A global event on nutrition—Sun Global Gathering—is going to be held in Kathmandu from November 4 to 7. SUN, or Scaling Up Nutrition, is a global movement launched in 2010 with an aim of ending all forms of malnutrition. SUN brings together governments, civil society, private sector, academia, activists, and others in a common platform and provide framework for working together to improve the nutritional outcomes worldwide. SUN Global Gathering (SUNGG) is the flagship event of the SUN movement which aims to develop a common understanding on the issue of malnutrition and reinforce commitment from governments and other sectors to improve nutrition. The Government of Nepal is co-hosting the event with SUN movement Secretariat. It is an important opportunity for Nepal to showcase and reflect on its progress and learn from the experiences of other SUN countries in bringing down malnutrition.
Why nutrition matters?
According to one of the latest UNICEF reports at least one in three children under five is either undernourished or overweight globally. Malnutrition has far reaching consequences. A child suffering from malnutrition may face irreversible consequences of poor health in later years. The physical and mental development of the child is restricted resulting a poor brain development and cognitive ability which often leads to poor school performance of young children. Such children are usually more susceptible to infectious diseases as their immune system is weak. In addition, a malnourished child is also more prone to developing chronic diseases in adulthood. Thus, malnutrition impairs person’s overall growth and development with resultant lower productivity and less income of a person. Malnutrition, therefore, is economic as well as social burden on family, society and the country on the whole and reinforces poverty and underdevelopment. The World Bank estimates that under-nutrition causes losses of up to three percent of economic development. According to the Global Nutrition Report (2016), for every dollar invested in nutrition, a country can get 16 dollars in return. Thus, improving nutrition is a pre-condition to break the cycle of poverty and underdevelopment.
Malnutrition in Nepal
Malnutrition has been a serious socio-economic problem and a hurdle in the path of the rapid economic growth in the country. According to the Nepal Demographic and Health Survey (NDHS) 2016, in the last 20 years Nepal has made a good progress in reducing rate of stunting (from 57 percent to 36 percent) and underweight (from 42 percent to 27 percent) in children under five. However, the figures are still quite high compared to many other developing countries. Likewise, prevalence of anemia, and vitamin and mineral deficiencies in women and children are also quite high. On the other hand, a recent UNICEF report on the State of the World’s Children 2019 reveals an alarming situation of obesity among children and adolescents in Nepal as it has increased by 29 times in the past four decades.
Unhealthy dietary pattern has been blamed for malnutrition in Nepal in recent times as shown by many studies. Unhealthy food items such as biscuits, instant noodles, juice drinks, ultra-processed foods and sweetened drinks which are easily available in even most remote parts of the country, thanks to aggressive marketing strategy of multinationals and domestic companies, are taking toll on the heath of young children and adolescents. Moreover, raw and processed foods with pesticide residues above the safe limit and indiscriminate use of antibiotics and hormones in livestock and poultry are causing dire health consequences.
Measures for remedies
Tackling the problem of unhealthy diet and putting an end to malnutrition is a herculean task that needs a multi-sectoral approach. Multi-sectoral Nutrition Plan (MSNP) II, Nepal’s flagship program on nutrition, is being implemented under the leadership of NPC with the involvement of sectors like health, agriculture, education, water and sanitation, gender and social inclusion, and trade and private sector. Yet, there is a growing realization that agriculture and food sector has to be more nutrition-sensitive in order to bolster the fight against hunger and malnutrition as this sector largely determines the quantity, quality and affordability of food. Key role of agriculture and food systems in improving nutrition has also been identified by the Rome Declaration on Nutrition.
A number of nutrition-sensitive interventions within the agriculture and food system are necessary to improve nutrition. This is the high time that we review our policy to strike balance between few staple crops and landraces as well as local crops (such as finger millet, buckwheat, foxtail millet, pearl millet, amaranths, legumes, and so on), which are highly nutritious yet neglected and underutilized. More policy support and incentive structure are crucial to encourage farmers to produce such crops as they are climate-resilient as well. Likewise, farmers should be supported and incentivized for producing pesticide free, safe and organic fruits and vegetables. Indiscriminate use of antibiotics and hormones in poultry and other livestock should also be regulated.
Some other potential interventions include national campaign on homestead garden to enhance the access and consumption of fruits and vegetables by vulnerable and marginalized groups, amendment of Food Act and Regulations and other related acts to put stringent condition on producing processed foods containing high levels of trans-fats, free sugars and salt and enforcement of minimum standard of food and mandatory minimum requirements for food labeling. Similarly, advertising and promotion of such unhealthy foods should be restricted and fast foods and highly processed packaged foods in and around schools should be prohibited. Likewise, nationwide school nutrition program should be implemented. Moreover, a massive public awareness campaigns and nutrition education programs should be launched mobilizing mass media, health workers, extension workers, network of NGOs, local clubs and, Civil Society Organizations, and celebrities from entertainment and sport sectors.
Nepal has made some great strides in improving many health and nutrition indicators over the past two decades or so. However, it faces a number of challenges to continue the pace of the progress, the most important one being the streamlining the nutrition agenda up to grassroots level. It will be only possible through the strong commitment of provincial and local governments. A statutory provision and system of functional linkage between federal and lower level governments is highly desirable for the effective planning and implementation of national framework of nutrition such as MSNP II.
Nepal can reap the demographic dividend before becoming an aged society in nearly 35 years. Therefore, it is crucial that we focus on child nutrition to develop a quality human capital to realize the expected economic growth and prosperity. Healthy diet not only provides nutrition to us, it also nourishes the planet earth mainly by consuming less energy in food production and preparation as this year’s SUNGG theme aptly calls for “nourishing people and planet together.” Therefore, let’s rise from where we stand to ensure better health and happy life of ourselves and our loved ones, and at the same time also save our planet earth.
This Mela on nutrition is expected to garner a renewed commitment to make the country free of hunger and malnutrition. Nepal will be presenting success stories in combating malnutrition which for many of us could be an eye-opening revelation. We will also hear stories and learning from the participants of SUN countries which will further our learning and motivate us to keep moving. Successful completion of the event and global media coverage will also help spread a message that Nepal is safe and wonderful place to visit which may result in more visitors turn out for upcoming Visit Nepal Year 2020.
Shrestha is a Senior Agriculture Extension Officer at Department of Agriculture. Rupakhetee is Joint Secretary at National Planning Commission and SUN Government Focal Point