This article was originally posted on Devex by Patrick Webb.
“Are we there yet?” my children used to call out from the back seat. Long car journeys could be exhilarating, but they could also be tiresome when the end was not clearly in sight.
Apparently, the same can be true for adults. As development professionals, we have framed recent decades in terms of goals, targets and objectives: collective endpoints. Visions of a desirable future, kept alive by annual progress reports and repeat measures of how well our efforts, resources and attention stay focused on the dream.
It started with Henry Kissinger’s claim that “within a decade, no child will go to bed hungry.” That was in 1974. A decade passed, the dream unfulfilled. A similar goal was set in 1992 at the International Conference on Nutrition, when 159 states pledged “to reduce substantially within this decade starvation and widespread chronic hunger, and undernutrition, especially among children.” That pledge was concretized at the 1996 World Food Summit, which dedicated the international community to “eradicate hunger in all countries, with an immediate view to reducing the number of undernourished people to half their present level no later than 2015.” The time-bound target chosen then was subsequently enshrined (in 2000) as part of Millennium Development Goal 1.
So here we are, knocking at the door of 2015. It’s been quite a journey. Despite early grumblings about top-down approaches and lack of government buy-in, there have been some major successes. The goal of halving the proportion of people without improved drinking water sources was achieved 5 years ahead of schedule, in 2010. By 2012, all developing regions had more or less achieved gender parity in primary education. And perhaps most surprisingly, extreme poverty was halved by 2010, half a decade ahead of schedule — a truly remarkable achievement by any measure.
But what about hunger? What about all those malnourished children? Well, sadly, they are still with us. More than 200 million children remain growth impaired (stunted) and/or wasted, while 2 billion people suffer one or more vitamin and mineral deficiencies, and over half a billion people are now obese. Good nutrition, as a key to social and economic development, was largely overlooked by the MDGs. Too few countries will meet even the limited nutrition goals defined under MDG 1.
Which means we have to do a lot better in the post-2015 era. Poverty reduction is good, but it does not suffice where it does not improve equitable distribution. Growth in food production is also good, but it does not suffice when it does not enhance access to the quality diets that lie at the nexus linking agriculture, income, health and nutrition. Inhabitants of low- and middle-income countries increasingly have sufficient food to meet their basic caloric needs, but they still face serious deficiencies in key nutrients because of poor quality foods and uncertain access to the variety and diversity of products needed to sustain sound health and nutrition. Those same countries are simultaneously experiencing a dramatic increase in non-communicable diseases caused in part by consumption of foods that are energy-dense yet low in essential vitamins and minerals, contributing to an increase in overweight and obesity. As a result, food-related NCDs — including diabetes and cardiovascular disease — are the fastest-growing causes of adult mortality in countries where undernutrition is the main contributor to preventable child deaths.
Moving forward, it’s essential that post-2015 development agendas pay adequate attention to nutritional compromise in all its forms. This will require the promotion of a range of appropriate multi-sectoral policies that link producers, markets and consumers to sustainable high quality diets. As things stand, the proposed Sustainable Development Goals, which have 2030 as the endpoint, do not even mention the words diet or obesity. This has to change.
To achieve the SDGs’ stated aims of ending poverty and ensuring healthy lives, decision makers in the agriculture, food and health sectors must identify and implement nutrition-enhancing policies of many kinds. Many current policies focus on increasing commodity production, making food prices affordable to urban consumers, and encouraging food trade; but there is limited understanding of the impact of these and related policies on nutrition outcomes, particularly among vulnerable groups. There’s an urgent need to assemble and promote empirical evidence that can better inform policy and program designs that contribute to the sustained diet diversity, quality and sufficiency to which all people are entitled. This means focusing on agricultural processes, food systems and family behaviors — not just on achieving single metrics of child growth by a given date.
While the destination, or the goal, we choose is supremely important, the way we get there is perhaps more important still.
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