|Title||Questioning the Solutions: Reaching the 800 million people living with hidden hunger in South and South east Asia, with effective interventions|
Despite one third of global nutrition aid being spent on micronutrient interventions, there are still 2 billion people in the world living with micronutrient deficiencies (hidden hunger). Over 800 million of these people live in South and South east Asia. A critical academic and political discussion is urgently needed. This dialogue needs to be based on evidence to analyse the reasons why interventions, like the present Vitamin A universal supplementation programme are continued, despite evidence illustrating continued increases in prevalence and incidence of Vitamin A deficiency. The most impactful of all micronutrients, zinc, has been added to essential drug lists in most countries, yet coverage remains under 2%.
Globally over 50% of women, of child bearing age, are anaemic. In India this figure is as high as 80%. There is emerging evidence that if more than one ferrous sulphate tablet is taken a day, the treatment can be toxic to liver cells, yet some anaemic mothers are being advised to take one iron table three times a day. Iron supplementation programmes are also marred by stock outs and failure of patients to adhere to the supplementation, for the whole pregnancy and during lactation. How do we reach the 800 million people in South Asia with effective interventions? Donors and civil society have spent millions on micronutrient supplementation and fortification programmes that do not always reach the most vulnerable. One third of global nutrition expenditure focuses on behaviour change, telling people to change without supporting them effectively. Too often solutions for one deficiency may have adverse impacts in the long term, as seen with the present normalisation of giving high calorie biscuits to children or fortified cereals laden with excessive amounts of sugar for breakfast.
There is also evidence linking such deficiencies to an increased risk of obesity and chronic illness in later life. Interventions such as exclusive breastfeeding reach just over a third of infants globally, despite its protective capacity, for improved nutrition outcomes, throughout the life cycle. Aggressive marketing of breast milk substitutes and other challenges such as lack of support to mothers have led to these low figures.
The speakers will present, the present South and South east Asian situation, including emerging research. They will critically appraise the donor preference for ‘vertically delivered, low cost solutions’, such as fortification and supplementation, to address the hidden hunger crisis, rather than addressing diet diversity challenges and food security. As present, diets contain more processed foods, which are rich in salt and sugar, they also contain fewer natural forms of micronutrients, which are essential for health and development throughout all stages of life. Challenging present food systems and questioning the involvement of the processed food industries in public health nutrition funding needs to be prioritised more by academics, NGOs and UN agencies.
1. To identify interventions that are not effective in addressing hidden hunger, using examples.
Participants and format
Chair: Dr. Prema Ramachandran
Speaker 2: Regina Keith RGN RM RPN MSc SfHEA WPHNA, Senior Lecturer University of Westminster, UK Reaching the 800 million: Questioning the solutions: are we implementing evidenced based approaches to address hidden hunger or simply those that donors will fund?
Each member of the Expert Panel will have one minute to answer the discussion question: How can we effectively address micronutrient deficiencies in South and South east Asia? Suggesting what actors can do at government, organization, service and practitioner level, to ensure evidenced based programmes are prioritized and implemented, in national policies, plans, interventions, priority setting and delivery.
Panel member one: Professor HPS Sachdev Senior Consultant in Paediatrics
|Keywords||Hidden Hunger, Micronutrient deficiencies, South east Asia, Asia|
|Conference||Critical Public Health Consequences of the Double Burden of Malnutrition and the Changing Food Environment in South and South East Asia|
|Web address (URL) of conference proceedings||https://www.youtube.com/watch?v=iue9u_rkhi8&list=PLoHg1UZiy8oFw0VzMAwVqJIOu0rgb8Ivt|
|Web address (URL)||https://drive.google.com/open?id=1ALYdCsCXq0J8Lhxu6YO-Y9ZMMlruAzKz|