My Lords, poor nutrition is a killer. Some 2.5 million children die from it every year. If it was a newly discovered virus from China, the world would be in a state of complete panic about it—but, sadly, we are inured to such devastation among our fellow human beings. Also, as has been said by numerous speakers, stunting, wasting and even obesity limit education and economic productivity, and drive ill health and costly treatments. Annually, the global economy loses $3.5 trillion from malnutrition. So, in spite of relatively good progress in recent decades —although not so much in recent years—the world in 2020 needs to focus on this continuing blot on our landscape.
In the short time on such a broad subject, I will focus on only three points. The first can loosely be described as home-grown nutrition. A community that lives on the foods it can produce itself is a healthy community. One that lives on imports of packaged foods is a dependent community that needs either an alternative source of income to pay for that food or continuous food aid, which of course is unsustainable. So an aid agenda that stimulates improved agriculture is vital for both nutrition and the local economy.
When 80% of your population is dependent on agriculture for their living, as is the case in many African countries, transforming their output is the key to success. Although new roads, markets, finances, land tenure and water all matter to this agenda, the key is training: training in what to grow—such as, say, the highly nutritious and relatively new orange-fleshed sweet potato or other fortified or nutritious crops—and training in how best to grow and sell them to maximise yield and, above all, distribution.
My second point is that this training is also important in nutrition itself. I led a parliamentary group to Rwanda a few years back. The latest UN stats on stunting in Rwanda came out while we were there, showing an unnecessarily high figure for a country that is relatively productive in vegetables and good food. The President there immediately called a meeting of the leaders of the three key ministries—agriculture, education and health. The permanent secretary for agriculture told us that evening that the problem was that, although mothers were satisfactorily breastfeeding their babies, after weaning the tradition was to feed them maize milk, which is nothing more than ground-up maize and water and contained almost no nutrients at all. We asked what they were going to do about it, and he said that they would ask every village to choose their own most respected mother. They would put her on to a nutrition training course, and her role would
then be to go back and teach her village about the importance of a mixed diet for young children, which in Rwanda with its varied agriculture should not be too difficult to achieve. This pyramid selling, or rather pyramid training, seemed to be a good idea and it would be interesting to return and see how it is working.
That scheme brings me to my third point: the benefits of partnership, both nationally and internationally. Bringing together the departments of agriculture, education and health, which we saw in Rwanda, is also the key to the very effective World Food Programme school feeding programmes that I have seen in many countries—Ghana and Ethiopia to name but two. It is also the key to the Anganwadi village feeding centres that I came across in India in the state of Bihar, run by the Integrated Child Development Services programme, the key word there being “integrated.” Where they exist, the Anganwadis are very effective, but there are just not enough of them.
Of course, all these initiatives, of which there are many, depend on being pushed from the very top, like my example in Rwanda, where the President stepped in and pulled everyone together, or in Bihar, where it was the chief minister who was driving the Anganwadi programme. Players have to be forced to get out of their silos, preferably by their own leaders. But also, foreign aid money can exert considerable leverage in terms of driving an agenda of partnership and co-operation. If the world is determined to stamp out malnutrition, this leverage has got to be exercised, and that is the very least we should expect from Tokyo.
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