Is Food the Answer to Malnutrition? - The Oxford Topic of Food, Politics, and Society - page 423

to improve nutrition. I have discussed the emerging obesity epidemic and emphasized
that it is no longer confined to the wealthy countries of North America and Europe.
Although there is worrisome evidence that programs like food stamps may contribute
to increased obesity in the United States, there is far more limited evidence of studies
suggesting that feeding programs and the like may have similar consequences in devel-
oping countries. It is certainly advisable, however, to remain vigilant to this possibility.
Similarly, other negative consequences of food-based nutrition programs, particularly
those based on the use of food aid, are also well documented. These include the nega-
tive impact on the policy environment where aid contributes to a complacency on the
part of policymakers, the potentially deleterious consequences on farmers and producer
incentives, and the changing of consumers' patterns of demand for commodities, some
of which are less healthy or that are less likely to be produced locally, increasing the reli-
ance on procurement on international markets. The potential that food aid would be
used as a weapon of foreign policy with the consequent harmful effects on recipients
seems to have declined in recent years, but such policy certainly was a widespread prac-
tice for several decades. Indeed, careful programming of food aid and its propitious
deployment can avoid or mitigate these potential negative consequences.
As we consider the way forward, I am intrigued by a question that was posed by
Ian Darton-Hill, Senior Adviser, Child Survival and Nutrition at UNICEF; Martin
W. Bloem Chief, Nutrition, World Food Programme; and Mickey Chopra, Director,
Health Systems Research Unit, Medical Research Council of South Africa: “ When will
nutrition stop being the Cinderella of health interventions when it comes to global fund-
ing priorities?” (Darton-Hill, Bloem, and Chopra 2006). Why, for example, is there
no Global Fund for broad-based nutrition programming (as there is for HIV/AIDS,
tuberculosis, and malaria)? Part of the answer may lie in a lack of understanding of the
complexity of the causes of malnutrition as well as the appropriate interventions to alle-
viate the problem. Nevertheless, there is an emerging evidence base that points the way
forward, in terms of promoting the types of actions discussed here for investing in the
health of women, infants, and children.
Notes
1. See http://www.who.int/vmnis/vitamina/prevalence/report/en/index.html.
2. http://apps.who.int/bmi/index.jsp
3. Author's calculations from the Demographic Health Surveys.
4. In the developed country context where markets are more complete and nutrient avail-
ability is less constrained, the framework just given would likely be considered sufficient
to model health production, nutrition, and fertility with the household's other consump-
tion decisions. Such separability between consumption and production, or factor markets,
may not apply in certain African contexts for two main reasons: (a) many rural households
in Africa engage in both own-account agriculture and the cultivation of cash crops, so
their food consumption and production decisions are jointly determined; and (b) nutri-
ent availability is more variable and often reaches levels at which health and labor market