Patrick Webb, Dean for Academic Affairs Friedman School of Nutrition Tufts University Boston Des Moines, Iowa October 13, 2005 Child Malnutrition – Child Malnutrition – TRENDS, SUCCESSES AND CHALLENGES TRENDS, SUCCESSES AND CHALLENGES United Nations Syste Standing Committee on Nutrition
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Patrick Webb, Dean for Academic Affairs Friedman School of Nutrition Tufts University Boston
United Nations System Standing Committee on Nutrition. Patrick Webb, Dean for Academic Affairs Friedman School of Nutrition Tufts University Boston. Child Malnutrition – TRENDS, SUCCESSES AND CHALLENGES. Des Moines, Iowa October 13, 2005. - PowerPoint PPT Presentation
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Patrick Webb, Dean for Academic Affairs
Friedman School of NutritionTufts University
Boston
Des Moines, Iowa October 13, 2005
Child Malnutrition – Child Malnutrition – TRENDS, SUCCESSES AND TRENDS, SUCCESSES AND
CHALLENGESCHALLENGES
United Nations System Standing Committeeon Nutrition
United Nations United Nations Standing Committee on Standing Committee on Nutrition (UN SCN)Nutrition (UN SCN)
“The SCN vision is a world where hunger and malnutrition are no longer impediments to human development.”
The mandate of SCN is to mobilize commitment to solve nutrition problems; to refine the direction, increase the scale and strengthen the coherence and impact of actions against malnutrition worldwide.
In 2005, c. 11 million children will die before age of 5—one every five seconds.
Many will die in conflicts or natural disasters
Most will die because already undernourished
But most child deaths occur outside emergencies
The main cause of death varies, but >50% willdie of factors linked directly to malnutrition.
The RealityThe Reality
0
5
10
15
20
25
30
35
neonataldeaths
diarrhea pneumonia malaria other AIDS Measles Unknown
% o
f ch
ild d
eath
s
proportion of deaths from being underweight
Under-nutrition is responsible for Under-nutrition is responsible for half of all Child Deathshalf of all Child Deaths
Important gains in vitamin A Important gains in vitamin A and iodine; but…and iodine; but…
Successes Successes (…yes there are many!)
1. Protocols and Products1. Protocols and Products: Saving lives in crises
2. Technology and Targeting2. Technology and Targeting: Delivering the goods
3. Knowledge and Know-How3. Knowledge and Know-How: Nutrition as a right(legislation in India, Brazil); Entitlements;
Nutrition Education
4. Synergies not Silos4. Synergies not Silos: UN/SCN; MDG Hunger Task Force; joint agency programming; WFPrize
1.1. Protocols and Products Protocols and Products
in Emergency Reliefin Emergency Relief
Despite rise in number and scale of disasters, excess mortality in crises has been falling. Reported non-violent deaths in major emergencies fell by 40% 1993 and 2003 compared with previous decade.
Humanitarian agencies are doing better at saving lives through more timely responses, improved mobilization of resources, and better management of both the symptoms and causes of malnutrition.
Niacin 10 mg*
Biotin 0.1 mg
Potassium 1173 mg*
Magnesium 73 mg*
Iron 0.35 mg max
Zinc 20 mg*
Copper 3 mg*
Selenium 47 μg*
Iodine 76 μg*
Sodium 170 mg max
2. Technology and Targeting2. Technology and Targeting
Mobile milling and Mobile milling and fortification unitfortification unit (Nangweshi refugee camp, Zambia)
3. Knowledge and Know-how3. Knowledge and Know-how
Awareness that nutrition is everyone’s responsibility (Gambia example)
Knowledge about rights, entitlements
Nutrition education (breastfeeding; riding out shocks)
“[Poorest] households with nutrition knowledge… allocate 20% more of their food budget to micronutrient-rich foods than do households lacking nutrition knowledge.”
Block (2004) Maternal Nutrition Knowledge and Demand for Micronutrient-Rich Foods, JDS.
Based on work by HKI, UNICEF, Gov Indonesia
Nutrition knowledgeNutrition knowledge..
4. Synergies not Silos:4. Synergies not Silos:Optimum packages for nutritionOptimum packages for nutrition
“Although increased incomes are essential, it has been shown that countries implementing direct nutritioninterventions have been more successful in
reducing malnutrition.
Approaches that should be supported include;promotion of breastfeeding, supplementary feeding, immunization, treatment of diarrhoea, supplementssuch as iron, folic acid, iodised salt, food
supplementation and micronutrient-rich foods.”
OECD/WHO. 2003. Poverty and Health. DAC Guidelines. Paris.
Synergies not SilosSynergies not Silos
Indicative trend in cost per additional dose delivered as polio NIDs phase out
0
0.05
0.1
0.15
0.2
0.25
0.3
2004 2005 2006
US
$
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
extra cost per additional dose delivered to reach >= 70% coverage on each round
% of global VAS coverage met through polio NIDs
Micronutrient Initiative 2005
Institutional Synergies, not SilosInstitutional Synergies, not Silos
SCN is forum for identifying gaps in knowledge (science and practice), promote harmonized policies and approaches, share information, advocate.
Joint programming among agencies
Persistent Challenges Persistent Challenges
Reaching early pregnancy and 0-2 years Exclusive Breastfeeding Iron deficiency anemia Preventing obesity
Interventions at scale Resolving the worst cases—where capacity
is weakest and funding negligible Mutually reinforced actions needed