There is a common condition that too often prevents children from growing to their full potential. From surviving to age 5. From learning well in school if they do survive, and from earning as much in adulthood as they otherwise might. A condition that stands in the way of achieving many of the Sustainable Development Goals (SDGs). It's micronutrient malnutrition.
Micronutrient malnutrition--a chronic lack of essential vitamins and minerals--weakens minds and bodies, sentencing survivors to a life of diminished cognitive and physical performance. Also known as hidden hunger, this form of malnutrition impacts 2 billion people worldwide, exacting a devastating health and economic toll.
In developing countries, people often experience overlapping micronutrient deficiencies that together add insult to injury, with iron, vitamin A and zinc deficiencies being particularly problematic. Iron deficiency contributes to 20 percent of maternal deaths. It also robs people of strength and energy, making them less able to work and consequently lowering earnings. Chronic lack of vitamin A is the chief cause of preventable blindness in children. It also claims an estimated 670,000 lives each year by impairing immune systems, which increases the risk of death from common diseases. And insufficient zinc stunts children and leaves them especially vulnerable to child killers like pneumonia and diarrhea. It has been estimated that malnutrition lowers a nation's GDP by up to 11 percent. Additionally, iron deficiency anemia, zinc and vitamin A deficiencies rank among the 15 top causes of disease, costing $180 billion each year.
Yet micronutrient malnutrition is entirely preventable. We know how to ensure good nutrition: a diverse diet, and where that's not possible or in the short term, interventions like food fortification and micronutrient supplementation become critical. And they are cost effective--every $1 spent on childhood nutrition can yield up to $166 in savings.
But where should investing in these interventions be a priority?
A recent study on trends in hidden hunger over a 16-year period helps illuminate where action is most urgently needed. Developed by Sight and Life with input from scientists, academics and decision-makers from a range of global institutions, the "Global Update and Trends of Hidden Hunger, 1995-2011: The Hidden Hunger Index" shows the combined prevalence in preschool children of multiple micronutrient deficiencies: iron, vitamin A and zinc. This Hidden Hunger Index identifies global micronutrient deficiency hot spots and provides a ranking of 138 affected countries over time.
The study found that while we must applaud the 100 countries that reduced their rates of micronutrient malnutrition among children under age 5, alarmingly, 38 countries saw rates rise. Africa was the only region to experience an overall increase in hidden hunger, with West and Central Africa faring worse than East and Southern Africa. The country with the highest rate of children suffering from hidden hunger in 2011 was Niger, followed by the Democratic Republic of the Congo, Central African Republic, Madagascar and Burundi. While negative trends in these countries are likely in part attributable to periods of conflict and climate change-related shocks such as drought and floods, we need to be alert to the impending crisis and immediately initiate interventions to reverse the trend as far and as quickly as possible.
East Asia and the Pacific made the most progress in reducing micronutrient deficiencies among preschoolers, and the remaining regions achieved modest reductions. One reason for the remarkable progress made in certain Asian countries--including Indonesia, Vietnam, Cambodia and Myanmar--could be the significant economic growth experienced during the period analyzed that has a spin-off benefit of improved nutrition. Overall, progress in reducing micronutrient malnutrition can largely be attributed to reductions in zinc and vitamin A deficiencies, while anemia partly due to iron deficiency persisted and even increased. There is much work still to be done.
Where we've seen success, we must work to accelerate this progress and avoid back-sliding. And where we're not yet having enough impact, such as in addressing iron-deficiency anemia, we must urgently step up our efforts. Children's lives and futures are at stake.
Research like the Hidden Hunger Index provides valuable evidence that clearly shows leaders where to step up and scale up, and where the promises of SDG 2--to end hunger and achieve food security and improved nutrition--must be turned into actions. National governments and large-scale micronutrient programs can use the Hidden Hunger Index trend findings to better target their programs to vulnerable populations in the highest burden countries, and to the specific micronutrients missing.
The Index also provides the kind of information that will be crucial as decision makers determine how the world will achieve the SDGs and where the focus needs to be. In fact, we need even more data. We must collect frequent, nationally representative data on more countries and more micronutrients. Such evidence is critical to inform the nutrition policies and programs needed not only to end hunger, but also--as IFPRI's recent Global Nutrition Report (PDF) outlines--to end poverty, ensure healthy lives, promote learning, achieve gender equality, promote sustained economic growth and more.
We know what to do to prevent malnutrition. The Hidden Hunger Index is one tool to show us where to do it.
Now it's up to our leaders to get it done.