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Tackling hunger
By: Dr Abid Qaiyum Suleri
While Pakistan is trying to manage its twin deficits – the current account and the fiscal deficit – there is another deficit challenging the government. This one is food deficit, in particular nutritious-food deficit.
Exacerbated by the two monetary deficits, the food deficit is posing a major threat to the current and future generations of Pakistan. According to the latest National Nutrition Survey (NNS 2018), four out of ten children under the age of five in Pakistan are stunted (low height for their age). One in six children (17.7 percent ) suffer from wasting (low weight for height), and almost one in three children (28.9 percent) in Pakistan are underweight (low weight for age).
While wasting among young children in Pakistan is on the rise since 1997, there is marginal improvement in the prevalence of stunting – from 43.7 percent in 2011 to 40.2 percent in 2018. However, the worrying fact is that the prevalence of both stunting and wasting (a direct manifestation of malnutrition) in Pakistan remains at a global critical level. Our performance in South Asia on these counts is second worst after Afghanistan. Thus, we are producing a generation whose height is lower than its age, whose body weight is lower than its age and height, and who has a low IQ level compared with its peers elsewhere in the world. Let us not forget that malnutrition among children under the age of five causes a delay in brain development and an irreversible loss of IQ.
It is not just a significant number of our children that are suffering from malnutrition; a considerable number of our adults are also facing hunger. According to the latest Global Hunger Index (GHI) report published by IFPRI in 2018, Pakistan ranked at 106 (with prevalence of severe hunger) – only above Zimbabwe, Liberia, North Korea, Timor-Leste, Afghanistan, Sudan, Haiti, Sierra Leone, Zambia, Madagascar, Yemen, Chad and the Central African Republic.
Among 96,307 households assessed for food insecurity under the NNS 2018, one in every six households was found to experience severe food insecurity – hunger – whereas another 18.9 percent households were found to be mild to moderately food insecure, that is: their access to nutritious and sufficient food is compromised. This means that in total more than one third households covered under the NNS 2018 were food insecure.
People often wonder how Pakistan, which is a major producer of cereals and milk, an exporter of rice and fruits such as orange and mangoes etc can suffer from hunger and malnutrition. Food security has four pillars; physical availability (through production, imports or aid) is one of them. The second pillar of food security is access to food – that is, food should be within socio-economic access (cultural acceptability and affordability) to everyone. The third pillar of food security is the enabling situation where the body may assimilate the food for a healthy growth and development. Clean drinking water, sanitation facilities, health facilities, and literacy level play an important role in improved food assimilation. The fourth pillar is the sustainability of the above mentioned three factors – for all the people all the time.
Although with regional inequalities and distributional issues, the food availability situation is slightly better in Pakistan. However, the situation is compromised as for as rest of the three pillars are concerned.
One can argue that Pakistan is not an exception. According to the FAO’s latest ‘State of Food Security and Nutrition in the World’, the rise in food insecurity and hunger between 2011 and 2017 coincided with an economic slowdown (declined growth) or downturn (negative growth) in 65 (including Pakistan) out of 77 countries. However, the worrying factor for us is that our growth projections for the next three years, under the IMF programme indicate further economic slowdown, meaning we are vulnerable to more hunger and food insecurity. Here I am taking the external economic factors (such as change in fuel prices), and possibility of extreme weather scenario as constant. Any negative change in these factors would further deteriorate the economic access to food and reduced spending on prerequisites for food assimilation.
The best case scenario is that in Pakistan the state of food insecurity does not deteriorate further (if it does not improve) despite the economic slowdown. Theoretically speaking, that should be possible because nutrition is very close to Prime Minister Imran Khan’s heart. Perhaps he is the first head of state/head of government who, in his maiden speech after taking oath, publicly showed brain scans of a malnourished and a healthy child and resolved to address the issue of child malnourishment on a priority basis.
Theoretically speaking, it should also be possible because, according to Pakistan’s Economic Survey 2019, the government is planning to bring a new constitutional amendment to move Article 38(d) from the ‘Principles of Policy’ section into the ‘Fundamental Rights’ section – thus making provision of food, clothing, housing, education, and medical relief for those citizens who could not earn a livelihood due to infirmity, sickness or unemployment, a state responsibility and their (citizen’s) fundamental right.
Finally, the best case scenario should also be possible as increased spending on social protection through BISP and the Ehsaas Programme are included among Pakistan’s performance targets (commitments) for the successful conclusion of the IMF programme.
Without a pro-poor and inclusive transformation that tackles existing inequalities at all levels, through multi-sectoral policies that keep these inequalities as the central focus, we cannot think of addressing hunger in our years of economic slowdown. This transformation as per the FAO’s report will not be possible by focusing on economic growth alone. The FAO emphasizes that, ultimately, this kind of transformation will only materialize if policies (at all level) effectively strengthen the economic resilience of countries to safeguard food security and nutrition at times when the economy slows or contracts.
One hopes that our government and the IMF are paying attention to what the FAO is advising here.

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The opinions expressed in this article are the author's own and do not necessarily reflect the viewpoint or stance of SDPI.