Malnutrition in the developing world & Future food needs

Malnutrition in the developing world

Food deficits, regardless of whether they are on national, local or individual level, or if they range from marginal to crippling, are rarely caused by absolute physical short-ages. Such cases arise repeatedly only as a result of protracted civil wars (recently in Afghanistan, Angola, Ethiopia, Mozambique, Somalia, and Sudan) and temporarily as an aftermath of major natural catastrophes. Chronic undernutrition and malnutri-tion result from inadequate individual or group access to food that is strongly related to social status and income. This conclusion is true for both the richest as well as the poorest countries.

FAO’s past estimates of the global share of undernourished people ranged from a clearly exaggerated fraction of two-thirds in the late 1940s (an overestimate caused largely by unrealistically high assumptions regarding average protein needs) to less than one-seventh in the early 1990s. The latest estimate, for the period between 1996 and 1998, adds up to 826 million undernourished people, or about 14% of the world’s population at that time (FAO, 2000). As expected, the total is highly unevenly split, with 34 million undernourished people in the developed and 792 million people in the developing world. The highest shares of undernourished population (about 70% of the total) are now in Afghanistan and Somalia, whereas the rates for India and China are, respectively, about 20% and just above 10%. These shares make India the country with the largest number of undernourished people (just over 200 million, or roughly a quarter of the world’s total, spread pretty much all around the country), whereas China’s aggregate (mostly in the northwestern and southwestern interior provinces) is about 140 million.

There are, of course, different degrees of undernutrition, ranging from mildly under- weight (with body mass index of 17–18.5) to severely underweight (with body mass index below 16; the normal healthy range is 18.5–25). The FAO (1996) also put the number of stunted children (with low height-for-age) at 215 million, underweight chil-dren (low weight-for-age) at 180 million, and wasted children (low weight-for-height) at 50 million. As there are many uncertainties regarding both the data and assumptions that go into the process of comparing food supplies and needs, all of these figures must be seen as informative estimates rather than as accurate totals. Nevertheless, there can be no doubt about the enormous human and socioeconomic toll of this nutritional dep-rivation. Perhaps the worst health impact arises from the well-documented effect of  undernutrition on early brain development (Brown and Pollitt, 1996).

Shortages of food energy and dietary protein are not the only causes of serious mal- nutrition as micronutrient deficiencies are even more common. Blindness caused by shortages of vitamin A is among the most cruel consequences of inadequate diets. The xerophthalmia syndrome includes night reversible blindness caused by lack of retinol in the eye’s retina, corneal ulceration and eventually irreversible loss of eyesight. In addition, low levels of vitamin are associated with higher mortality from respiratory and gastrointestinal diseases, and with their more severe course. FAO estimates that the total population at risk is well over half a billion, that there are about 40 million preschool children with vitamin A deficiency, and that perhaps half a million of them go blind annually (FAO, 1996).

Some micronutrient deficiencies have environmental origins. The World Health Organization estimated that 1.6 billion people, or more than a quarter of the world’s population, have some degree of iodine deficiency (WHO, 1993). Estimates of the total number of people with goiter, the condition almost always associated with some mental impairment, are as high as 600 million (Lamberg, 1993). WHO also credits iodine deficiencies during pregnancy with at least 25 million seriously brain-damaged children and nearly six millions cretins, whose severe mental retardation is combined with hearing loss or mutism and abnormal body movements. As for the economic impact, Arcand (2000) concluded that if the sub-Saharan countries with average dietary supply below the minimum requirement in 1960 had eliminated hunger by raising the average per capita food availability to nearly 2800 kcal/day (i.e., essentially China’s current mean) their per capita GDP in 1990 could have been as much as $3500 rather than the actual $800.

Future food needs

Three key factors will drive future demand for food. By far the most important is the continuing population growth throughout the developing world. Second, is the all too obvious need to close the gap between today’s inadequate food intakes that have to be endured by some 800 million people throughout the poor world and the minima com-patible with healthy and productive lives. The third factor is the further improvement of the quality of diets in poor countries (given the great existing food surplus, getting rid of nutritional inadequacies throughout the rich world should not call for any increases in production). At least three principal factors will determine the eventual outcome: the level of agricultural investment and research; the extent and tempo of dietary transitions, particularly the higher consumption of animal food in today’s developing countries; the success in making future food production more compatible with biospheric limits and services; and the fate of genetic engineering.