Fighting an invisible enemy has sidelined many of our national issues. With the world’s fifth largest population and more than 87 million children under the age of 18 – the glamorous political facade and the power play have not resulted in much factual realizations of no hunger and free education fustians – except for written letters or uttered words. In the latest publication of the report, ‘The State of the World’s Children’, by UNICEF – the annual number of under-5 deaths in Pakistan was 409,000 in 2018, which made it the third largest country in this regard. Surprisingly, countries such as Sudan and Afghanistan had 80,000 and 74,000 deaths respectively. Whilst, the ghost of our erstwhile policies resulting in such numbers still haunts us – the human tragedy associated with Covid-19 implies more bankruptcies, dwindling profits, lost earnings and unemployment – which would further exacerbate our damaged macroeconomic impediments and socio-economic fabric. This might lead to a hiatus in the already critical and staggering path to the accomplishment of ‘SDG 2: Zero Hunger’. This particular SDG pledges to ‘end hunger, achieve food security and improve nutrition and promote sustainable agriculture by 2030’.
Target 2.1 states that ‘by 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round’. For this target, indicator 2.1.1 deals with the prevalence of undernourishment which shows a slight decline in the percent of people who are undernourished in Pakistan. This prevalence of undernourishment – which refers to the population below minimum level of dietary energy consumption – fell from 21.1 percent in 2010 to 20.3 percent in 2017. But a disquieting sight in this regard can be seen from the statistics from Global Hunger Index which shows that Pakistan lies at the 94th position out of a total of 117 countries with a score of 28.5, declaring the level of hunger in Pakistan as ‘serious’. Indicator 2.1.2 deals with the prevalence of moderate or severe food insecurity in the population, based on the Food Insecurity Experience Scale (FIES). Unfortunately, in our country, 15.92 percent households experience moderate or severe food insecurity with the highest prevalence in Sindh. Unquestioningly, this will impact our children the most – who will pay for this throughout their life in the form of impaired growth and cognitive abilities.
In 2019, UNICEF’s Executive director, Henrietta Fore made a chilling statement that ‘if children eat poorly, they live poorly’. This statement rings true at many levels. Poor diet and consumption habits lead to impaired cognitive functions and overall growth as well. This ultimately leads to a person, unable to live up to their productive potential because they might not suffice at the requirements of their equals who excel at the skills the current world demands. This relates to target 2.2 which aims that ‘by 2030, ending all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons’. Micro nutrients and vitamins which are essential for growth are neglected by mothers when they are expecting or when a child is in the early growing years. This leads to stunting, which corresponds to the indicator 2.2.1 of the former target dealing with the ‘prevalence of stunting among children under 5 years of age’. Stunting is defined as the children whose height for age is more than two standard deviations below the WHO Child Growth Standards median. For the available statistics of 2018, malnutrition among preschool-aged children (0-4 years of age) 2013-2018 resulted in moderate and severe stunting in 28 percent of children. Similar statistics can be seen from the 2018 National Nutrition Survey in Pakistan – which showed that four out of ten children under five years of age are stunted while 17.7% suffer from wasting.
The fact that Pakistan suffers from malnutrition and the resulting threefold dilemma of stunting, wasting and being overweight, is because of the permeating illiteracy and widespread unawareness in our society. In the same aforementioned UNICEF report – the statistic of women going for at least four antenatal care visits (among women aged 18-49) stood at just 51% for the time period of 2013-18. Misogynistic mindsets and/or lack of resources often result in poor health and literacy for young women. This, coupled with early marriages, lack of decision making by women at a household level and a general lack of education about nutritional aspects of food and fertility choices lead to such predicaments. The worst aspect in all this situation is that there has been no major change to address such social determinants resulting in such numerals.
So, what are possible solutions to this alarming myriad of issues? Evolving social protection at the time of Covid-19 paralleled with the debate of lives versus livelihoods. The launching of Ehsaas Emergency Cash Programme helped us in a tricky situation. Even before that, many evaluations showed that Benazir Income Support Program (BISP) had an impact on nutrition and increasing the consumption of the poorest households. Correspondingly, the innovative idea enacted upon in 1983 by Muhammad Yunus in the form of Grameen bank led to huge improvements in poverty reduction through the introduction of microfinance institutions worldwide to-date. These microfinance and microfinance institutions may provide credit to start small scale businesses and to overcome emergency situations. Women, in particular, have been known to benefit more from these MFIs and a majority of these women spend the cash to utilize their rights over the use of resources and to improve the general consumption of the household. Yet the scale and reach of these two factors – social safety nets (SSNs) and micro finance schemes – need to be increased to far flung areas, as well as to the people who do not fulfill the requirements for eligibility of such initiatives.
Whilst there is no denying that these programs have had significant improvements in the nutrition as well as empowerment of women regarding dietary decisions in the household, if these two aspects of social protection and microfinance institutions are paired and complemented by training and graduation programs, that would ensure sustained livelihoods. Nevertheless, it should not be forgotten that MFIs also face a risk of insolvency and SSNs face fiscal constraints, for which the confidence of creditors and a helping hand from donors can be a cure.
Our supply side issues should not be forgotten as well. The locust attack already baffled our agriculture, efforts and resources. According to the Food and Agriculture Organization (FAO), 38 percent of Pakistan’s agricultural fields are breeding grounds for insects. While we faced the locust attack, we should remember that investment in scientific and technological know-how for agriculture should be stressed on. Hence, budgetary allocations should be mindful of these facts to modernize agriculture. The Federal government allocated Rs 10 billion for locust control and an additional Rs 12 billion has been allocated for food security and agriculture. However, the Punjab government has reduced the allocations for the agriculture sector to Rs 8.065 billion from Rs15.5 billion in last year’s Annual Development Programme. In the case of Sindh, these allocations increased from Rs 10.6 billion to Rs 14.8 billion in the current budget. These allocations are important because other than the aforementioned issues, there is a severe shortage of irrigation water along with our deteriorating top soil. Some consistency in the civil servants assigned to the irrigation department will also be much appreciated.
Individual citizens, associations and NGOs can finance more free meals by including more targeted areas. Governments, on the other hand, can have renegotiations with IMF, reduce the burden of indirect taxation of essential food commodities, and educate the masses on proper nutritional value. In fact, in lieu of increasing aggregate demand, the training and hiring of nutritionists should be increased at government hospitals. Health workers can be guided about daily nutritional and caloric requirements and the concepts of body mass index (BMI), who can later create awareness. Obviously, to finance such initiatives, at such a critical time, the operating expenses of some ministries can be reduced.
Last, but not the least, farmers should be recognized as stakeholders regarding important decisions such as crop diversification, crop rotation and application of modern techniques in agriculture to increase our yield per hectare. Stuck in this downward spiral, one possible way out can be more targeted subsidies to support the agricultural system and farmers in the form of a mini-budget. It would be prudent to remember that our concepts of individuality should be replaced with solidarity. The myriad of events in the form of an imperceptible virus showed us that ‘united we stand, divided we fall’.
Dr. Izza Aftab is the chairperson of the Economics Department at Information Technology University, Lahore. She is also the Director of the SDG Tech Lab and the Program Director of Safer Society for Children. She tweets @izzaaftab.
Noor Ul Islam is currently working as a Research Associate at the SDG Tech Lab established in collaboration with Information Technology University, Lahore, UNDP and UNFPA. She tweets @Noor_Ul_Islam20
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