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From: IRIN <[email protected]>
Date: Mon, 10 Jun 2013 14:27:51 +0100
Subject: Ten ways to save a million lives
To: Elisabeth Janaina <[email protected]>

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Ten ways to save a million lives
<http://www.irinnews.org/report.aspx?reportid=98203>


 lead photo<http://www.irinnews.org/images/2012/201209130934060801.jpg>
LONDON, 10 June 2013 (IRIN) - In London on 8 June, UK Prime Minister
David Cameron, together with an array of presidents, prime ministers,
businesspeople and philanthropists, signed the Global Nutrition for
Growth Compact, an agreement to improve the nutrition of children and
pregnant women around the world. Inside the meeting room, organizers
said they had secured new commitments
<https://www.gov.uk/government/news/nutrition-for-growth-beating-hunger-
through-business-and-science>  of up to US$4.15 billion to tackle
undernutrition between now and 2020; outside, in Hyde Park, activists
laid a carpet of flower petals to represent the lives of children lost
each year through malnutrition.

 The children represented by those petals do not starve to death.
Rather, many of them die of diarrhoea, pneumonia, malaria or measles -
the usual child-killer diseases
<http://www.childinfo.org/mortality_underfive.php>  - but
under-nutrition is an underlying factor in many of these fatalities.
Being poorly nourished more than doubles a child's likelihood of dying.

A major new Lancet series
<http://www.thelancet.com/series/maternal-and-child-nutrition>  on
maternal and child nutrition attempts to quantify the damage done by
poor nutrition. Taking into account infant mortality linked to
undernourished mothers and nutrition-linked birth defects, the authors
of the study estimate that poor nutrition is the root cause of 45
percent of child deaths - 3.1 million deaths among children under age
five each year.

Mortality figures would seem to be the ultimate measure of the world's
failure on nutrition, but the broader damage, say many in the field, is
to children's long-term development.

Sally Grantham-McGregor, of the Institute of Child Health, said,
"Really, we have to move on from the outcome being death. We know that
once children get severely malnourished, their development is going to
be bad. Once a child is severely malnourished, feeding alone will only
save their lives, not their brains. We are perpetuating the cycle of
poverty, and we have got to break it."

Life-saving steps

There has been progress since the last such report
<http://www.thelancet.com/series/maternal-and-child-undernutrition>
was published five years ago. The number of the world's children who
are stunted - who never grow to their potential height - has dropped
steadily over the past two decades, from more than 253 million in 1990
to 167 million in 2010. The drop has been especially dramatic in Asia.
In Africa, the percentage of stunted children has dropped, but
population growth means that the numbers affected have actually risen.

In the past five years, there has also been a steady accumulation of
knowledge about what works to reduce malnutrition. This new Lancet
series aims to go further than its predecessor by presenting a list of
10 interventions whose effects are backed by scientific evidence.

It recommends: universal salt iodisation; the promotion of early and
exclusive breastfeeding; micronutrient supplementation for all pregnant
women; calcium supplements for pregnant women who need them; food
supplements for pregnant women who need them; vitamin A supplements for
children between six months and five years old; zinc supplements for
children between one and five years old; education about appropriate
complementary feeding, backed by supplements where needed; proper
management moderate acute malnutrition; and proper management of severe
acute malnutrition.

The authors estimate that if this package achieves 90 percent coverage
in the 34 countries with the highest malnutrition burdens, it could
save nearly a million lives a year at a cost of $9.6 billion.

The lead author of the paper on interventions, Zulfiqar Bhutta, of
Pakistan's Aga Khan University, said, "We believe that these 10
nutrition-specific interventions have the potential to save lives. The
cost is affordable for a world which spends close to a hundred times
more than this on conflict."



<http://www.irinnews.org/photo/Download.aspx?Source=Report&Year=2012&Ima
geID=201208011414180678&width=490>
Photo: Kate Holt/IRIN <http://www.irinnews.org/photo/>
Under-nutrition can cause poor health and developmental problems in
children (file photo)
The World Food Programme (WFP) has welcomed the proposed package. Its
executive director, Ertharin Cousin, told IRIN, "We believe that it's
very helpful, a recognition that the provision of interventions does
make a difference in an area where WFP has a comparative advantage -
distributing micronutrient support to mothers and to children. And we
have now announced a partnership with UNFPA [the UN Population Fund]
where we will support pregnant and lactating women's access to
nutritious food, as well as adolescent girls."

Interventions that do not directly involve nutrition also have a role
to play. The health of adolescent girls, their education level, and the
age at which they marry and start to have children all affect the
nutritional status of their children. Targeted agricultural programmes
can improve child nutrition, as can social safety nets and other
programmes to reduce poverty. But one of the hurdles to improving
mother and child nutrition is that it must bring together many
different disciplines and agencies.

Political will needed

Better nutrition is now a more high-profile cause than it has been in
the past. The food price spike of 2008 brought the issue to the fore,
and the UN high-level panel on post-2015 development goals has
recommended the inclusion of a separate goal on nutrition.

But Lancet editor Richard Horton told a symposium on the series: "The
high-level panel is only one strand of [a] series of political
processes that are taking place over the next six to 12 months. So
although we should feel good that nutrition and food security are
there, we should not be complacent about its position in the political
process."

Talking about ways of building commitment on the issue, Lawrence
Haddad, the director of the UK's Institute of Development Studies,
stressed the need for political action. "You don't often see the words
'politics' and 'malnutrition together'. but international development
is political - no two ways about it. And malnutrition is potentially
more political than some other issues because it needs lots of
different actors to come together to act in concert towards something
that none of them could achieve on their own, and that requires a lot
of coordination and alignment of incentives. Also, we know that
malnutrition in many of its guises is invisible."

Haddad says malnutrition must be reduced through deliberate action.
Improvements in nutritional status tend to lag behind economic growth,
he said, meaning people must apply pressure to make their leaders
fulfil their commitments." Let's will the politicians to act," he said.

eb/rz


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