Growing the farming sector in developing countries will improve children’s health. Or will it? Katy Wilson reports.
Evidence of the impact of agricultural interventions on nutrition security is urgently needed. This was an issue raised at the launch of a Montpellier Panel briefing paper, Scaling Up Nutrition, in the UK Parliament on 17 May, authored by Tom Arnold, CEO Concern Worldwide and myself.
As we have learned from the Green Revolution, it is often the poorest and most in need that are neglected as agriculture develops. India is the second fastest growing economy in the world (with real growth rate of GDP equalling 8.3 per cent in 2010) but the prevalence of underweight children is still high at around 40 per cent.
It’s intolerable that 3.5 million maternal and child deaths each year globally are attributable to inadequate nutrition. The briefing paper highlighted the importance of agricultural development to tackle this. But does the evidence base support this recommendation?
The known unknown
We know that direct nutrition interventions can reduce child undernutrition and are cost-effective. Indeed, a study in a special edition of The Lancet in 2008 detailed that 13 interventions, when implemented in the 36 worst affected countries, could save one million lives per year.
What we don’t have is evidence that agricultural development activities can also be a (cost-effective) pathway to nutrition security.
This is important given that financing interventions such as nutrient supplementation and fortification of foods cannot be sustained over the long-term and development investments are guided by potential impact.
The evidence base needs strengthening if policy makers are to be persuaded to invest in agricultural development as a means of addressing child undernutrition. In a systematic review of agricultural interventions, conducted between 1990 and 2010, aimed at improving the nutritional status of children, DFID found a lack of impact. This was mainly because studies were not rigorous enough and, as a consequence, the ability of studies to detect an impact was low. This gap needs to be addressed urgently.
An analysis of the impact and cost-effectiveness of biofortification projects conducted by HarvestPlus is a step in the right direction. Results showed that costs saved per DALY (disability-adjusted life years, a metric for welfare) for many projects, such as vitamin A cassava in Nigeria and iron rice in Bangladesh, are highly cost-effective. For example, the cost per DALY saved was estimated at between $4.20 and $9.70 for vitamin A sweet potato in Uganda.
Given the scale of child undernutrition, in some African countries the proportion of children stunted is as high as 50%, we must invest in proven interventions now while also gathering evidence on agricultural activities that have co-benefits for nutrition.
The momentum to link agriculture, research and nutrition across programmes is greater than ever before, providing a real chance to achieve nutrition security. The evidence base will be key to sustaining this momentum and proving that our intuition, that agricultural development can reduce child undernutrition, is correct.
About Katy Wilson
Katy Wilson joined Agriculture for Impact at Imperial College London in August 2010 and is working with Gordon Conway on the new edition of his book The Doubly Green Revolution. She has previously worked as an event coordinator and editorial assistant, interned in New York and volunteered at Harnas Wildlife Foundation in Namibia. She recently completed an MSc Environmental Technology at Imperial College London and Ag4Impact’s work can be followed on Twitter @Ag4impact.