The Economic Rational for Improving Nutrition

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The Economic Rational for Improving Nutrition

• Adapted from Per Pinstrup Andersen

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The Triple Burden of Malnutrition

• Energy and protein deficiencies Hunger
• Specific nutrient deficiencies Hidden Hunger
• Excessive net energy intake Overweight
  Obesity

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Approximate Global Prevalence of Malnutrition
Millions
Hunger Child stunting Child underweight
800 182 150
Overweight or obese Overweight (pre-obese)
Obese
1,000 700 300
Source Data from FAO, UNICEF, UN Population
Fund, and the International Obesity Task Force
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Global Dalys Attributed to Nutrition-related
Risk Factors, 2000
Daly disability adjusted life-years Sources
FAO SOFS 2004
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Impact of Various Forms of Malnutrition on
Productivity and Lifetime Earnings
Sources FAO SOFS 2004
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Estimated benefits of shifting 1 infant from low
birth weight status
Sources FAO SOFS 2004
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Cost of Undernutrition in Asia

• Human Costs (Vit A, Iodine, Iron)
• Premature death
• Increase risk of infection as stunting increases
• 2.8 m children die each year in 9 low-income
  Asian countries (Bang, Cam, PRC, India, Lao PDR,
  Nepal, Pak, SL, Viet Nam)
• Economic Costs
• Stunting - 10
• Childhood anemia 4
• Children of mothers with goiter 10

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Cost of Protein-energy Malnutrition and Iodine
Deficiency
Sources FAO SOFS 2004
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Cost of Iron Deficiency Anemia
Sources FAO SOFS 2004
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Estimated global economic cost due to stunting in
1990 87 billion ¼ of developing countries
health costs
Source Pinstrup-Andersen, et. al (1993)
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Global loss due to malnutrition in 1990 46
million years of productive disability-free life
at 1/day
Translates to 17 billion
Source Pinstrup-Andersen, et. Al (1993)
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Estimated Loss in GDP Due to Micronutrient
Deficiencies ()
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Reducing Vitamin A Deficiency in Asia

• Cost 26 pesos per child per year
• Improves survival rate of children 23

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Rubber Plantation Workers in Indonesia

• Productivity of anemic workers was 20 lower than
  non-anemic
• Difference disappeared after intervention

Source Basta, et al (1979)
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Costs and Benefits of Interventions to Reduce
Hunger and Malnutrition
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Prevalence of Adult Overweight and Obesity in
Selected Countries ()
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Prevalence of Overweight in China
Percent of population
40
Men
Women
30
20
10
0
1989
1997
2020
1989
1997
2020
projection
projection
Source Gillespie and Haddad, Attacking the
Double Burden of Malnutrition In Asia, IFPRI,
Washington, DC (2000).
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Obesity in China
1 Overweight and obesity
Source Popkins, Horton Kim (2001)
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The Cost of Obesity in China
Source Popkins, Horton Kim (2001)
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The Cost of Obesity Sri Lanka
Source Popkins, Horton Kim (2001)
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• Who should invest in Nutrition?
• Why?

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Why Public vs. Private Investment in Improved
Nutrition?

• Public good
• Large externalities
• Users and providers value differ
• Important for equity