Overcoming “Hidden Hunger”

Melinda Gates
Bill & Melinda Gates Foundation

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The migration and refugee crisis — and the pressure it’s putting on Italian society — has been one of the most pressing issues in this country for more than a year. But it’s important to remember that, for the new arrivals, it’s not a refugee crisis. It’s a crisis of suffering. And it started not on the shores of Sicily but elsewhere, mainly in Africa, when life at home became so intolerable that people felt they had no choice but to escape.

One root cause of this crisis is famine. In fact, the number of hungry people in the world went up last year, from 777 million to 815 million. The world’s response to famine and hunger depends a lot on Italy. The country has been a global leader on food security and agriculture issues since it became the headquarters for the United Nations’ food security operations in 1951. As president of the G7 this past year, Italy has continued to champion these priorities.

When we think of hunger, we imagine the children with distended bellies we saw in photographs from Ethiopia in the 1980s. However, many more people suffer from what is sometimes called “hidden hunger,” which means that while they’re not literally starving, they don’t get the nutrients they need to thrive. That’s why it’s so important that Italy is now making nutrition a priority by hosting the landmark Global Nutrition Summit next week in Milan.

Globally, one in four children are what’s known as stunted, or significantly shorter than they should be. Stunting is one of the clearest indicators of chronic malnutrition over the course of months and years. We know that chronic malnutrition blocks not just children’s physical growth but also their emotional and cognitive development. The impact of stunting is devastating: every stunted child is a child prevented from reaching his or her full potential, and a nation in which people don’t reach their full potential — in which not enough people have a chance at a good life — is a nation cut off from prosperity.

One of the ramifications of thinking not just about acute hunger but also chronic malnutrition is that we have to change the way we think about solutions, too. Traditionally, food security programs have focused on feeding people, but it’s now clear that basic calories don’t always include the nutrients brains and bodies need to mature properly. Organizations focused specifically on nutrition have had success fortifying staple foods like flour and salt with essential vitamins and minerals, but the world needs to think bigger.

Following Italy’s example, we need to be more innovative with agriculture: what food a country’s farmers grow, how they grow it, and who gets to eat it. We also need to pay attention to health and sanitation, since diseases of the gut play a significant role in whether children can absorb the nutrients from their food. And we need to educate parents so they can give their children the right nutrition at the right time — not just a healthy diet, but also practices like exclusive breastfeeding, which can save almost 1 million children every year.

Despite the magnitude of the challenges chronic malnutrition presents, however, we know that they can be overcome. In Peru, for example, a group of advocates came together in 2006 and argued that, in the words of one, chronic malnutrition was putting “a huge dent in the country.” The government mixed and matched the most effective programs, from vaccinating children to counseling mothers about feeding their children, and as a result stunting in the country has fallen from 28 to 18 percent in just 10 years — one of the fastest reductions ever recorded. In Ethiopia, once synonymous with famine, thousands of trained professionals provide health care and nutrition counseling to all 100 million citizens in their communities. Stunting rates, while still much too high, are going down faster in Ethiopia than in all but a handful of countries.

Farming families in poor countries aren’t organized like the international development community and they don’t distinguish between nutrition, food security, and agriculture. They just want to be able to give their kids enough healthy food to eat to build a better future.

Foreign aid helps unlock potential, especially when it addresses nutrition along with other priorities. We look forward to Italy’s continued leadership and generosity, beginning when world leaders convene here at next week’s Global Nutrition Summit.

This piece originally appeared in La Stampa.

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Melinda Gates
Bill & Melinda Gates Foundation

Co-chair of the Bill & Melinda Gates Foundation, businesswoman, and mother. Dedicated to helping all people lead healthy, productive lives.