Students at Columbia University carry mattresses on the Carry That Weight National Day of Action to show their support for survivors of sexual assault. Credit: Warren Heller

By Lyndal Rowlands
UNITED NATIONS, Nov 25 2014 (IPS)

“A recurring nightmare for me is I’m trying to tell someone something and they are not listening. I’m yelling at the top of my lungs and it feels like there is a glass wall between us.”

Jasmin Enriquez is a two-time survivor of rape. Like two-thirds of rape survivors, Enriquez knew her rapists. The first was her boyfriend when she was a high school senior, the second a fellow student she had been seeing at college."What I hear from women is that they are told to shut up: they are told to shut up during it, they are told to shut up after it, and they are told by some institutions to continue keeping their mouths shut." -- Dr. Dana Sinopoli

“[The nightmare] shows how I’ve always felt that even as someone coming forward as a survivor, as soon as I start giving details to some people, they instantly start to shut it down. As in, you’re being crazy or hyperemotional, instead of taking it as one whole piece and looking at it holistically,” Enriquez told IPS.

Women who have experienced gender-based violence are at a significantly increased risk of developing a mental disorder, such as post-traumatic stress disorder, anxiety or depression, within one to three years after the assault.

Enriquez explains, “People don’t seem to understand that after being sexually assaulted, it’s something that you have to live with the rest of your life.

“Most of the time there is an incredible amount of anxiety or depression or other mental health issues that people just don’t understand,” she says. “It’s been five years since I was sexually assaulted and I still live through the trauma.”

A special Lancet series published Friday says that one in three women have experienced physical or sexual violence from their partner.

Researcher Dr. Susan Rees from the University of New South Wales told IPS that there is strong evidence that if you are exposed to gender-based violence, you are at a much higher risk for the onset of post-traumatic stress disorder (PTSD), anxiety and depression as well as attempted suicide.

Rees’ research into the connection between gender-based violence and mental disorders has shown that women who have been assaulted are significantly more likely to experience a mental disorder in their lifetime.

Women who have experienced one form of gender-based violence have a 57 percent chance of developing a mental disorder compared with only 28 percent of women who have not experienced gender-based violence. Significantly, 89 percent of women who have experienced gender-based violence three to four times will develop a mental disorder.

It is important for survivors of assault to get early support to help prevent the onset of an associated mental disorder, Rees said.

However, experiencing sexual assault can be confusing, especially for young women and girls, and this may prevent them from getting early intervention.

Enriquez explains that she didn’t initially realise the connection between her response to the trauma of sexual violence and the symptoms she was experiencing.

“I’ve recently been very jumpy, kind of always tense and I get startled easy, I didn’t understand why that was happening and it was very frustrating.”

Enriquez’ fiancé, who is not the person who assaulted her, used to jump out at her or play games to surprise her, and she found this really upsetting,

“I didn’t understand that it was related to me being sexually assaulted until probably my senior year of college. I feel like if I had been educated about what normal symptoms are of PTSD, I would have known that there was more to it and that it was a normal piece of it.”

Community attitudes affect prevalence

Community attitudes towards women, including strong patriarchal attitudes, power imbalance and gender inequality contribute to the prevalence of violence against women, said Rees.

“It makes sense that if you change attitudes then you can change prevalence, you can reduce the risk for women,” she said.

This is what Enriquez aims to do with her organisation Only With Consent. Together with her fiancé, Enriquez speaks with students to raise awareness and change young people’s attitudes towards sexual assault.

“I definitely think that there’s a gender piece that goes with both the mental health and the sexual assault and that it ties back to any time a woman expresses an emotion of being angry or upset we immediately call her out for being irrational or emotional.” Enriquez told IPS.

“If the majority of survivors who are speaking out are women, and they are expressing these feelings of being upset or being angry, or being really hurt, or any of those feelings, we discredit what they are saying, because we see them as irrational creatures,” Enriquez said.

Psychologist Dr. Dana Sinopoli told IPS that it is also important to consider how gender-based violence affects men, especially men who experience childhood sexual assault. She said that this should involve addressing gender stereotypes such as that men are aggressive or impulsive.

As Carry That Weight explains on its website:

“People of all gender identities can experience and be affected by sexual and domestic violence—women are not the only survivors just as men are not the only perpetrators. We strive to challenge narrow and inaccurate representations of what assault looks like and also acknowledge that these forms of violence disproportionately affect women, transgender, gender nonconforming, and disabled people.”

Sinopoli added however that changing community attitudes towards women was an important part of addressing gender-based violence.

“Consistently what I hear from women is that they are told to shut up, they are told to shut up during it, they are told to shut up after it, and they are told by some institutions to continue keeping their mouths shut.

“That is what we can link to the depression and the anxiety and a lot of the re-experiencing and retriggering that is so central to PTSD,” Sinopoli said.

Sinopoli added that “the way that society reacts, to someone who discloses or is struggling, is so important.

“The more that people speak up the more that we will actually see a decline in such significant psychological symptoms.”

Early intervention can help

When helping someone who has experienced violence, Rees said that it is important that friends and family reassure the victim that it “it is never acceptable to be hit, or to be treated violently or to be raped.”

Unfortunately, population studies show that women who have experienced gender-based violence are also at increased risk of experiencing it again in their lifetime.

“This might be the case because often men target women who are vulnerable, so if she has a mental disorder or trauma as a result of an early childhood adversity, she may be more likely to be targeted by men who in a sense benefit from powerlessness, inequality and fear.”

She said that warning bells that a relationship is unhealthy include controlling, jealous behaviour such as telling you who you should socialise with, or getting jealous because you are doing better than he is at university.

“Often women think that’s because he cares about me, he’s worried about me and that why he wants to know where I am all the time,”

But this type of behaviour should actually be seen as a warning of future emotional and perhaps physical abuse, Rees said.

Rees said that the reasons women don’t leave violent relationships are complex,

“She may be suffering depression. She may not have the economic resources to leave. She may worry about the children, and rightly so, because often people end up homeless, and she also may know that she’s at high risk of retaliation from the perpetrator if she leaves.”

Rees also explained that it is important for health practitioners to receive training so they can be confident to ask about domestic violence and respond appropriately.

She added that primary health care responses need to be integrated with community-based services to ensure that survivors have access to help that is sensitive to the complex impact of sexual violence.

Edited by Kitty Stapp

Schools around the world, like this one in Melilla, Uruguay, are trying to introduce healthy eating habits to bring down rates of obesity and overweight. Credit: Victoria Rodríguez/IPS

By Farangis Abdurazokzoda
WASHINGTON , May 31 2014 (IPS)

Over two billion people – or 30 percent of the world’s population – are either obese or overweight, and no country has successfully reduced obesity rates to date, according to a new study published this week by the British medical journal, The Lancet.

The number of overweight and obese people increased from 857 million in 1980 to 2.1 billion in 2013, according to the research, which was conducted by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and funded by the Bill & Melinda Gates Foundation.

Titled “Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013,” the study calls obesity a “major public health epidemic” in both the developed and the developing regions of the world.

An individual is considered to be overweight if he or she has a Body Mass Index (BMI), or weight-to-height ratio, greater than or equal to 25 and lower than 30, while obesity is defined as having BMI equal to or greater than 30.

“Obesity is an issue affecting people of all ages and incomes, everywhere,” said Dr. Christopher Murray, director of IHME and a co-founder of the Global Burden of Disease (GBD) study.

Not surprisingly, the largest proportion of the world’s obese people are found in the United States (13 percent).

In the Middle East and North Africa (MENA), Central America, and the island nations of the Pacific and the Caribbean, overweight and obesity rates have skyrocketed over the past 30 years – to 44 percent or higher.

Several oil-rich states in the MENA region – including Saudi Arabia, Kuwait, Qatar, and Libya – account for the world’s largest increase in obesity over the past generation.
But rates are also increasing the world’s two most populous nations – China and India. They currently account for 15 percent of the world’s overweight or obese population.

“These trends have nothing to do with genetics, but rather our lifestyle that has increasingly become indoors and immobile,” Ali Mokdad, who teaches at the University of Washington in Seattle, told IPS.

“We are paying the price for progress,” Mokdad, one of the study’s co-authors, added. “Machines have made our lives easier; thanks to machines, we can produce food faster and cheaper than ever, while microwaves make meals quick and easy. All these contribute to the problem.”

“It’s not a cosmetic issue, but a major risk factor for morbidity and mortality,” he said.
Particularly disturbing is the rise in obesity among children and adolescents. In the three decades covered by the study, the number of overweight or obese children and adolescents increased by 50 percent.

While in the developed world countries, 22 percent of girls and 24 percent of boys are overweight or obese, boys and girls in developing countries are catching up, as nearly 13 percent of them are overweight or obese.

“We know that there are severe downstream health effects from childhood obesity, including cardiovascular disease, diabetes, and many cancers. We need to be thinking now about how to turn this trend around,” said the study’s lead author Marie Ng.

The study stresses the need to mobilise not only the people, but also governments in the fight against obesity and its consequences.

“It’s not only the Ministry of Health that has to be concerned, but also the Ministry of Agriculture which needs to take into account how to build programmes and develop infrastructure in a way that would encourage people to be more healthy,” according to Mokdad.

He saluted U.S. First Lady Michelle Obama’s initiative “Let’s Move!” – a four-year-old effort “to end the epidemic of childhood obesity in a generation so that kids born today will grow up healthy.” In addition to encouraging exercise among youths, “Let’s Move!” urges schools to reduce the excessive consumption of sugar, salt, and fat and include more fruits and vegetables in meals served to students.

In a column published Thursday by the New York Times, the First Lady wrote that the U.S. spends 190 billion dollars a year treating obesity-related conditions in the general population. ”Just think about what those numbers will look like in a decade or two if we don’t start solving this problem now,” she wrote.

Her efforts have drawn criticism from right-wing Republican sectors and their allies in the press. The Wall Street Journal Thursday called Obama’s efforts “cuisine central planning” and cited recent statistics showing that consumption of federally funded school lunches has declined nearly four percent since the government’s new standards were first enforced, presumably because the recommended menus no longer included items popular with young consumers.

Qatar was found to suffer the highest rates of obesity and overweight at 73.9 percent, followed by Egypt (73.6 percent), Kuwait (73.4 percent), Libya (71.9 percent), Saudi Arabia (69.4 percent), Jordan (69.3 percent), Syria (69.1 percent), Mexico (68.9 percent), Iceland (68.5 percent), and the U.S. (67.4 percent).

Among South Americans, Chileans and Paraguayans led the region, with 66.1 percent and 63.9 percent, respectively.

In sub-Saharan Africa, where obesity and overweight were least prevalent among all regions, oil-rich Equatorial Guinea was the regional leader, with 58.7 percent of the population obese or overweight. It was followed by South Africa, at 52.9 percent, and another oil-rich country, Gabon, at 47.7 percent. In Ethiopia, by contrast, only 5.5 percent of the population was obese or overweight.

South and East Asia were also relatively slim, compared to wealthier regions. Malaysia was the heavyweight at 45.3 percent, followed by South Korea (33.2 percent), Pakistan (30.7 percent), and China (28.3 percent). By contrast, less than one out of five Indians were obese or overweight (19.5) percent.

The leanest, however, included Vietnam (12.4 percent), while North Korea and Timor Leste tied for the world’s lowest prevalence at 4.6 percent, according to the study. Rates in neighbouring Australia, on the other hand, neared those of the world’s heaviest, at 63.3 percent.

Most of the countries that are heaviest today, including Libya, Egypt, Iceland, as well as many wealthy countries, were also heaviest 30 years ago. But the obesity and overweight gap between them and most developing countries, particularly in sub-Saharan Africa and Asia, has since closed.

In 1980 China, for example, only about ten percent of the population was overweight or obese – or about one-third of the percentage in 2012.

More country data can be found here.

Jim Lobe contributed to this article.

Delegates to this week’s annual meeting of the World Health Assembly (WHA) in Geneva should agree on an ambitious agenda to sharply cut the rate of newborn deaths and stillbirths over the next two decades, according to maternal and infant health experts.

Reducing the rates of newborn deaths and stillbirths has lagged significantly behind the remarkable progress achieved in cutting mortality among children between the ages of one month and five years, according to a new study in the “Every Newborn” Series published by the British medical publication, ‘The Lancet”.

Thanks in major part to the U.N.’s Millennium Development Goals (MDGs), reductions in mortality for children 1-59 months and maternal mortality have averaged 3.4 percent and 2.6 percent annually, respectively, in recent years. By contrast, the neo-natal mortality and stillbirth rates fell by only two percent and around one percent per year, respectively.

Breast milk is vital for a premature newborn weighing barely 500 grams.
Credit: Manipadma Jena/IPS

That lag has been caused above all by “disappointing levels of investment in newborn health,” according to the study, which drew on the work of more than 55 experts from 29 institutions in 18 countries.

“So far, investment targeted to newborn health has been miniscule,” noted Joy Lawn of the London School of Hygiene & Tropical Medicine, who led the research on which the study is based along with Zulfiqar Bhutta from the Hospital for Sick Children in Canada and the Aga Khan University in Pakistan.

“Nearly half (44 percent) of all deaths in children under five are in the first month of life, yet only four percent of donor funding to child health even mentions the word newborn,” Lawn told IPS.

Indeed, every year, some 2.9 million infants die within 28 days of their birth, and another 2.6 million die in the last three months of pregnancy or during childbirth, according to U.N. estimates. Nearly half of these deaths occur during labour.

Many of those stillbirths have remained invisible, however, on the global health agenda, because nearly all of them go unreported to health authorities, and data collection on both stillbirths and neo-natal deaths is in any case inadequate. This is particularly true in the most-affected countries which include India, Pakistan, Afghanistan and Bangladesh, as well as Nigeria and a number of other sub-Saharan countries, according to the study. More than 75 percent of newborn deaths occur in South Asia and sub-Saharan Africa.

This week’s meeting of the WHA, the governing body of the World Health Organisation (WHO), will take up the “Every Newborn Action Plan” (ENAP) aimed at encouraging donors and beneficiary countries to accelerate action aimed at addressing the problem.

“The plan is based on a series of measures that are already proving effective in keeping women and children healthy – from preconception and pregnancy through to childhood and adolescence,” according to Dr. Elizabeth Mason, irector of WHO’s Department for Maternal, Newborn, Child and Adolescent Health. “Our goal is to end preventable newborn deaths within a generation.”

Specifically, the plan envisages reducing national neo-natal mortality to fewer than ten deaths per 1,000 live births and stillbirth rates to fewer than ten per 1,000 by 2035, resulting in global averages of seven and eight, respectively, according to the report.

If successful, that would cut current rates of neo-natal mortality and stillbirths by more than half and by as much as 85 percent in the worst-affected nations.

The study identifies proven interventions, including the promotion of breastfeeding; neo-natal resuscitation; so-called kangaroo mother care, which involves holding pre-term infants close to the mother’s skin for warmth and regulating their heartbeat; and providing corticosteroids that prevent infection resulting from cutting the umbilical cord.

The implementation of these interventions by themselves “could get newborn deaths down substantially in the first couple of years,” Melinda Gates, co-chair of the Bill and Melinda Gates Foundation, the world’s largest private source of funding for global health initiatives, told the ‘Wall Street Journal’ in an interview published Monday.

She is scheduled to address the WHA in support of ENAP Tuesday. Along with the U.N. Children’s Fund (UNICEF), WHO, and various bilateral agencies, the Gates Foundation is expected to be a major source of funding for the plan.

Lawn stressed the importance of having trained personnel available during and immediately after birth. “A critical issue is the need for more midwives and nurses with skills to look after women in labour and small and sick newborns,” she told IPS in an email. Each year, one million babies die on the day of their birth, according to the report.

Indeed, the most common barriers to improving survival rates were related to the dearth of trained health workers, according to studies of eight of the worst-affected countries – Afghanistan, Bangladesh, Democratic Republic of Congo, India, Kenya, Nigeria, Pakistan, and Uganda.

The study found that those countries that have achieved the most rapid reductions in maternal and newborn mortality – such as Malawi, Nepal, and Peru – have done so in major part by expanding their health workforce, improving care for small and sick newborns, and implementing new programmes designed to reach the poorest families.

Along with trained personnel, the availability of healthcare facilities is also critical.

“The increasing number of women who are giving birth at healthcare facilities presents the most immediate opportunity for action,” according to Bhutta.

“Our analysis shows that by increasing facility births and closing the quality gap at healthcare facilities by 2020, we could prevent an estimated 113,000 maternal deaths, 531,000 stillbirths, and 1,325 million newborn deaths each year. This should clearly be an immediate priority,” she added.

Lily Kak, the senior advisor for Global Partnerships and Newborn Health at the U.S. Agency for International Development (USAID), praised ENAP, calling its introduction a “historic moment and opportunity” and noting that it is “the first plan to unite the global community around progress toward newborn health outcomes.”

“Although we have seen incredible success in bringing down under-5 deaths, neo-natal mortality rates have declined at a slower pace,” she told IPS in an email. “This is in part because newborn health was not a global priority, investments were minimal, and simple and cost-effective ways of tackling the leading causes of newborn mortality—prematurity, asphyxia and sepsis— are better understood now.”

In Swaziland, which has been hard-hit by the AIDS pandemic, an HIV-positive mother sits next to her 18-month-old baby girl. Credit: Mantoe Phakathi/IPS

By Jim Lobe
WASHINGTON, Dec 3 2013 (IPS)

The gap in health standards between the world’s poorest countries and the more advanced middle-income nations could close by the year 2035, according to a major new report published Tuesday by Britain’s The Lancet medical journal.

Written by a group of 25 of the world’s top global-health experts and international economists, Global Health 2035: A World Converging Within a Generation makes the case for the international community, governments and key donors, such as the Bill and Melinda Gates Foundation, to increase investments in health to meet the target.

“Now, for the first time in human history, we are on the verge of being able to achieve a milestone for humanity: eliminating major health inequalities, particularly inequalities in maternal and child health, so that every person on earth has an equal chance at a healthy and productive life,” according to Harvard University professor and former U.S. Treasury Secretary, Lawrence Summers.

“The powerful drugs and vaccines now available make reaching this milestone affordable. It is our generation’s unique opportunity to invest in making this vision real,” said Summers, who 20 years oversaw the preparation of the only ‘World Development Report’ (WDR) devoted to global health when he served as the World Bank’s chief economist.

The 58-page report, which calls for government policymakers to adopt a new approach to measuring the importance of health to their national economies, is being published as the Global Fund to Fight AIDS, Tuberculosis and Malaria – a unique multilateral agency that has approved 29 billion dollars in grants since its founding in 2002 – is meeting here this week to gain new donor commitments for its fourth three-year replenishment.

The three diseases are among the biggest health challenges faced by the world’s poorest countries and poorest people in middle-income nations.

The Fund’s leadership got a big lift here Monday when, at a World AIDS Day ceremony, President Barack Obama pledged continued U.S. support for the Fund, promising to provide one dollar for every two dollars committed by other donors over the next three years, up to a total of five billion dollars.

Bill Gates also announced that his foundation – the single biggest private funder of global health initiatives – will provide up to 500 million dollars through 2016, including 300 million dollars that was previously committed and up to 200 million dollars in new matching grants.

“Don’t leave our money on the table,” Obama said, speaking to many of the delegates who have gathered here for the pledging conference. “Now is the time to replenish the Global Fund.”

The Fund’s new executive director, Mark Dybul, said he was confident that this week’s pledging would significantly exceed the 9.2 billion dollars that was committed at the last replenishment in 2010.

The Lancet report offers what it calls a “roadmap to achieving dramatic gains in global health through a grand convergence around infectious, child and maternal mortality; major reductions in the incidence and consequences of non-communicable diseases (NCDs), and injuries; and the promise of ‘pro-poor’ universal health coverage.”

If followed, the roadmap could result in averting some 10 million deaths across the target countries in 2035 alone, according to the report.

It points to the experience of the “4C countries” – Chile, China, Costa Rica, and Cuba — as models for poor and lower-middle-income countries. All four started off at similar levels of income and mortality as today’s poor countries but, by 2011, had become among the best-performing middle-income nations.

Among the specific goals, according to the report, are reducing under-five mortality to 16 per 1,000 livebirths, and reducing annual AIDS-caused and TB-caused deaths to eight and four per 100,000, respectively.

To achieve these and other aims, the report calls for “aggressively scaling up” efforts to fight HIV/AIDS, TB, and malaria as well as improve maternal- and child-health conditions which were a major focus of the Millennium Development Goals (MDGs); strengthening health systems to focus on the most problematic sectors, including poor rural sub-populations of middle-income countries that are disproportionately affected by infectious diseases; and devoting more and earlier investment to family planning.

In addition, government should be encouraged to pursue fiscal policies – notably by heavily taxing tobacco and other harmful substances, such as alcohol, that can sharply reduce NCDs and injuries, as well as leverage significant new revenue for low- and middle-income countries that can, in turn be used to reduce subsidies on items, such as fossil fuels that produce air pollution which in turn cause NCDs.

Such savings will provide most countries with enough funds to finance many of the steps urged in the report. It thus urges that, while donor countries, which hopefully will include emerging economies, should increase their investment into research and development to produce new drugs, vaccines, and other health technologies.

The report calls for at least a doubling in health R&D from current annual spending of around three billion dollars to six billion dollars by 2020, with half of the increment coming from middle-income countries.

The report argues that the economic returns from investments in health are “much greater” than policy-makers have previously assumed.

The 1993 WDR found considerable evidence that improvements in health increased gross domestic product (GDP) per capita by enhancing childhood educational advances and adult worker productivity, as well as increasing access to natural resources and foreign investment that are encouraged by controlling diseases like malaria.

But the GDP analysis, the Lancet report asserts, measures only the impact of health improvements on economic productivity. It fails to capture the intrinsic value people place on their own improved health, including their greater life expectancy.

A full-income approach combines growth in national income with the value of additional life years (VLY). The report estimates that, on average, across low- and middle-income countries, one VLY – a one-year increase in life-expectancy – is about 2.3 times greater than per capita income.

Using that approach, the report found that, between 2000 and 2011, 24 percent of the growth in full income in those countries resulted from health improvements; that is, in VLYs gained. By the same token, setbacks to life expectancy, such as in countries hit hard by the HIV/AIDS pandemic, resulted in a far greater adverse impact than the impact on GDP per capita would suggest.

“We believe that if nations worldwide adopt a full-income approach to economic planning, the human returns to investing in health can be brought into resource allocation decisions,” said Dean Jamison, a University of Washington professor who co-chaired the Commission with Summers.

“People value a longer and healthier life, and the notion of full income simply places that value in monetary terms. While it does not put a monetary value on an individual’s life, it does place a value on changing mortality risk, which traditional notions of GDP neglect,” he added.

Children in drought-struck Camotán, in Chiquimula province, Guatemala. Credit: Danilo Valladares/IPS

By Sudeshna Chowdhury
UNITED NATIONS, Jun 6 2013 (IPS)

Kevin’s Carter’s disturbing picture of the 1993 famine in Sudan won him a Pulitzer Prize.

The image of an emaciated child being watched by a vulture was etched into the world’s memory forever, drawing attention to conditions where survival becomes the only priority.

Reducing the child mortality rate and improving maternal health prominently figure in the list of the U.N.’s Millennium Development Goals (MDGs) that were adopted by the international community in 2000 in New York with a 2015 deadline.

As the world body draws up a list of new Sustainable Development Goals (SDGs), the medical journal The Lancet published a series of reports Wednesday finding that,among other things, malnutrition is responsible for nearly half (45 percent) of all deaths in children under five.

Around three million deaths of children under five occur from malnutrition, which encompasses undernutrition and overweight, both global problems.

The focus of agricultural programmes should shift towards enhanced nutrition rather than just increasing crop yields, Professor Robert Black of Johns Hopkins Bloomberg School of Public Health told IPS.

“These programmes have not been set up in an ideal way,” he said.

Calling for the idea of “nutritional sensitive agriculture”, Black also emphasised the importance of actions at the community level to address issues on malnutrition.

Collaboration among civil society, humanitarian agencies and the commercial sector would make a difference at the local level, Black told IPS. “More engagement of organisations such as the Food and Agriculture Organization (FAO) is important,” he said.

Martin Bloem, senior nutritional advisor with the World Food Program (WFP), echoed a similar sentiment. He emphasised the role of Anganwadis, government sponsored child-care centres in India, in countries like India.

Reports suggest that lack of resources as well as unhygienic conditions in these centres have raised new challenges when it comes to addressing issues of malnutrition in a country like India.

But inspection and strict monitoring is paramount when local communities are involved, Bloem said.

The findings in The Lancet come ahead of the Group of Eight (G8) summit, which will be preceded by the UK and Brazilian governments co-hosting a high-level event on Nutrition for Growth.

The findings suggest that addressing the problem means addressing the underlying causes of malnutrition, such as, “poverty, food insecurity, poor education, and gender inequity”.

The study also stated that close to 15 percent of all deaths in children under the age of five could be prevented by providing vitamin A and zinc supplements to children up to the age of five, as well as taking care of dietary needs of pregnant women, among many other measures.

But, it is the time of pregnancy and the first 1,000 days that are most crucial for a child’s growth, Bloem told IPS. The health of the mother is equally important, he said.

“Also people do not realise the relation between stunted growth and obesity which can increase the chances of cardiovascular diseases. Also, there is an urgent need to link the health and the food system all around the world,” he said.

Public-private partnerships can help create products which are nutritional, affordable and accessible to vulnerable populations all over the world, Ellen Piwoz, senior programme officer for family health and nutrition at the Bill & Melinda Gates Foundation, told IPS.

But what is stalling the fight against malnutrition is “the lack of a real commitment and drive among international governments,” said Werner Schultink, UNICEF’s head of nutrition.

While reducing hunger and poverty have been leading priorities for the U.N., “if you look at the indicators, such as underweight, the progress is insufficient.”

According to the study, emerging problems of obesity and overweight are “resulting in a ‘double burden’ of maternal and child disease and illness,” in countries where undernutrition is already a huge problem.

A right balance of adequate nutritional diet and an affordable food industry spearheaded by public and private sectors as well as community-level initiatives could provide solutions to tackle this “killer”, said experts.