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Malnutrition on the rise

December 23, 2012

MALNUTRITION is increasingly becoming a global phenomenon. Between 2010-12 about 870 million people were reported to be chronically undernourished in the world according to The State of Food Insecurity in the World report released by the Food and Agriculture Organisation of the UN.

Of these, 850 million live in the developing world. Pakistan showcases the extent of chronic malnutrition in all its complexity.

In recent times malnutrition has made headlines in the aftermath of the 2010 floods, when a Unicef report showed that more than 23 per cent of the population of Sindh was suffering from chronic malnutrition.

This figure was far above the WHO’s threshold of 15 per cent. Further confirmation of this growing problem has come from the National Nutrition Survey of 2012 (NNS), which says that more than 40 per cent of the population suffers from chronic malnutrition nationally.

More alarmingly, the NNS has shown that 43.7 per cent of children under five are stunted nationally, with another 15 per cent wasted. This should ring alarm bells and make the state managers and policymakers sit up.

The NNS indicates that low awareness of micronutrients such as iron, zinc, vitamin A, B complex and D is a factor contributing to malnutrition. Among other medically related factors adding to malnutrition include the low nutritional status of women due to inadequate intake of nutritious food and diseases such as diarrhoea, which prevents absorption of food.

However, this list of causative factors is largely related to health-focused reasons. The NNS is largely confined to exploring the health side of malnutrition while giving the occasional nod to the larger issue of agriculture and food security.

This approach currently informs the debate about malnutrition. Yet this appears to be changing, with increased attention being paid to agricultural growth and food policies being followed by governments and multinationals.

The new approach is beginning to link malnutrition and food policies in a causative relationship which has been overlooked so far. In particular, the issue of food security has assumed added significance against the backdrop of rising food prices and deepening poverty all over the world, especially in developing countries.

An indication of the severity of the problem of food availability and affordability was furnished by a number of reports by different government departments recently.

According to the latest government estimates the proportion of those living in a food-insecure state has grown to 58 per cent.This figure has come from the NNS.

Allied to this finding was the report released by the Planning Commission, which showed an increase of 130 per cent of the food basket between 2006 and 2011. This means ever-increasing spending on buying food. Different estimates have put the household budget spent on food purchase between 50-60 per cent.

The NNS also shows that food price escalation accentuates the nutrition gap between the rich and the poor, as the latter spent 13 per cent compared to five per cent of the former. This finding is in line with global trends.

While food security is linked to diverse, affordable and nutritious food domestically, it has also become inextricably intertwined with market speculation in food commodities.

In 2006, Merrill Lynch estimated that food speculation led to 50 per cent increase in the price of food items. In 2009, Goldman Sachs pocketed a tidy profit of $1 billion by speculating on food commodities, according to estimates of the World Development Movement.

It is no surprise then that a recent report released by the African Network on the Right to Food pinpointed the role of global food giants and market forces in causing food insecurity in most parts of the world.

Even in countries such as Ethiopia, where agricultural productivity is high, food insecurity and malnutrition persist because of food policies which are geared towards exporting agricultural produce.

This is observable in Pakistan too, where despite a bumper crop of wheat, prices are on an upward trajectory.

Given the multi-layered complexity of the problem, it is imperative to attack the issue from multiple fronts. A number of measures can be undertaken which can begin to address the problem and contribute to its amelioration.

First, the problem has to be viewed through the lens of the agricultural, nutrition and health framework in a wider effort to put together a coordinated response to this multi-layered issue.

On the health side of the malnutrition spectrum greater awareness regarding micronutrient deficiencies and fortifying foods with micronutrients would go a long way.

This has already produced some results where the use of iodised salt is concerned, as reported in the NNS. More importantly, the MCH (mother and child health) strategy, of which breastfeeding is an integral part, can contribute hugely to the health aspect.

In this regard the Child Nutrition and Breast Feeding Act, 2004, needs to be vigorously enforced to prevent baby formula milk flooding hospitals and health facilities.

As for the agricultural roots of malnutrition, there is a major need to introduce policies which encourage food sovereignty by promoting diverse, affordable and nutritious food in the domestic market. This means reining in corporate farming and fostering agricultural practices that contribute to domestic food sovereignty.

At a time of growing food price escalation, the government needs to make sure that social protection schemes are in place to protect poor people, similar to the public food distribution system being run by the Indian government. Alongside this curbing cartelisation of food production and distribution is a must.

Lastly, and more importantly, the right to food should be enshrined in the constitution and a rights-based approach to food should be actively promoted. This far-reaching step would cap all the suggested measures. Otherwise the spectre of a stunted, wasted generation will haunt us all.

The writer is an Islamabad-based development consultant and policy analyst.