The prospects of turning over the current state seem extremely grim. This comes as no surprise since the issue of malnutrition has barely been on the political agenda with almost no incentives for state officials to go beyond their prescribed functions. There needs to be a paradigm shift in government policies, if we want to see some real results. The last intervention by the government was back in 2011 and if it hadn’t been for international donors Pakistan would have been lost for initiatives to address malnutrition. Prior to 2011, Pakistan lacked a national nutrition policy, with the 2002 National Nutrition Strategic Plan never having been implemented. The 2011 Pakistan Integrated Nutrition Strategy (PINS), however, sets out an incremental plan for the implementation of a host of nutrition-related interventions, and is now in its preliminary stages of adoption. Each of the four provinces of Pakistan have begun drafting inter-sectoral nutrition strategies. The implementation in 2011 of a National Nutrition Survey (NNS) underscored the increased interest in the issue. The survey revealed both high and stagnant rates of malnutrition. Although malnutrition is by definition a multi-sectoral issue, implementation to date has not been coordinated across ministries and departments, and responsibilities have often not been clearly delineated. The 18th Amendment that devolved 17 ministries from the center to the provinces, including the ministries of health and food, created a new fiscal distribution system and a fully restructured system for social service delivery.
After which the main work was done in Punjab with the launch of Punjab Food Authority and its licensing process. Other provinces following Punjab, also initiated changes in the health departments like the provincial government of Sindh passed the Compulsory Iodization of Salt Act in 2013, prohibiting the manufacture, processing or import of edible salt with an iodine content less than 30 parts per million (ppm). This is consistent with the national standard for iodized salt, which specifies a minimum iodine content of 30ppm at the manufacture level and 15ppm at the retail level. There is still no provincial legislation for mandatory salt iodization in place in KPK or Baluchistan. However, KPK and Baluchistan both mandate salt iodization province-wide through amendments to their provincial Pure Food Rules, and in Punjab, district by-law amendments to the provincial Pure Food Rules have made iodization mandatory in the majority of districts.
However, during the 2013 elections in Pakistan, not a single political party had malnutrition on their list of the issues that needed to be resolved in the country. A condition that has for decades plagued the masses of Pakistan, was receiving scant attention from the media, political parties and policy-makers who continued to ignore the malaise.
But when PML-N came to power in 2016 the health standards for Punjab drastically improved. While in 2016, the KPK government requested the implementation of Khyber-Pakhtunkhwa integrated nutrition strategy and the KP Protection of Breast-Feeding and Child Nutrition Act, 2015. They also stressed on the allocation of adequate resources for nutrition programmes and projects in the budget.
The measures taken however are not proportional to the degree of the crisis and hence have resulted in unsustainable efforts, failing Pakistan miserably in achieving its millennial developmental goals (MDGs).
In order to steer away from a major demographic nightmare Pakistan has to shift its focus dramatically towards the ominous signs of the malnutrition plague. It should be viewed as an opportunity by the government of Pakistan and should proactively work towards eliminating the lurking problems of poverty and under developed socio economic conditions underlying the crisis of malnutrition.
If prioritized, malnutrition can be overcome in a generation. Malnutrition doesn’t just persist in Pakistan but it has spread its tentacles throughout the subcontinent. According to research conducted in India by Development Horizons, by Lawrence Haddad, which is also closely working with Global Alliance for Improved Nutrition (GAIN), political parties in India don’t have malnutrition on their short or long terms goals. During the 2014 elections in India, Congress mentioned nutrition twice during the whole campaign, BJP mentioned it 12 times while AAP never mentioned it at all. According to the UN’s research, some of the very important initiatives taken by countries to eradicate malnutrition are Argentina’s campaign led by the national ministries for Health and Human Rights. Argentina’s Zero Hunger program is presently focusing on social programming, particularly nutrition, sanitation, and housing to help eliminate hunger in the country.
In June 2015, Environment Minister Greg Hunt announced a Zero Waste 2025 plan to cut in half the country’s $10b food waste bill. This initiative will work in line with “a country with zero waste, zero hunger and zero poverty” in Australia.
In Bangladesh, following a 2014 visit to Brazil, the government launched a pilot project in partnership with the WFP to provide hot meals in schools. The programme encourages strong involvement of local communities, and purchases food from local women farmers.
While in Indonesia the Central Government has committed to allocating 5% of the state budget to the health sector in 2016.
Malnutrition is a global catastrophe and calls for concerted actions. Governments need to add malnutrition to their short and long-term goals so that the problem can be eradicated. There is an urgent need to build programs which aim to reduce poverty in both rural and urban areas, and which will take into account inequalities being observed between the provinces.
All in all, the fact that Pakistan is a country in transition, has a significant constraint on getting an issue like nutrition on the national agenda. But, with the assistance of other actors like donor agencies, we can at least hope to build momentum for nutrition within a transitional environment. This can serve to support and strengthen policy and administrative processes and translate into democratic consolidation. A time like this compels political parties and governments to rise above their differences and to work as a team so that we can defeat the menace of malnutrition.
Saira Iftikhar, "Malnutrition crisis," Business Recorder. 2018-06-20.Keywords: Political agenda , International donors , Women farmers , Political parties , Iodine content , Transitional environment , Greg Hunt , Pakistan , Indonesia , PINs , GAIN , WFP , BJP , KPK , NNS