BANGKOK — In a region that hosts the majority of the world’s megacities, Asia is seeing malnutrition following the masses to urban areas.
Urbanization can be a signal of positive social and economic development. But if it isn’t managed early and inclusively from a nutrition standpoint, rapid rural to urban transitions can also lead to dysfunctional food systems. Undernutrition and obesity can occur in the same city or even in the same household, according to a new joint report from World Food Programme, Food and Agriculture Organization, the United Nations Children’s Fund, and the World Health Organization.
The rate of urbanization in Asia is the highest in the world at 1.5 percent per year, according to the “Asia and the Pacific Regional Overview of Food Security and Nutrition” report. At this rate, more than 55 percent of the Asian population will be urban by 2030. Of the world’s 31 megacities in 2016, 17 are located in the Asia-Pacific region — and six of the 10 additional cities projected to become mega between 2016-2030 will be from this region.
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Now is the time to ensure that these rapidly expanding cities are planned in an inclusive, sustainable, and nutrition-sensitive manner, said Sunniva Bloem, knowledge management officer at WFP’s regional office for Asia and the Pacific. Delivering on these needs will require involvement from an array of stakeholders — particularly various government ministries, the private sector, and newer players to the nutrition landscape, such as urban planners.
But efforts to reduce malnutrition and hunger have stalled in the region, according to the report. Despite rapid economic growth, the region hosts nearly half a billion people who go hungry. Without marked changes, many parts of the region will not reach the U.N. Sustainable Development Goal 2 of ending all forms of malnutrition and achieving zero hunger by 2030.
Those working on urban nutrition issues can fall into the trap of trying to apply rural solutions to urban areas, Bloem warned. While the primary determinants of food security — availability, access, stability, and utilization — and malnutrition are the same for both urban and rural areas, there are vast differences when it comes to the drivers of these factors.
“Previously, any time ‘urban’ and ‘food’ are brought together, there’s a big focus on urban agriculture,” Bloem told Devex. “While urban agriculture is part of the solution, it is just one component. We have to look at retail environments and infrastructure, housing policy, whether or not there's public spaces for people to walk … it's such a diverse and complex landscape, so we can’t only have one of these solutions.”
Urban areas themselves vary, and some of the issues that might show up more prominently in a megacity won’t surface in a mid-sized city closer to rural areas. In many megacities in Asia, for example, tiny kitchens drive a reliance on purchasing fast — and often fatty and high caloric — food away from home. Slum populations, on the other hand, might not be recognized by the government and therefore ineligible for some of the social safety nets for food and nutrition security available to other urban populations.
And food safety and other issues that can impact food quality, such as lack of water and sanitation, can also look far different in various urban settings, according to Britta Schumacher, WFP regional nutrition advisor based in Bangkok.
Many of these issues have been raised by the 2015 Milan Urban Food Policy Pact, at the U.N. Habitat III meeting in 2016, and via programs and research conducted by FAO and WFP in various contexts. Now, some cities are taking the lead in experimenting with programs to address the multiple burden of food insecurity and undernutrition, and the growing prevalence of overweight and obesity.
In 2017, the city of Seoul, South Korea, launched its “Seoul Food Master Plan” that declared every citizen’s right to food in a city where the frequency of skipping breakfast and eating out has increased, as has the intake of sugar from processed foods.
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To combat this, the city is increasing the amount of vegetable and fruit vending machines and fruit cafes at public transport hubs. Seoul has also started piloting logos that identify restaurants as “low salt” and is experimenting with certifying “smart meals” at restaurants, child care centers, and corporate cafeterias.
And increasingly, cities are considering how urban planning impacts whether and how people can access safe and nutritious food in a move to show how urban planners can be better nutrition partners — a point stressed in WFP’s joint report. Singapore, for example, has engaged urban planners to ensure that street food outlets, known as hawker stalls, offering healthier options are available in a variety of neighborhoods throughout the city.
“The reality of the situation is that urban planners and city governments have never — or until recently — really thought much about food and nutrition specifically,” Bloem said.
The private sector will be another important partner by producing more balanced products, rather than those high in sugar or fat — and designing urban malnutrition solutions. In Dhaka, one of the world’s largest cities, WFP is working with the textile industry to offer fortified rice to female workers, many of whom suffer from anemia and micronutrient deficiencies. In Singapore, hawker stalls were incentivized to start cooking with healthier oils thanks to a government deal with oil suppliers to bring down costs.
Anticipating a rural to urban transition and working on greater nutrition education in rural areas before people leave for the city will also be key moving forward, according to Schumacher.
People often gain weight quickly after making the transition from rural to urban areas because their diet, in terms of what is available and affordable, changes greatly when they arrive to an urban slum. “They are kind of lost, and they turn to high-sugar, high-fat, high-salt, poor-nutrient foods despite the greater diversity,” Schumacher said.
Medium-sized cities that provide linkages between bigger cities and rural areas could serve as a jumping-off point to address some of these inherent issues, but getting ahead of malnutrition or obesity — and making up ground toward meeting SDG 2 — will require a partnership-heavy approach, Bloem said.
Update, Nov. 18: This story was updated to clarify that Britta Schumacher is a regional nutrition advisor based in Bangkok.