Investing in nutrition

Good nutrition has been recognised both as a basic ingredient and as an outcome of human development globally. As food and nutrition are important factors in human development, they are widely recognised by high income and middle to low income countries.

In this context, the international community and developmental agencies have decidedly focused and prioritised nutrition. In 2004, under the ‘Copenhagen Consensus Initiative’, eight of the world’s most distinguished economists agreed that providing micronutrients would yield returns comparable to those of the best economic policies at that time. Revisiting the issue in May 2008, this eminent team of economists, commissioned by the Copenhagen Consensus Centre, reviewed and prepared a list of the most promising solutions to ten of the most pressing challenges facing the world today.

Five out of the 10 most cost-effective and sustainable solutions are directly related to nutrition. Hence, it was concluded in the 2008 Copenhagen Consensus Conference that combating malnutrition in undernourished children, specifically providing vitamin A and zinc, delivers the most beneficial returns on investment. Furthermore, micronutrient fortification with iron and iodine ranked third, above other critical interventions like expanded immunisation coverage for children.

Similarly, the Lancet 2008 and 2013 series, a leading scientific journal in the field of global health and nutrition, made it a point that chronic malnutrition, or stunting, is the main nutritional problem, because it is a key obstacle in development. The series indicated that the window to prevent stunting is very small, spread over a period of 1,000 days from the conception of a baby in the foetus to two years of age. Stunting at two years is associated with ill health, poorer school performance and an increased risk of obesity, diabetes and other chronic diseases, contracted later in life. Economic analyses have indicated that poor nutrition intake in early life negatively effects the overall economic development of nations.

According to the Food and Agriculture Organisation of the UN, malnutrition costs the global economy $3.5 trillion per year. Also malnutrition and micronutrient deficiencies cost up to $2.1 trillion per year. This cost of malnutrition is high, but spending on interventions to address this problem can result in increased nutritional status globally – consequently increasing economic growth in the long term. One recent research revealed that investing $1.2 billion annually on micronutrient supplements, food fortification and biofortification of staple crops for five years can reap annual benefits of $15.3 billion – a benefit-to-cost ratio of almost 13 to 1 – and would result in better health, fewer deaths and increased future earnings.

Though malnutrition is a global issue, it is particularly posing more serious threats to South Asian countries. Literature reviews depict that in Bangladesh anaemia alone is causing a loss to its economic productivity, losing 7.9 percent of the gross domestic product (GDP). In India, four percent of the country’s GDP is estimated to have been lost due to malnutrition. The economic consequences in Pakistan attributed to malnutrition show a similar picture. According to the World Food Programme, Pakistan is losing $7.6 billion, or three percent of the GDP annually, which is even more than the two percent GDP loss because of the energy crises.

Interestingly, despite this dismal picture of India and Bangladesh, literature presents these countries as success stories in combating their malnutrition issues because of constant improvement in their economic indicators over the decades. However, in Pakistan, despite evidence suggesting that the situation has seen a slight improvement, the reality is that it is quite insignificant. During 2001-2011, the proportion of underweight children under five years of age declined from 38 to 32 percent, but the levels of stunting increased from 37 to 44 percent and of wasting from 13 to 15 percent.

In such a situation, there is a need to address the issue on an emergency basis. Though Pakistan has made several global commitments pertaining to achieving nutrition milestones – like the World Health Assembly nutrition targets, Sustainable Development Goals (SDGs) and Scaling Up Nutrition (SUN) strategy – the government needs to take a top-down approach. The government should involve communities and policymakers to understand the multi-level causation of malnutrition and address it through collaboration and coordination among different sectors, especially in order to prevent stunting.

Malnutrition in all its forms contributes to an intolerable burden not only on the national health system but on the entire cultural, social and economic fabric of a nation. It is the greatest impediment to the fulfilment of human potential. Without good nutrition, the mind and body cannot function well and the foundations of economic, social and cultural life are undermined.

Therefore, investing in nutrition makes economic sense as it reduces healthcare costs, improves productivity and economic growth and promotes education, intellectual capacity and social development for the present and future generations of the countries.

The writer is a public health consultant.

Email: fauziawaqar_28@hotmail.com