In-depth: A global food crisis
GLOBAL: Food aid that gets you two for the price of one
Communities need to be educated about the benefits of quality food
Johannesburg, 18 November 2009 (IRIN) - Good quality food aid can save billions of dollars that would otherwise be spent on saving lives, says a major report from the World Bank, one of two new studies that uncover some unsettling facts about food aid and malnutrition.
Spending US$200 to treat a severely malnourished child can save $1,351 in treating nutrition-related illnesses, said the report,Scaling up Intervention: What will it cost?
which argued that "The cost of not intervening ... is much higher. The benefits from iron fortification of staples and salt iodization alone are estimated at $7.2 billion per year."
The 2007/2008 food price crisis, followed by one of the worst economic recessions in recent times, has revived the humanitarian aid world's interest in malnutrition, especially in the quality of food aid being dispensed.
The other report, Malnutrition: how much is being spent?
by international medical charity Médecins Sans Frontières (MSF), agreed with the World Bank's conclusion in that food aid abysmally fails to meet nutrition requirements.
Food aid does not necessarily focus on the "window of opportunity" from pregnancy until a child turns two, when children and women are most vulnerable, said Meera Shekar, a leading health and nutrition specialist at the World Bank and co-author of its report.
"Rarely does the food aid target the most vulnerable groups: children under five, pregnant women and lactating mothers," said Stéphane Doyon, a co-author of the MSF report.
Donors spent very little on nutrition - barely 1.7 percent of development and emergency food aid between 2004 and 2007 actually addressed malnutrition, said MSF.
|Food aid does not necessarily focus on the "window of opportunity" from pregnancy until a child turns two, when children and women are most vulnerable
Doyon said their analysis suggested that donors should maximise the value of funding by ceasing in-kind donations and provide cash instead, allowing aid agencies to source cheaper or more appropriate food in the region or beneficiary country. However, donor countries in the European Union (EU) and Canada, which had recently moved to provide cash, were not spending enough on nutrition.
The World Bank report noted that addressing malnutrition in the 36 countries where 90 percent of the world's most malnourished children live would be relatively cheap - only $11.8 billion to step up 13 proven nutrition interventions from current coverage to 100 percent of the target population.
Scaling up these programmes which include providing fortified food, deworming tablets and promoting breastfeeding could save the lives of more than 1.1 million children younger than five in these countries, where an estimated eight million children die of malnutrition-related causes every year.
The World Bank report takes a comprehensive look at the nuts and bolts of nutrition interventions like providing micronutrient-fortified foods, and not only details how much each intervention should be stepped up, but also its impact in monetary value.
Children who received fortified complementary food before they were three years old grew up to be more economically productive, said the World Bank study, citing an investigation led by John Hoddinott
, a senior research fellow at the International Food Policy Research Institute (IFPRI), published in the British medical journal, The Lancet, in 2008.
The World Bank study represented "A careful attempt to assess what resources are needed to put a significant dent in malnutrition around the world ... [the] striking feature of these estimates is, in fact, how small these financial requirements are," Hoddinott told IRIN.
"For a fraction of the amount of money spent on bailing out financial institutions, governments around the world could significantly reduce micronutrient deficiencies and dramatically reduce the incidence of stunting."
The global economic slowdown, combined with high food prices, has added some 100 million people around the world to those already living in chronic hunger and poverty in 2008, according to the UN Food and Agriculture Organization (FAO).
Between 3.5 million and 5 million children under five years of age die every year from malnutrition-related illnesses, accounting for 11 percent of the global burden of disease, according to the reports.
The MSF study said about 40 percent of nutrition funding flows were allocated to sub-Saharan Africa, where the main recipient countries included Sudan, Ethiopia, Somalia, Niger, Kenya, Zimbabwe and the Democratic Republic of Congo; almost 18 percent of the funds went to South and Central Asia; the remainder was "unspecified".
The nuts and bolts
Of the $11.8 billion the World Bank said was needed to address malnutrition in the 36 countries, $1.5 billion could be contributed by wealthier households in the beneficiary countries to purchase iodized salt and fortified staple foods, such as flour, which were available locally.
The World Bank study found that undernutrition was surprisingly high, even among the wealthiest populations. "For example, in India, Bangladesh, and Ethiopia, respectively 20, 30, and 37 percent of children under the age of five in the highest-income quintiles are underweight."
The remaining $10.3 billion could buy vitamin A supplements, iron-folic acid tablets, and staple foods fortified with iron, among others, for several million children and mothers.
Besides rescuing lives, these interventions could save an estimated 30 million disability-adjusted life-years (DALYs) or years lost to premature death and disability, as well as the money needed to treat patients and provide care.
Severe acute malnutrition could be halved from the current prevalence of 19 million; an estimated 138,000 of the current 276,000 annual deaths would be averted by preventive measures; a further 50,000 deaths would be averted by treating severe acute malnutrition.
Photo: OECD DAC
|Spending on nutrition has been relatively flat
The World Bank study recommended scaling up interventions in two phases: expanding the distribution of micronutrients, and educating people about eating healthy food in Phase 1; providing complementary or therapeutic foods to prevent and treat moderate malnutrition in children younger than two, and spending on resource-intensive interventions to treat severe malnutrition in Phase 2.
However, MSF's Doyon pointed out that prevention and treatment had to run concurrently. "What's the point in educating people about micronutrient interventions when they will have to wait to access them? "
What about the money?
The World Bank study suggested that the allocation of funds in recipient countries would be made more efficient by filling the gaps in costed and agreed-upon national strategies, and noted that this perception was growing.
In a complementing move, several developed countries, including those in the EU, have "either developed new nutrition strategies or position papers on food security, or seem poised to do so".
"It's about changing the mindset from providing food aid to assistance, keeping the people's needs in mind," said Doyon.
The authors of the World Bank report were upbeat over the recent announcement by the G8 group of industrialised countries in L'Aquila, Italy, that an additional $20 billion over three years would be spent on food security.
There is also a possibility that Canada will pursue this agenda when the G8 meets next, in 2010, by moving "from food security to nutrition security", offering "yet another opportunity for financing the nutrition scale-up".