This week, the Global Alliance for Improved Nutrition has welcomed me as its new executive director. As an economist, I have been working on issues at the intersection between nutrition, poverty and food security for over 25 years, most recently at the International Food Policy Research Institute and at the Global Nutrition Report as founding co-chair.
But as I start this new role, here are my thoughts on the negative consequences of malnutrition on human development, GAIN’s role in the nutrition sector, and the importance of innovative partnership models to tackle malnutrition in a sustainable and effective way.
The negative consequences of malnutrition
What can be done to end iodine deficiency disorders?
By Greg S. Garrett, director of food fortification at GAIN
Iodine deficiency is the most prevalent, yet easily preventable, cause of brain damage in the world. Thanks in large part to salt iodization, one of the easiest and most cost-effective interventions for social and economic development, the number of countries where iodine deficiency is a public health problem has been halved over the past decade. This represents a great success for the nutrition and the development community. Nevertheless, an estimated 25 countries remain iodine deficient.
From 2008 until last year, GAIN — in close collaboration with UNICEF, governments and the private sector — worked in 14 countries with low coverage of iodized salt to ensure that vulnerable populations have access to iodized salt. In these countries, we are seeing a lot of exciting progress: we were able to increase coverage of iodized salt to an additional 120 million children from 6 months to 15 years of age. This is improving their overall IQ, educability and opportunities in life. However, more needs to be done to sustain these efforts and GAIN is looking to continue to engage in high burden countries to improve iodine nutrition. We are hoping that, perhaps, in the next five to 10 years, we will be able to control iodine deficiency disorders at the global level and help hundreds of millions of children reach their full potential.
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The consequences of malnutrition are profound. Nutrition is vital for our physical and cognitive development and shapes our future potential. It determines how fast and well infants grow and how their immune systems and their brains develop. For example, babies are born with brains weighing 0.4 kilograms and that goes up to 1 kg in the first year of life — adults have brains of 1.5 kg. Nutrition has a huge impact on how the brain grows in that first year of life.
The consequences of malnutrition are devastating, especially if we consider that 45 percent of all deaths of children under the age of 5 are attributable to malnutrition.
The economic consequences are also dramatic, with 10 percent of national income and 40 percent of household income lost globally due to malnutrition. You are a third more likely to live in poverty as an adult, if you have been malnourished as a child.
Focus on the global food system
Together with my team at the Global Panel on Agriculture and Food Systems for Nutrition we recently launched a report on food systems, diets and the challenges of the 21st century. The report says that diet is pretty much the number one factor in the global burden of disease (six of the top 11 risk factors driving the global burden of disease are related to diet).
Whether it is too little food or not enough food of the right type — or it is about too much salt, sugar or too few micronutrients — globally, poor diets pose a greater risk to our health than alcohol, tobacco, drugs, unsafe sex and even air pollution.
Most of the things driving diets are related to the food system, which is everything from production to consumption, from farm to fork. The food system is currently not delivering high quality diets. In a way, we can say that it is acting as a villain, but it could also be a hero, as food systems can be the source of the solutions to the problem of malnutrition.
The Glopan report also says that policy makers have many opportunities to reform the food system, from production through to distribution, storage, trade, marketing and retailing. The report outlines a number of those options and it helps countries to make the case for their leaders that focusing on malnutrition issues is important. Diets are really the cause of most of the illness and mortality in the world.
GAIN’s approach
I am very excited about working on these issues at GAIN, which plays a unique role in the nutrition sector. First, GAIN looks systemically at a set of problems. It doesn’t focus only on one kind of nutrition intervention, but tries to look across the board and analyze where the most pressing issues are. Is it in the production section, or in the fortification or processing section? Is it in the demand for healthier foods or in the first 1,000 days window? GAIN tries to look across the system and I think we could do more of that.
Secondly, GAIN looks at sustainability issues and aims to have an impact at scale. Sustainability means that we are not just interested in small projects that die out once the work is done and everyone leaves. We are interested in feeding into big, powerful policy reforms and resource flows, and working through markets as well.
Thirdly, GAIN focuses on building alliances. Malnutrition is created by a combination of factors — that’s why strong and powerful alliances are needed to overcome to overcome this complex problem. Governments, businesses, nongovernmental organizations and other development partners can’t tackle it on their own. Only by coming together do we have a chance.
GAIN tries hard and has had some success over the years in bringing these partners together to do things that none of them alone would be able to do.
GAIN at the Micronutrient Forum
The Micronutrient Forum is a consultative group that brings together researchers, policymakers, program implementers and private sector representatives interested in reducing micronutrient malnutrition.This year, the Micronutrient Forum Global Conference will take place in Cancun, Mexico, on Oct. 24-28, 2016, and will put women at the forefront of nutrition interventions, highlighting their role as the focus of and partners in delivering programs for children, families and communities.
GAIN, with its partners, the Iodine Global Network, the Food Fortification Initiative and the Micronutrient Forum is holding a symposium on “A New Global Repository for Food Fortification: Helping to Map and Track Food Fortification Efforts Globally.” To learn more about the Forum and the events GAIN will take part in, check out the program.
Innovative partnerships
This is particularly important if we consider that, in the nutrition sector, we tend to talk to people working in the same or related sectors. We often talk with the public health, agriculture or water and sanitation people; it is a sort of echo chamber! I believe we don’t talk to businesses, media, economists, risk insurers and political leaders enough. There is an entire set of actors out there to whom we don’t communicate enough and we have to come together. We need very powerful alliances to overcome the multiple faces of malnutrition.
I am very ambitious for GAIN and, in the coming years, I want the organization to be at the forefront of this revolution around how to make food systems more nutrition-supporting and friendly. GAIN has the potential to be a real game changer for the sector: much of what the Grameen Bank did for microfinance, GAIN can do for the idea of sustainable system wide solutions for food that is safe, accessible, nutritious and affordable to all.
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About the author
Lawrence Haddad
Lawrence Haddad is a World Food Prize winner and has been GAIN’s executive director since 2016. Haddad chaired Action Track 1 Ending Hunger and Malnutrition at the 2021 U.N. Food Systems Summit. In 2022, he was awarded a CMG for “services to international agriculture and nutrition” by King Charles III of the United Kingdom. Before GAIN, Haddad co-founded the Global Nutrition Report, was director of the Institute of Development Studies, and was director of the International Food Policy Research Institute’s Division of Food Consumption and Nutrition. An economist, Haddad completed his Ph.D. in Food Research at Stanford University in 1988.
