SWBP: Hunger and Malnutrition

SWBP is Solutions to the World's Biggest Problems,
a 2007 book I'm reading, Ch.22: Hunger&Malnutrition,
by Jere R. Behrman (U of Pa), Harrold Alderman (World Bank),
and John Hoddinott (Int'l Food Policy Research Institute)
My book report/ Commentary and Summary
pp. 390-403

Brother, can you spare a dime (I haven't eaten today)?

Almost a billion people, of all ages, are chronically malnourished.
160M of these are children of pre-school age.
Each year, 12M babies are born underweight due to maternal malnourishment.

Improved nutrition and reductions in hunger create LARGE productivity gains in poorly nourished populations (as if all we care about is productivity...actually, we kind of do). Also, nutritiously fed/unhungry populations have less costs associated with infectious diseases and premature mortality, money from which is then freed up for other purposes.

Hunger, defined, is when people lack the basic food intake to provide the energy and nutrients to live fully productive lives. It is measured according to varying requirements for each individual (defined by age, sex, and activities).

Malnutrition, defined, is (I guess) hunger plus other factors, including the person's health state, which describes a person's "nutritional status."

In any case, 90% of the world's hungry are in 2 regions:
Asia and the Pacific, and
sub-Saharan Africa

In 2003, Asia had 505M and Africa had 198M undernourished.

Regarding low birth-weight, IUGR (intra-uterine growth retardation) is significantly caused by mother's long run nutritional status, her weight and micro-nutrient status prior to conception, and her weight gain during pregnancy. Also, infections and parasites play a role, such as malaria, where endemic.

Besides LBW (low birth weight), other factors contributing to poor childhood nutritional status are: limited periods of exclusive breastfeeding, poor diets, and infections (primarily gastrointestinal). Most malnutrition occurs in the first 2 years of life, and it often leads to deficits in cognitive development.

-30% of S. Asian babies are born with Low Birth Weight, and
-The 162M malnourished children are STUNTED (about 1/3 of all children). Stunting link.
-In sub-Saharan Africa, prevalence of stunting has remained unchanged, and numbers have increased (2004).

Micro-nutrients, as they are called, deserve special mention. These are Iodine, Vitamin A, and Iron. So anemia (iron-deficiency) is tied into this. The chapter says "more than 40% of children aged 0-4 in developing countries suffer from anemia." Anyway, Iodine prevents iodine deficiency (um, yeah), which adversely affects development of the Central Nervous System (e.g. the brain) and results, on average, in lower IQ's. Adequate Iron is also necessary for brain development. Vitamin A deficiencies are associated with increased risk of infant and child mortality.

To do the BCR thing, this book describes how it is a somewhat vague and fuzzy process, albeit informative nonetheless. Life-expectancy tables, such as those used by life-insurance companies, are a part of this. Depending on what figures you use for benefits and costs, your priorities can be re-arranged all over the place. But I seriously think the world needs to find the leadership and the heart (the leadership within ourselves) to do it all. Basically, everything listed in this book is a good investment. Some investments are described as better than others, and we should obviously do those. But the world MUST have the WILL to ACT (and SPEND) to solve it's major quality of life problems. Personally, I think every problem can be solved. I'm just that way. And certainly, every problem in this book can be addressed simultaneously, in a coherent framework. I'm pulling for you, Barack (in tandem with the UN).

Anyway, the solutions listed in the tables in this chapter (with various associated figures I won't give you) are: 1. Reducing low birthweight for pregnancies with a high probability of LBW (particularly in S. Asia), 2. Improving infant and child nutrition in populations with high prevalence of child malnutrition., and 3. Reducing micro-nutrient deficiencies in populations in which they are prevalent.

Specifically, for 1., this means: treatments for women with asymptomatic bacterial infections, treatment for women with presumptive STD, and drugs for women with poor obstetric histories.

Specically, for 2., this means: breastfeeding promotion in hospitals in which the norm was promotion of infant formula, and integrated childcare programs (adding improved home child care practices).

Specifically, for 3., this means: Iodine (per woman of childbearing age), Vitamin A (per child under 6), and Iron (per pregnant woman, and then over the lifecycle of the child(ren)).

I have to give this BCR example, just to show you how easy it is to do something immensely good and important: (iron) A cost of $19 yields a benefit of $12,821 (at a 3% discount rate).

Another one (breastfeeding) is a cost of $599 yields a benefit of $159,401 (!) (also, 3%).

In the summary, the authors mention how health and productivity gains aren't the only benefits to reducing health and malnutrition. There's obviously significant spillover into everything else, like women's education and status, infectious disease, improving infrastructure to reduce possibilities of famine or chronic hunger, improving water and sanitation, reducing international trade barriers, lessening conflicts, and improving governance.

They also mention that there are probably many other solutions, such as improving agricultural technology or lessening zinc deficiencies, that didn't lend themselves as well to analysis for the BCR format of this book.

And finally, why the hell haven't these awesome opportunities already been taken?? For example, Do the children and infants just have too little a political voice? And, Do marginal costs rapidly increase if interventions are scaled up?

Whatever, just do it. Git'r done.
I don't know if I want to say inaction is the equivalent of murder, but there's definitely a wide world of opportunity for happiness, on the other hand.