SALLY COWAL: Can you set the scene for us? What is the scale and the nature of the global nutrition problem?
DR. DAVID NABARRO: We start from the reality that the world’s food systems are not working as well as they should. So although there is enough food to go around at the moment, there are about 1 billion people chronically hungry. This means they don’t get enough food in their homes to feed their families at least two good meals a day. Most of these 1 billion are also at risk of undernutrition.
SC: As the world population approaches 7 billion people, what links do you see between population growth and food security?
DN: Demand is rising for two reasons in our modern world: one is population growth. It’s not going to go on growing forever, but it’s certainly going to grow until 2050. It might stabilize then between 9, 10, 11 billion. The second reason why demand is increasing is that there are certain parts of society that are moving into a more affluent lifestyle with diets that include more meat. Meat, in return, requires cereal, because domestic livestock are typically fed on cereal. People are consuming food that is more demanding in terms of what is needed to make it, to develop it. So both the increase in population and the growing affluence in population are factors in that demand.
SC: Tell me, as a physician, what effect does undernutrition have on a person’s health and development?
DN: To speak as a medic, the simple language that I use is that you need adequate nutrients in your body for growth, for work, for repair and, of course, for maintaining body functions. Our bodies are quite efficient in that they tend not to need too much in the way of energy or nutrients for body functions, but if they’re deficient in a key nutrient, like vitamin A or zinc or iron, the function can get impaired very quickly. Micronutrient deficiency is a very pernicious and unpleasant determinant of the function. We pay a lot of attention to that and recently have been looking for ways to deal with micronutrient deficiency.
SC: What kinds of nutritional interventions are working best to address the macro food security and an individual’s undernutrition?
DN: The combination of direct nutritional interventions and nutrition-sensitive policies in a range of different sectors are better for nutrition. Food security may be complex, but in summary it’s about ensuring that sufficient food is produced, ensuring that all households can access that food, ensuring they can use that food to get adequately nourished and ensuring stability of supply and access. But to get there, we need a combination of many different actions – and it is easy to work them out if we consider food security from the perspective of the individual and the household.
SC: So are these then the objectives of the Scale Up Nutrition (SUN) movement?
DN: The Scale Up Nutrition movement is an attempt to build a more concerted and coordinated approach to addressing nutrition. The idea is to get a unified policy framework in which stakeholders from a variety of sectors can work together on the issue. There is something interesting here for all – stakeholders can plug themselves into six task forces and two focus groups to scale up nutrition.
SC: PSI is convinced by your argument and those of The Lancet and others that nutrition is an enormous challenge and one that we should all get behind. We are beginning to look at ways in which we could bring what we have to offer to this movement. So we’ll be looking for your guidance.
DN: PSI is a very important organization, and I’m happy that you’re prepared to think about coming on board. We are counting on you to work in it. The three things I like about PSI are that firstly, you are fearless and go to places where others aren’t set to go. Secondly, you are marketeers and you believe in the power of markets. And thirdly, you believe in, and are good at, social marketing and franchising which are approaches that sure have an application in the worldwide effort to combat under-nutrition.
SC: I have confidence in your ability to move this forward on a world scale. So it gives me hope.