2012 G20 Watch
Date: Mon, 2012-06-18
Location: Los Cabos, Mexico
Hosting organization: The Government of Mexico
PMNCH Chair Dr Frenk's Blog to G20
Addressing global health challenges through improved nutrition
With diseases related to malnutrition on the rise, the challenge is not only to ensure food security, but also to address the nutritional quality of the food being consumed and its impact on health.
By Julio Frenk, Chair PMNCH Board; Dean Harvard School of Public Health
My father, Dr Silvestre Frenk, who worked at the Children’s Hospital in Mexico, was one of the world’s leading authorities on child malnutrition. I have followed his leadership in my own career, prioritising this issue when I was Mexico’s minister of health from 2000-06. More recently, I have become involved in the fight against non-communicable diseases, including rising rates of obesity and their impact on chronic diseases.
Thus I have been exposed to the issues of malnutrition – including both undernutrition and over-nutrition – from early childhood through my current professional life. I am now proud, but not surprised, that Mexico has taken a leadership role in naming food security as one of the five priorities of its presidency of the G20.
Malnutrition and food security
The Mexican government, in its paper entitled Food Security: a G20 Priority, defines food security “not only as an increase in production, but also the availability of, and access to, food by the population”. I agree with this and would urge the G20 to go even further and integrate nutrition security into its deliberations and recommendations.
Poor nutrition is a key issue faced by low-, middle- and high-income countries. It is a marker of social inequity as it affects the most vulnerable. Malnutrition, in all forms, is a major contributor to disease and early deaths, especially for women and children whose low socioeconomic, legal and political status increases their exposure and vulnerability to disease.
Under-nutrition is an underlying cause of death for 2.6 million children annually (one-third of child deaths) and leaves millions more with lifelong physical and mental impairments. Under-nutrition inhibits healthy development and reduces productivity, and therefore economic development. Malnourished children are at a greater risk of having difficulty learning, playing and engaging in normal childhood activities. Adults who were malnourished as children earn 20 per cent less, on average, than those who were not.
Women are also adversely affected by malnutrition. For example, malnutrition often leads to anaemia and other deficiencies that can cause death and limit their productivity and contribution to economic development.
The double burden of malnutrition
Today, the world increasingly faces a double burden of malnutrition, where under-nutrition and over-nutrition contribute to worsening health outcomes. At least 2.8 million people die each year as a result of being overweight or obese. By increasing the risk of chronic diseases such as diabetes and heart disease, obesity also reduces productivity and leads to rising costs in healthcare. High-fat, high- sugar, high-salt, micronutrient-poor food tends to be cheaper than healthy food and thus has a larger detrimental health impact on the poorest. Obesity is an increasing problem not only in high-income countries, but also in G20 countries such as Brazil, China, India and Mexico, as well as in other low- and middle-income countries.
Malnutrition in the form of under- nutrition alone leads to losses in gross domestic product by poor countries of as much as three per cent per year.
Challenges to food and nutrition security are growing. Climate change is affecting food production patterns and may place regions and countries most vulnerable to food insecurity at even greater risk. Food prices have been notably higher since 2000 than in the previous two decades, They continue to be volatile. Volatility and higher food prices lead poor households to consume food of lower nutritional value, entrenching them in a cycle of poor nutrition.
The G20, led this year by Mexico, must invest in nutrition, especially for the most vulnerable notably women and children – in order to improve health outcomes, livelihoods and overall development. The G20 should commit to multi-sectoral approaches aimed at promoting country nutrition strategies as recommended by the Scaling Up Nutrition movement. This should include efforts to expand on successful interventions to address under- and overnutrition. Such initiatives should include the following:
- Investment to improve nutrition for mothers and children during the critical 1,000 days from gestation to age two – when better nutrition can have a lifelong impact on a child’s future and help to achieve long-term progress in health and development;
- Direct nutritional interventions to prevent under-nutrition, such as exclusive breastfeeding for six months, micronutrient supplements, food fortification for children and complementary feeding;
- Population-wide weight-control campaigns that raise awareness about over-nutrition among medical staff, policymakers and the public, and promotion of health literacy; capacity-building and empowerment to raise awareness of risk factors of obesity; incentives to stimulate substitution of high-calorie, low-nutrition foods; and
- Improving agricultural productivity with a focus on smallholder farmers to promote food security, in a way that addresses climate change-related issues (such as breeding crops that are more nutritious and heat resistant) and education interventions that have a powerful impact over time in preventing under-nutrition.
Existing food systems have failed to address malnutrition, and continuing food-price volatility has limited the access of vulnerable populations to sustainable, nutritious diets. If this problem is not addressed, malnutrition will continue to undermine sustainable economic development.