Nutrition and Health: Big Challenges Ahead


Agriculture has succeeded in massively increasing the amount of staple grains produced, but the world still faces serious challenges related to nutrition: • The number of hungry people rose from 873 million in 2004–06 to 925 million in 2010. • About 115 million children are underweight, and 186 million under age five are stunted. • Nearly half of the world’s preschool-age children suffer from anemia, and one-third are deficient in vitamin A. • Undernutrition is the underlying cause of nearly one in three deaths from all diseases in preschool-age children. • 1.7 billion people are overweight, and 500 million of them are obese.1


Agriculture also poses serious health risks to both food producers and food consumers:


• Agriculture is one of the most hazardous occupations worldwide. Health risks include microbial and other pollutants from wastewater irrigation, exposure to zoonotic pathogens and chemicals like pesticides and herbicides, and accidents and exposure to extreme weather events or patterns.


• Three-quarters of emerging diseases are zoonotic in origin.


• In developing countries, 4.5 billion people are chronically exposed to aflatoxin, a highly carcinogenic natural toxin that is thought to affect 25 percent of the world’s food crops.2


incomes and in turn their expenditures on food, as well as by raising government revenues to help fund health, nutrition, and infrastructure programs. But what does the evidence show? A look at successful episodes in fighting malnu- trition reveals that for low-income countries, rapid economic growth is a necessary condition for reducing malnutrition—but not a sufficient one. Agricultural growth, in particular, is as- sociated with increases in calorie consumption, depending on the size of the agricultural sector in a country, but it does not necessarily result in more diverse diets. Moreover, agricultural growth is often associated with reductions in malnutrition, except in India, which is home to one-third of the world’s malnourished children (see box on page 10). Some middle-income countries, like Brazil, Honduras, and Mexico, have been able to improve nutrition even in the absence of rapid economic growth, perhaps be- cause existing national income was high enough to fund effective social programs.


The type of agricultural growth that takes place also matters a great deal for nutrition. In


Tanzania, for example, high agricultural growth has done little to improve nutrition because it was driven primarily by crops that poor people were less likely to grow.3


Experience has shown


that growth in staple crops contributes more to poverty reduction and calorie intake than does growth in export crops because poor farmers often lack the financial resources and technolo- gies required to grow export crops.4


In the long term, the best way to conquer malnutrition is to promote a nutrition-sensitive growth strategy. Such a strategy could increase demand for and access to nutritious foods all along the value chain, mitigate the health and nutrition risks associated with agriculture, and breed more nutritious varieties of staple food crops consumed by poor people. It could promote diversification of agriculture into nutri- tious and high-value products like dairy, hor- ticulture, and fish, which offer great potential for small farmers because they are land saving and labor intensive. Public support systems for agriculture, like credit and extension programs, should be made to work better for women


“We desperately need another revolution, one that deals with agricultural productivity for the smallholders. . . . We need to answer these questions: Are we growing the right foods? Are we growing them in the most efficient way with respect to inputs, water, and land? Are we growing them in the most sustainable way? And what foods are consumers actually eating in terms of quality and quantity, nutrition, and food safety?”


—Inger Andersen, World Bank and CGIAR Fund Council 2


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