Malnutrition is leading cause of death and ill-health worldwide

By Jean Shaoul
15 May 2020

One in nine people are chronically hungry—820 million people worldwide—because they cannot access or afford healthy food. It is a major contributing factor in premature death.

It beggars belief that this is the situation in the 21st century, amid unparalleled developments in food science. But that is what the “Global Nutrition Report 2020: Action on equity to end malnutrition” says.

The report, launched Tuesday, not only found that hunger is widespread but also that obesity and other diet-related non-communicable diseases (NCDs) are increasing rapidly almost everywhere. One in three people is overweight or obese, while almost a quarter of all children under five years of age are stunted.

Nakitela Epur is pictured with her eleven-month-old daughter, Epuu, who is recovering well after being treated for acute malnutrition in the pediatric ward in Lodwar District Hospital, in Kenya's northern Turkana county. (UK Department for International Development)

Taken together, these various forms of malnutrition have become the leading cause of ill health and death. Yet most people cannot access health care and treatment. Worldwide, only about one-quarter of the 16.6 million children under 5 years of age with severe acute malnutrition received treatment in 2017.

The report states that these various forms of malnutrition are the result of inequities in food distribution and health care systems. But as is the nature of such reports, it only hints at the utterly criminal indifference of all national governments to these issues.

Not one single country is on course to meet all 10 of the 2025 global nutrition targets set in 2013. Only 8 out of 194 countries are likely to meet even four targets and a shocking 88 countries are set to meet none of the targets by 2025. Only a tiny proportion of health care budgets is spent on action to deal with nutritional issues, even though this can be highly cost-effective, reducing health care spending in the long-run.

The cost of eliminating world hunger has been variously estimated at between $7 billion to $265 billion per year. At the opposite end of the spectrum, the medical costs of treating the consequences of obesity are “staggering,” estimated at a total of $1.2 trillion a year by 2025, with the US by far the biggest spender.

The report insists that “poor diets and resulting malnutrition are not simply a matter of personal choice. Most people cannot access or afford a healthy diet of quality nutrition care.”

As it points out, new analysis shows that the global and national patterns of malnutrition in all its forms mask huge inequalities within countries and populations.

The most vulnerable groups are the worst affected. Some 30 million people in the US, the richest country in the world, go hungry.

There are also significant differences between countries, with underweight a major and continuing issue in the poorest countries, often 10 times higher than in the more advanced countries, while overweight and obesity prevail in the advanced countries at five times the rate of poorer countries.

Malnutrition coexists alongside striking inequalities in location, age, sex and education and above all wealth, and is compounded by wars and conflicts, as well as low prices for farm crops, high prices for food, low wages and unemployment.

The report deliberately ignores the role that US and European imperialism plays in fostering these conflicts, either directly or through their allies and proxies. Neither does it criticise the corrosive social effects of the profit motive that is responsible for both climate change and the dearth of affordable nutrition in both the advanced and the so-called “developing” countries.

The Global Nutrition Report 2020 simply notes that commercial agricultural production systems focus on an overabundance of staple grains such as rice, wheat and maize, which can be stored and transported easily, rather than perishable fresh fruit, vegetable and nuts that are more expensive to produce and dependent upon fast and reliable transport systems. Food corporations focus on highly processed foods that are cheap and intensively marketed in high-income countries and increasingly now in middle-income countries.

The report, although written before the emergence of the COVID-19 pandemic, comes just a few weeks after the United Nations’ World Food Programme warned that hundreds of millions of people face starvation and millions could die as a result of the pandemic without urgent action and funding.

The UN secretary general’s special representative for food security, David Nabarro, said that the report now had a “heightened significance,” warning, “COVID-19 does not treat us equally” as undernourished people may be more at risk to coronavirus, due to their weakened immune systems, while obesity and diabetes were linked to worse outcomes.

Writing in the foreword, he said the virus had exposed the “vulnerability and weakness of our already fragile food systems,” which had been weakened by climate extremes and “deadly health care disparities.” But he said little or nothing about the deliberate neglect of these issues by governments around the world.

Major improvements in health—as was the case in the advanced countries in the past, when health improved with the provision of clean water, sanitation, decent housing and living conditions, higher wages and vaccination programs—are dependent on broader public health measures, not individual “lifestyle” choices.

Despite the shocking conditions outlined in the report, its recommendations for resolving the situation are striking in terms of their inadequacy and spinelessness. The authors call on governments, businesses and civil society, the very institutions that have done so much to create and perpetuate this situation, “to step up efforts to address malnutrition in all its forms and tackle injustice in food and health systems.”

As the authors admit, the primary contemporary causes of famine and malnutrition are economic inequality, wars and climate change. Global hunger and malnutrition cannot be eradicated by pathetic pleas to governments but only by putting an end to the capitalist mode of production for private profit that fosters brutal competition, environmental damage, global warming and wars.

The benefits of scientific advances can only be realized if they are employed freely and equitably under a globally planned, socialist economy, rather than monopolized by private agribusiness corporations. The Global Nutrition Report 2020 may call attention to widespread undernourishment, but only the struggle of a united international working class can put an end to it.

 

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