Malnutrition

"Stunting early in a child's life can cause irreversible damage to cognitive development and has educational, income, and productivity consequences that reach far into adulthood. The economic costs of under nutrition, in terms of lost national productivity and economic growth, are significant-ranging from 2 to 3% of GDP in some countries and up to 11% of GDP in Africa and Asia each year"- the World Bank.
The Government apparently is brainstorming on ways and means to achieve a rather ambitious target of 9% GDP growth in the near future; ambitious, because of two reasons. Firstly, we haven't touched 9% growth in a few decades; for the record Pakistan's highest GDP growth rate was 10.22% back in 1954. Secondly, a pure quantitative growth target perhaps is not the solution for Pakistan's economic woes; growth brought about purely by consumption, even if 9%, might be a very costly affair for the nation's economic conditions going forward. We can hardly afford the 6% growth. On the other hand, growth brought about by improvement in net trade, even half of this target, would be absolutely stupendous.
Apparently, or rather finally, the Pakistan Banking Council (PBC) is also waking up to the necessity of Government support for pursuing export oriented import substitution manufacturing industry in Pakistan. While the current demands of PBC, diplomatically, ask for renegotiating Free Trade Agreements, especially with China, and provide level playing field for domestic manufacturing, I venture a guess. Pretty soon domestic business will ask for outright protection from the government, and you know what, I support that!
Notwithstanding the importance of reducing the trade deficit, I perhaps have been made wiser now and subscribe to the World Bank's solution for achieving higher GDP growth; getting rid of malnutrition. But let me flip it; with or without any impact on GDP growth, stunting due to malnutrition is shameful for any democratic government, as rightly stated in the Budget Speech 2018-19. While the speech, admirably, also mentions an allocation of Rs 10 billion for a program that will end stunting, there remain associated ifs and buts.
Unfortunately, the importance of malnutrition for our governments can be gauged from the very fact that the last nutrition survey was carried out in 2011; apparently one is now being launched in 2018. I wish I am proven wrong on this one!
"Results from the 2011 National Nutrition Survey (NNS) indicated little change over the last decade in terms of core maternal and childhood nutrition indicators. With regard to micronutrient deficiencies, while iodine status had improved nationally, vitamin A status had deteriorated and there had been little or no improvement in other areas linked to micronutrient deficiencies. The ratio of males to females was approximately 50.4% to 49.6% across Pakistan. A total of 45.7% of household heads were illiterate and 38.7% were workers or labourers. 15.5% of the population was unemployed - with higher rates in the urban population (18.9% urban unemployment, 14.0% rural unemployment). Using a standard questionnaire, the NNS 2011 indicated that 58.1% of households were food insecure nationally... . The National Nutrition Survey 2011 indicates that stunting, wasting and micronutrient malnutrition are endemic in Pakistan"-extracts from Executive Summary.
Notwithstanding that the survey seems to be challenging the literacy and unemployment rate in the country in one breath as well, whether or not Rs 10 billion is sufficient to address an issue which is endemic is the bigger question. Except, how did we allow malnutrition to become endemic is the upsetting part; not only for democracies, but for all the governments since independence. How we, as a nation, can have lived with the statistics given in the 2011 survey: Results showed that in Pakistan 43.7% of children were stunted. In rural areas stunting in children was higher (46.3 %) than in urban areas (36.9%). The wasting rate was 15.1% and the proportion of wasted children was lower in urban areas (12.7%) than in rural areas (16.1%). About 31.5% of the children were underweight, with higher rates in rural areas (33.3%).
I wish the government had focused on eradication of stunting in their first budget and not in the last; two months before they leave. After all, according to their own estimates, they just needed Rs 10 billion to end stunting. Nonetheless, whoever comes in next, needs to follow through with this commitment to end stunting, whatever it takes and however much it costs. Personally, I am ashamed too; ignorance is not a valid excuse in this case. I remain grateful to two gentlemen who brought this matter to my attention; thank you.
Dear readers, just when you think that you have unravelled the mystery of economic growth in the country, and decided that simultaneous investment in education and manufacturing, export oriented and import substitution, is the answer, you suddenly realize that the problem is deeper. Tackling stunting has to be the priority if we are to get anywhere with educating the masses.
Come next election, the intelligentsia needs to stop goofing about and focus on the real issues; malnutrition should be way up there on the top, in the list of the real issues faced by Pakistan.
(The writer is a chartered accountant based in Islamabad. Email: [email protected])