Rethinking the measurement of undernutrition in a broader health context

Should we look at possible causes or actual effects

Researchers and policymakers are paying increasing attention to the nexus of hunger, malnutrition, and public health, and to the related measurement of food and nutrition security. However, focusing on proxy indicators, such as food availability, and on selected head count figures, such as stunting rates, gives an incomplete picture. In contrast, global burden of disease (GBD) studies are outcome based, they follow an established methodology, and their results can be used to derive and monitor the burden of chronic and hidden hunger (undernutrition) at the global level. Judging by this measure, the international goal of halving global hunger between 1990 and 2015 has already been achieved—which is in stark contrast to the picture that emerges if the first Millennium Development Goal’s indicator for measuring hunger is used.
In view of current discussions of the post-2015 development agenda, this discrepancy highlights the need to choose carefully the indicators that are used for operationalizing any new set of goals. Better access to existing data, a more detailed coverage of nutrition-related health outcomes, and more frequent updates of GBD studies would facilitate further analyses and the monitoring of global food and nutrition security.
While the disability-adjusted life years (DALYs) that are used as a health metric in GBD studies may be somewhat abstract, they can be converted tentatively into more easily understood monetary terms using per capita income figures. The resulting preferred estimate of the annual cost of global hunger in all its forms of 1.9 trillion international dollars may be better suited to illustrate the magnitude of remaining food and nutrition insecurity worldwide. Despite the progress that has been made so far in reducing global hunger, the problem is still huge and its eradication requires continued efforts.

Stein, Alexander J.
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International Food Policy Research Institute (IFPRI)
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