Malnutrition rates are declining in various regions around the world, with the principal factor being political commitment. Photo: Siegfried Modola/IRIN
LONDON, 17 October 2011 (IRIN) - Malnutrition is a huge problem worldwide, especially chronic malnutrition, the kind of everyday, year-round hunger that stunts children's growth and means they never reach their full physical or intellectual potential. But rates are declining, and in some countries the numbers are falling fast. In Brazil, for instance, where 30 years ago underweight and wasted children were common in the poorer regions and lower income groups, these problems have almost been eradicated.
Care and Action Contre le Faim, together with researchers from the Oakland Institute in the US, the Institute of Development Studies (IDS) in the UK and Spain's Tripode Proyectos, have studied national success stories in a bid to tease out the factors behind the improvements.
Political policy turned out to be a common thread. The principal factor in reducing malnutrition was not farming or food aid, but political commitment.
Andres Mejia Acosta of IDS worked on what he calls "the Peruvian Surprise". After 10 years of very little progress, malnutrition rates plummeted post-2006. "Our first reaction," says Mejia Acosta, "was that this should be an income effect; there was a very large mining boom, the product of the commodities bonanza."
But there was very little correlation between the regions that had benefited most from the boom and the ones that had most reduced malnutrition. "It turns out we are discovering that it came from policy and political interventions; in the case of Peru, a nationwide poverty reduction strategy and a conditional cash transfer programme... The only thing we appear to find of relevance associated with reduced malnutrition is poverty reduction."
In Peru, President Alan Garcia was elected in 2006 after signing a "5x5x5" pledge to reduce malnutrition in children under five years old by 5 percent over the next five years. Once in office he raised the target to 9 percent and set a 100-day plan of action. The programme was run out of the office of the president, as are similar programmes in Brazil and Malawi.
Building leadership
The realization by a politician that reducing chronic hunger may get him elected or keep him in power can have a wonderfully bracing effect. But at the launch of these reports, Lawrence Haddad of IDS recalled being told by journalists in India how difficult it was to get their editors interested in nutrition, "because it's not an election issue".
"Where does this kind of leadership come from?" asks Haddad. "Do we just wait for it to drop from the heavens, and be grateful when it occurs or is there something as a community we can do to manufacture it, to support it, to enable its evolution?"
The Peruvian Surprise was actually the result of a lot of hard work by a coalition of NGOs and civil society organizations who seized the opportunity the election gave them, persistently lobbied all the presidential candidates and kept up the pressure in the immediate post-election period.
In Niger, a military coup provided the catalyst. According to Manuel Sanchez-Montero of Tripode Proyectos, "In the last years of President [Mamadou] Tandja, hunger was a banned word. One of the reasons for putting him out [of office] was a food crisis, and the government was trying to keep control of information and not recognize that there was a food crisis coming. The transitional government took the fight against malnutrition as one of their priorities, because they knew it was one of the key reasons for their public support."
The new studies also look at how political commitment is turned into practical success. Apart from having leadership commitment and citizens prepared to lobby energetically for the cause, successful countries took a multi-sectoral approach, tackling poverty in a wider sense, not just malnutrition alone, and often using cash transfers and social protection programmes to do it.
They worked on institutional coordination, getting government departments and NGOs to work together and stop duplication. Mejia Acosta said it had been helped by the way it was done: "In Peru there was a very clear division of labour where they said, 'We don't step on each other's toes.' The other issue was that they were not engaged in pooled funding, so there was never this issue of who puts more money in which pot."
Asked by IRIN whether he thought the leaders who had managed to push down malnutrition rates were in fact now reaping a political reward, Mejia Acosta said the answer was a mixed one; in Peru the regional presidents had perhaps drawn more political capital from it than mayors, and Garcia had not stood for re-election. "But the simplest quote came from a governor who told me, ‘In the past politicians didn't care about issues like nutrition, because children don't vote, but now they have realized that their mothers do.'"
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