Sadhana Ghimire, 23, makes sure to give her 18-month-old daughter nutritious food, such as porridge containing grains and pulses, in order to prevent stunting. Credit: Mallika Aryal/IPS

By José Graziano da Silva and Margaret Chan
ROME/GENEVA, Nov 13 2014 (IPS)

The scourge of malnutrition affects the most vulnerable in society, and it hurts most in the earliest stages of life. Today, more than 800 million people are chronically hungry, about 11 percent of the global population.

Undernutrition is the underlying cause of almost half of all child deaths, and a quarter of living children are stunted due to inadequate nutrition. Micronutrient deficiencies – due to diets lacking in vitamins and minerals, also known as “hidden hunger” – affects two billion people.Our food systems are simply not sustainable or healthy today, let alone in 2050, when we will have to feed more than nine billion people. We need to produce more food but also nutritious food and to do so in ways that safeguard the capacity of future generations to feed themselves.

Another worrying form of malnutrition – obesity – is on the rise. More than 500 million adults are obese as a result of diets containing excess fat, sugars and salt.

This exposes people to a greater risk of noncommunicable diseases – like heart disease, stroke, diabetes and cancer – now the top causes of death in the world. Poor diet and physical inactivity also account for 10 percent of the global burden of disease.

Many developing countries now face multiple burdens of malnutrition, with people living in the same communities – sometimes even the same households – suffering from undernutrition, hidden hunger and obesity.

These numbers are shocking and must serve as a global call to action.

Besides the terrible human suffering, unhealthy diets also have a detrimental impact on the ability of countries to develop and prosper – the cost of malnutrition, in all its forms, is estimated between four and five percent of global GDP.

Government leaders, scientists, nutritionists, farmers, civil society and private sector representatives from around the world will gather in Rome from Nov. 19 to 21 for the Second International Conference on Nutrition (ICN2). It is an opportunity they cannot afford to miss: making peoples’ right to a healthy diet a global reality.

Current food systems are unsustainable and unhealthy

Creating healthy and sustainable food systems is key to overcoming malnutrition in all its forms – from hunger to obesity.

Food production has tripled since 1945, while average food availability per person has risen by only 40 percent. Our food systems have succeeded in increasing production, however, this has come at a high environmental cost and has not been enough to end hunger.

Meanwhile, food systems have continued to evolve with an even greater proportion of food being processed and traded, leading to greater availability of foods with high energy, fats, sugars and salt.

Our food systems are simply not sustainable or healthy today, let alone in 2050, when we will have to feed more than nine billion people. We need to produce more food but also nutritious food and to do so in ways that safeguard the capacity of future generations to feed themselves.

Put simply: we need healthy and sustainable food systems – that produce the right balance of foods, in sufficient quantity and quality, and that is accessible to all – if we want to lead healthy, productive and sustainable lives.

Acting now

In preparation for ICN2, countries have agreed to a Political Declaration and a Framework for Action on nutrition containing concrete recommendations to develop coherent public policies in agriculture, trade, social protection, education and health that promote healthy diets and better nutrition at all stages of life.

The Framework for Action gives governments a plan for developing and implementing national policies and investments throughout the food chain to ensure healthy, diverse and balanced diets for all.

This can include strengthening local food production and processing, especially by family farmers and small-scale producers, and linking it to school meals; reducing fat, sugars and salt in processed food; having schools and other public institutions offer healthy diets; protecting children from marketing of unhealthy foods and drinks; and allowing people to make informed choices regarding what they eat.

While government health, agriculture, and education ministries should take the lead, this task includes all involved in producing, distributing and selling food.

The ICN2 Framework for Action also suggests greater investments to guarantee universal access to effective nutrition interventions, such as protection, promotion and support of breastfeeding, and increasing nutrients available to mothers.

Countries can start implementing these actions now. The first step is to establish national nutrition targets to implement already agreed-upon global targets, as set out in the Framework for Action. ICN2 is the time and place to make these commitments.

FAO and WHO are ready to assist countries in this effort. By transforming commitment into action and cooperating more effectively with one another and with other stakeholders, the world has a real chance of ending the multiple burdens of malnutrition in all its forms within a generation.

Edited by Kitty Stapp

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By Margaret Chan
GENEVA, Feb 23 2009 (IPS)

Countries at all levels of economic development are concerned about the impact of the financial crisis on health. If unemployment continues to rise, safety nets for social protection fail, savings and pension funds erode, and public spending drops, it is inevitable that people’s health will suffer.

The impact is direct when stress causes a rise in mental illness and in the use of tobacco, alcohol, and other harmful substances. It is made worse when health services cannot sustain the level of care that people need when they fall ill.

This prediction is not based on theory but on what has happened in past recessions, most of which have been less deep and of shorter duration than what most experts predict we are now facing.

Financial markets, economies and businesses are more closely interconnected than ever before. As we have seen, financial turmoil is contagious, moving rapidly from one country to another and spreading quickly from one sector to others. Making matters worse, particularly in developing nations, the financial crisis comes hard on the heels of food and fuel crises, which are estimated to have tipped more than 100 million people back into poverty.

The crisis thus comes at a precarious time for public health. We are in the midst of the most ambitious drive in history to tackle the root causes of poverty and reduce the gaps in health outcomes. No one wants this momentum to stall.

In past recessions, development aid was cut just when it was needed most. This must not happen again. We cannot afford to sacrifice hard-won gains in child and women’s health, in the fight against AIDS, TB, and malaria, and in building strong, health delivery systems. The financial crisis cannot be allowed to undermine our pursuit of the Millennium Development Goals.

In times of economic crisis, people in all countries tend to forego private care and turn to publicly-financed services. This comes at a time when public health systems in many countries -in both the developed and developing world- are already overstretched and underfunded.

In many low-income countries, more than 60 percent of domestically-sourced health spending is private, largely in the form of direct out-of-pocket payment. Economic downturn increases the risk that people will neglect health care and prevention. A drop in preventive care is particularly disturbing at a time when demographic ageing and a rise in chronic diseases are global trends.

We know, too, that women and young children are among the first to be affected by a deterioration in financial circumstances and food availability. Moreover, recent trends in international trade have left many countries with little self-sufficiency in the production of staple food items, a cornerstone of food security.

The World Health Organisation (WHO) recently held a high-level consultation that brought together Member States and experts from around the world representing donor agencies, development banks, national governments, and civil society. Five areas for action emerged from the discussion:

First, leaders in health must be prepared to speak out, unequivocally and on the basis of sound evidence. Regional institutions can be a powerful force in bringing countries together to exchange information in a rapidly-changing environment. The need to safeguard progress in health and ensure that donors keep their promises must become a focus in all meetings of global leaders.

Contingency planning must be based on high-quality information. The impact of the crisis will vary country by country. Early warning systems will require collaboration among organisations with complementary fields of expertise -economists working with health experts. WHO will be monitoring financial flows from governments and donors and looking carefully for signs that the utilisation of health care is falling.

Counter-cyclical public spending provides a means of reviving economies in those countries that can afford it. Aid will play a key role in providing a boost that many low-income countries cannot finance alone. The challenge is to ensure that spending genuinely helps the poor and positively effects health.

Renewing the focus on primary health care is crucial at a time of financial crisis. Primary health care stresses the importance of equity, solidarity, and gender. It is concerned with working towards universal coverage and the pooling of risk. It recognises that good health depends on access to clean water, sanitation, education, nutritious food, and many other factors -not just on health services alone.

Lastly, the financial crisis requires that the international health community ask some fundamental questions about the way we do business. We cannot afford duplication between different agencies. We must insist on co-ordinated modes of working that ensure maximum synergy among health programmes. The crisis has to be seen as a spur to reform of the UN development system, not a constraint. And, above all, we have to use this opportunity to make sure our joint efforts are aligned with countries’ priorities. It is they who face the toughest choices.

This crisis poses an enormous challenge to global health. But it also offers opportunities which we should not forego -to lay the foundations for more equitable and effective health systems in the future, and to rationalise and improve the way that international organisations work for the health of people throughout the world. (END/COPYRIGHT IPS)

(*) Margaret Chan is Director-General of the World Health Organisation (WHO).

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