Mal­nu­tri­tion prob­lem

The Pak Banker - - FRONT PAGE -

Ac­cord­ing to a new of­fi­cial re­port, Pak­istan loses US$7.6 bil­lion or three per cent of its GDP each year due to mal­nu­tri­tion. ' The Eco­nomic Consequences Of Un­der Nu­tri­tion In Pak­istan: An As­sess­ment Of Losses', a re­port pre­pared by the Pak­istan Scal­ing Up Nu­tri­tion (SUN) Sec­re­tariat, in col­lab­o­ra­tion with the United Na­tions World Food Pro­gramme (WFP), has used eco­nomic mod­el­ing to re­view 15 nu­tri­tion in­di­ca­tors from the 2011 Na­tional Nu­tri­tion Sur­vey and the 2013 Pak­istan De­mo­graphic Graphic Sur­vey. Ac­cord­ing to the re­port, more than 177,000 chil­dren die an­nu­ally in Pak­istan be­fore their fifth birth­day due to them or their moth­ers fall­ing vic­tim to mal­nu­tri­tion. This con­sti­tutes as fu­ture gen­er­a­tions of work­force lost and costs Pak­istan an es­ti­mat­edUS$2.24 bil­lion per year.

It is an alarm­ing sign that more than two-thirds of Pak­istan's chil­dren suf­fer­ing from anaemia, io­dine de­fi­cien­cies or stunt­ing will suf­fer deficits in men­tal and phys­i­cal health, which re­sults in lower school per­for­mance and lower pro­duc­tiv­ity as adults. This im­pacts the GDP by a shock­ing US$3.7 bil­lion an­nu­ally. Dur­ing his re­cent visit to Pak­istan, the World Bank Pres­i­dent said that Pak­istan should ad­dress the high preva­lence of stunt­ing among its chil­dren on a pri­or­ity ba­sis. UNICEF says in a re­port that Vi­ta­min A could re­duce child deaths by be­tween a quar­ter and a third in many de­vel­op­ing coun­tries, sav­ing be­tween 1 and 3 mil­lion young lives a year. It could also save the eye­sight of hun­dreds of thou­sands of chil­dren. Iron and Vi­ta­min A are in­ex­pen­sive and needed only in tiny amounts. The chal­lenge is one of get­ting them to the mil­lions who lack these mi­cronu­tri­ents.

The term 'Food for­ti­fi­ca­tion' refers to the ad­di­tion of mi­cronu­tri­ents to pro­cessed foods. In many sit­u­a­tions, this strat­egy can lead to rel­a­tively rapid im­prove­ments in the mi­cronu­tri­ent sta­tus of a pop­u­la­tion, and at a very rea­son­able cost, es­pe­cially if ad­van­tage can be taken of ex­ist­ing tech­nol­ogy and lo­cal dis­tri­bu­tion net­works. Since the ben­e­fits are po­ten­tially sig­nif­i­cant, food for­ti­fi­ca­tion can be a very cost-ef­fec­tive pub­lic health in­ter­ven­tion. How­ever, an ob­vi­ous re­quire­ment is that the for­ti­fied food needs to be con­sumed in ad­e­quate amounts by a sig­nif­i­cant pro­por­tion of the tar­get in­di­vid­u­als in a pop­u­la­tion. It is also nec­es­sary to have ac­cess to and to use for­ti­f­i­cants that are well ab­sorbed, yet do not af­fect the sen­sory prop­er­ties of foods.

Food for­ti­fi­ca­tion has a long his­tory of use in in­dus­tri­alised coun­tries for the suc­cess­ful con­trol of de­fi­cien­cies of Vi­ta­mins A and D, sev­eral B Vi­ta­mins (thi­amine, ri­boflavin and niacin), io­dine and iron. For­ti­fi­ca­tion has be­come an in­creas­ingly at­trac­tive op­tion in re­cent years, so much so that planned pro­grammes have moved for­ward to the im­ple­men­ta­tion phase more rapidly than pre­vi­ously thought pos­si­ble. Given the suc­cess of the rel­a­tively long-run­ning pro­gramme to for­tify sugar with Vi­ta­min A in Cen­tral Amer­ica, where the preva­lence of Vi­ta­min A de­fi­ciency has been re­duced con­sid­er­ably, sim­i­lar ini­tia­tives are be­ing at­tempted in other world re­gions. Cur­rently, the first sugar for­ti­fi­ca­tion ex­pe­ri­ence in sub-Sa­ha­ran Africa is tak­ing place in Zam­bia, and if suc­cess­ful will be em­u­lated else­where.

If sim­i­lar steps could be im­ple­mented here, we could go a long way to­wards tack­ling the scourge of mal­nu­tri­tion. It is only by arm­ing our youth with ba­sic men­tal and phys­i­cal health and nu­tri­tion that we can pre­pare them to take Pak­istan for­ward into the fu­ture. The need for this is very ur­gent; all stake­hold­ers need to play their role in cre­at­ing aware­ness. Al­ready, most of the main­stream po­lit­i­cal par­ties have signed a com­mit­ment for the in­clu­sion of nu­tri­tion re­quire­ments as part of their party man­i­festos dur­ing a high level fo­rum on 'Food and Nu­tri­tion Se­cu­rity', or­gan­ised by the Plan­ning Com­mis­sion Gov­ern­ment of Pak­istan. While this step shows that the po­lit­i­cal elite ap­pears to have re­alised the scale of the epi­demic, only time will tell if they are pre­pared to take the con­crete steps needed to bat­tle the dan­ger of hid­den hunger.

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