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What are the Challenges and Opportunities to End Malnutrition in Asia?

Published on 24 July 2019

With hundreds of millions of children and adults in Asia’s rapidly expanding cities suffering from undernutrition or obesity, malnutrition has dominated conversations in the industry, sparking urgent actions from global leaders.

Warren T K Lee, Senior Nutrition and Food Systems Officer, Regional Office for Asia & the Pacific at the Food and Agriculture Organization of the United Nations (FAO); Sukiet Kittitammachote, Head of Corporate Affairs at Cargill Thailand; and Mansharan Seth, Lead of Public Private Partnerships at Tata Trusts, spoke to ARoFIIN on the critical steps needed from various stakeholders to end all forms of malnutrition in Asia.

1) What do you think are the key challenges that the world is facing today in terms of improving health and nutrition?

Warren T K Lee, FAO: There are a number of challenges that we need to tackle collectively for better health and nutrition. Consumer behaviour change is crucial to improve health and nutrition in different age, gender and socio-economic groups. To achieve this, we require quality data to develop policies and programmes that are adapted to local cultures, as well as sufficient human and institutional capacities to track progress and ensure the effectiveness of these interventions.

Sukiet Kittitammachote, Cargill: One key challenge would be managing the food supply to feed a growing population. In addition to being smart about how we use natural resources such as land and fresh water, we need to combine responsible production and innovative technology to help us manage our limited resources and ensure that we have enough food to feed the world.

The second challenge would be ensuring the accessibility of safe food and good nutrition for all, including underprivileged people and people living in remote areas. The private sector can support the community through initiatives that provide safe and good nutrition in daily lives. At Cargill, we started the 50 Healthy Schools project in Thailand, initiated in partnership with Save the Children, to develop a holistic nutrition and physical activity programme that also provides nutrition education to children, parents and teachers.

Mansharan Seth, Tata Trusts: Malnutrition in all its forms continues to be one of the greatest challenges faced by our generation. Countries like India face a dual burden characterized by the co-existence of undernutrition along with overweight and obesity, or diet-related non communicable diseases (NCDs), within individuals, households and populations. While undernutrition remains a major threat to child survival in India, over-nutrition has also emerged as an important public health problem in the recent years.

Obesity is on the rise in all regions of the world. Globally, nearly 2 billion adults are overweight, of whom 672 million are obese. Each year, 15 million people die from an NCD between the ages of 30 and 69 years, with over 85% of these “premature” deaths occurring in low- and middle-income countries. The childhood obesity epidemic has also been growing for decades in countries throughout the world. The average weight loss needed by an Indian today is 11kg. According to the World Health Organization (WHO), there will be more than 80 million Indians suffering from diabetes by 2030.

Overweight and obesity are risk factors for many NCDs such as heart diseases, stroke, type 2 diabetes, and some cancers. These NCDs are economically costly to societies, owing to high treatment costs, lost income and earning potential, and reduced labour productivity.

2) How important are partnerships to unlock change at the rate and scale needed to make better health a reality for more people in Asia?

Warren T K Lee: The etiology and contribution to nutritional health in Asia cuts across many sectors, namely health, food and agriculture, social protection, education, trade & marketing, consumer behaviour and the private sectors. Multi-stakeholder partnerships ensure that the causes of ill health are addressed sufficiently from different perspectives so that effective results can be obtained upon implementation of cohesive, specific and effective policies and measures. We need to break the silos to allow inter-sectoral collaboration for the promotion of health and nutrition in Asia.

Partnerships accelerate changes to make better health a reality and help reduce people’s suffering from ill health and its complications. Building partnerships also helps to expedite national development and reduce economic losses due to ill health.

Mansharan Seth: Public-private partnerships are important because of the fact that different skills, experiences and resources can be brought together through diverse organisations. Strong partnerships can achieve a lot to improve nutrition as well as transform children’s futures than a single organization can do alone. The idea to develop unconventional cross-sector partnerships and build new business models to serve those ‘unserved’ by regular market channels is of utmost importance.

Tata Trusts has been working together with Mars in India to tackle malnutrition in school-going children by creating social enterprise models that deliver affordable, accessible nutrition at scale in a sustainable way. Other areas of focus include fortification of staple foods and product development. We also work with DSM and PATH to promote rice fortification in India and have partnered with many private sector dairies for the fortification of milk. Today, more than 75 million people in India are reached with fortified milk in several states.

3) How do you develop localised approaches for a global problem like malnutrition?

Warren T K Lee:/strong> We first need to understand the food availability, accessibility and affordability, as well as the food culture and risk factors for ill health and malnutrition in the locality. Preventative or interventional measures have to be locally adapted before they are implemented in a local setting. To do this, we require partnerships with local food, health and nutrition workers who have extensive knowledge on the health and nutrition situation. Local community leaders or other key opinion leaders on nutrition should also be included in the conversation for buy-in before launching an action.

Mansharan Seth: A multi-sectoral programme approach with nutrition-specific and nutrition-sensitive interventions targeted towards vulnerable geographies and populations is crucial. Leveraging the right data sets for micro-targeting interventions at localized population levels can be a game changer. That is why Tata Trusts, in partnership with the National Institution for Transforming India (NITI Aayog), has set up a data analytics initiative supported by the Institute of Economic Growth (IEG) and Harvard University to leverage the use of data in driving decision making. Some of the work focuses on using multiple data sets to arrive at the level of malnutrition at the level of parliamentary constituencies, enabling ministers to micro-target their interventions.

4) What do you think is essential to end malnutrition in all forms by 2030?

Warren T K Lee: With 2030 only 11 years away, swifter action is needed to plan and implement programmes as well as to monitor the progress. Countries must also be supported to prioritise an actionable programme and to provide a tool box with validated methodologies to end all forms of malnutrition.

Sukiet Kittitammachote: Public policies should address and raise awareness on the double burden of malnutrition. On the other hand, the private sector requires a clear direction that supports positive food and nutrition outcomes. Encouraging the free flow of goods can also help consumers gain better access to nutritious food.

Mansharan Seth: Despite the urgent and pressing need, nutrition is definitely dangerously underfunded. Global spending by donors on high impact interventions to tackle undernutrition amounts to 0.5 per cent of Overseas Development Assistance (ODA). It is important to remember that for every dollar spent in nutrition interventions can deliver a return of up to $35, giving massive returns on investment.

However, reducing the risk of undernutrition and stunting can be inexpensive, as proven by The Power of Nutrition. Formed in 2015 by the Department for International Development (DFID) and Children’s Investment Fund Foundation (CIFF), these founding funders have committed more than $150 million to The Power of Nutrition to date. This investment will enable them to support a growing number of nutrition programmes in countries in Asia and Sub-Saharan Africa with a high burden of undernutrition and stunting, as well as the chance to work with international partners and national governments to take proven interventions to scale.

Investing in proven nutrition interventions, along with policy changes to address underlying causes of malnutrition, would help millions of children to develop into healthy and productive members of society.

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