A new report calls for more funding to combat
malnutrition, but warns efforts should be targeted to pregnant women
and children under two. It warns that trying to improve nutrition in
children later in life is too late, too expensive and
ineffective.
March 2, 2006—A new World Bank report warns
unless action is taken within the first two years of a child’s life
to improve nutrition, children will suffer irreparable damage,
ultimately adversely affecting the country’s economic growth.
The report, Repositioning Nutrition as Central to
Development , says malnutrition remains the world’s most
serious health problem. Poor nutrition is implicated in more than
half of all child deaths worldwide – a proportion unmatched by any
infectious disease since the Black Death.
“Malnutrition is among the most serious health problems in the
world today that has not been tackled, “says Meera Shekar, the
report’s lead author. “Roughly 30% of children in the world are
undernourished and in fact 60% of children for example who die of
common diseases like malaria and diarrhea would not have died had
not they not been malnourished in the first place”
While criticizing the lack of large scale action internationally
and within countries to tackle malnutrition, the report says
improving nutrition could add two to three percent to the growth
rates of poor countries.
And contrary to popular belief, it reveals the rates of
malnutrition in South Asia are almost double those in
Sub-Saharan Africa.
“We find the problem is much more severe in South Asia, than in
Sub-Saharan Africa. Roughly 50 percent of children in
South Asia are undernourished as compared to about 25 percent in
Sub-Saharan Africa. But we also find that the problem is not limited
to those two regions alone. There are countries in other regions –
Indonesia, Uzbekistan, Yemen, Guatemala and Peru – where the problem
is acute as well.”
Not Just a Problem for the Poor
The report dispels the notion that malnutrition is simply a
problem for the world’s poor countries.
“Poor nutrition also exists elsewhere, thus suggesting it’s not
simply a question of access to food,” Shekar says. “India and
Ethiopia have about the same levels of malnutrition. And 26 percent
of children in the highest income bracket in India are underweight
and 65 percent are anemic.
“Anemic children perform less well in school, are more likely to
drop-out and have lower intellectual and physical productivity as
adults. Everyone talks about how well India is doing in the IT
industry –imagine how much better it could do, if 65 percent of the
richest and 88 percent of the poorest children were not anemic!”
As Shekar says, the developed world also faces the other side of
malnutrition – obesity.
“In the developed world, there’s the other aspect of malnutrition
that is coming up and that is the overweight agenda. And that links
very closely to non communicable disease like cardio-vascular heart
disease, diabetes and cancers.”
Small Window of Opportunity
Repositioning Nutrition as Central to Development also dispels
the notion that simply putting more food into the mouths of children
can overcome malnutrition. It says actions targeted to older
children have little, if any effect on improving nutrition. The
emphasis of any programs to combat nutrition should therefore target
pregnant women and children under two years of age.
“There is actually a very, very tight window of opportunity which
is between conception through the first two years of life,” Shekar
says. “If we miss this window, we miss a whole generation”
“This is the time when the damage that happens due to
malnutrition is in fact essentially irreparable damage. So if we had
only one dollar to invest in improving nutrition that is where we
would like to focus our actions.”
“Many people assume that feeding children later in life will
improve nutrition. Well, it’s too little, too expensive and too late
to improve nutrition or to improve future productivity.”
Need for a Re-Think
Shekar says it’s now time for the international community to
re-think the importance it places on the value of nutrition.
As the report says, “the unequivocal choice now is between
continuing to fail, as the global community did with HIV/AIDS for
more than a decade, or to finally put nutrition at the center of
development so that a wide range of economic and social improvements
that depend on nutrition can be realized.”
Shekar says in the past, the international community has thought
of nutrition merely as a food consumption issue or a welfare
issue.
“But the case we are making in this report is that nutrition is
an investment issue. It is something that can drive economic growth
rather than riding on the coat-tails of economic growth, because
children who are well-nourished have been shown to have much higher
income potential as adults.”
The report makes the point that malnutrition is costing poor
countries up to three percent of their yearly GDP. And with the
economies of many developing countries growing at a rate of two to
three percent annually, the report says improving nutrition could
potentially double those rates.
“I think the biggest challenge now is getting the donor community
to rally around this issue – to put resources, both technical and
financial, behind this issue. And at the same time, there’s a need
to build commitment among government partners as well to not only
invest in nutrition but invest in the right kinds of things for
nutrition.”
The report calls on the donor community to co-finance a grant
fund to jumpstart action in commitment-building and action research,
complementing a recent Bank US $3.6 million grant to help mainstream
nutrition into maternal and child health programs. Concurrently
substantive funding is needed for developing countries through
existing funding channels, to scale-up actions to prevent
malnutrition.
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