Friday, January 18, 2008

Chronic malnutrition

Chronic malnutrition
By Editor
Friday January 18, 2008 [03:00]

The existence of 47 per cent of our children under the age of five with chronic malnutrition constitutes an affront to all of us as a nation. A stable, permanent solution must be found for this serious problem. Meeting the basic needs of families must take priority in any government planning, with an agricultural policy that really respects the earth, the farmer and the consumer. Hunger in our society is a sign of gross injustice and a block to development.

We cannot continue to have people each day who cannot meet the basic needs necessary for a decent human life. It is a strict duty of justice and truth not to allow fundamental needs to remain unsatisfied. Economic justice requires that each individual has adequate resources to survive, to develop and thrive, and to give back in service to the community.
It has been long known that malnutrition undermines economic growth and perpetuates poverty. Yet we have failed to tackle malnutrition over the past decades, even though well-tested approaches for doing so exist. The consequences of this failure to act are now evident in our inadequate progress toward the Millennium Development Goals (MDGs) and more generally toward poverty reduction.

Persistent malnutrition is contributing not only to our failure to meet the first MDG – to halve poverty and hunger – but also to meet other goals in maternal and child health, HIV/AIDS, education, and gender equity. The unequivocal choice now is between continuing to fail, as we have done with HIV/AIDS for more than a decade, or to finally make nutrition central to development so that a wide range of economic and social improvements that depend on nutrition can be realised.

The returns to invest in nutrition are very high. Malnutrition slows economic growth and perpetuates poverty. And it does this through direct losses in productivity from poor physical status, indirect losses from poor cognitive function and deficits in schooling and losses owing to increased healthcare costs. Malnutrition’s economic costs are substantial: productivity losses to individuals are estimated at more than 10 per cent of lifetime earnings, and gross domestic product loss to malnutrition runs as high as two to three per cent. Improving nutrition is therefore as much – or more – of an issue of economics as one of welfare, social protection and human rights.

Reducing under-nutrition and micronutrient malnutrition directly reduces poverty, in the broad definition that includes human development and human capital formation. But under-nutrition is also strongly linked to income poverty. The prevalence of malnutrition is often higher among the poorest income quintile than among the highest quintile. This means that improving nutrition is a pro-poor strategy, disproportionately increasing the income-earning potential of the poor.

Improving nutrition is essential to reducing extreme poverty. Recognition of this requirement is evident in the definition of the first MDG, which aims to eradicate extreme poverty and hunger. The two targets are to halve, between 1990 and 2015: the proportion of people whose income is less than one dollar per day; the proportion of people who suffer from hunger – as measured by the percentage of children under five who are underweight.

Therefore, improving nutrition is in itself an MDG target.

Malnutrition and HIV/AIDS reinforce each other, so the success of HIV/AIDS programmes depend in part on paying more attention to nutrition.
Markets are failing to address the malnutrition problem wherever families do not have the money to buy adequate food or healthcare. Human rights and equity arguments, as well as economic return arguments, can be made for government to intervene to help such families. And the government should intervene because improved nutrition is a public good, benefiting everybody. For example, better nutrition can reduce the spread of contagious diseases and increase national economic productivity.
Under-nutrition’s most damaging effect occurs during pregnancy and in the first two years of life, and the effects of this early damage on health, brain development, intelligence, educability, and productivity are largely irreversible. Actions targeted at all the children have little, if any effect. With the government’s very limited resources, it is therefore advised that we focus our actions on this small window of opportunity, between conception and 24 months of age.
Income growth and food production, as well as birth spacing and women’s education are therefore important but long routes to improving nutrition. Shorter routes are providing health and nutrition education and services such as promoting exclusive breast feeding and appropriate complementary feeding, coupled with pre-natal care and basic maternal and child health services and micronutrient supplementation and fortification.

We need to reposition nutrition much higher in our development agenda.

But we are not alone with this problem. It is a problem that is affecting so many fellow Third World countries. Over 46 years have elapsed since the World Indicative Plan for Agriculture Development was presented within the framework of FAO in 1962. It reflected the difficult food and agricultural development situation at the time and established the guidelines for a programme that was, by the end of the 1980s, to make hunger and undernourishment mere bitter memories of an unpleasant past for the peoples of the Third World and turn the agricultural sector into a dynamic development factor instead of a traditionally stagnant and weak sector.

Over 34 years have, likewise, elapsed since the World Food conference in Rome in 1974, urgently convened in view of the massive famines and alarming decrease of food reserves recorded those years. On that occasion, the conference solemnly declared that hunger and undernourishment should be stamped out on the planet in 10 years and called on all nations to cooperate in an enormous effort for international food security.

The failure of these endeavours to achieve the basic and essential objective of supplying all human beings with enough food to develop their potentialities for enjoying a full life is today more evident than ever. The fact that today in 2008 about 47 per cent of Zambian children under the age of five suffer from chronic malnutrition and the near billion hungry people in the world – a terrifying and skyrocketing figure – are turning into a tragic irony the good intentions of the World Indicative Plan of reaching a calorie-intake level equal to the projected demand in the Third World by 1975, and that this intake surpassed by 10 per cent the required levels by 1985. It is obvious that the eradication of hunger as stated by the World Food Conference is simply one more well-meant although unsuccessful attempt of the kind that characterise the path of our countries’ negotiating positions in the world economy.

The so-called food crisis is not a recent phenomenon, although the current deep economic crisis contributes to its worsening. Strictly speaking, the food crisis, understood as widespread hunger and malnutrition among the broad masses of the population – so paradoxically in contrast with food over consumption by some minorities – has always been an avoidable component of colonialism, neo-colonialism and underdevelopment. The food crisis must be considered by the majority of the underdeveloped world as a secular, permanent condition of their precarious life. For them, the hypothetical recovery of the developed economies has almost no meaning, since not even the greatest economic booms of the system have been able to prevent the present of hunger and undernourishment in the Third World. For the hundreds of millions of hungry people living in our world, the food crisis is not a mere conceptual reference, but rather a tragic daily experience, a disgraceful reality for all humankind.

The painful truth is that, despite the goals to eradicate it, hunger persists and tends to grow.

And all this is happening in the midst of an unbridled arms race, senseless both because of its essence, dangerousness and dimensions, and because of the contrast between the huge resources spent in developing means for man’s extermination and our people’s vital and daily needs. The existence of large numbers of hungry and undernourished people in the world constitutes an affront to all mankind. A stable, permanent solution must be found for this serious problem.

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