The most neglected health problem in the world?

Melinda Gates
Co-Chair, Bill & Melinda Gates Foundation
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In global health, we talk a lot about neglected diseases like onchocerciasis and schistosomiasis—serious ailments that most people have never heard of. But a condition that everybody is perfectly aware of, malnutrition, may be the most neglected health problem in the world—and it affects many more people than any single disease.

In fact, malnutrition is an underlying cause of almost half of childhood deaths. In other words, almost half the children in the world who die before the age of five were more susceptible to whatever killed them because their bodies had been weakened by malnutrition. Yet, less than 1 percent of development aid goes to promoting better nutrition. And, in a field that is replete with reports and white papers about every imaginable topic, there has never been a comprehensive report about the state of the world’s nutrition.

Until last week.

The Global Nutrition Report describes how almost every country in the world is doing on key indicators of good nutrition, so now it’s public knowledge if they are fulfilling commitments to improve nutrition. The fact that the report is truly global—it includes information about poor countries and rich countries—matters, because malnutrition is truly a global issue.

Typically, when we think about malnutrition, we think about children who are starving or not developing properly because they don’t have enough to eat. Ironically, the opposite problem—what is known as “overnutrition“ including obesity and the many chronic diseases associated with it—is also becoming a massive health crisis in many countries.

The good news is that we know a lot more than we did even a decade ago about how to fight malnutrition effectively. For example, we know that breast milk is the global gold standard for infant nutrition (and it serves as the baby’s first immunization by delivering antibodies from mother to child).

Encouraging more women in poor countries to breastfeed immediately and exclusively will save the lives of hundreds of thousands of infants every year. But this isn’t just an issue in developing countries. In the United States, we spend $10 billion every year to treat babies with conditions associated with suboptimal breastfeeding.

It’s possible to improve breastfeeding very quickly and on a large scale. Take Vietnam, where the number of women breastfeeding immediately and exclusively tripled in less than four years in areas where they were exposed to media and counseling about nutrition.

No country can maximize its potential unless its citizens, especially children, are getting the right nutrition at the right times in their lives. The Global Nutrition Report is an important resource and a good sign that the world is starting to pay more attention to this urgent priority.

But what really matters is what comes next: Do countries and donor governments start investing more resources more strategically in the nutrition programs that are proven to be effective? When we can answer yes to that question, malnutrition will no longer be the most neglected health problem in the world.

Published in collaboration with Impatient Optimists

Author: Melinda Gates is co-chair of the Bill and Melinda Gates Foundation. 

Image: A woman with a baby on her back looks on at an informal settlement in the capital Luanda, August 30, 2012. REUTERS.

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