengthen accountability in areas where state capacity alone falls short.

What do you think? Is collaboration with the government a more effective strategy for civil society than confrontation, or does it risk diluting independent advocacy? And how far should non-state actors like SUN-CSA be relied upon to address problems that are fundamentally the responsibility of the state?

References

1. https://www.unicef.org/pakistan/media/2861/file/NNS%20KFR.pdf
2. https://www.gainhealth.org/countries/pakistan
3. https://www.suncivilsociety.com/about-the-sun-civil-society-network/
4. https://scalingupnutrition.org/news/building-political-commitment-nutrition
5. https://www.sunpunjab.org/civil_society
6. https://www.suncivilsociety.com/alliances/scaling-up-nutrition-civil-society-alliance-pakistan-suncsapak/
7. https://scalingupnutrition.org/news/pakistani-sun-networks-meet-revisit-success-establish-plans-2024
8. https://scalingupnutrition.org/about-us/our-governance/our-networks/sun-civil-society-network
9. https://www.dailyindependent.com.pk/2025/08/22/civil-society-and-government-reaffirm-commitment-to-nutrition-highlighting-its-central-role-in-human-capital-and-national-security/