Malnutrition in the world and children
February 2008

Yet, 8 million of the 11 million childhood deaths worldwide each year could easily be prevented, says a Cornell University expert, writing in the authoritative medical journal The Lancet .

That's because almost 60 percent of deaths of children under 5 in the developing world are due to malnutrition and its interactive effects on preventable diseases.

"Every single day -- 365 days a year -- an attack against children occurs that is 10 times greater than the death toll from the World Trade Center," says Jean-Pierre Habicht, professor of epidemiology and nutritional sciences at Cornell. "We know how to prevent these deaths -- we have the biological knowledge and tools to stop this public health travesty, but we're not yet doing it."

Habicht is a member of the Bellagio Child Survival Study Group, made up of leading child-health researchers, that has extensively conducted research on how to prevent the global toll on young children.

Only 10 years ago, child-health experts believed that malnutrition played only a negligible role in child mortality in the developing world. Then, Habicht and his colleagues at Cornell published a study showing that the majority of these childhood deaths were due to the interactive effect of malnutrition on disease. They also reported that more than 80 percent of malnutrition-related deaths were due to mild-to-moderate malnutrition rather than severe malnutrition.

The Cornell nutritionists had already shown that malnutrition worsens with illness in malnourished children. This compares with the effects of the same illnesses on well-nourished children, who do not become malnourished.

Habicht points out that both malnourished and better nourished children are killed by a few preventable diseases, such as measles, malaria, diarrhea and pneumonia, which can be prevented or managed effectively to prevent death. "These are also the diseases that kill malnourished children, so that dealing with these diseases is a first step for well-fed children and a fall-back step for malnourished children. Preventing deaths from these diseases costs only pennies per year," Habicht says.

Sadly, the childhood death toll remains high despite effective and inexpensive preventions because of problems at upper levels of organizations, Habicht and the Bellagio Group assert.

Either families don't get the information they need to seek medical care or help is not available because the organization of services is inadequate. "These issues turn out to be more difficult to resolve than the biological challenge was," Habicht says. "Remarkably little research is devoted to developing, testing and implementing strategies for care compared to the amount of research that goes into improving the biological effectiveness of care."

There is an imperative necessity  for a strategy to make health care more equitable, preventing one-third to one-half of childhood deaths without an increase in resources.

"It is, however, naive to think that the research, development and implementation of new strategies can be undertaken without more resources devoted to health care, even if in the long run they will become less expensive as efficiency improves," Habicht says.

Unfortunately, international funding for health care in developing countries is flagging. Washington is proposing to spend one-third less on international maternal and child health in the next federal budget, he says.

"We know how to prevent the deaths of millions of children," Habicht concludes. "Now we just have to do it."

"In the next 50 years, the degree of malnutrition, resultant disease and human misery is unimaginable. But we have to try to consider the future while there is still time to make meaningful changes, to reverse these trends and ensure a sustainable food supply."

The importance of soil in sustaining civilization has been stressed out by Cornell University researchers.

Several troubling trends have been outlined by the researchers:

1. Harvests of cereal grains, the mainstay of human diets and 80 percent of the world food supply, have increased slightly since 1985 but not nearly fast enough to keep pace with increases in population.
    
2. Rising malnutrition increases human susceptibility to other diseases, such as malaria, diarrhea and AIDS.
    
3. The prediction of a 12 billion global population by 2054 is based on the current rate of growth with each couple producing an average of 2.9 children. Even if nations' policy changes reduce the birth rate to an average of 2 children per couple, the 12 billion mark would be reached in 70 years.
    
4. Because more than 99.8 percent of human food comes from the land, doubling the planet's population will further stress resources for fresh water, renewable and fossil energy, fertilizers and pesticides.
    
5. For the most finite resource of all, land, each year more than 10 million hectares of cropland are degraded and lost because of soil erosion. This comes at a time when food production should be increasing dramatically to meet the needs of a rapidly expanding population. Pimentel noted that per-capita cropland has declined 20 percent worldwide in the past decade.

"The only way to reverse the growing imbalance between human population numbers and food supply is to actively conserve cropland, fresh water, energy and other environmental resources," Pimentel said.

"We must focus on developing appropriate, ecologically safe agricultural technologies for increasing food production. Either we are brave enough to limit our numbers or nature will impose its limits on our numbers and existence," he added.

 

Bibliography: