Nutrition: Women and Girls

Baroness Thornton Excerpts

Wednesday 22nd February 2017 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I congratulate the noble Baroness on bringing this important debate to the Floor of the House. I put my name down to speak in it because I wanted to identify myself and these Benches with this important issue—which my noble friend will also do—and at the end of my remarks I have a few questions for the Minister to consider.

It is inevitable that statistics will be bandied about during a debate like this, and some of them are startling and shaming. Malnutrition is partly responsible for 45% of childhood deaths. It destroys the most human potential on the planet. Children who are stunted are not just below their global peers in height but are behind them in cognitive development, and that will limit these children their whole lives. Nutrition is the biggest missed opportunity in global health, and were it solved, it would unleash waves of human potential. Yet overall, only 1% of foreign aid goes towards basic nutrition. Malnutrition is not starvation; malnourished children can be getting enough calories but not the right nutrients. That makes them more susceptible to conditions like pneumonia or diarrhoea—and more likely to die from them.

Over half of the world’s population lives in cities, a trend that will accelerate more quickly in the coming decades. In many cities, over half the population lives in informal settlements and slums, and rates of malnutrition are exceedingly high. Urban food systems in many countries are not developing rapidly enough to cope with the challenges of a fast-growing population, a factor which increases obesity levels as traditional diets are swapped for snacks and high-energy foods. So in many ways the global food system is broken.

Estimates seem to vary, but GAIN says that in total about 3.5 billion people—half the people on the planet today—are malnourished in one way or another. Each day, 795 million people go hungry. Each year, malnutrition undermines billions of people’s health. It kills probably 3.1 million children under five and leaves 161 million stunted. Rapid population growth and climate change pose new challenges to an already overburdened food system.

It is clearly obvious—I know that the British Government agree with this—that solving these problems can be done only as part of a collective global effort.

There are some simple and some not so simple solutions. Breast-feeding within the first hour and exclusively for the first six months is the first and simplest intervention and has long-term benefits for nutrition. However, of course it needs the mother to be healthy enough to breast-feed, and it requires the culture surrounding her to encourage her and requires her to understand that that is the best start she can give her child. Of course, the noble Baroness is quite right that this is a women’s issue in particular.

Experts are also figuring out how to breed crops with higher nutritional levels and how to get key nutrients in the food supply, in either salt or cooking oil. Those are promising approaches. However, nutrition is still one of the biggest mysteries in global health. Nutrition gets better as a country gets richer, but it does not seem to have any noticeable effects on positive outliers—there are poor countries with almost half their children undernourished.

In exploring some of the solutions put forward in this area, I came across the Nutrition Knowledge Bank—part of the GSMA mNutrition initiative to help tackle malnutrition in Africa and Asia—which is a collection of content on good nutritional practices and includes downloadable factsheets and mobile messages. This is not the complete answer, but it must be part of the solution, which is to do with knowledge and accessibility and using modern technology to improve nutritional practices, particularly for women and the vulnerable groups we have mentioned. I was struck by the work being undertaken by mNutrition in the various places in the world where it works.

The noble Baroness mentioned the targets that the World Health Organization put forward in this area. The Comprehensive Implementation Plan on Maternal, Infant and Young Child Nutrition, which the WHO endorsed in Geneva in 2012, set some very high targets indeed for solving this problem. The plan proposes:

“40% reduction of the global number of children under five who are stunted … 50% reduction of anaemia in women of reproductive age … 30% reduction of low birth weight … no increase in childhood overweight … increase the rate of exclusive breastfeeding in the first six months … reduce and maintain childhood wasting to less than 5%”.

Five action points flow from the World Health Organization’s proposals. I will not go through those in detail, but I ask the Minister whether the British Government are working to the action plan, to what effect and with what resources.

When the British Government were tackling tobacco as a public health issue, one of the biggest drivers of change in governmental practice were the strong rules about discussions with the tobacco industry. What discussions have been had, and what is the relationship, between the Government or DfID and the food industry? Some of the large companies providing food throughout the world that is not nutritious are based in the UK and Europe. Are the British Government thinking about how to deal with this fact? Indeed, is the Minister being lobbied by some of our large food manufacturers? When we were addressing the issue of tobacco, tobacco companies switched their attention from the first world to the third world because that was where they could make their money. That issue occurred to me and I genuinely do not know what the answer to the question is, but it is one that we need to ask. Does DfID have guidelines on this matter?

Has thought been given to how we will continue to be a leader in our aid programmes, particularly on this one, in a world in which we will not necessarily be able to join forces with our European colleagues in a coherent way, given that a lot of our aid work is currently done through our relationships with the European Union? Also, what consideration has the Minister given to the changing attitude of the new Administration in the United States of America to world aid and to the United Nations and its institutions? I accept that it might be too soon to say, but these are things that we need to think about.