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Stronger political commitment needed to reduce malnutrition, says Gates Foundation director

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About the author: Shawn Baker is the Director of Nutrition at the Bill and Melinda Gates Foundation. He is also Chair of the SUN Movement Executive Committee.

He says strong political commitment and use of resources targeting those who need it can change the dismal picture of nutrition in any economically progressing country, as Brazil has shown the world.

Brazil is a global example for reducing stunting by 80 percent in one generation.

The Director Nutrition was talking to in Dhaka as he came to Bangladesh on Saturday, 20 years after being the country director of Helen Keller International in Dhaka from 1994 to 1996.

He has come to attend the board meeting of the Global Alliance for Improved Nutrition (GAIN) and also to see the projects of the Gates Foundation funds in Bangladesh.

Bangladesh has earned global kudos for cutting maternal and child deaths but the situation is not satisfactory when it comes to nutrition.

The current stunting rate of children under five years of age is 36 percent, a rate which had long stood at over 40 percent.

As the economy grows, nutritionists lament that they do not find its reflection in the nutritional outcome.

“It’s a budget issue whether the government will use the economic development to reinvest in its people or not.” Baker said.

“You need breastfeeding and complementary feeding (home-made food introduced after six months of age along with breastfeeding) practices. You need food fortification and mothers’ income for good nutrition.”

He says mothers’ income is important as women care for their children more than men in general do.

The Gates Foundation funds many unique researches and projects targeting nutrition in Bangladesh, a focus country of this charity fund.

Its ‘Alive and Thrive’ project generated lessons that are being replicated in other countries.

The project created dramatic impacts on increasing exclusive breastfeeding and complementary feeding practices in Bangladesh, as evident in last year’s Demographic and Health Survey.

“The success is now being replicated in other countries,” Baker says, as the Gates Foundation has nutrition projects in India, Nigeria, Burkina Faso, and Ethiopia.

He identified four ‘fundamental’ key-words referring to factors that obstruct the improvement of nutrition — invisible, orphan, poor data and voiceless.

“In the public mind malnutrition means a severely emaciating child. It goes invisible in a village if a child is too short or stunted. They don’t consider it a nutritional problem.

“It’s orphan because nobody claims responsibility for nutrition — ministry of health, agriculture, or social development. Nobody wakes up every morning saying if I don’t do it (nutrition improvement) I am going to lose my job.”

He said nutrition is voiceless as those at risk are least likely to have a political voice. “For HIV you have voices speaking in parliament. But for stunting you don’t have a voice”.

He said a politically enabling environment is essential and applicable for any country.

In Bangladesh, nutrition is an underinvested area as the total health sector budget is less than one percent of the GDP.

“There has to be a change in the mindset,” Baker said.

He felt that nutrition costs should be seen as an investment for the future of the country.

The Gates Foundation, in addition to scaling up previous efforts, will focus on maternal nutrition in its new programme in Bangladesh.

“If maternal nutrition is not addressed, the baby is going to born too small that is irreparable damage on both physical growth and cognitive development,” he said.

Baker said they are now having a dialogue with the highest levels of the governments in different technical areas to work on the obstacles. They will scale up their efforts and then assist the government with the proven interventions.

On private sector involvement in nutrition, Baker said he is a “pragmatist”, and for that he sees that the private sector has the “potential to do real good and do harm as well”.

“The government must create an enabling environment that optimises what the private sector will do and minimises any unintended negative consequences.”

Nutrition is a separate goal among the new sustainable development goals. He says the international community will make a strong pledge in next year’s Nutrition for Growth summit in Brazil to translate the nutrition goal in the SDGs into reality.

“I hope Bangladesh will also go with a big commitment.”

This article was originally published at See the original article.

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