Daily Times

KARACHI: The global community today faces many challenges in the form of malnutrition, a condition that directly affects every one in three people. Malnutrition manifests itself in many different ways: as poor child growth and development; as individuals. who are skin and bone or highly prone to infection; as those who are carrying too much weight, or whose blood contains too much sugar, salt, fat, or cholesterol; and those who are deficient in important vitamins or minerals. Malnutrition continues to remain, by far, the biggest risk factor for the global burden of diseases: every country currently faces a serious public health challenge in the form of malnutrition, according to a new Global Nutrition Report, recently issued by the World Health Organization (WHO).

The economic consequences of this tragedy are validated by the grave losses of as many as 11 percent of Gross Domestic Product (GDP) every year in countries of Africa and Asia, whereas preventing malnutrition delivers as high as $16 as returns on investment of every $1. The international community has agreed on setting targets for nutrition, however, despite some progress in recent years, the world is still way off-track to reach those targets. This third stocktaking of the state of the world’s nutrition points to ways to reverse this trend and end all forms of malnutrition, by 2030.

Over the past decade, the momentum around the debate on nutrition has been steadily building. In 2012, the World Health Assembly adopted the 2025 Global Targets for Maternal, Infant and Young Child Nutrition. The following year, it went on to adopt additional targets for noncommunicable diseases (NCDs), including those relevant to nutrition. Also in 2013, at the first Nutrition for Growth (N4G) Summit, donors committed the amount of US$23 billion to improve nutrition. With the Second International Conference on Nutrition (ICN2), in 2014, and with the recent naming of 2016-2025 as the United Nations Decade of Action on Nutrition, more and more people have now begun to recognise the importance of addressing malnutrition in all its forms. In 2015, the UN Sustainable Development Goals also enshrined the objective of “ending all forms of malnutrition,” challenging the world to think and act differently on malnutrition, to focus on all its faces and work to end it, for all people, by 2030. Now, 2016 brings some major opportunities to translate the previous commitments into action. These opportunities include countries’ adoption of their own targets related to the Sustainable Development Goals, the ongoing Nutrition for Growth process, and Japan’s growing leadership on the issue of nutrition in the lead-up to the 2020 Tokyo Olympics and Paralympics.

Malnutrition and poor diets continue to exist as the biggest driver of the global burden of diseases. We already know that the annual GDP losses from low weight, poor child growth, and micronutrient deficiencies average around 11 percent in Asia and Africa—much greater than the loss experienced during the 2008-2010 financial crises. This report presents new data on the cost of malnutrition to both the societies and the individuals. In the United States, for example, when one person in a household is obese, the whole household bears the brunt of additional annual health care costs, which are equivalent to 8 percent of its annual income. In China, a diagnosis of diabetes results in an annual 16.3 percent loss of income for those with the disease. All of these figures indicate that the burden of malnutrition falls heavily on all of us, whether we are directly suffering from it or not. However, these costs also represent large opportunities for human and economic betterment, and this report provides many such examples of countries that have seized these opportunities to improve the lives of their people and the health of their societies by addressing the giant of malnutrition.

If we do not pay heed to the matter at SShand, the world will not be able to meet the global nutrition and NCD targets, adopted by the World Health Assembly. However, this assessment also hides significant variations and holds some surprises. Many countries are on their course for meeting targets related to stunting, wasting, and overweight among children under the age of five, with a particular focus on breastfeeding. Nearly all countries are off course, however, for meeting targets on anaemia in women, adult overweight, diabetes, and obesity. The ratios of obesity and overweight individuals are rising in every region and nearly every country is presently staggering global challenge. The number of children under the age of five, who are overweight is fastly approaching the number who suffer from wasting. The headline also hides regional variations: the number of stunted children under the age of five is declining in every region except Africa and Oceania; the number of overweight children under the age of five is increasing most rapidly in Asia. Behind these rather gloomy numbers is a cause for hope: some modest changes can still put many countries on course to meet global targets. This report outlines where those opportunities lie.

Given the scale of the malnutrition problem, the current expenditure being designed to overcome the problems is too low. The analysis shows that as many as 24 low- and middle-income governments allocate only 2.1 percent of their spending to reducing under nutrition, whereas they spend a total of more than 30 percent on agriculture, education, health, and social protection. Donors’ allocations to the nutrition-specific interventions are stagnating at $1 billion, although donor allocations to nutrition through other development and social sectors are, we believe, still increasing. Spending on nutrition-related NCDs also appears to be low. At present, we do not know how much governments allocate to combating nutrition-related NCDs. In 2014, donors spent around $611 million on all types of NCDs— which was still less than 2 percent of their overall health spending. And despite the fact that nutrition-related NCDs account for nearly half of all deaths and disability in low- and middle-income countries, new data presented in this report show that donors spent just $50 million on these types of NCDs in 2014.