A young Quechua mother, originally from Peru's southern Andes highlands, walks through the streets of Lima, carrying her young daughter in her lliclla (a colorful shawl made by native women in the Andes). A quarter of Peru's rural population under the age of five suffers from chronic malnutrition, clear evidence of inequality, which will have severe impacts on the rural child population. CREDIT: Wálter Hupiú / IPS

By Mariela Jara
LIMA, Mar 27 2024 (IPS)

Quechua farmer Felipa Noamesa, who lives in the southern Peruvian department of Cuzco, prepares a cream of fava bean soup for breakfast every morning with bread and vegetable soup with noodles. Her children are grown up, so her priority is that her five-year-old granddaughter does not suffer from anemia or malnutrition, two problems she frequently sees in her community.

“At my neighbors’ homes there are little children who don’t want to eat, who have swollen tummies, who have parasites, whose eyes look yellow and who fall asleep at school because they can’t stay awake,” the 44-year-old indigenous horticulturist told IPS during an interview at her plot of land in Paruro, the town where she lives with her husband, her daughter and her five-year-old granddaughter, Mayra, who she takes care of while her mother goes to school."Peru will have a couple of generations with much greater health problems, much lower productivity and many more restrictions to generate sustainable livelihoods in the broad sense." -- Carolina Trivelli

At their house they don’t eat beef, pork or lamb, but they do eat guinea pigs (Cavia porcellus), an Andean rodent of recognized nutritional value, which she raises in a small shed next to her house, close to their organic garden.

“For lunch I make broth, stew or roast guinea pig and combine it with fresh corn, potatoes, vegetables from my garden and cheese,” she said in her home in Paruro, the seat of the province of the same name, located more than 3,000 meters above sea level.

Peru, a country of 33 million people, faces a political and institutional crisis aggravated by the interim presidency of Dina Boluarte, who in December 2022 replaced Pedro Castillo, ousted and imprisoned for an attempt to seize control of all branches of power after less than 19 months in office.

The institutional crisis is compounded by an economic recession, the reduction of agricultural production due to climatic phenomena such as El Niño, and a poverty level that climbed to 30 percent in 2023, according to official provisional data.

Against this backdrop, the levels of anemia and malnutrition in children under five years of age are of concern.

According to official figures presented last year, chronic malnutrition affected 11.7 percent of the population, but with a greater impact in rural areas: 24 percent compared to seven percent in urban areas.

Other forms of malnutrition also present worrying indicators: 42 percent of the population aged six to 35 months has anemia, with a higher percentage in rural areas (51.5 percent) than in urban areas (39 percent). Meanwhile, nine percent of children under five years of age are overweight or obese.

In the Andes highlands department of Cuzco, with a population of 1.4 million divided among its 13 provinces, child malnutrition reaches 14 percent and anemia 51 percent. It is only surpassed by the central-western department of Huancavelica, which reports 29 percent child malnutrition. This situation reflects the harsh impact of inequality and poverty.

Felipa Noamesa, a 44-year-old Quechua farmer, stands in her vegetable garden in Paruro, a village in the southern Peruvian department of Cuzco. Malnutrition is a common problem in her community and her concern is to feed her young granddaughter a nutritional diet so that she will grow up strong and healthy. CREDIT: Mariela Jara / IPS

A price the whole country will pay

Carolina Trivelli, an economist and researcher at the Institute of Peruvian Studies, which has worked for more than 50 years in the country, said that as a result of the COVID-19 pandemic and the subsequent economic crisis, access to nutritious and healthy food for individuals and families has declined.

“Unfortunately chronic malnutrition stopped going down and has remained steady at around 11.7, 11.5, 12 percent over the last three to four years,” the former minister of Development and Social Inclusion during the government of Ollanta Humala (2011-2016) told IPS in an interview at her home in Lima.

She said this has to do with the specific situation of families, the public apparatus and structural conditions such as high food inflation that affects the ability of families in a context of recession to afford food in sufficient quantity and quality to combat malnutrition. In addition, there is anemia, overweight and obesity.

Trivelli said these three elements make up a set of malnutrition problems that particularly affect the most vulnerable groups, including children from the poorest socioeconomic sectors.

Economist and former Minister of Inclusion and Social Development of Peru, Carolina Trivelli, is interviewed in her home office in Lima. She warns about the cost that the country will pay over the next two generations due to the high level of chronic child malnutrition, a problem that she says should be a priority on the public agenda. CREDIT: Mariela Jara / IPS

When looking at the figures for consumption of food needed to address anemia and chronic child malnutrition, the difference between the consumption levels of the poorest 20 percent and the wealthiest 20 percent is enormous. So not only is there a problem of access to affordable food, but it is a major issue among the most vulnerable sectors.

“Peru is going to pay the cost of this, all Peruvians are going to pay it over the next two generations,” she warned.

The expert in agricultural economics said that “Peru will have a couple of generations with much greater health problems, much lower productivity and many more restrictions to generate sustainable livelihoods in the broad sense.”

Ernesto Fisher is mayor of San Salvador, a town in the province of Calca in the southern Peruvian Andes highlands region of Cuzco, which has one of the highest levels of chronic child malnutrition in the country. The municipal government has put a priority on attention to the problem, but he said they need the support of the central government to ensure drinking water and sanitation for the entire population. CREDIT: District of San Salvador

Focus on water and sanitation

Calca, another of Cuzco’s provinces, contains some of the municipalities with the most worrying rates of malnutrition and anemia. For example, in the municipality of San Salvador, population around 6,000, child anemia stands at 26 percent.

This fact is related to the quality of their housing, most of which is in a precarious condition, while they have low levels of access to services, especially those who live in the countryside.

“From the mayor’s office we are prioritizing food security projects for raising chickens and guinea pigs so that families can improve their nutritional intake, and we are also delivering iron syrup to health posts to be supplied to children and their mothers,” the mayor, Ernesto Fisher, told IPS from San Salvador.

In a telephone interview, Fisher, in office since 2022, said that to eradicate the problem it is necessary to address water and sanitation deficiencies in his town. To this end, the municipal government is designing projects aimed at guaranteeing water resources for irrigation of family crops, drinking water and sewage services connected to the public network.

“Without sanitation it is impossible to talk about fighting anemia and malnutrition. We will not be able to complete it in this administration, but we will leave the projects on track so that eight years from now all of San Salvador will have running water and sanitation,” he promised.

He called on the national authorities, especially President Boluarte, to prioritize projects that help close inequality gaps such as securing water for different uses. “The rest will come later,” the mayor said, stressing that this should be the top priority.

Boiled ears of fresh corn, pieces of cheese and beans, and roasted corn are common foods in the diet of rural Andean families in Peru. However, the decline in agricultural production due to droughts and other climatic events has reduced their access in quantity and quality. CREDIT: Mariela Jara / IPS

It’s not just about budget funds

Peru’s public policies reduced chronic child malnutrition between 2008 and 2016, as documented by the World Bank, which pointed to it as a successful experience.

However, the current situation shows that the problem is no longer seen as a priority. Trivelli said that it is not just a question of budget funds, but of combining multiple efforts simultaneously so that resources are spent effectively.

“We can give a family all the food and training they need, but if they don’t have sewage, a safe water source, and proper solid waste management, the problems of chronic malnutrition and anemia are not going to be reduced. If those children go to a school that does not have toilets, we will continue to reproduce the cycle,” she said.

Statistics show that it is the poorest people in rural areas and children who are directly affected by policies that do not place them at the center of their actions.

Trivelli argued that anemia and chronic malnutrition in children should be considered a priority problem of public interest addressed by a body at the highest political level, such as the Presidency of the Council of Ministers, in order to overcome the current scattered approach.

“We are not talking about a health issue only but about a crisis of food, development and poverty, and it needs to be part of the public agenda,” she insisted.

Mother’s group in Accham feed home-cooked meal to their children. Credit: MARTY LOGAN

By Sonia Awale
KATHMANDU, Nov 8 2019 (IPS)

For the first two decades after 1990, Nepal took great strides in reducing malnutrition. But progress has stalled.

Nepal registered one of the most dramatic reductions in undernourishment among children and women after the government and international agencies took action in recent decades to reverse shocking statistics that showed half of under-5 mortality in the country was due to insufficient nourishment.

“Nepal is the best country to showcase how political will can implement a multisectoral nutrition program,” says Brenda Kellen, director of Scaling Up Nutrition (SUN), which is holding a global nutrition conference in Kathmandu this week.

“From being one of the countries with the highest malnutrition in the 1990s, with stunting at 57%, to have reduced it to 36% — Nepal can offer lessons for the rest of the world and its model can be replicated elsewhere,” says Kellen, who added that holding the fifth SUN global gathering in Kathmandu was recognition of this achievement.

Over 1,000 delegates from 61 countries are attending the conference to discuss the progress, challenges and priorities ahead to ending malnutrition by 2030, a target set by the United Nations’ World Health Assembly.

However despite initial progress, figures for stunting, wasting and anaemia in Nepal have plateaued. UNICEF’s report, State of the World’s Children 2019, released last month, stated that 43% of children under five in Nepal were malnourished.

“Malnutrition is still very much prevalent in Nepal, mainly among young children, adolescents and new mothers. We are not satisfied with the progress and there is still much to do,” says Anirudra Sharma at UNICEF Nepal.

According to the 2016 Demographic and Health Survey (DHS) wasting (low weight for age) among Nepali children under 5 still hovers at 10% — a mere 1% decrease from 8 years ago. The UN’s Sustainable Development Goals (SDGs) require Nepal to reduce wasting to less than 5% by 2030. Stunting needs to be well below 15% in 10 years to meet the global target — it is about 36% now.

Says Swarnim Waglé, former vice-chair of the National Planning Commission who helped draw up Nepal’s Multi-Sectoral Nutrition Plan: “While a 20% reduction of chronic malnutrition in two decades is quite impressive, 36% stunting is still very high and unacceptable in this day and age. Conventional approaches will not help achieve targets.”

Anaemia among Nepali women has always been very high, but instead of declining it actually increased from 35% to 41% between 2011 and 2016. Anaemia in children below 5 rose dangerously in that period: from 46% to 53%.

Exclusive breastfeeding in the first 6 months also declined, and is now 65% against a target of greater than 90%. There has been no significant change in low birth weight either, which declined only 2%, to 27%, in five years. The SDG target is below 5%.

“Improvements in nutrition levels are stagnant because we have not reached the most vulnerable communities such as Dalits and people in remote far western Nepal,” says public health expert Aruna Uprety. “I see no reason to boast about our past achievements when the present level of chronic malnutrition is so serious.”

Nutrition levels are affected not just by food intake, but access to safe drinking water and education about the right selection of food. Underweight children in cities and the rise in obesity are a result of the proliferation of junk food replacing traditional nutrient-rich grains. Childhood obesity has decreased from 1.4% in 2011 to 1.2% but the figure needs to drop below 1% to meet the target.

An article in The Journal of Nutrition earlier this year found that infants in Kathmandu were getting 25% of their calories from junk food and instead of being fat, those who consumed the most junk food were on average shorter than their peers.

Brenda Kellen agrees that while there is a lot of concern about hunger and food security, there is not as much awareness about whether food is nourishing or not.

“Let’s look at all the tools available to reduce malnutrition. Fortifying foods can mean that people get micronutrients but it should go hand in hand with promotion of locally produced foods,” Kellen says.

Nutritionists believe that Nepal is on the right track, but it needs to make nutrition a political priority, scale up its programs throughout the country and target groups susceptible to malnutrition.

UNICEF’s Sharma says: “Nutrition should be universal, households should not be left behind. The government has to increase national investment on raising nutrition standards.”

Private sector for nutrition?

Do the private sector and nonprofits have a role in reducing malnutrition? Does their involvement allow the government to shirk its responsibility of ensuring equitable nutrition?

Brenda Kellen of the Scaling Up Nutrition Movement

The issue arose this week at a global conference on nutrition in Kathmandu. Among the 1,000 delegates attending the global gathering are representatives of Scaling Up Nutrition (SUN) Business Network, which tries to build strong alliances between the private sector and government to reduce malnutrition.

“There are many small scale enterprises that are looking for opportunities to provide local solutions to nutrition-related challenges,” says Brenda Kellen (pictured left) of the Scaling Up Nutrition Movement, which is behind the global gathering in Kathmandu, 4-7 November.

In fact, Nepal’s Multi-Sectoral Nutrition Plan 2018-2022 underlines the need for government to partner with business. Experts say that while it makes sense to involve food manufacturers and traders to improve nutrition, there is an inherent contradiction between businesses that are out to maximise profits and the need to ensure nutrition for communities that cannot afford adequate food.

Nutrition activist Aruna Uprety is against private sector involvement in ensuring proper nutrition for all. “If you involve businesses they will look first for profit, not adequate nourishment. It is 100% the government’s job to reduce malnutrition.”

Uprety says last week she left the Baliyo Nepal Nutrition Initiative, which is supported by the Bill and Melinda Gates Foundation (BMFG), because it would mobilise Nepal’s private sector food companies to raise nutrition levels among Nepalis. Baliyo Nepal was launched by President Bidya Devi Bhandari on 1 November (pictured below).

Baliyo Nepal was dragged into controversy recently after one of its backers, the Chaudhary Foundation, told the media that BMFG funding would be used to fortify its popular instant noodle brand Wai Wai. BMFG did test instant noodle fortification, but Waglé says the initiative was not taken any further.

He told Nepali Times: “We are not touching any junk food. We want to make nutrition affordable for all Nepalis and collaborate with companies to meet the demand. We are creating a sustainable and independent approach to meet malnutrition targets.”

Some experts argue that nutrient fortification of food brands has been successful in Nepal in the past. Iodisation of the Ayo Noon brand of salt helped eradicate goitre and cretinism in Nepal in the 1990s.

Whatever the merits of involving the private sector in ensuring nutrition for all, the real scandal is one in three Nepali children are still malnourished.

This story was originally published by The Nepali Times

Excerpt:

A bakery shop in Cairo, Egypt. Egyptian flatbread, known as Aish baladi or country bread is on the table of all Egyptians, even the poorest, thanks to a smartcard system that assigns certain quantities to each family to avoid unnecessary waste.

By Maged Srour
CAIRO, Apr 18 2019 (IPS)

“Unfortunately the overall nutritional panorama of Egypt does not look well,” says Dr. Sara Diana Garduno Diaz, an expert concentrating on nutrition and biology at the American University of the Middle East. Diaz’s research focuses on dietary patterns and ethnic-associated risk factors for metabolic syndrome.

“While traditionally a country known for its lavish and welcoming food patterns, the quality of eating has been compromised,” she tells IPS.

Her findings are echoed by Oliver Petrovic, Chief of Health and Nutrition at the United Nations Children’s Fund (UNICEF), Egypt: “Unhealthy foods such as sugary biscuits, candy, chips and cakes, make up one-third of the foods consumed daily by Egyptian infants.”

Child consumption of sugary snack foods was associated with a 51 percent higher likelihood of being part of a ‘stunted child and obese mother’ household, Petrovic tells IPS. “Only about half of children under two consume iron rich foods,” he adds.

In a country where one in five children are stunted or too short for their age, malnutrition accounts for 35 percent of the disease burden in children younger than five, warns the Food and Agriculture Organization of the United Nations (FAO).

The definition of stunting, according to UNICEF, “is a measure of chronic malnutrition; it reflects inadequate nutrition over a long period, or effects of recurrent or chronic illnesses.” 

A 2018 UNICEF report on Egypt explains maternal and child malnutrition are influenced by inadequate dietary intake and disease. The report further states that inadequate dietary intake refers to poor access to “a balanced diet among the poorest sections of society, as well as poor dietary habits, lifestyle and lack of nutritional awareness across the population, as opposed to issues of food availability.”

It also notes that not being able to optimise breast feeding plays a role in this. In addition, poor sanitation and hygiene are also underlying causes of malnutrition. 

“Traditional eating practices of the entire region relied heavily on seasonal and local foods, slow cooking methods, communal eating and avoidance of food waste but more recently habits such as rushing meals and preference for cheaper sources of energy are becoming the norm,” Diaz points out.

Junk food is on the rise

And the negative consequences of this extends over time.

FAO estimates that between two and six percent of stunted children become stunted adults who are less productive than adults of normal stature. Increased morbidity and mortality; decreased cognitive, motor, language and socio-emotional development; and an increase in non-communicable diseases like diabetes and heart conditions are some of the short- and long-term effects of stunting.

“It is important to be aware of the crucial importance of a proper nutrition in the first years of life. They have a profound effect on a child’s future. These years are a critical early window of opportunity to provide the nutrition, protection, bonding and stimulation that children need to reach their full potential,” Petrovic tells IPS.

“Adequate nutrition, safe environments and responsive adult caregiving are the best ways to support healthy brain development,” he adds.

On the other hand, the undernourishment rate in the total Egyptian population between 2014 and 2016 was less than five percent according to the World Food Programme. Undernourishment, according to FAO, is “an estimate of the proportion of the population whose habitual food consumption is insufficient to provide the dietary energy levels that are required to maintain a normal active and healthy life.” 

The prevalence of five percent is the same as most industrialised countries, showing that the situation is not as critical as in sub-Saharan Africa. In Zambia, Zimbabwe and Malawi, for instance, one in every three people is undernourished.

Egypt and food challenges: high score in ‘food loss and waste’, poor score in ‘dietary patterns’

But the problem lies not only with Egypt. All Arab countries face complex food challenges, as identified by the Food Sustainability Index (FSI), developed by the Economist Intelligence Unit with the Barilla Center for Food and Nutrition (BCFN).

Each country  is ranked according to food loss and waste, sustainable agriculture and nutritional challenges. According to the FSI Whitepaper 2018, Egypt ranked 50th out of 67 countries analysed worldwide for malnourishment, making it one of four countries not from sub-Saharan African that were ranked in the bottom 20.  The other three nations are Saudi Arabia, India and Indonesia.

However, overall Egypt scored moderately for nutritional challenges. The rather good result obtained in the ‘life quality’ category, did not sufficiently offset the very low results obtained in the ‘lifestyle’ and ‘dietary patterns’ categories.

Food loss and waste: the ‘smartcard system’ in Egypt

Arab countries all ranked low in the FSI with regards to food loss and waste. Saudi Arabia and the United Arab Emirates (UAE) were ranked the 29th and 35th performing countries respectively for food loss and waste among 35 high-income countries, while Egypt ranked 10th out of 23 middle-income countries.

Egypt has specifically introduced a measure–a smartcard system–that has limited the problem nationally.

The programme, which impacts about 80 percent of the Egyptian population, establishes the maximum daily amount of subsidised bread that can be requested by each family member.

As a result, food waste has decreased considerably and other countries like Jordan are considering implementing this model to avoid waste on subsidised basic food items.

What can be done?

Egypt certainly lives in a situation of great vulnerability regarding nutritional challenges.

The aridity of the region places pressure on agriculture and the Nile alone is not enough to satisfy the needs of more than 90 million inhabitants. Much of the Nile water is used for agriculture and inefficient water management at local level can lead to scarcity of supply to entire communities. Moreover, climate change amplifies all these challenges.

The rise in prices of foodstuffs has also forced millions of Egyptians to adopt a less expensive but also less healthy lifestyle.

To reverse the current trends of malnutrition (high prevalence of stunting, increasing underweight and increasing overweight at the same time), requires careful consideration of the common causes and a complex, multisector approach to address the underlying causes.

“At the policy level, UNICEF and the World Bank have worked on better understanding of the problem,” Petrovic tells IPS.

“They have supported the Egyptian Ministry of Health and Population (MoHP) in developing an investment case, with in-depth analysis of the situation and with the proposed and costed interventions needed to reduce stunting. UNICEF is also providing technical support to the Ministry of Health and Population in revising the Nutrition Strategy and developing the new and costed action plan for nutrition,” he adds.

Overall, the picture of food security in Egypt appears positive and negative at the same time. The situation must be kept under control by authorities, farmers and all Egyptians themselves.

“In my opinion it is not a question to be addressed exclusively by policymakers,” says Diaz.

“I believe the solution requires changes at an individual and community (home) level. These changes of course require support from policymakers, for example, through nutrition education programmes, micro-loans to boost local farmers and other local food production initiatives and infrastructure to improve food security.

“The policies may exist or be under developed but will remain useless unless they are accepted and implemented by the people.”

AfDB President Akinwumi Adesina adressing delegates at the nutrition event while Ambassador Kenneth Quinn, World Food Prize Foundation, listens. Credit: Friday Phiri/IPS

By Friday Phiri
AHMEDABAD, India, May 24 2017 (IPS)

Developing Africa’s ‘grey matter infrastructure’ through multi-sector investments in nutrition has been identified as a game changer for Africa’s sustainable development.

Experts here at the 2017 African Development Bank’s Annual Meetings say investing in physical infrastructure alone cannot help Africa to move forward without building brainpower.“We can’t say Africa is rising when half of our children are stunted.” --Muhammad Ali Pate

“We can repair a bridge, we know how to do that, we can fix a port, we know how to do it, we can fix a rail, we know how to do that, but we don’t know how to fix brain cells once they are gone, that’s why we need to change our approach to dealing with nutrition matters in Africa,” said AfDB President, Akinwumi Adesina, pointing out that stunting alone costs Africa 25 billion dollars annually.

Malnutrition – the cause of half of child deaths worldwide – continues to rob generations of Africans of the chance to grow to their full physical and cognitive potential, hugely impacting not only health outcomes, but also economic development.

Malnutrition is unacceptably high on the continent, with 58 million or 36 percent of children under the age of five chronically undernourished (suffering from stunting)—and in some countries, as many as one out of every two children suffer from stunting. The effects of stunting are irreversible, impacting the ability of children’s bodies and brains to grow to their full potential.

On a panel discussion Developing Africa’s Grey Matter Infrastructure: Addressing Africa’s Nutrition Challenges” moderated by IFPRI’s Rajul Pandya-Lorch, experts highlighted the importance of urgently fighting the scourge of malnutrition.

Laura Landis of the World Food Programme (WFP) said the cost of inaction is dramatic. “We have to make an economic argument on why we need action,” she said. “The WFP is helping, in cooperation with the African Union and the AfDB, to collect the data that gets not just the Health Minister moving, but also Heads of State or Ministers of Finance.”

The idea is to get everyone involved and not leave nutrition to agriculture and/or health ministries alone. And panelists established that there is indeed a direct link between productivity and growth of the agriculture sector and improved nutrition.

Baffour Agyeman of the John Kuffuor Foundation puts it simply: “It has become evident that it is the quality of food and not the quantity thereof that is more important,” calling for awareness not to end at high level conferences but get to the grassroots.

Assisting African governments to build strong and robust economies is accordingly a key priority for the AfDB. But recognizing the potential that exists in the continent’s vast human capital, the bank included nutrition as a focus area under its five operational priorities – the High 5s.

And to mobilise support at the highest level, the African Leaders for Nutrition (ALN) initiative was launched last year, bringing together Heads of State committed to ending malnutrition in their countries.

As a key partner of this initiative, the Bill and Melinda Gates Foundation foresees improved accountability with such an initiative in place. “ALN is a way to make the fight against malnutrition a central development issue that Ministers of Finance and Heads of State take seriously and hold all sectors accountable for,” said Shawn Baker, Nutrition Director at the Foundation.

However, African Ministers of Finance want to see better coordination and for governments to play a leading role in such initiatives to achieve desired results. “Cooperation and coordination are key between government and development partners,” said Sierra Leone’s Finance and Economic Development Minister Momodu Kargbo. “Development partners disregard government systems when implementing programmes whereas they should align and carefully regard existing government institutions and ways of working.”

Notwithstanding the overarching theme of Africa rising, Muhammad Ali Pate, CEO of Big Win Philanthropy, says, “We can’t say Africa is rising when half of our children are stunted.” He pointed out the need to close the mismatch between the continent’s sustained GDP growth and improved livelihood of its people.

With the agreed global SDG agenda, Gerda Verburg, Scaling Up Nutrition Movement Coordinator sees nutrition as a core of achieving the goals. “Without better nutrition you will not end poverty, without better nutrition you will not end gender inequality, without better nutrition you will not improve health, find innovative approaches, or peace and stability, better nutrition is the core,” she says.

Therefore, developing Grey Matter Infrastructure is key to improving the quality of life for the people of Africa. But it won’t happen without leadership to encourage investments in agriculture and nutrition, and more importantly, resource mobilization for this purpose.

Students at the “República de Venezuela” School in the indigenous Lenca village of Coloaca in western Honduras, where they have a vegetable garden to grow produce and at the same time learn about the importance of a healthy and nutritious diet. Credit: Thelma Mejía/IPS

By Thelma Mejía
COALACA, Honduras, Jul 15 2016 (IPS)

Barely 11 years old and in the sixth grade of primary school, this student dreams of becoming a farmer in order to produce food so that the children in his community never have to go hungry. Josué Orlando Torres of the indigenous Lenca people lives in a remote corner of the west of Honduras.

He is part of a success story in this village of Coalaca, population 750, in the municipality of Las Flores in the department (province) of Lempira.

Five years ago a Sustainable School Feeding Programme (PAES) was launched in this area. It has improved local children’s nutritional status and enjoys plenty of local, governmental and international participation.

Torres is proud of his school, named for the Republic of Venezuela, where 107 students are supported by their three teachers in their work in a “teaching vegetable garden”. They grow peas and beans, fruit and vegetables that are used daily in their school meals.

Torres told IPS that he did not used to like green vegetables, but now “I’ve started to like them, and I love the fresh salads and green juices.”

Josué Orlando Torres, an 11-year-old student, dreams of becoming a farmer to ensure that children like himself have access to free high-quality food at this school in the indigenous community of Coloaca, where a sustainable school programme is beginning to overcome chronic malnutrition. Credit: Thelma Mejía/IPS

“Here they taught us what is good for us to eat, and also to plant produce so that there will always be food for us. We have a vegetable garden in which we all plant coriander, radishes, cucumbers, cassava (yucca), squash (pumpkin), mustard and cress, lettuce, carrots and other nutritious foods,” he said while indicating each plant in the school garden.

When he grows up, Torres does not want to be a doctor, engineer or fireman like other children of his age. He wants to be “a good farmer to grow food to help my community, help kids like me to be well-fed and not to fall asleep in class because they had not eaten and were ill,” as happened before, he said.

The 48 schools scattered throughout Las Flores municipality, together with other schools in Lempira province, especially those located within what is called the dry corridor of Honduras, characterised by poverty and the onslaughts of climate change, are part of a series of sustainable pilot projects being promoted by the Food and Agriculture Organization of the United Nations (FAO), and PAES is one of these.

The purpose of these sustainable school projects is to improve the nutritional status of students and at the same time give direct support to small farmers, by means of a comprehensive approach and effective local-local, local-regional and central government-international aid  interactions.

As a result of this effort in indigenous Lenca communities and Ladino (mixed indigenous-white or mestizo) communities such as Coalaca, La Cañada, Belén and Lepaera (all of them in Lempira province), schoolchildren and teachers alike have said goodbye to fizzy drinks and sweets, and undertaken a radical change in their food habits.

Parents, teachers, students, each community and municipal government, three national Secretariats (Ministries) and FAO have joined forces so that these remote Honduran regions may see off the problems of famine and malnutrition that once were rife here.

A family production chain was developed to supply the schools with food for their students, who average over 100 at each educational centre, complementing the school vegetable gardens.

Every Monday, small farmers bring their produce to a central distribution centre, and municipal vehicles distribute it to the schools.

View of Belén, a town that is the head of a rural municipality of the same name amid the mountains of western Honduras, in the department (province) of Lempira, where a programme rooted in local schools is improving nutrition among remote indigenous communities. Credit: Courtesy of Thelma Mejía

Erlín Omar Perdomo, from the village of La Cañada in Belén municipality, told IPS: “When FAO first started to organise us we never thought things would go as far as they did, our initial concern was to stave off the hunger there was around here and help our children to be better nourished.”

“But as the project developed, they trained us to become food providers as well. Today this community is supplying 13 schools in Belén with fresh, high-quality produce,” the community leader said with satisfaction.

They organised themselves as savings micro-cooperatives to which members pay small subscriptions and which finance projects or businesses at lowinterest rates and without the need for collateral, as required by banks, or for payment of abusive interest rates, as charged by intermediaries known as “coyotes”.

“We never dreamed the project would reach the size it is today. FAO sent us to Brazil to see for ourselves how food was being supplied to schools by the families of students, but, here we are and this is our story,” said the 36-year-old Perdomo.

“We all participate, we generate income and bring development to our communities, to the extent that now the drop-out rate is practically nil, and our women have also joined the project. They organise themselves in groups to attend the school every week to cook our children’s food,” he said.

Rubenia Cortes, a mother and volunteer cook at the school in the remote village of La Cañada in the department (province) of Lempira, in western Honduras. They cook in a kitchen that was built by parents and teachers at the school. Credit: Courtesy of Thelma Mejía

A 2012 report by the World Food Programmme (WFP) indicated that in Central America, Honduras had the second worst child malnutrition levels, after Guatemala. According to the WFP, one in four children suffers from chronic malnutrition, with the worst problems seen in the south and west of the country.

But in Coalaca, La Cañada and other nearby villages and small towns, the situation has begun to be reverted in the past five years. The FAO project is based on the creation of a new nutritional culture; an expert advises and educates local families in eating a healthy and balanced diet.

“We don’t put salt and pepper on our food any more. We have replaced them with aromatic herbs. FAO trained us, teaching us what nutrients were to be found in each vegetable, fruit or pulse, and in what quantities,” said Rubenia Cortes.

“Look, our children now have beautiful skin, not dull like before,” she explained proudly to IPS. Cortes is a cook at the Claudio Barrera school in La Cañada, population 700, part of Belén municipality where there are 32 PAES centres.

Cortes and the other women are all heads of households who do voluntary work to prepare food at the school. “Before, we would sell our oranges and buy fizzy drinks or sweets, but now we do not; it is better to make orange juice for all of us to drink,” she said as an example.

From Monday to Friday, students at the PAES schools have a highly nutritious meal which they eat mid-morning.

The change is remarkable, according to Edwin Cortes, the head teacher of the La Cañada school. “The children no longer fall asleep in class. I used to ask them, ‘Did you understand the lesson?’ But what could they answer? They had come to school on an empty stomach. How could they learn anything?” he exclaimed.

In the view of María Julia Cárdenas, the FAO representative in Honduras, the most valuable thing about this project is that “we can leave the project, but it will not die, because everyone has appropriated it.”

“It is highly sustainable, and models like this one overcome frontiers and barriers, because everyone is united in a common purpose, that of feeding the children,” she told IPS after giving a delegation of experts and Central American Parliamentarians a guided tour of the untold stories that arise in this part of the dry corridor of Honduras.

There are 1.4 million children in primary and basic secondary schooling in Honduras, out of a total population of 8.7 million people. Seven ethnic groups live alongside each other in the country, of which the largest is the Lenca people, a group of just over 400,000 people.

Edited by Estrella Gutiérrez/ Translated by Valerie Dee

Nearly half the children in drought-stricken South Madagascar are malnourished. Credit: Miriam Gathigah/IPS

By Miriam Gathigah
AMBOVOMBE, Madagascar, Jul 8 2016 (IPS)

Voahevetse Fotetse can easily pass for a three-year-old even though he is six and a pupil at Ankilimafaitsy Primary School in Ambovombe district, Androy region, one of the most severely affected by the ongoing drought in the South of Madagascar.

“Fotetse is just like many of the pupils here who, due to chronic malnutrition, are much too small for their age, they are too short and too thin,” explains Seraphine Sasara, the school’s director.

The school has a total population of 348 – 72 boys and 276 girls – and they range from three to 15 years. Fewer boys stay in school as they spend most of their time helping on the farm or grazing the family livestock.

The tide, however, turns when the girls reach 15 years, at which point most are withdrawn from school and married off.

But in school or out of school, nearly half of the children in Southern Madagascar have not escaped malnutrition. The United Nations World Food Programme (WFP) says that stunting –  where children are too short for their age – affects at least 47 percent of children under five.“I feed my eight children on rice for breakfast and supper but for lunch, they have to eat cactus fruits." -- Mamy Perline

Compared to acute malnutrition, which can develop over a short period and is reversible, stunting has more far-reaching consequences.

“Stunting is a gradual and cumulative process during the 1,000 days from conception through the first two years of a child’s life,” Sasara told IPS.

It develops as a result of sustained poor dietary intake or repeated infections, or a combination of both.

“It is not just about a child being too short for their age, it has severe and irreversible consequences including risk of death, limited physical and cognitive capacities,” Sasara said.

Statistics show that two million children in this Southern African country are stunted, placing Madagascar fourth in the “Global Chronic Malnutrition” table.

In February this year, though the global acute malnutrition level reached an average of eight percent, it is much higher in many regions in Southern Madagascar where most districts have surpassed the critical threshold of 10 percent.

Rainfall deficit and recurrent drought in Southern Madagascar has led to the deterioration of household food security, which has had a significant impact on the nutritional status of children under five.

Sasara says that the situation has been worsened by the rice eating culture across Madagascar “where children eat rice for breakfast, lunch and supper.”

But Mamy Perline told IPS that even rice is not always available. “I feed my eight children on rice for breakfast and supper but for lunch, they have to eat cactus fruits,” she said.

According to the WFP, which runs a school feeding programme in affected districts, Tsihombe district in Androy region is the most affected, with an average of 14 percent of children under five presenting signs of acute malnutrition.

WFP estimates show that nearly 50 percent of the Malagasy children under five suffer from iron deficiency which causes anemia.

Consequently, of every 1,000 live births, 62 result in children dying before they reach five years.

The lack of clean water and proper sanitation has compounded the situation facing the South.

The education sector continues to bear the brunt of the severe drought, with statistics by various humanitarian agencies including WFP showing that the net primary education enrolment rate in Madagascar is on a downward spiral.

Though an estimated 96.2 percent of children were enrolled in 2006, the number had dwindled to 69.4 percent in 2012, with Sasara saying that the current enrolment is likely to be much lower as children are too hungry to stay in school.

This is the case in Tanandava village, Amboasary district, Anosy region, where hundreds of out of school children gather each day to receive a meal from the village canteen offered by Catholic Relief Services, a humanitarian agency working in the area.

WFP statistics further show that the number of out of school children between six and 12 years is estimated at 1.5 million, with regions such as Anosy, Androy and Atsimo Andrefana in the South of Madagascar which have high rates of food insecurity posting alarmingly low levels of school performance.

Since 2005 WFP has implemented a school feeding programme, providing daily fortified meals to nearly 300,000 children in 1,300 primary schools in the south of the country but also in the urban slums of Antananarivo, Tulear and Tamatave.

“The meals are fortified with micronutrients and are crucial in breaking the malnutrition cycle in this country,” Sasara said.

The school feeding programme is a joint community effort where parents are involved in the preparation of the food, therefore providing a platform for the implementation of other interventions geared towards improving the health and nutrition of vulnerable children.

These interventions access to water and sanitation, which are twin problems in this region.

“When it rains and water collects in potholes on the road, this is the water we collect in containers for drinking, cooking and washing. It does not matter how many cars or people have stepped into the water, it is the only source we have,” says Perline.

Given the increase in acute malnutrition, a contributing factor to child mortality, WFP supports the National Office for Nutrition through its Regional Office for Nutrition, which continues to provide supplementary feeding programs for the treatment of moderate acute malnutrition across villages in the South.

“Treating children affected by moderate acute malnutrition can reduce drastically the number of those affected by severe acute malnutrition and to restore an adequate nutritional status,” says Yves Christian, Head of Regional Office for Nutrition.

WFP is further providing technical assistance to the government at various levels that is expected to result in a nationally owned school feeding programme.

New modalities of school feeding will also be piloted at the start of the next school year later in September 2016.

Despite severe malnutrition among children, which erstwhile Indian PM Dr Manmohan Singh called a "national shame", India has still not prioritised breastfeeding. Credit: Neeta Lal/IPS

By Neeta Lal
NEW DELHI, Jun 1 2016 (IPS)

The recent launch of Amaara, New Delhi’s first human milk bank, has been greeted with much cheering. The initiative endorses the long-term goal of reducing infant mortality and addresses the critical issue of lack of mothers’ milk for physically fragile newborns in India’s capital city.

The service couldn’t have come a day too soon. India, a nation of 1.25 billion people, has the world’s highest number of low birth weight babies, with a critically high Neo-natal Mortality Rate (NMR) rate described as deaths in the period of 0-28 days per thousand live births. India witnessed 28 deaths per 1,000 live births in 2013 and an Infant Mortality Rate (IMR) of 40 in the age 0-1 year per thousand live births according to the Annual Report of India’s Ministry of Health and Family Welfare.

Of the 26 million babies born in India every year, one million babies are blighted before they reach the age of one month. Despite reducing child mortality – from 2.3 million deaths of children under the age of five in 2001 to 1.4 million in 2012 – India still accounts for 20 percent of infant mortality globally.

Many of these needless tragedies can be avoided, say doctors, if the little ones are nourished with mother’s milk. “Feeding these babies with donor breast milk through milk banks can have the single largest impact on reducing child mortality,” says Bhavdeep Singh, CEO, Fortis Healthcare, a pan-India hospital chain which launched Amaara in collaboration with the Breast Milk Foundation.

Breast milk, described as ‘superfood’ for newborns, contains “bioactive components” which protect them against life-threatening illnesses, serious infections and other complications related to pre-term birth which commercially available formula milk can’t, say doctors. The World Health Organisation (WHO) recommends that the best option for a baby who cannot be breastfed is milk expressed from its own or from another healthy mother. Children who are fed mother’s milk are also less vulnerable to certain non-communicable diseases and grow up to be better workers, says WHO.

“Keeping in mind the complications associated with formula feeding and some mothers’ inability to breastfeed, there’s a strong need to establish human milk banks. It’s a boon for high-risk newborns who are unable to receive the nurturing care a mother provides, ” adds Singh.

Donor banks collect, screen, process, store and prescribe donated human milk to babies who need such milk donated by lactating mothers not biologically related to them. The milk is either extracted manually or with breast pumps and collected by trained staff in labelled and sterile containers. It is transported to the banks under cold storage conditions, and immediately frozen at 20 degrees centigrade, after which a sample is taken for its culture. If the bacterial culture is negative, then the milk is pasteurized for future use.

Who can donate milk? Healthy lactating moms of term or preterm babies who are not on any medications, and have had no significant illnesses in the past or present, can do so. However, it is only the excess milk (milk obtained after fully feeding the donor’s own child) that can be donated.

According to the WHO and UNICEF, globally only 20 per cent of working women are able to breast feed their children – a must for at least for one to one-and-a-half years after birth. A study has indicated that babies not breastfed fall ill more often and have extra days of hospitalisation as well as extra prescriptions in the first year of their lives.

In developing countries like India, Sri Lanka, Bangladesh and several others in the Southeast Asian region — where health resources are poor — the situation is especially dire.

Although globally human milk banking is a common practice, in India, only 14 such banks currently exist, as per the Indian Academy of Paediatrics. This compares poorly to other developing nations like Brazil. Brazil hosts 210 such banks which have helped reduce its malnutrition level by 73 per cent.

India’s poor record in this field is surprising because Mumbai was where the first mother’s milk bank in Asia was established in 1989. Experts attribute the paucity of this service to a lack of public awareness and promotion of formula milk by the industry.

Customs and changing social dynamics too play a catalytic role. “In the villages, it’s considered ominous to feed the child with the milk extracted from another woman,” says Anjali Yadav, a volunteer with Save the Child Foundation. “In the cities, we’re finding that women have become increasingly career-oriented. In their rush to rejoin work post-childbirth, their breastfeeding plans get aborted.”

Doctors caution that there are serious health ramifications for women who avoid breastfeeding. These women are apparently at a potential risk of developing cancer at a later stage in life. Studies have proved that mothers who suffer from breast cancer during the pre-menopausal period may have contracted this due to skipping breastfeeding. Women who usually breast feed in their early thirties are more protected as compared to those who do so later in life.

Pratibha Jain, 32, a new mother, has been making life-saving withdrawals for her daughter Kareena, who was born prematurely, from Divya Mother Milk Bank at the Panna Dhai Hospital in Udaipur in the desert state of Rajasthan.

“I’ve enough breast milk during daytime. But night feeds have been a challenge so I’ve to rely on donated bank milk,” she told IPS. “The donated milk has helped me save my only child’s life.”

Interestingly, though the concept of human milk banks is a relatively new one, donation of breast milk from one woman to an unrelated infant goes back centuries. Earlier, weak infants with mothers were breastfed by a “wet nurse”. Rules governing wet nursing came about in 1800 BC. However, by the 15th century, wet nursing became infamous due to the spread of syphilis.

Human milk banking has faced similar challenges largely due to the aggressive promotion of infant formula milk by the industry. In addition, since the 1970s, a fear of transmission of viruses, including HIV in body fluids, also created public anxiety about breast milk.

Despite severe malnutrition among children, which erstwhile Indian PM Dr Manmohan Singh called a “national shame”, India has still not prioritised breastfeeding. Lack of legislation has only made matters worse. Currently the only law that regulates breastfeeding in India is the Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) formulated in 1992 which prohibits advertisement of infant milk substitutes.

However, the lack of rigorous implementation of even this solo law has resulted in its violation by the industry players.

“Also, there’s been no proactive promotion of breast milk or milk banks by the government through mass sensitization campaigns,” Dr. Kirti Saxena, Senior Paediatrician, Max Hospitals, told IPS. “Initiatives such as milk banks are commendable, but unless they’re incorporated in national policy and rigorously enforced by all stakeholders, their impact will be limited. The future of our children is at stake.”

Felistas Ngoma, 72, from Nkhamenya in the Kasungu District of Malawi, prepares nsima in her kitchen. Credit: Charity Chimungu Phiri/IPS

By Charity Chimungu Phiri
BLANTYRE, May 27 2016 (IPS)

It’s Saturday, market day at the popular Bvumbwe market in Thyolo district. About 40 kilometers away in Chiradzulu district, a vegetable vendor and mother of five, Esnart Nthawa, 35, has woken up at three a.m. to prepare for the journey to the market.

The day before, she went about her village buying tomatoes and okra from farmers, which she has safely packed in her dengu (woven basket).

Now she’s just waiting for a hired bicycle to take her and her merchandise to the bus station, where she will catch a minibus to Bvumbwe market. This way, her goods reach the market quicker and safer. Afterwards, she and her colleagues will pack their baskets and walk back home.

“We walk for at least three hours…our bodies have just gotten used to it because we have no choice. If I don’t do this, then my children will suffer. As I am talking to you now, they are waiting for me to bring them food,” Nthawa told IPS.

“I will buy a basin of maize there at the maize mill and have it processed into flour for nsima [a thick porridge that is Malawi’s staple food]. That’s the only meal they will eat today,” she said.

Nthawa added: “Last harvest we only realised two bags of maize as you know the weather was bad. That maize has now run out, we are living day by day…eating what we can manage to source for that day.”

Nthawa’s story resonates with many Malawians today. Almost half of the country’s population is facing hunger this year due to no or low harvests, resulting from the effects of El Nino which hit most parts of the southern and northern regions late last year.

Minister of Agriculture, Irrigation and Water Development George Chaponda said in Parliament on May 25 that 8.4 million Malawians will be food insecure during the 2016/2017 season.

His statement clearly contradicts President Peter Mutharika, who on Friday said in his State of the Nation Address that 2.8 million people faced hunger.

The new high figure follows a World Food Programme Rapid assessment which said over eight million Malawians will be food insecure this year due to the effects of El Nino. Destructive floods in the north have compounded the country’s woes, causing the president to declare a state of emergency in April.

With the drought also affecting Zimbabwe and other countries in southern Africa, an estimated 28 million people are now going hungry.

In order to deal with the crisis, Agriculture Minister Chaponda says the government has “laid out a plan to import about one million metric tons of white maize to fill the food gap”. The authorities project that at least 1,290,000 metric tons of maize are needed to deal with the food crisis, out of which 790,000 metric tons will be distributed to those heavily affected by the drought starting from April 2016 to March 2017.

The government also plans to intensify irrigation on commercial and smallholder farms, with an aim of increasing maize production at the national level. Officials say 18 million dollars is needed to carry out these measures.“There’s too much politicisation and overreliance on maize as a crop for consumption." -- Chairperson of the Right to Food Network Billy Mayaya

In the meantime, food prices continue to rise daily as the national currency, the Kwacha, continues to depreciate, forcing poor farming families to reduce their number of meals per day or sell their property in order to cope with the situation. A bag of maize which normally sells for seven dollars now costs 15 dollars.

As usual, children have been hardest hit by the situation. The latest statistics on Severe Acute Malnutrition (SAM) show a 100 percent increase from December 2015 to January 2016, according to the United Nations Children’s Fund (UNICEF).

UNICEF says it recorded more than 4,300 cases of severe malnutrition in the month of January alone this year, double the number recorded in December 2015.

Dr. Queen Dube, a pediatrician at Queen Elizabeth Central Hospital in Blantyre – the main government referral hospital in southern Malawi – affirmed to IPS that there has been an increase in the number of malnutrition cases at the hospital.

“At the moment, we have about 15 children admitted at our Nutrition Rehabilitation Unit…they have Marasmus, where they’re very thin or wasted, while others have Kwashiorkor, where the body is swollen. In other cases, the children have a combination of the two. These children suffer greatly from diarrheal diseases,” said Dube.

She added that the hospital offers these children therapeutic feeding of special types of milk and chiponde (fortified peanut butter) for a determined period of time, until they pick up in weight and improve in general body appearance.

“They are also given treatment for any underlying illness which they might have. Additionally, we also provide counseling to the mothers and guardians on proper nutrition so that when they get back home they can utilize the very little foods they have to prepare nutritious meals for their children,” she explained.

Rights activists say it is high time the authorities started taking on board recommendations on how to make Malawi food secure made by independent groups such as the Malawi Vulnerability Assessment Committee-MVAC, which said 2.8 million people faced hunger in 2015.

Chairperson of the Right to Food Network Billy Mayaya told IPS: “There’s too much politicisation and overreliance on maize as a crop for consumption. The government needs to use the data from MVAC as well as consider the Green Belt Initiative (GBI) and modalities to bring it to fruition.

Calling for greater diversity in the traditional diet, he said, “These plans can be effected as long as there‘s a sustained political will.”

In his state of the nation address on May 20, President Mutharika said the Green Belt Initiative was still his government’s priority “in order to increase productivity of selected high value crops.

“I am therefore pleased to report that construction of the irrigation infrastructure and the sugarcane factory in Salima district has been completed…the government has an ongoing Land Management Contract with Malawi Mangoes Limited where land has been provided for the production of bananas and mangoes,” he said.

In addition, the president said the government plans to increase rice production for both consumption and export, as well as make the tobacco industry vibrant again. Malawi mainly relies on tobacco for its foreign exchange earnings.

In February, President Mutharika made an international appeal for assistance, following which development partners including Britain and Japan provided over 35 million dollars. The government also obtained 80 million dollars from the World Bank for the Emergency Floods Recovery Project.

The U.S. government has been the first to respond to the latest crisis, providing the Malawian government with 55 million dollars.

Meanwhile, the struggle for survival continues for poor Malawian families such as Esnart Nthawa’s. Her children are still eating one meal a day, as those in power continue to meet to strategize on the crisis over fancy dinners in expensive hotels.

Nepal has one of the highest rates of malnutrition in the world. Over 41 percent of the country’s children suffer from chronic malnutrition, predominantly in rural areas. Credit: Naresh Newar/IPS

By Jomo Kwame Sundaram
ROME, Mar 9 2015 (IPS)

In 2014, an estimated 805 million people – one in nine people worldwide – were estimated to be chronically hungry. All but 14 million of the world’s hungry live in developing countries, i.e., 791 million are in developing countries, where the share of the hungry has declined by less than half – from 23.4 per cent (1990-1992) to 13.5 per cent (2012-2014).

Progress uneven

Overall progress has been highly uneven. Some countries and regions have seen only slow progress in reducing hunger, while the absolute number of hungry has even increased in several cases. Marked differences in reducing undernourishment have persisted across regions.Nutrition failures are due not only to insufficient food access, but also to poor health conditions and the high incidence of diseases such as diarrhoea, malaria, HIV/AIDS and tuberculosis.

There have been significant reductions in both the estimated share and number of undernourished in most countries in South-East Asia, East Asia, Central Asia, Latin America and the Caribbean – where the target of halving the proportion of the hungry has been reached, or nearly reached.

Progress in sub-Saharan Africa has been more limited, and the region now has the highest prevalence of undernourishment. West Asia has seen a rise in the share of the hungry compared to 1990-1992, while progress in South Asia and Oceania has not been sufficient to meet the MDG hunger target by 2015.

In several countries, underweight (low weight-for-age) and stunting (inadequate length or height for age) persist among children, even when undernourishment is low and most people have access to sufficient food. Nutrition failures are due not only to insufficient food access, but also to poor health conditions and the high incidence of diseases such as diarrhoea, malaria, HIV/AIDS and tuberculosis.

One in seven children under five are underweight

An estimated 99 million children under five years of age were underweight in 2012. This represents a fall of 38 per cent from an estimated 160 million underweight children in 1990. Yet, 15 per cent, or about one in seven, of all children under five worldwide are underweight.

East Asia has led all regions with the largest decrease of underweight children between 1990 and 2012, followed by the Caucasus and Central Asia, Latin America and the Caribbean, and West Asia. While the proportion of underweight children was highest in South Asia, the region has also experienced the largest absolute decrease since 1990, contributing significantly to the global decrease over the period.

Despite a modest reduction in the proportion of underweight children, Sub-Saharan Africa was the only region where the number of undernourished children increased, rising from 27 million in 1990 to 32 million in 2012.

In 2013, about 17 per cent, or 98 million children under five years of age in developing countries were underweight. Underweight is most widespread in South Asia (30 per cent), followed by West Africa (21 per cent), Oceania and East Africa (both 19 per cent) and South-East Asia and Central Africa (both 16 per cent) and Southern Africa (12 per cent).

Underweight prevalence was below 10 per cent in 2013 in East, Central and West Asia, North Africa and Latin America and the Caribbean.

Globally, the proportion of underweight children under five years of age declined from 25 per cent to 15 per cent between 1990 and 2013. Africa experienced the smallest decrease, with underweight prevalence declining from 23 per cent in 1990 to 17 per cent in 2013, while in Asia, it fell from 32 per cent to 18 per cent, and in Latin America and the Caribbean, from 8 per cent to 3 per cent.

This means Asia and Latin America and the Caribbean are likely to meet the MDG target for underweight, while Africa is likely to fall short, achieving only about half of the reduction target. And although Asia as a whole is likely to meet the MDG target, underweight rates remain very high in South Asia (30 per cent). With its large, growing population, South Asia will be home to 53 million underweight children in 2013.

One in four children under five are stunted

Stunting is a better indicator than underweight for capturing the cumulative effects of child undernutrition and infection during the critical thousand day period from conception through the first two years of a child’s life. Stunting is also more common than underweight, with one in four children globally affected in 2012.

Stunting is caused by long-term inadequate dietary intake and continuing bouts of infection and disease, often beginning with maternal malnutrition, which leads to poor fetal growth, low birth weight and poor growth. Stunting causes permanent impairment to cognitive and physical development that can lower educational attainment and reduce adult incomes.

Although the prevalence of stunting in children under five fell from about 40 per cent in 1990 to 25 per cent in 2012, an estimated 161 million children under five in 2014 remained at risk of diminished cognitive and physical development due to chronic undernutrition.

Nearly all regions in the world have seen declines in the number of children affected by stunting. The exception is sub-Saharan Africa, where the number of stunted children increased by a third, from 44 million to 58 million between 1990 and 2012.

Lessons

In countries where low undernourishment coexists with high malnutrition, specially-designed nutrition-enhancing interventions may be crucial to address early childhood stunting. Improvements in nutrition generally require complementary policies, including improving health conditions, hygiene, water, sanitation and education. More sophisticated and creative approaches to coordination as well as adequate resources are needed.

The Second International Conference of Nutrition in Rome in November 2014 articulated coherent bases for accelerated progress to overcome all types of malnutrition (undernourishment, micronutrient deficiencies, obesity) and defined pathways to international cooperation and support for integrated national nutrition efforts.

The international community, including those in the U.N. system, must come together to improve coordination for a sustained effort against malnutrition over the next decade.

But with high levels of deprivation, unemployment and underemployment continuing and likely to prevail in the world for the foreseeable future, poverty and hunger are unlikely to be overcome without the extension of universal social protection to all in need.

Edited by Kitty Stapp

Excerpt:

By Paloma Duran
UNITED NATIONS, Mar 5 2015 (IPS)

The countdown has begun to September’s Summit on the Sustainable Development Goals (SDGs), with world leaders discussing the 17 goals and 169 targets proposed by the United Nations Open Working Group.

The post-2015 development agenda will focus primarily on strengthening opportunities to reduce poverty and marginalisation in ways that are sustainable from an economic, social and environmental standpoint.

Courtesy of Paloma Duran/UNDP

How shall the world set the measure for all subsequent work?

The SDG Fund, created by the United Nations Development Programme (UNDP), with an initial contribution from the government of Spain, has been designed to smoothen the transition from the Millennium Development Goals phase into the future Sustainable Development Goals.

The rationale of the joint programme initiative is to enhance the development impact of technical assistance by combining inputs from various U.N. entities, each contributing according to its specific expertise and bringing their respective national partners on board.

To illustrate, we are currently implementing joint programmes in 18 countries addressing challenges of inclusive economic growth for poverty eradication, food security and nutrition as well as water and sanitation.

The majority of our budget is invested in sustainable development on the ground and is directly improving the lives of more than one million people in various regions of Latin America, the Caribbean, Asia, Arab States and Africa.The main objective of the SDG fund is to bring together U.N. agencies, national governments, academia, civil society and businesses to find ways in which we can reduce poverty, improve nutrition and provide access to affordable water and sanitation.

National and international partners provide approximately 56 percent of these resources in the form of matching funds.

Each programme was originally chosen through a selection process including the review by thematic and development independent experts.

In addition, we ensure that local counterparts engage in the decision-making processes from programme design to implementation and evaluation. More than 1,500 people were directly involved in designing the various programmes.

The main objective of the SDG fund is to bring together U.N. agencies, national governments, academia, civil society and businesses to find ways in which we can reduce poverty, improve nutrition and provide access to affordable water and sanitation.

Drawing from extensive experience of development practice as well as the former Millennium Development Goals Achievement Fund, we are continually seeking better ways in which to deal with challenges that present themselves.

Gender equality, women’s empowerment, public-private partnerships and sustainability are cross-cutting priorities in all areas of our work.

It is noteworthy to point out that we are focusing our efforts on forging partnerships with the private sector as we recognise the importance of actively engaging with businesses and ensuring their full participation in the development process.

It is in this vein that a Private Sector Advisory Group will be established this spring, consisting of representatives from various industries worldwide with the aim to collaborate and discuss practical solutions pertaining to the common challenges of contemporary sustainable development.

Together we will work diligently to identify areas of common interest and promote sustainability of global public goods.

As an example of how we work on the ground, we are setting into motion programme activities that relate to alleviating child hunger and under-nutrition as well as projects that promote sustainable and resilient livelihoods for vulnerable households, especially in the context of adapting to climate change.

To illustrate, in Peru we are contributing towards establishing an inclusive value chain in the production of quinoa and other Andean grains, so that the increase of demand in the international market can convert into economic and social improvements on the ground.

In addition, we are supporting programme activities that promote the integration of women in the labour market as it is key to equitable, inclusive and sustainable development. We are conscious of the fact that gender equality and the full realisation of human rights for women and girls have a transformative effect on development and is a driver of economic growth.

To illustrate, the SDG Fund is currently financing five joint programmes in Africa that address some of the most pressing issues in the region, and seek to achieve sustainable development through inclusive economic growth.

In Ethiopia, rural women lag behind in access to land property, economic opportunities, justice system and financial assets. Female farmers perform up to 75 per cent of farm labour and yet hold only 18.7 per cent of agricultural land in the country.

We are taking a multifaceted approach to generate gender-sensitive agricultural extension services, support the creation of cooperatives, promote the expansion of women-owned agribusiness and increase rural women’s participation in rural producer associations, financial cooperatives and unions.

To conclude, we are looking forward to making a significant impact in the coming years with the hope to meet the needs of the present without compromising the ability of future generations to meet their own needs.

Edited by Kitty Stapp

Excerpt:

Novice monks beg for alms near the Sule Pagoda in downtown Yangon. The barbed wire barricades behind them were once a permanent feature on this busy road, but have been pushed aside to make way for peace. Credit: Amantha Perera/IPS

By Amantha Perera
YANGON, Nov 21 2014 (IPS)

Myanmar is never out of the news for long. This has been the case since a popular uprising challenged military rule in 1988. For over two decades, the country was featured in mainstream media primarily as one unable to cope with its own internal contradictions, a nation crippled by violence.

Since 2011, with the release of pro-democracy icon Aung San Suu Kyi from house arrest, as well as democratic reforms, the country experienced a makeover in the eyes of the world, no longer a lost cause but one of the bright new hopes in Asia.

U.S. President Barack Obama has visited the country twice since 2011, most recently this month for the 9^th annual East Asia Summit (EAS).

But beneath the veneer of a nation in transition, on the road to a prosperous future, lies a people deep in poverty, struggling to make a living, some even struggling to make it through a single day.

A woman loads bags full of vegetables on to a train carriage in Yangon. Many use the slow-moving passenger trains to transport goods that they will sell in outlying villages, since few can afford road transportation. Credit: Amantha Perera/IPS

Arranging vegetables into small bundles, this vendor tells IPS she wakes up at three a.m. three days a week to collect her produce. She makes roughly three dollars each day. Credit: Amantha Perera/IPS

The commercial capital, Yangon, is in the midst of a construction boom, yet there are clear signs of lopsided and uneven development. By evening, those with cash to burn gather at popular restaurants like the Vista Bar, with its magnificent view of the Shwedagon Pagoda, and order expensive foreign drinks, while a few blocks away men and women count out their meagre earnings from a day of hawking home-cooked meals on the streets.

The former likely earn hundreds of dollars a day, or more; the latter are lucky to scrape together 10 dollars in a week.

A woman waits for passersby to buy bird feed from her in Yangon. The World Bank estimates that over 30 percent of Myanmar’s 53 million people lives below the national poverty line. Credit: Amantha Perera/IPS

A man pushes a cartful of garbage near a busy intersection in Yangon. The 56-billion-dollar economy is growing at a steady clip of 8.5 percent per annum, but the riches are obviously not being shared equally. Credit: Amantha Perera/IPS

The World Bank estimates that the country’s 56.8-billion-dollar economy is growing at a rate of 8.5 percent per year. Natural gas, timber and mining products bring in the bulk of export earnings.

Still, per capita income in this nation of 53 million people stands at 1,105 dollars, the lowest among East Asian economies.

The richest people, who comprise 10 percent of the population, control close to 35 percent of the national economy. The government says poverty hovers at around 26 percent of the population, but that could be a conservative estimate.

According to the World Bank’s country overview for Myanmar, “A detailed analysis – taking into account nonfood items in the consumption basket and spatial price differentials – brings poverty estimates as high as 37.5 percent.”

A man collects his harvest from a vegetable plot that is also a putrid water hole just outside of Yangon. The World Bank estimates that at least 32 percent of all children below five years of age in Myanmar suffer from malnutrition. Credit: Amantha Perera/IPS

Women walk with heavy loads after disembarking from a train. Thousands still rely on the dilapidated public transport system, with its century-old trains and belching buses, because they cannot afford anything else. Credit: Amantha Perera/IPS

The country’s poor spend about 70 percent of their income on food, putting serious pressure on food security levels.

But these are not the only worrying signs. An estimated 32 percent of children below five years of age suffer from malnutrition; more than a third of the nation lacks access to electricity; and the national unemployment rate, especially in rural areas, could be as high as 37 percent according to 2013 findings by a parliamentary committee.

Over half the workforce is engaged in agriculture or related activities, while just seven percent is employed in industries.

Democracy icon Aung San Suu Kyi admits that Mynmar suffers from a long list of woes, but insists that the first step to healing is the return of the rule of law. Credit: Amantha Perera/IPS

Large-scale construction is not unusual in downtown Yangon, where foreign investments and tourist arrivals are pushing up land prices. Officials say they expect around 900,000 visitors this year. Arrivals have shot up by 49 percent since 2011. Credit: Amantha Perera/IPS

Development banks call Myanmar a nation in ‘triple transition’, a nation – in the words of the World Bank – which is moving “from an authoritarian military system to democratic governance, from a centrally directed economy to a market-oriented economy, and from 60 years of conflict to peace in its border areas.”

A man pushes his bicycles laden with scrap in the streets of Yangon. Despite rapid economic growth, disparities seem to be widening, with 10 percent of the population enjoying 35 percent of Myanmar’s wealth. Credit: Amantha Perera/IPS

The biggest challenge it faces in this transition process is the task of easing the woes of its long-suffering majority, who have eked out a living during the country’s darkest days and are now hoping to share in the spoils of its future.

 Edited by Kanya DAlmeida

A pregnant woman waits in line for a medical check-up. Health indicators for women on Sri Lanka’s tea estates are lower than the national average. Credit: Amantha Perera/IPS

By Kanya D'Almeida
COLOMBO, Sep 23 2014 (IPS)

A mud path winds its up way uphill, offering views on either side of row after row of dense bushes and eventually giving way to a cluster of humble homes, surrounded by ragged, playful children.

Their mothers either look far too young, barely adults themselves, or old beyond their years, weathered by decades of backbreaking labour on the enormous tea estates of Sri Lanka.

Rani* is a 65-year-old mother of six, working eight-hour shifts on an estate in Sri Lanka’s Central Province. Her white hair, a hunched back and fallen teeth make her appear about 15 years older than she is, a result of many decades spent toiling under the hot sun.

She tells IPS that after her fifth child, overwhelmed with the number of mouths she had to feed, she visited the local hospital to have her tubes tied, but gave birth to a son five years later.

“If women are the primary breadwinners among the estate population, generating the bulk of household revenue in a sector that is feeding the national economy, then maternal health should be a priority." -- Mythri Jegathesan, assistant professor in the department of anthropology at Santa Clara University in California
Though she is exhausted at the end of the day, and plagued by the aches and pains that signal the coming of old age, she is determined to keep her job, so her children can go to school.

“I work in the estates so that they won’t have to,” she says with a hopeful smile.

Her story is poignant, but not unique among workers in Sri Lanka’s vast tea sector, comprised of some 450 plantations spread across the country.

Women account for over 60 percent of the workforce of abut 250,000 people, all of them descendants of indentured servants brought from India by the British over a century ago to pluck the lucrative leaves.

But while Sri Lankan tea itself is of the highest quality, raking in some 1.4 billion dollars in export earnings in 2012 according to the Ministry of Plantation Industries, the health of the labourers, especially the women, leaves a lot to be desired.

Priyanka Jayawardena, research officer for the Colombo-based Institute of Policy Studies of Sri Lanka, tells IPS that “deep-rooted socio-economic factors” have led to health indicators among women and children on plantations that are consistently lower than the national average.

The national malnutrition rate for reproductive-age mothers, for instance, is 16 percent, rising to 33 percent for female estate workers. And while 16 percent of newborn babies nationwide have low birth weight, on estates that number rises significantly, to one in every three newborns.

A higher prevalence of poverty on estates partly accounts for these discrepancies in health, with 61 percent of households on estates falling into the lowest socio-economic group (20 percent of wealth quintile), compared to eight percent and 20 percent respectively for urban and rural households.

Other experts say that cultural differences also play a role, since estate populations, and especially tea workers, have been relatively isolated from broader society.

“Many women are uneducated, and tend to be careless about their own health, and the health of their children,” a field worker with the Centre for Social Concern (CSC), an NGO based in the Nuwara Eliya district in central Sri Lanka, tells IPS.

“They have a very taxing job and so spend less time thinking about food and nutrition,” she states.

In fact, as Jayawardena points out, only 15 percent of under-five children on estates have a daily intake of animal protein, compared to 40-50 percent among rural and urban populations.

The same is true for daily consumption of yellow vegetables and fruits, as well as infant cereals – in both cases the average intake among children on estates is 40 percent, compared to 60 percent in rural and urban areas.

Breastfeeding patterns are also inadequate, with just 63 percent of estate workers engaging in exclusive breastfeeding for the first four months of a child’s life, compared to 77 percent in urban areas and 86 percent in rural areas, according to research conducted by the Institute of Policy Studies.

The situation is made worse by the demands of the industry. Since many women are daily wage labourers, earning approximately 687 rupees (just over five dollars) each day, few can afford to take the required maternity leave.

But even when alternatives are provided by the estate management, experts say, a lack of awareness and education leaves children without proper attention and care.

Jayawardena tells IPS that almost half of all women on estates drop out of school after the primary level, compared to a national dropout rate of 15 percent. Literacy levels are low, and so even awareness campaigns often fail to reach the targeted audience.

Many female estate workers are daily wage labourers, earning approximately 687 rupees (just over five dollars) each day. Credit: Anja Leidel/CC-BY-SA-2.0

“Women on the estates do not believe they have many options in life beyond working on the plantations,” the CSC field officer says.

“Most are extremely poor, and from childhood they are exposed to very little – there are hardly any playgrounds, libraries, gathering places or social activities on the estates. So they tend to get married early and become mothers at a very young age.”

Though the national average for teenage pregnancies stands at roughly 6.4 percent, it shoots up to ten percent among estate workers, resulting in a cycle in which malnourished mothers give birth to unhealthy babies, who will also likely become mothers at a young age.

“If women are the primary breadwinners among the estate population, generating the bulk of household revenue in a sector that is feeding the national economy, then maternal health should be a priority,” Mythri Jegathesan, assistant professor in the department of anthropology at Santa Clara University in California, tells IPS.

“Any form of agricultural labour is hard on the body, and many of the estate workers in Sri Lanka work until they are seven or eight months pregnant. They need to be acknowledged, and more attention given to their wellbeing and health,” she adds.

Several NGOs and civil society organisations have been working diligently alongside the government and the private sector to boost women’s health outcomes.

According to Chaaminda Jayasinghe, senior project manager of the plantation programme for CARE International-Sri Lanka, the situation is changing positively.

The emergence of the Community Development Forum (CDF) introduced by CARE in selected tea estates is providing space and a successful model for inclusive development for estate communities, he tells IPS.

This has already resulted in better living conditions and health outcomes among estate communities while mainstreaming plantation communities into the larger society.

*Not her real name.

This story originally appeared in a special edition TerraViva, ‘ICPD@20: Tracking Progress, Exploring Potential for Post-2015’, published with the support of UNFPA, the United Nations Population Fund. The contents are the independent work of reporters and authors.

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 Mallika Aryal
RASUWA, Nepal, Jul 22 2014 (IPS)

Durga Ghimire had her first child at the age of 18 and the second at 21. As a young mother, Durga didn’t really understand the importance of taking care of her own health during pregnancy.

“I didn’t realise it would have an impact on my baby,” she says as she sits on the porch of her house in Laharepauwa, some 120 kilometers from Nepal’s capital, Kathmandu, nursing her third newborn child.

It is late in the afternoon and she is waiting expectantly for her two older daughters to return from school. One is nine and the other is six, but they look much smaller than their actual age.

“They are smaller in height and build and teachers at school say their learning process is also much slower,” Durga tells IPS. She is worried that the girls are stunted, and is trying to ensure her third child gets proper care.

A recent United Nations Children Fund (UNICEF) report shows that Nepal is among 10 countries in the world with the highest stunting prevalence, and one of the top 20 countries with the highest number of stunted children.

“Reducing stunting among children increases their chances of reaching their full development potential, which in turn will have a long-term impact on families’, communities’ and the country’s ability to thrive.” -- Peter Oyloe, chief of USAID Nepal’s Suaahara (‘Good Nutrition’) project at Save the Children-Nepal
UNICEF explains stunting as chronic under-nutrition during critical periods of growth and development between the ages of 0-59 months. The consequences of stunting are irreversible and in Nepal the condition affects 41 percent of children under the age of five.

“Nepal’s ranking […] is worrying, not just globally but also in South Asia,” Giri Raj Subedi, senior public health officer at Nepal’s ministry of health and population, tells IPS.

A 2013 progress report on the Millennium Development Goals (MDGs) done by Nepal’s National Planning Commission (NPC) says while the number of stunted children declined from 57 percent in 2001 to 41 percent in 2011, it is still high above the 30 percent target set by the U.N..

“Stunting is a specific measure of the height of a child compared to the age of the child, and it is indicative of how well the child is developing cognitively,” says Peter Oyloe, chief of party of USAID Nepal’s Suaahara, or ‘Good Nutrition’ project at Save the Children Nepal.

Oyloe adds, “Reducing stunting among children increases their chances of reaching their full development potential, which in turn will have a long-term impact on families’, communities’ and the country’s ability to thrive.”

Child health and nutrition experts argue that, while poverty is directly related to inadequate intake of food, it is not the sole indicator of malnutrition or increased stunting.

Saba Mebrahtu, chief of the nutrition section at UNICEF-Nepal, says the immediate causes include poor nutrient intake, particularly early in life. Fifty percent of stunting happens during pregnancy and the rest after infants are born.

“When we are talking about nutrient-rich food […] we are talking about ensuring that children get enough of it even before they are born,” says Mebrahtu. The time between conception and a child’s second birthday is a crucial period, she said, one of rapid growth and cognitive development.

Thus it is incumbent on expecting mothers to follow a careful diet before the baby is born.

Basic education could save lives

Sadhana Ghimire, 23, lives a few doors down from Durga. Separated by a few houses, their approaches to nutrition are worlds apart.

Ghimire breast-fed her 18-month-old daughter exclusively for six months. She continues to make sure that her own diet includes green leafy vegetables, meat or eggs, along with rice and other staples, as she is still nursing.

She gives credit to the female community health-worker in her village, who informed her about the importance of the first 1,000 days of a child’s life.

In preparation for her daughter’s feeding time, Ghimire mixes together a bowl of homemade leeto, a porridge containing one-part whole grains such as millet or wheat and two-parts pulses such as beans or soy.

“I was only using grains to make the leeto before I was taught to make it properly by the health workers and Suaahara,” she says.

However, making leeto was not the most important lesson Ghimire learned as an expecting mother. “I had no idea that simple things like washing my hands properly could have such a long term effect on my daughter’s health,” she says.

Even seemingly common infections like diarrhoea can, in the first two years, put a child at greater risk of stunting.

“That is because the nutrients children are using for development are used instead to fight against infection,” says Mebrahtu emphasising the need for simple practices such as proper hand washing and cleaning of utensils.

If children are suffering from infection due to poor hygiene and sanitation they can have up to six diarrhoeal episodes per year, she warns, adding that while “children recover from these infections, they don’t come back to what they were before.”

Fighting on all fronts

Food insecurity is one of the biggest contributing factors to stunting in Nepal. Rugged hills and mountains comprise 77 percent of the country’s total land area, where 52 percent of Nepal’s 27 million people live.

Food insecurity is worst in the central and far western regions of the country; the prevalance of stunting in these areas is also extreme, with rates above 60 percent in some locations.

Thus experts recognise the need to fight simultaneously on multiple fronts.

“Our work in nutrition has proven again and again that a single approach to stunting doesn’t work because the causes are so many – it really has to be tackled in a coordinated way,” says UNICEF’s Mebrahtu.

In 2009 the government conducted the Nutrition Assessment and Gap Analysis (NAGA), which recommended building a multi-sector nutrition architecture to address the gaps in health and nutrition programmes.

“The NAGA study stated clearly that nutrition was not the responsibility of one department, as was previously thought,” Radha Krishna Pradhan, programme director of health and nutrition at Nepal’s NPC, tells IPS.

Nepal is also one of the first countries to commit to the global Scaling Up Nutrition (SUN) movement, which recognises multiple causes of malnutrition and recommends that partners work across sectors to achieve nutritional goals.

Thus, in 2012, five ministries in Nepal came together with the NPC and development partners to form the Multi-Sector Nutrition Plan (MSNP).

Public health experts say MSNP is a living example of the SUN movement in action and offers interventions with the aim of reducing the current prevalence of malnutrition by one-third.

Interventions include biannual vitamin D and folic acid supplements for expectant mothers, deworming for children, prenatal care, and life skills for adolescent girls.

On the agricultural front, ministries aim to increase the availability of food at the community level through homestead food production, access to clean and cheap energy sources such a biogas and improved cooking stoves, and the education of men to share household loads.

MSNP’s long-term vision is to work towards significantly reducing malnutrition so it is no longer an impending factor towards development. The World Bank has estimated that malnutrition can cause productivity losses of as much as 10 percent of lifetime earnings among the affected, and cause a reduction of up to three percent of a country’s GDP.

At present the Plan is in its initial phase and has been implemented in six out of 75 districts in Nepal since 2013.

(END)

Even as aid workers are warning that children in South Sudan are falling victim to mass malnutrition, international agencies are said to be missing their fundraising goals to avert a looming famine in the country.

On Monday, Medecins Sans Frontieres (MSF), the international medical relief organisation, reported that nearly three-quarters of the more than 18,000 patients admitted to the agency’s feeding programmes in South Sudan have been children. South Sudan has experienced mounting civil violence in recent months, which humanitarian groups warn has directly impacted farmers’ ability to plant and grow crops.

A child snacks in her family’s new shelter, at Protection of Civilians (POC) camp III, near UN House, in Juba. Credit: UN Photo/JC McIlwaine

Yet even as South Sudan’s malnutrition epidemic intensifies, seven major international aid agencies, all of which prioritise food security in South Sudanese villages, may have to shut down their projects due to severe funding gaps.

Naming South Sudan to be “the most pressing humanitarian crisis in Africa,” CARE International, a U.S.-based relief agency, has stated that the United Nations’ most recent appeal for South Sudan is less than half funded.

The U.N. says some 1.8 billion dollars is urgently needed in the country, yet CARE says that seven implementing agencies are short by some 89 million dollars.

“We will be staring into the abyss and failing to avert a famine if funds do not start arriving soon,” Mark Goldring, chief executive of Oxfam, said in CARE’s report.

“This is a not a crisis caused by drought or flood. It is a political crisis turned violent. The people of South Sudan can only put their lives back together once the fighting ends. In the meantime… we are asking the public to help us with our urgent humanitarian work, but mainly we are calling on governments to fund the aid effort before it is too late.”

On Thursday, the U.S. Department of State announced it would provide another 22 million dollars in humanitarian assistance to facilitate “basic life support” in South Sudan. Yet the following day, three U.S. lawmakers wrote a letter to President Barack Obama, expressing “grave concern” over the growing conflict in South Sudan’s border region and urging “renewed diplomatic engagement” with the international community.

While solving the political problem at the root of South Sudan’s current violence is a significant priority, aid workers say the international community’s most dire concern should be for the nutritional needs of South Sudanese children.

“Many of these children have walked for days to receive medical care and food security, and these are only the ones we see,” Sandra Bulling, media coordinator for CARE International, told IPS from South Sudan. “We don’t even know about the ones hiding in the bush.”

Centrality of nutrition

The malnutrition crisis comes amidst tumultuous domestic politics in South Sudan, resulting in fighting that has raged since December. Some 1.5 million South Sudanese residents are now estimated to be displaced within the country, thereby decreasing their access to reliable food sources and requiring them to share already-limited supplies.

Dr. Jenny Bell, a medical worker and expert on South Sudan with the University of Calgary in Canada, acknowledges that “the nation’s health situation wasn’t brilliant before December,” but warns that the civil conflict has “compounded” the country’s medical issues.

South Sudan “already had the world’s highest maternal mortality rate, and it had been estimated that one in five South Sudanese children die before they reach age five,” she told IPS.

“But even though there had barely been enough food before, now there really won’t be enough, as [internally displaced] farmers were unable to grow crops [due to the violence], and cannot do so now because South Sudan is well into [its] rainy season.”

Adequate nutrition needs to be South Sudan’s top priority, Bell emphasises. The three leading causes of death in the country – malaria, diarrhoea and respiratory infections – are much more likely for a person to contract when he or she is malnourished, she notes.

Yet she adds that despite the “amazing agricultural potential” of South Sudan, funding for this purpose has been weak.

“The United States’ monetary aid to the region is complicated because they don’t trust the South Sudanese government,” she says. “Because of this, they’ve shifted everything to humanitarian aid, and all the development efforts have been wiped out.”

In addition to monetary aid for agricultural development, Bell says health-care facilities urgently need both supplies and personnel.

CARE’s Bulling agrees that training medical personnel is of key importance in South Sudan, adding that her focus is to work with local staff but fly in as many experts as possible.

“But it is mainly money that we need, so we can procure medicines and all of the necessary nutritional requirements,” she says.

When asked what it would take for the international community to react to the need for more funding in South Sudan, Bulling cited a technique that she says has historically been effective.

“We need to have photos of children starving and dying before the world reacts to such a disaster,” she says.

“This is what has worked for Somalia … you need these pictures to talk. For South Sudan we do all these press releases and calls to action, but as long as there is no big report with photos to show how bad the situation is, there is no response.”

A family living in an urban slum in Sonagachi, Kolkata, India. Credit: UN Photo/Kibae Park

By Jim Lobe
WASHINGTON, Oct 10 2013 (IPS)

Four hundred million children under 13 years of age are living in extreme poverty worldwide, according to a new study released by the World Bank here Thursday.

That total constitutes fully one-third of the 1.2 billion people still living on less than the equivalent of 1.25 dollars a day, according to the report.

“All but three countries in the world have ratified the Convention on the Rights of the Child, which guarantees some access to basic social services for children, including basic social protection,” Jeffrey O’Malley, director of policy and strategy for the U.N. children’s agency UNICEF, told IPS. “The scale of children living in extreme poverty shows how far we are from fulfilling those rights.

“But it’s also important because, beyond the needs and rights of those children, their families, communities, and countries won’t reach their development potential, if the children don’t benefit from adequate food, nutrition, water, health care – all of which are essential to their intellectual and physical development into productive adults,” he said.

Indeed, the report found that half of all people living in absolute poverty in the world’s 35 poorest countries – most of them in sub-Saharan Africa and South Asia – are 12 years old or less.

“Children should not be cruelly condemned to a life without hope, without good education, and without access to quality health care. We must do better for them,” the Bank’s president, Jim Yong Kim, said at a press conference here on the eve of the annual meetings here of the Bank and the International Monetary Fund (IMF).

Later this week, Kim will host a special event with Malala Yousafzai, who was awarded the European Parliament’s Sakharov Prize Thursday and is considered a favourite for winning the 2013 Nobel Peace Prize. He said the 16-year-old Pakistani school girl and education activist was a “powerful symbol of hope” for the 400 million children who remain in extreme poverty.

“She would not be denied,” he said in a reference to her continuing fight for girls’ education before and after the 2012 attempt on her life by Taliban gunmen in Pakistan’s SwatValley and subsequent threats against her after her recovery.

His remarks came as the IMF’s managing director, Christine Lagarde, announced that it had received sufficient authorisation from its membership to transfer profits it made from sales of part of its gold holdings to its Poverty Reduction and Growth Trust (PRGT), a fund to provide no-interest loans to low-income countries.

“We now have secured critical resources to provide adequate levels of financial support to the poorest countries for years to come,” she said.

Eighty percent of the IMF’s member states agreed to transfer their share of the profits to the PRGT which will permit the facility to lend an average of 1.92 billion dollars a year to its clients.

The announcement was hailed by anti-poverty groups who have long campaigned for the IMF to use its gold sales to aid low-income countries. Oxfam called it “great news, especially in these difficult financial times.”

“We’re excited that the profits are going into zero-percent lending, which essentially qualifies as debt relief for some of the poorest countries,” Jubilee USA director Eric LeCompte told IPS.

“That’s money that can go back into social protections for the poorest – most of whom are women and children — in their countries,” he said. “There’s no doubt that even a few billion dollars can go a long way to addressing extreme poverty.”

Since assuming the Bank presidency in July 2012, Kim has repeatedly stressed that the reduction of extreme poverty should be the institution’s top priority. Earlier this year, he set a goal of eliminating extreme poverty by the year 2030, along with promoting greater equity by increasing income growth of the bottom 40 percent of the population in developing countries.

Unveiling a major re-organisation of the Bank Wednesday, he set an interim goal of reducing global poverty levels to nine percent by 2020, which would mean increasing incomes of an additional 510 million people to greater than USD 1.25 a day in real terms.

The new report, entitled “The State of the Poor”, is being billed by the Bank as the first effort to provide an in-depth profile of the world’s poorest people who pose the greatest challenge to meeting those goals.

While reductions in extreme poverty in the developing world between 1981 and 2010 have been remarkable, according to the report, most of the progress has been confined to middle-income countries.

Increasing incomes among the poorest in low-income countries (LICs), on the other hand, has proved far more difficult. Indeed, the number of poor people in LICs actually increased by 103 million during the same period.

Indeed, after India, about one third of whose population lives in absolute poverty, LICs contain most of the world’s poorest — 29 percent in 2010. In 1981, the same countries accounted for only 13 percent of the world’s total, according to the report.

As to who the world’s poorest are, the study found that over 78 percent of the absolute poor in the developing world live in rural areas, a significantly higher percent than the 58 percent of the total developing-country population who are rural-dwellers.

Moreover, 63 percent of the absolute poor work in agriculture, mostly in small-holder farming.

The study also found a gender gap in education among those living in extreme poverty. Poor women aged 15 to 30, on average, have a year less schooling than poor men of the same age group.

But extreme poverty rates were found to be highest among children under 13 – 33 percent in the developing world as a whole and 50 percent in the LICs.

Not surprisingly in that connection, the study also found that the average number of prime-age adults available to provide income and support per child in non-poor households in developing countries was three. That was more than twice the number found in poor households where there was an average of only 1.4 adults per child.

Camps for internally displaced people (IDPs) in northern Pakistan are breeding grounds for malnutrition. Credit: Ashfaq Yusufzai/IPS

By Jomo Kwame Sundaram
ROME, Jun 6 2013 (IPS)

Between 2010 and 2012, 868 million people worldwide were deemed hungry by a conservative definition. This figure represents only a small fraction of the world’s population whose health and lives are blighted by malnutrition.

Jomo Kwame Sundaram, assistant director-general for economic and social development at the United Nations Food and Agriculture Organisation (FAO). Credit: @FAO/Giulio Napolitano

Currently, malnutrition is believed to be the underlying cause of death for 2.6 million children annually. Meanwhile, two billion people lack adequate micronutrients – vitamins and minerals – that are essential for their mental and physical development.

A quarter of the children in the world, and a third in developing countries, are stunted because they do not get the right nutrients. Four in five of these malnourished children are in just 20 countries, including almost half of Indian children under five.

In Nigeria, over half of the poorest children are stunted, while in China, children in poor rural counties are six times more likely to be stunted than urban children. In Indonesia, a sharp rise in wasting – or acute malnutrition – in the wake of recent food crises has hit children from the poorest households hardest.

Receiving the right nutrients in the first years of life is not only a matter of life and death, but also a major determinant of future life chances – potentially raising future earnings by a fifth. Today, about 170 million children under five are stunted because they do not get the right nutrients, while their cognitive and physical development is impaired.

Some progress has been made in reducing hunger over the past two decades. With a strong final push, the Millennium Development Goal (MDG) objective of halving the prevalence of hunger by 2015 is within reach. Already, 51 countries have achieved the target, or are on track to do so.

With modest progress over the past two decades, the share of stunted children declined from 40 percent in 1990 to 27 percent in 2010. And if present trends continue, half a billion more children will be stunted in the next 15 years.

Meanwhile, around one and a half billion people are overweight, with half a billion deemed obese, and hence, more vulnerable to serious non-communicable diseases. Malnutrition could cost as much as five percent of global income – 3.5 trillion dollars, or 500 dollars per person – in terms of lost productivity and health care expenses.

What should we do to eradicate malnutrition? The 2013 report by the United Nations’ Food and Agriculture Organisaion (FAO), ‘The State of Food and Agriculture: Food systems for better nutrition’, shows the way forward. Good nutrition must start with food production. Improved food systems must make nutritious foods affordable.

Overcoming malnutrition – caloric undernourishment, micronutrient deficiencies, obesity – requires appropriate interventions in food systems, public health, education and social protection. Tackling malnutrition is a complex task requiring strong political commitment, leadership at the highest levels, and unprecedented cooperation and coordination among various ministries and partners.

Better organised food systems are key to more diversified and healthier diets. Policy must ensure that all people have informed access to a wide range of nutritious foods to make healthy choices. Consumers need help making better dietary choices for improved nutrition with regulation, education, information and other interventions.

Food systems must become more sensitive to the special needs of mothers and young children. Malnutrition during the critical first 1,000 days from conception can cause permanent physical and cognitive impairment in children and lasting damage to the mothers’ health.

Food security and nutrition are now at the apex of the international development agenda. In June 2012, the United Nations Secretary General made the call to set the ambitious but feasible goal of zero hunger. The Zero Hunger Challenge calls for a world without hunger, no more stunting, minimal food waste and losses, sustainable agriculture and doubling poor farmers’ incomes.

On Jun. 8, the governments of Brazil and the United Kingdom will co-host a high-level pre-G8 meeting entitled ‘Nutrition for Growth: Beating Hunger through Business and Science’ in London. UK Prime Minister David Cameron intends to follow up by sponsoring a high-level global panel on agriculture and food systems for nutrition.

On Nov. 19-21, 2014, the FAO, the World Health Organisation (WHO) and others in the U.N. system will co-organise the inter-governmental International Conference on Nutrition (ICN2), 22 years after the first one in 1992, to establish the bases for sustained international cooperation and policy coordination to overcome malnutrition. The preparatory technical meeting on Nov. 13-15 this year will establish the evidence base for this purpose.

Malnutrition’s time has come. By cooperating effectively, we have a real chance of ending this blight on humanity within a generation.

(END/COPYRIGHT IPS)

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