Economic and other costs of malnutrition

It is ironic that a lack of adequately nutritious food is not only a sign of economic disempowerment, but that the resulting malnutrition in turn also causes significant economic losses to households, and to overall national incomes.

Besides outright hunger and food insecurity, malnutrition in Pakistan is a serious issue. Malnutrition is also related to the problem of poverty and the resulting lack of access to sufficient food, or else, lack of access to food of adequate nutritional value. Thus, even Pakistani families which seem to have enough food not to feel hungry, lack well-balanced diets, which results in widespread deficiencies in protein, iron and iodine.

Malnutrition in Pakistan is widespread and it afflicts people of all ages. The UN’s Food and Agriculture Organisation (FAO) estimates over 37.5 million people in Pakistan are malnourished. A national nutrition survey back in 2011 had categorised 44 per cent of Pakistani children as being stunted, primarily due to inadequate diets. While such statistics are perturbing, the resolve to seriously tackle malnutrition in our country is still not evident. A new report “The Economic Consequences of Undernutrition in Pakistan: An Assessment of Losses” has been recently released, which uses economic modelling to calculate the financial consequences of the nutritional deficiencies. While the pain and suffering experienced by individuals and families due to malnutrition is difficult to monetise, the amount of money lost due to labour productivity losses and resulting healthcare expenses can be converted into financial terms. The resulting econometric analysis reveals that Pakistan is losing up to $7.6 billion, or 3 per cent of GDP, every year, due to malnutrition.

This above research provides evidence that malnutrition is not only compounding the suffering of poor families, but is also bad for the economy of Pakistan. Each time a malnourished child is born to a malnourished mother, the economic burden of malnutrition grows. More than 10 million working adults who are part of our labour force have anaemia, as per this above study, which causes chronic weakness and fatigue, and reduces the economic output in industry, agriculture and other sectors which rely on manual labour. A majority (two-thirds) of children suffering from stunting, anaemia or iodine deficiencies will suffer deficits in mental and physical development, leading to not only untold personal and household suffering, but also causing lower school performance and economic lower productivity as adults.

Pakistan signed a Declaration of Scaling Up Nutrition (SUN) in 2013, an approach which is being implemented in 57 countries. We now have a SUN Secretariat in Islamabad, which is trying to track spending on nutrition and take on other important issues with nutritional implications, such as poor breastfeeding practices. Promoting nutrition education, scaling up programmes providing micro-nutrients to children, and iron/folate to pregnant lactating women, enhancing coverage of vitamin A supplementation, doing more to de-worm children and women, and intensifying diarrhoea and pneumonia management are important strategies, which have been identified to address the prevailing problem. The SUN initiative would do well, if it can remain vigilant in ensuring adequate government and donor commitments to effectively implement these above strategies.

Moreover, it would be interesting to see recognition of the underlying, and more contentious, causes of malnutrition. We need entities like the SUN initiative to also take a stance against the convergence of interests between big seed and fertiliser providers, politically affluent farmers, and market-driven agricultural development policies of entities like the World Bank, which exacerbates problems such as malnutrition. Donors like the World Bank are quick to point to the economic costs of stunting and malnutrition, but they need to be held accountable for their own role in the hyper-commercialisation of agriculture. It is such landless rural families, many of which have been migrating to the urban slums, which lack enough money to ensure adequate nutrition of their households.

Published in The Express Tribune, June 10^th, 2017.

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