The Lancer has run a most important series of 5 review articles on malnutrition finishing with the February 6th edition of the Journal.
The final editorial reads
Later this month, the first batch of seeds will be stored in the Svalbard Global Seed Vault to ensure that should a major catastrophe ever hit the planet, survivors should at least have access to a seed bank and so may be able to grow food. Eventually, over 200 000 crop varieties will be hidden in this Arctic ice sanctuary deep in a mountain near the village of Longyearbyen, built by the Norwegian Government for the benefit of mankind. And last week, the Bill & Melinda Gates Foundation announced a S20 million grant to develop hardy rice crops to help poor farmers cope with the effects of climate change. While these visionary philanthropic works are admirable, what about doing something to help the millions of people throughout the world who are starving right now?
The World Food Programme continues to raise awareness of current food insecurity emergencies. Last week’s target was Tajikistan, where the coldest winter in five decades and rising world food prices have resulted in a disastrous situation. If past experience is anything to go by, the Programme’s pleas for emergency funding will fall on
deaf donor ears, and many people in Tajikistan will starve. So why can’t the same attention, energy, innovation, and financial and technical resources, reserved to mitigate the effects of potential future disasters, be channelled into tackling current hunger crises? Although not immediately relievable by a scientific quick-fix, it should not be beyond the bounds of possibility to redistribute the abundance of global food resources and tackle wider socioeconomic factors often involved in food security issues.
The final article in our under nutrition Series clearly outlines what needs to be done. The global architecture of the international nutrition system needs to be radically reformed and become more accountable and inclusive. And everyone from major donors to the editors of academic journals all have their part to play. It is absurd and profoundly unjust that, as many countries are putting their resources into tackling the obesity epidemic, many people throughout the world are continuing to starve to death. We must all act now and turn the Series’ realistic recommendations into robust action. ■
The core problems were identified as
Lack of high level interest
Inadequate human sources
Unpredictable and inflexible funding
Inadequate strategies
Limited sticking power of policies
Structures that impede collaboration
Weak coordination
Weak linkages with countries

Their recommendations were
The international nutrition system—made up of international and donor organisations, academia, civil society, and the private sector—is fragmented and dysfunctional. Reform is needed so that it can perform key stewardship functions, mobilise resources, provide services in emergencies, and strengthen capacity in low-income and middle-income countries
Current processes for producing normative guidance are laborious and duplicative, and fail to produce guidance that is prioritised, succinct, and evidence-based.
Programme evaluation is weak, and insufficient resources are devoted to analysing and responding io major global challenges (including the evolving epidemiology of nutrition)
The funding provided by international donors to combat under nutrition is grossly insufficient and poorly targeted, and is inappropriately dominated by food aid and supply-led technical assistance. Much more investment is needed in human and institutional capacity for nutrition in low-income and middle-income countries
The problems of the international nutrition system are long-standing and deeply embedded in organisational structures and norms. The international community needs to identify and establish a new global governance structure that can provide greater accountability and participation for civil society and the private sector
Linkages with national-level processes need to be significantly enhanced, so that priorities that are felt at country level are better reflected in international normative guidance, donor funding, research, and advanced training
Morris et al 2008 Effective international action against under nutrition : why has it proven so difficult and what can be done to accelerate the progress. Lancet vol 371 pp 608-621
Leader Lancet 2008 Tackling global food insecurity Lancet vol 371 p 532

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Martin Eastwood

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