Is Food the Answer to Malnutrition? - The Oxford Topic of Food, Politics, and Society - page 422

long-term functional and human consequences of malnutrition in utero and in the first
months of life are particularly devastating. The damage from undernutrition at these
critical periods will persist across the entire life course, as manifested in deficits in cog-
nitive abilities, physical work productivity, as well as susceptibility to disease later in life,
including chronic diseases such as diabetes and cardiovascular disease.
The question then becomes how to address undernutrition in these most critical peri-
ods. Although the answer is not simple, one clear reality is that women too often do
not follow best practices in terms of breastfeeding, and families do not take appropriate
measures to prevent infection and disease. This may be either due to ignorance of the
importance of behaviors such as boiling water and washing hands and ensuring a more
hygienic and healthier environment for infants and young children, or a lack of material
resources to purchase critical inputs such as clean water, soap, and primary health care.
Similarly, food consumption choices are often inappropriate and fail to recognize, for
example, the importance of dietary diversity to achieve adequate intake of micronutri-
ents. There is also an overall lack of knowledge or attention to the preventative and pri-
mary health care needs of pregnant women, infants, and children. By implication, these
factors can be viewed as a market failure, not of food markets, but instead of health care
markets, and more generally, the market for information and knowledge.
The focus on promoting health services and related behavioral change is not to
diminish the paramount importance of building on the amazing success of the green
revolution and the new technologies that are to be credited with preventing widespread
famine. Complacency, in terms of continued research and investment in agriculture,
food markets, supply chains, and so forth would be a tragic mistake. This is especially so,
since a robust agricultural sector is often a critical pathway for countries and households
to rise out of poverty. However, when we think about combating the global malnutri-
tion problem, we must be equally cognizant that many traditional strategies, such as
food aid distribution programs, school feeding programs, and food stamps, as well as
interference in food markets through food subsidies and ration programs, are likely not
to directly address the most direct and immediate causes of undernutrition and micro-
nutrient deficiencies.
Why such programs have been sold as cost-effective nutrition interventions and are
widely accepted as such, in developed and developing countries is an interesting ques-
tion. The answer is likely to be found in the fact that food was a resource looking for
a purpose, and nutrition seemed to be a cause that the food and agricultural lobby, as
well as institutions such as the United Nations and volunteer agencies from developed
countries, were eager to embrace. Similarly, governments seem all too eager to showcase
feeding programs and other food-based initiatives as a sign of commitment to nutrition
problems. In practice, such externally financed projects may be easy on the budget of
poor countries, but they are also short on results, which, in part, explains the seeming
intractability of providing for what is arguably the most basic human right—the right to
health and adequate nutrition.
Another underlying theme of this chapter is the potential for unintended deleteri-
ous health consequences of food-related interventions that are purportedly designed