CHAPTER 4: NUTRITION AND HUMAN DEVELOPMENT
Few people - whether or not they are nutrition professionals - would dispute the fact that malnutrition constrains people’s 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.
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