Putting money into nutrition or health was not a cost for governments but an investment, an investment in building human capital that would pay off many, many more times in the future, World Health Organisation’s chief scientist Soumya Swaminathan said.
Speaking on “advances in maternal and infant care nutrition” at an international conference of Nutrition Society of India, Chennai chapter on Saturday, she observed: “There are a lot of inequalities in our societies, and the inequalities have been further brought out and exacerbated by the pandemic. If we continue to measure the inequality index, we will find that the disproportionate impact of the pandemic on the poor, marginalised and vulnerable is going to lead to a downstream impact on other health conditions, particularly on poverty, and poverty is always associated with nutritional disorders as well as diseases such as tuberculosis,” she said.
She expressed concern that the effect of the pandemic would be felt for many years to come including on education due to the closure of schools. “We have to think about our human capital. If we want to invest in human capital, then without good health, nutrition and education, we cannot build it,” she said.
It was those countries that have invested in health and nutrition, particularly in primary healthcare that have been able to build their economies, Dr. Swaminathan said. She said that unfortunately, it was very difficult to get governments to invest in prevention.
GROWING MALNUTRITION LEVELS:
“Malnutrition continues to affect millions of people in the developing world, and low and middle income countries whether it is stunting, undernutrition, wasting, and worryingly obesity. The prevalence has remained unacceptably high,” she said.
The status of food and security produced by Food and Agriculture Organisation and WHO showed the number of hungry people in the world have increased for the first time in decades, she said, adding: “We still have 150 million children under-5, stunted, 50 million wasted and 40 million overweight. There are differences between regions and countries,” she said. The rising food prices, inflation, people losing their livelihood and jobs, and now, the war in Ukraine would all add on to the stressors that already existed, she said.
“India is a paradox because our economic growth has been accompanied by alarmingly high levels of hunger and stunting. The recent global hunger index 2020 ranked India 94th out of 107 countries, way behind some of the other developing countries,” she said.
She added that new data from National Family Health Survey (NFHS) suggest that while less children are dying — a lot of progress has been made in reducing maternal mortality and under-5 mortality — but those who survive are becoming malnourished and anaemic.
“NFHS-5 showed worsening of nutritional indicators especially in children under-5 and increase in both stunting and wasting in about half of the States. That is extremely worrying,” she said.
Another cause of worry was the increase in the prevalence of anaemia in women of child-bearing age as well as in children, she said, adding : “Nutritionists must address the question of why despite a massive iron and folic acid programme as well as deworming programme that States have implemented for many years now, is anaemia not reducing but increasing. We need good research to answer that question.”
“To me, a simple explanation would be that iron and folic acid alone is not enough. We need a balanced diet that has proteins and fat in addition to carbohydrates and micronutrients. We have known for a long time now that micronutrient deficiency is a bigger problem in India than macronutrient deficiency,” she added. She observed that the biggest challenge was that most Indians were not getting enough diversity on the plate.
“The solution is that we need a more comprehensive, holistic life-course approach. We need to think from birth to old age and what are the nutritional needs at different ages and stages,” she said.
She put forward the need to educate people on traditional diets that were quite well-balanced and were replaced by diets based on cereals and commercially processed food.