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close this bookEnding 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.)
View the document(introduction...)
View the documentExecutive Summary: Main Messages of the Commission Report
close this folder1. Recent Progress
View the document1.1 International declarations for action in the 1990s
View the document1.2 Progress in accelerating improvements for nutrition
View the document1.3 The case for investing in nutrition
View the document1.4 Setbacks to progress: nutritional well-being during economic crisis
close this folder2. Global Nutrition Challenges: A Life-Cycle Approach
View the document(introduction...)
View the document2.1 Poor nutrition starts in utero
View the document2.2 Adult undernutrition
View the document2.3 Micronutrient deficiencies are major public health problems in nutrition
View the document2.4 Changing food consumption patterns
View the document2.5 Preventing premature adult death and disability
close this folder3. Societal Issues Underlying Malnutrition: Implications for Progress
View the document(introduction...)
View the document3.1 Conceptual framework
View the document3.2 Poverty and nutrition
View the document3.3 Women
View the document3.4 Care
View the document3.5 Education
View the document3.6 Key role of local communities
View the document3.7 The importance of non-governmental organisations (NGOs)
View the document3.8 The potential for public-private co-operation
View the document3.9 Purposeful action: the need for equity
close this folder4. Food, Agriculture and Environment: Future Challenges
View the document4.1 Food as an important determinant of nutritional status
View the document4.2 The constraints to meeting future demands
View the document4.3 Other forces affecting food security: trade, global finance and new technology
View the document4.4 Food production and food security: meeting the challenges
close this folder5. Food, Nutrition and Human Rights
View the document(introduction...)
View the document5.1 What difference does a rights-based approach make?
View the document5.2 The International Code of Conduct of the Human Right to Adequate Food
close this folder6. Vision and Goals for the Future
View the document(introduction...)
View the document6.1 A Vision
View the document6.2 Achieving rapid progress for the 21st century
View the document6.3 The need to review goals and options
View the document6.4 Integrating goals for diet-related diseases
View the document6.5 An integrated approach
close this folder7. Establishing a New Agenda for Change
View the document(introduction...)
View the document7.1 Developing regional and national policies
View the document7.2 Improving UN Mechanisms
View the document7.3 National-level developments
View the document7.4 Linking national policy developments and actions to international support
View the document7.5 Key international issues relating to nutrition
View the document7.6 Conclusions and priorities
View the documentAnnex 1: The Establishment and Membership of the Commission
View the documentAnnex 2: Existing Nutrition Goals which Should be Maintained, Developed or Refined
View the documentAnnex 3: Ending Undernutrition in India by 2020
View the documentAnnex 4: Issues to be Considered by Regional and National Meetings
View the documentReferences

1.4 Setbacks to progress: nutritional well-being during economic crisis

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