LAHORE: While the tax-loaded budget did provide relief to parliamentarians and government servants, it did not highlight measures desperately needed by the country to reduce malnutrition that is afflicting a majority of the Pakistani population.
Most people in the country do not have enough resources to eat two meals a day but even those who can afford to fill their stomachs daily do not eat nutritious food. Other countries have resolved the issue through low-cost fortification of food items that are consumed by almost all segments of society.
The fortification of all edible oil preparations with Vitamin A and D has been made compulsory. But compliance is poor. If fortification is ensured, it will check for ailments related to vitamin A and D deficiencies. All these fortifications are done by manufacturers, who transfer the additional costs to consumers. The costs are nominal and do not hurt buyers much.
A more important issue of malnutrition that afflicts a majority of Pakistani children and women is iron deficiency, which results in anaemia. This condition, in many cases, ultimately leads to the deaths of infants and pregnant women. Every developed country fortifies wheat flour, which is a staple food for a majority of people across the world. Those countries that have made it compulsory to fortify iron preparation in wheat flour have seen anaemia cases disappear rapidly.
Luckily, wheat flour is the staple food of over 80 per cent of the population of Pakistan, and its fortification with iron can eliminate the most threatening micronutrient deficiency in the country.We already know about this threat and its solution, and since 1997, we have experimented with different iron compounds to find out the most suitable iron compound that could be fortified in wheat flour. Many pilot projects undertaken in different areas of Lahore and Faisalabad reveal remarkable improvements in the health of the population using ‘atta’ (flour) fortified with the approved salt.
Some time back, the Ministry of Health, through its department of micronutrient initiative, was distributing the iron compound to flour mills for fortifying flour with iron, but that was stopped after the devolution of the food department to provinces.
The provinces have not shown seriousness in addressing this issue. Knowing the nature of the private sector, they have to supply free iron fortifying compounds to flour mills. The federal government could have stepped in to procure the iron compound and supply it to each province on the basis of the number of operational flour mills.
The compound would not have cost more than Rs40 billion. This would have saved hundreds of billions of rupees spent on health issues related to iron and iodine deficiencies.Iron deficiency is a major cause of anaemia in children and pregnant women in Pakistan.
According to Unicef estimates, iron deficiency affects half of the developing world’s infants, undermines the health of 500 million women of reproductive age, and leads to more than 60,000 childbirth deaths a year. Iron deficiency is also one of the major causes of the high infant mortality rate in Pakistan. It also causes a range of other problems for millions of people, including impaired cognitive development in children, fatigue, maternal mortality, and low productivity in the workplace.
There is still time. The amount needed to supply the iron compound to flour mills could be arranged through BISP or export development funds. The World Bank estimates that GDP lost to malnutrition in many developing countries can be as high as 2-3 per cent. This is because malnutrition slows economic growth and perpetuates poverty through direct losses in productivity from poor physical status and indirect losses from poor cognitive function, deficits, schooling, and losses owing to increased health costs.