World Health Day: Charting a Course Ahead on Malnutrition

World Health Day is an opportunity to reflect on what's been achieved, the challenges that lie immediately ahead, and focus on the future. Particularly for malnutrition, this yearly event is vital.
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World Health Day is an opportunity to reflect on what's been achieved, the challenges that lie immediately ahead, and focus on the future. Particularly for malnutrition, this yearly event is vital.

By no means should we discount this year's theme selected by the World Health Organization: the danger of antimicrobial resistance and its global spread. But rather, we should consider global health in a broader context and the massive impact malnutrition has on the one in six - nearly one billion people - who suffer from chronic malnourishment globally. We must work on solutions to this overwhelming challenge that severely limits individual and community development, and utilize every opportunity to raise awareness and focus our best minds on overcoming this seemingly intractable dilemma.

While malnutrition is a crisis in our midst, to be sure, interventions and solutions to date - from hybrid seeds that are more nutritious and resilient to effective public-private partnerships - have saved countless lives and improved millions more. From the Green Revolution that took place in India in the 1960s and 1970s that saved millions of lives to more recent efforts to bring fortified foods to places as geographically and culturally diverse as Africa, China, and Latin America, remarkable dents have been made. Most recently, the Copenhagen Consensus recognized that an investment of only $347 million for fortification of vitamins and minerals would reap a return of $5 billion in reduced deaths, improved earnings, and overall reduced healthcare spending.

Still, immediately ahead, the challenge of malnutrition is growing increasingly dire. Already one billion suffer from chronic malnutrition, limiting normal physical and mental development in the communities it afflicts. It's also serving as a source of geopolitical instability, helping to serve as a trigger of the revolutions occurring throughout the Arab world. With global food prices and insecurity at an all-time high, this may only be the tip of the iceberg with much greater unrest to come.

With an expected 2.2 billion people added to the world's population over the next 40 years - many in countries that are already strained for basic staples - how do we plan to feed them? More than simply feeding them, how do we provide the sustenance needed to help communities thrive? And how do we do all of this with thinner budgets the US government scales back, and limited donor investment elsewhere?

One positive example is the "1,000 Days" initiative launched by Secretary Clinton at the UN General Assembly this past September. This project seeks to improve the understanding that a critical window - from conception to age two - is the most important for mental and physical development. The WHO confirmed that the potential for childhood development is the same across the world, independent of racial or ethnic makeup. Among public health leaders, it is overwhelmingly accepted that child growth failure occurs in a critical window of opportunity. From age three onward, children grow roughly the same on average regardless of who or where they are.

By building consensus around this idea, aid organizations are able to better direct resources and energy towards projects that improve nutrition for mothers and infants at the earliest stages of development, resulting in better outcomes and communities that are more capable of caring for themselves. Broader agreements like the SUN (Scaling-Up Nutrition) Roadmap launched at the MDG Summit in September 2010 set out clear and concrete recommendations for stakeholders - governments, NGOs, for-profit companies - on how they can contribute to the scaling up of nutrition goals. These exact types of multi-stakeholder movements that address urgent needs while coming together to multiply their assets and expertise through sharing are needed desperately. We must build coalitions at all levels - global, regional, and national - to be successful.

The solutions in the future will revolve around making markets work for the poor. Whether travelling to our field offices in places like Dhaka, Bangladesh or in Johannesburg, South Africa, I can sense the unsustainability of the present situations in the air. Many well-intentioned partnerships between governments, NGOs, and the private sector don't address the most pressing, prevailing needs on the ground. More challenging, these need to work in a way that is attuned to local culture and develops a local market that is sustainable in the long-term.

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