In his recent blockbuster book, Winners Take All, Anand Giridharadas states: “To question the doing-well-by-doing-good globalists is not to doubt their intentions or results, rather it is to say that even when all those things are factored in, something is not quite right.” This statement rings powerfully true for a range of development challenges, including malnutrition.
Despite all the attention and funding, we have a complex road ahead to end all forms of malnutrition by 2030, our Sustainable Development Goal promise. The Lancet’s most recent series titled the Double Burden of Malnutrition points to a stark reality: the co-existence of multiple forms of malnutrition within the same country and community contexts has become a dominant force. South Asia’s trajectory to end all forms of malnutrition is case in point.
South Asia is the hardest hit region when it comes to malnutrition. According to the 2018 Global Nutrition Report, South Asia is home to approximately 62 million of the world’s 155 million stunted children – children who are too short for their age. In addition, more than half of all children affected by wasting – too thin for their height – are in South Asia (26.9 million). Overweight, obesity, cardiovascular disease and diabetes are also increasing at an alarming rate across the region. Despite these statistics, South Asia has a backdrop of achievement and innovation, which well positions it to reject bystander status to this injustice.
South Asian countries have among the most extensive social safety net and rural development programs in the world. There have been billions of dollars dedicated to piloting and scaling food and nutrition innovations. The region boasts a legacy of agricultural achievement and innovation. And, most importantly, it has renowned, leaders in policy, research and program design and implementation, who are from the region, and taking control of the reigns to see progress achieved on terms that fit country and community contexts.
As we look toward a future where malnutrition in South Asia is a thing of the past, a few critical priorities come to mind:
•Evidence and research must be translated for action. Researchers, and donors that fund research, have the responsibility to invest in the translation of evidence so that domestic leaders and experts can concretely integrate nutrition knowledge into policy and programs. The metric for nutrition research achievement should go beyond papers published in peer-reviewed journals and technical convenings. It should be about making evidence meaningful with audiences who are shaping and influencing country responses.
•Ignite a movement of women and youth. Movements can be disconcerting to the power holders and the power brokers, but a movement for nutrition is urgent and necessary. We should be unapologetic about it. Women and youth in South Asian countries must be propelled forward – not as poster-children or passive messengers, but as those who speak truth to power, and transform what is grown, what and how their families eat, and what they expect from donors, international institutions and domestic systems.
•Big data for big impact. Big data, and innovative technologies to collect it, have transformed our understanding of consumers and the communities in which they live, work and learn. Data is being gathered by private and public sector institutions to understand consumer behavior, community patterns, and systems-specific opportunities and vulnerabilities across the South Asian context. We must be deliberate about using big data to create messaging and content that sticks, drive precise nutrition interventions in overlooked communities, and fill in important and urgent food, nutrition and health systems and infrastructure gaps.
•Look at the whole. If we win at delivering optimal nutrition, and fail at building a dynamic learning environment for our children, we won’t progress. If we prioritize physical activity, but provide no safe and inspiring spaces for children and adolescents to play, run and explore, our work is insufficient and incomplete. As we look toward 2030, taking a whole child and whole community approach to ending malnutrition is the way forward. Factors including household environment, equitable opportunities to play and learn, safety and security, surrounding infrastructure and more, all determine how successful we are in maximizing nutrition impact, and combating underlying and cross-cutting malnutrition vulnerabilities.
•Respect acts of love and dignity. Inspire change. In our efforts to combat malnutrition, we have largely overlooked cultural realities, taste preferences and the pride of caregivers in choosing what to feed, preparing food for, and deciding how to nourish their children. No doubt, there are South Asian realities and behaviors that undermine nutrition, and we should tackle those. But we must prioritize accounting for social and cultural nuances from the onset, and invest in the right ways to enable food and nutrition security in manners that promote dignity, autonomy and agency. Cooking and feeding are acts of love, and the framing of nutrition must be the same.
Our preconceptions of where malnutrition “lives,” and how we respond are being challenged. South Asia has the human capacity, historical contexts and tools to turn the tide on malnutrition. It’s time for leadership from across South Asia and across sectors in South Asia to continue to set the agenda, invest in it and drive it. For this is the only way to achieve the health, nutrition and development impact envisioned for South Asian communities, families and children at scale, and on their terms.
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Nabeeha Kazi Hutchins has more than 20 years of public health, nutrition, agriculture and early childhood development expertise. She directs programmes for KaBOOM!, a nonprofit that works with communities to ensure every child, everywhere, has access to inspiring play spaces. The founder and CEO of Humanitas Global, an international development organisation, she has served in senior roles with global communications firm, FleishmanHillard, The Clinton Foundation Global HIV/AIDS Initiative and No Wasted Lives, apart from leading advocacy and engagement programmes at the EastWest Institute and the International Maize and Wheat Improvement Center (CIMMYT). Nabeeha co-chairs the Community for Zero Hunger and serves as board member and technical advisor for a range of academic, research and non-profit institutions. Born in Pakistan to parents of Indian origin, and raised in Mexico and the United States, Nabeeha is proud of her Pakistani and Rajasthani heritage. She holds Bachelor’s degrees in Political Science and Journalism and Mass Communications from Kansas State University, in Manhattan, Kansas, and Master’s degrees in International Affairs and Public Health from Columbia University in New York. Nabeeha envisions a world where all children thrive and achieve their full potential.
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