(introduction...)
Few people - whether or not they are nutrition professionals -
would dispute the fact that malnutrition constrains peoples ability to
fulfill their potential. Hungry and undernourished people have less energy to
undertake work, are less able to attend school, and once in school are less able
to concentrate and learn. Diet-related chronic diseases take highly experienced
individuals out of the work force and take resources away from primary health
services. That improved nutritional status will lead to an improved ability to
secure rewarding and sustainable livelihoods is a common sense proposition.
How important is malnutrition to economic growth? Researchers
have derived conservative estimates of the forgone gross domestic product (GDP)
as a result of iron deficiency alone in childhood and iron, iodine, and
protein-energy malnutrition in adults.1 For Pakistan the annual
losses are over 5% of GDP. For Bangladesh, the cost of iron deficiency in
children alone is nearly 2% of GDP. Nutrition and food security also promote
economic growth by reducing the potential for conflict.2 Chapter 5
shows that the resources required for relief activities are large and growing.
Understandably these activities retain the first call on resources - resources
that could otherwise be allocated to longer-term development activities. The
designers and implementers of relief programmes are very aware of the importance
of building development into relief activities. In general, the need for future
relief flows can be reduced by improving nutrition today. Reduced relief flows
will increase the availability of funds for longer-term development.
Improvements in nutrition can thus serve as a crucial spur to overall economic
growth.
If the contributions of nutrition to economic development are
underrated, so too are the reverse contributions - both positive and negative.
Economic and demographic events such as globalization, HIV/AIDS, and
urbanization have large and far-reaching impacts on human development - such as
the capability to be well nourished and healthy, to undertake healthy
reproduction, and to be educated and knowledgeable - and they must be taken into
account in developing nutrition strategies.
The emergence of human development as a guiding principle for
overall development reflects a growing dissatisfaction with an exclusive
reliance on economic growth as a means to development. The focus on human
capabilities has opened the door for more normative arguments, including a human
rights - based approach to development. In his launch of the United Nations
reform, Secretary General Kofi Annan stated that all major UN activities should
be undertaken through a human rights perspective. Many UN agencies, particularly
the UNDP, UNFPA, UNHCR, and UNICEF, began operationalizing a human rights
approach to development. The debate about whether or not the UN should
base its work on human rights was over. The challenge now is how to develop
human rights - based strategies.
This chapter discusses these themes in more detail. First, it
describes some recent developments that highlight the contributions of improved
nutrition to the overall development process. Recent studies, for example,
confirm the strong relationship between infant nutrition, cognition, and school
enrollment - linkages exploited by the early childhood initiatives of the past
five years. The chapter then considers some of the policy implications of new
research on the links between foetal undernutrition and diet-related chronic
diseases in adults. This section of the chapter closes with a discussion of the
resurgence of interest in participatory development approaches and the
contributions that community-based nutrition initiatives might make to overall
development.
Second, the chapter describes some major socioeconomic and
demographic events together with their implications for nutrition policy and
programming. The chapter considers the implications of the freer movement of
financial resources, food, and information (three aspects of globalization) for
food and nutrition policy. The chapter then discusses the implications of rapid
urbanization and of HIV/AIDS for food and nutrition policy. Finally, the chapter
describes the emergence of the human rights perspective. The ascent of the human
rights agenda in an era of globalization is more than a coincidence. Human
rights principles will play a crucial role in the type of globalization that
emerges over the next ten
years.