[afro-nets] A Funding Call for Nutrition

[Leela McCullough <leela@healthnet.org>]

A Funding Call for Nutrition
----------------------------

 From ProNutrition-HIV <pronut-hiv@healthnet.org>

A Funding Call for Nutrition
http://www.worldbank.org

Report: Repositioning Nutrition (5 MB PDF)

A new report calls for more funding to combat nutrition, 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 prob-
lem. Poor nutrition is implicated in more than half of all child
deaths worldwide a proportion unmatched by any infectious dis-
ease 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 im-
proving nutrition could add two to three percent to the growth
rates of poor countries.

And contrary to popular belief, it reveals the rates of malnu-
trition in South Asia are almost double those in Sub-Saharan Af-
rica.

"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 prob-
lem 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 per-
cent of children in the highest income bracket in India are un-
derweight and 65 percent are anaemic".

"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 malnutri-
tion 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 nutri-
tion. 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 malnutri-
tion 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 im-
prove 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 con-
tinuing 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 improve-
ments 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 is-
sue.

"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 commu-
nity to rally around this issue * to put resources, both techni-
cal 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 re-
search, complementing a recent Bank US $3.6 million grant to
help mainstream nutrition into maternal and child health pro-
grams. Concurrently substantive funding is needed for developing
countries through existing funding channels, to scale-up actions
to prevent malnutrition.

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Leela McCullough, Ed.D.
Director of Information Services
SATELLIFE
30 California Street, Watertown, MA 02472, USA
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