Nutrition is the foundation of human health, education and economic development, and yet it gets poor attention pulling back nations from achieving development goals, Nutrition International President Joel C Spicer has said.
Cognitive development and immune system of humans largely depend on the nutritional value of the food intake of the mother and children in their early years.
Malnutrition, which is also related to overweight, not only adversely affects the child's learning capacity, but also raises risks of diseases like cancer, diabetes, respiratory and heart diseases, ultimately increasing health cost and lowering productivity.
"So, we call it double burden. What is less well understood is the connection between the two," Spicer said in an exclusive interview with The Daily Star at the office of Nutrition International (NI) in the capital.
He had come to Dhaka to launch a new initiative -- Right Start Initiative -- today and advocate for coordinated actions to promote nutrition.
While there is a bigger problem of underweight population, Bangladesh and many countries of the world are now facing a new problem of people suffering from overweight, obesity and non-communicable diseases.
Thirty-six percent of children under five years in the country are stunted, while 14 percent are wasted, according to Bangladesh Demographic and Health Survey (BDHS)-2014.
Stunting is low height-for-age, while wasting is low weight-for-height.
Apart from this, obesity among boys rose to 3 percent in 2016 from only 0.03 percent in 1975. Among girls, the rate went up to 2.3 percent from almost zero four decades ago, according to a study published by UK's prestigious medical journal, Lancet.
According to BDHS-2014, the rate of overweight women in their childbearing age has risen from 17 percent in 2004 to 39 percent in 2014. Around 19 percent women still remain underweight.
Joel Spicer said Bangladesh had done quite well in terms of reducing under-five child mortality rate -- from 133 in 1990 to 46 per 1,000 live births.
Globally, 159 million children under five years are now stunted, which is a nine percent less than that in 2000.
"But, what happens to those surviving? What about their health?," said the top official of the Canada-based organisation operating globally.
There are many cheap innovations like Vitamin A, zinc and oral rehydration salts, iodized salt, iron folic acid that can fight many of the nutritional, diarrhoeal and anaemic problems, yet so many people of the world cannot get access to those.
"This is the question of allocation, efficiency and political will," Spicer said, adding that this is the era of Sustainable Development Goals (SDGs) bringing forth the issue of integration and inclusion. Achieving the goals is not possible, leaving those suffering from stunting, wasting and overweight.
He suggests working in a different approach. There is a good leadership at the national nutrition council, but the investment is really low.
"When you look into the investment to fight the problem, it has been flat lined. It hasn't gone up over the last few years," Spicer said.
NI Bangladesh Country Director Zaki Hassan said budgetary allocation for nutrition is less than one percent in Bangladesh.
"The damage being caused is not well understood and the money being spent to address the damage is absolutely mismatched to the damage. As each day goes by, this gap and damage are increasing," Spicer said.
Referring to a World Bank report, he said the children who escaped stunting were 33 percent less likely to live in poverty. Also, the adult wage rate for them can be increased to 5-50 percent.
Now in the fourth industrial revolution of the Internet of Things, labour markets require people with high skills.
Expressing worries over what would happen to hundreds of millions of young people who are facing a deficit of hope and opportunity, Spicer said this would likely create a less stable world.
"What happens when there is instability in a neighbouring country? It does not politely wait outside of your border," he warned.
Against this backdrop, NI is launching the Canadian $3.2 million Right Start Initiative aimed at benefiting two million women of reproductive age and adolescent girls in Bangaldesh by 2020.
NI would provide them with rice fortified with iron, folic acid and other micronutrients to prevent anaemia, Zaki Hasan said.
Besides, 592,000 pregnant women in 10 districts and two city corporations will receive better antenatal, delivery and postnatal care under the programme, he added.