|Ending Malnutrition by 2020: An Agenda for Change in the Millennium - Final report to the ACC/SCN by the commission on the nutrition challenges of the 21st century (ACC/SCN, 2000, 104 p.)|
|1. Recent Progress|
Until 1997, many developing countries were benefiting from both reductions in poverty and improvement in the nutrition and health of their children and adults. The successes illustrated above emphasize the impact of community action even in poor circumstances. The sudden emergence of major financial crises in many Asian countries and in South America, however, may threaten much if not all of the progress made over the last decade if appropriate measures are not taken.
Recent evidence from Indonesia shows the re-emergence of nutrition deficiencies (Helen Keller International, 1998 and 1999). High inflation, massive unemployment and decline in consumer spending power have led both to a fall in the ability to buy expensive but micronutrient-rich foods such as eggs, meat and milk and to a fall in vitamin A and iron intake. Surveys suggest that four-fold increases in anaemia are likely, as well as increases in wasting, night-blindness and diarrhoea in children, adolescents and women. This may herald the emergence of another 'lost generation' unless rapid action, of the type undertaken in Thailand, is taken to minimise the impact of the financial crisis on the most financially insecure.
More effective safety nets to cushion the social and health effects of financial crises are essential. Some action is already being taken. Governments in Asia have sought to establish safety-nets in response to the 1997/8 financial crisis. The World Bank has established a Social Monitoring Early Response Unit to monitor the impact of the crisis in Indonesia. In January 1999, the Bank brought together governments, donor and development agencies, NGOs and others throughout the region to assess the situation and determine how to respond.
The set-backs are not confined to the developing world. In parts of Central and Eastern Europe, there has been a fall in life expectancy in the 1990s (WHO Europe, 1997), coinciding with the sudden change in government and national financial management. This is in marked contrast to the increasing life expectancy in the rest of Europe. The collapse of the command economies in the 1990s led to dramatic changes in the system of food production and consumption in many countries of Central and Eastern Europe. Russia, for example, became a net food importer: until recently Russia was importing one-third of its food requirements. The collapse of the rouble in the 1998 Russian financial crisis means that the country's ability to import foodstuffs has been severely reduced, and the Russian government has asked the European Union and the US government for food aid. The failure to organise specific economic and organisational measures to safeguard the population's health has led to huge societal costs. These issues are dealt with in later chapters.
Figure 1.2 Nutrition, health and economic growth