Session 3 b marie ruel

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Marie Ruel ︳ Food Secure Arab World ︳ Beirut, Feb 6-7, 2012

Opportunities and Challenges for

Achieving Nutrition Security in Low

and Middle Income Countries


INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE

GLOBAL TRENDS IN NUTRITION

Click to edit Master title style 171 million children under 5 are stunted

Source: WHO Global Database on Child Growth and Malnutrition, May 2009 - Mercedes de Onis, BMGF meeting 2010

Click to edit Master title style Stunting ↓ from 44-29% (1990-2010)

1990 2000 2010

010

2030

4050

Stu

ntin

g (%

)

4 0 .3

4 8 .6

2 3 .7

3 9 .3

3 7 .7

1 8 .1

3 8 .2

2 7 .6

1 3 .5

1990 2000 2010

050

100

150

200

Num

ber o

f stu

nted

(mill

ions

)

4 5

1 9 0

1 3

5 1

1 3 8

1 0

6 0

1 0 0

7

AFRICA ASIA LATIN AMERICASource: Department of Nutrition, World Health Organization

Mercedes de Onis, BMGF meeting 2010

%

Click to edit Master title style Overweight children ↑ steadily (1990-2010)

Mercedes de Onis, BMGF meeting 2010

1990 2000 2010

02

46

810

Overw

eig

ht (%

)

4

3 .2

6 .8

5 .7

3 .7

6 .8

8 .5

4 .9

6 .9

1990 2000 2010

05

10

15

20

Num

ber of overw

eig

ht (m

illions)

4

1 3

4

7

1 4

4

1 3

1 8

4

AFRICA ASIA LATIN AMERICASource: Department of Nutrition, World Health Organization



Vitamin A: 160 million children affected; ~30%

children (40% in Africa and South Asia); also

prevalent in women

Anemia: (half of which is due to iron deficiency):

Static at ~45% in children (Africa and Asia); 500

million women anemic (highest burden in Asia)

Iodine: widespread deficiency

Low birth weight: 25-33% in Africa and Asia

Slow progress on ↓ micronutrient deficiencies

and low birth weight



Coexistence of under and over nutrition

0

10

20

30

40

50

60

70

80

90

100

Egypt Peru Mexico

%

Other

Overweight

Obese

†*, †

Anemia in women

0

5

10

15

20

25

30

35

2003 2005 2008

Stunting

Wasting

Overweight

Egypt

In same country

In same household

In same individual



WHY DOES NUTRITION MATTER?


Height

at 18 y 81.2

Severe Moderate Mild Well-nourished

Height

at 3 y

Source: Paul Melgar, INCAP

Stunted child – Stunted adult

Damage is irreversible



High risk of illness and mortality (associated with

35% of child deaths)

Poor cognitive development, delays in starting

school, poor school performance

Reduced economic productivity – wages, income,

skilled jobs

Increased risk of obesity and NCD at adulthood

(and premature death)

Small mothers, small babies

Being undernourished in early childhood

= Being handicapped for life



GPD losses > 2-3 %

US $80 billion/y (Sridhar 2007)

Huge cost to society & global economy

Malnutrition Poverty



WHAT NEEDS TO BE DONE TO

ACCELERATE PROGRESS IN

IMPROVING NUTRITION?


LAC

Europe &

Central Asia

North Africa &

Near East

SS Africa

South Asia

-9 to 24 mo

1. PREVENT – Focus on 1st 1000 Days



2. Scale-up targeted nutrition Interventions

Series of Nutrition Interventions of known

efficacy (Lancet 2008):

• Maternal health and nutrition during pregnancy

(and before)

• Appropriate child feeding practices

• Micronutrient supplementation (e.g. vitamin A,

zinc, iron)

• Immunization

• Hygiene


15

3. Integrate nutrition into other

relevant sectors

Agriculture &

Food Security

Social

Protection

Poverty

Reduction

Health

Water &

Sanitation

Private

Sector

Trade/Fiscal

Policies

Environment &

Climate Change

GOVERNANCE GENDER

Work

Multi-

Sectorally

Source: World Bank 2011

http://www.karachibourse.com/wp-content/uploads/2011/01/Trade-Deficit.jpg

Click to edit Master title style 4. Use a life cycle approach



5. Focus on poor, vulnerable, left

behind, and on reducing inequities

6. Improve data, information,

measurement, documentation,

learning, evaluation



Several new initiatives are following these

principles

How will these translate into actions on the

ground and Improvements in nutrition at scale?

UK DFID

http://www.thousanddays.org/

Business

Session 3 b marie ruel