WASHINGTON – Scientists give us the facts. But aid organizations determine who gets help.
Although scientists agree there is a frightening prevalence of undernutrition,”significant improvements” in aid are needed to solve the problem,according to a new report that was the subject of a panel discussion Wednesday.
The Lancet,a medical journal,launched a series of articles on maternal and child undernutrition at the Woodrow Wilson International Center for Scholars,and in London,where the journal is based.
“Undernutrition” is a more specific term than “malnutrition,” because it encompasses “nutrition that is not normal,” said Dr. Robert Black,lead author of the five-paper series.
“Despite isolated successes in specific countries … most countries with high levels of undernutrition are failing to reach undernourished mothers and children with effective interventions supported by appropriate policies,” the report says.
It cites programs as simple and inexpensive as providing iodized salt and vitamin A.
“Considerable deficits remain in the performance of the international nutrition system. If the challenge of reducing global undernutrition is to be met,then all the organizations that are part of this system need to individually re-examine their strategies,” the report says.
The series of reports outlines seven “challenges” that aid providers and countries with undernourished residents need to meet. They include making nutrition part of the national agenda,avoiding practices that don't work and substituting those that do. In addition,the reports urge aid organizations and countries to make sure aid is getting to the right populations and that programs reach entire populations instead of starting slowly with small groups. Groups also need to gather data and make lasting changes in the way aid is delivered.
Including nutritional concerns in economic and social policy was the most sensitive of the conclusions reached in the reports. It ignited multiple questions from the audience,which included many doctors. One asked the panel about the possibility of universal nutrition standards.
“The most prudent thing to do is to invest directly in nutrition-related areas. These are the things we are talking about here,for the short term,” said Joy Phumaphi,World Bank vice president of human development. “In the short term,that is the best. Long term,of course,your solution is the best.”
Undernutrition in pregnant women can lead to low birth weight and nutrient deficiencies in babies. Over time,chronic stunting of growth can occur,as well as wasting,or significant weight loss.
Of the world's children under age 5,nearly a third,or 178 million,suffer from stunting,90 percent of whom live in 36 countries. Most undernourished children chronically lack zinc and vitamin A. Iron deficiency is a risk for pregnant women.
Zinc and iron are commonly found in animal products,which are generally more expensive and not available to poor people. Vitamin A deficiency is often an issue of diversity,found where diets are not varied.
Infectious diseases also contribute to undernourishment,and can divert governments and aid organizations,something the report recognizes.
“The high rate of infectious diseases actually causes malnutrition,itself,causing metabolic stress,reduction of nutrient intake,and mal-absorption,” explained Black,a professor at the Johns Hopkins Bloomberg School of Public Health.
He said researchers hope scientific evidence can influence policy,but programs need to be more accountable. “Many of the countries that were assessed said themselves that ‘we don't have the capacity to do this,'” Black said.
Phumaphi and others at the discussion emphasized additional benefits of good nutrition.
“Bigger and healthier bodies leads to higher physical productivity. Well-nourished children are more intelligent and do better in school. They are more productive as adults,” she said. “The economic benefits from improving nutrition are substantial.”
Kent Hill,of the U.S. Agency for International Development,said food fortification is cost-efficient. Every dollar spent on vitamin A fortification returns about $7 in increased wages and decreased disability.
“Improved health to the world's poorest people is not only a moral imperative,but also a pragmatic investment for peace,security and worldwide economic growth,” Hill said.
Global Alliance for Improved Nutrition Board Chairman Jayaseelan Naidoo emphasized the need to think about aid recipients' views. “Every parent – no matter what their status,wherever their lives are,whatever their wealth or poverty – wants to support their children,” he said.
The Bill and Melinda Gates Foundation's Dr. Tadataka Yamada stressed education. “We need new knowledge in nutrition,” he said.
The Gates Foundation provided financial support for the series,in coordination with the World Bank,UNICEF and the World Health Organization.
In a press release,Lancet researcher Dr. Richard Horton,said,”An agency,donor,or political leader needs to step up to this challenge. There is a fabulous opportunity right now for someone to do so. But who?”