Nutrition in National Development and Security: The Need for a Coordinated Approach
Nutrition and development
Securing nutrition is the first step in achieving a healthy society, which is vital in national development. Nutrition Security facilitates development at the same time as it is a result of a development plan, a well-nourished child, for example, is more likely to escape poverty as an adult and thus more likely to contribute to the endeavours of development programs (such as successful economic and social development). And a successful development program contributes to food security, completing a loop of positive development.
Nutrition and national security are also tightly related, since malnutrition impacts health, fitness, performance, and productivity. Council for Strong America reported in 2018 that in the United States, one in three youth aged 17-to-24-year is too overweight to qualify for military service. Though at present, obesity is not an issue in Eritrea, unbalanced-diet/malnutrition associated non-communicable diseases are on the rise. Since many non-communicable diseases expose patients to a lifetime dependency on pharmaceuticals (that are not locally produced), the fundamental national developmental strategy based on self-reliance may be negatively affected. Hence, nutrition affects national development, national security, and the development strategy (self-reliance). It is therefore, important to have a coordinated National Nutrition Strategic Plan to secure nutrition and to eliminate and control preventable diseases. By securing nutrition optimal and sustainable health for all at the personal, communal, and national level can be achieved, contributing to national development and national security.
Multi sectoral nature of nutrition
Nutrition is a multidisciplinary science that involves several disciplines that have central role in food production, food safety, food standardization and legislation, food trade, food technology and nutrition value-chains, food chemistry and analysis, nutrition resilience, health, nutrition education, awareness and research.Food production, a process that started with maintaining favourable environment, should reflect the physiological needs of the body and ensure the safety of the produced food. In this process nutrition connects agriculture and health through nutrition sensitive agriculture approach.
One of the common misconceptions in the field of nutrition is equating ‘food security’ to ‘food production’. Such misconceptions hinder the achievement of nutrition security in all its forms, since food production by itself cannot secure nutrition. Similarly, limiting nutrition to nutrition-specific approaches that merely deal with preventing hunger and preventing or treating deficiency disorders (so-called immediate causes of malnutrition) is not comprehensive. These narrow definitions limits the critical requirement of an integrated and holistic approach to achieving food security and promote optimal health.
For a holistic approach, the profound role of nutrition in promoting optimal health by preventing and treating communicable and non-communicable diseases, and reducing susceptibility to both, should be considered. Nutrition also deals with several disciplines and emerging knowledge in the field of nutrition are expanding the field and leading to new knowledge in food-drug interaction, personalized nutrition, nutraceuticals (medicinal foods) and epigenetic (changes in gene expression in an organism caused by environmental/dietary exposure). This suggests the importance of nutrition in drug efficacy, as well as the importance of nutrition-tailoring to enable nutrition treatment at a personal level, and the discovery of nutraceuticals extending the role of nutrition to the medical use of functional foods. A recent example of the unpredicted SARS-CoV-2 calls for a sustainable solution by keeping the immune system of the population top notch. Moreover, since SARS-CoV-2 affects people with co-morbidities, strengthening the natural immune defence is the only sustainable way to prevent foreseen and un-foreseen conditions. Hence the role of nutrition as nutraceutical in promoting the immune system and prevention of communicable and noncommunicable diseases, lowering dependency on pharmaceuticals is enormous. Accordingly research in identifying nutraceuticals should be given principal consideration in the prophylactic and treatment for known communicable and non-communicable diseases and prevention of possible viral or bacterial infections that may emerge in the future. Thus, national research laboratory operated under the Nutrition institution/unit is indispensable. Resource identification is important step in the fight against malnutrition and endeavours to achieve optimal health through integrated nutrition programs that require national research body.
Safe food (encompassing food standardization and legislation), which is central to optimal health, is a discipline that need to be emphasized and acted upon. Food safety (microbial, chemical and physical-safety) can be achieved by mechanisms to improve the standards and safety of food through following national and international food safety standards throughout the food systems. More over, through continues research to identifying and eliminate exposure of potential toxic and harmful compounds in the food the national safety standards should be updated.
Food resilience, assuring food availability accessibility and safety in any situation and making sure that no one if left behind is principal in assuring food security, thus every nutrition intervention should start with situation analysis, identifying vulnerable groups (in order not to leave any one behind). Last but not least, considering globalisation, political, social, and economic situation affecting global food production and distribution, the role of global food politics in food security and consequently national security is a sensitive area in nutrition that cannot be neglected.
Thus, research in the area of Nutrition Food Science and Health to feed all stakeholders with up to date relevant information is vital for achieving viable development in the area. As such, conducting research to reveal evidence-based knowledge tailored to the needs of the population, sensitising decision-makers on the full scope of nutrition, ensuring a harmonised and coordinated approach involving all stakeholders, and educating and raising awareness of the entire population on nutrition and the importance of nutrition in national development and security cannot be overemphasised.
All of the above points at an urgent need to understand that achieving nutritional goals is a much wider field than food production and that the role of nutrition extends beyond the prevention of deficiency to optimize health. Hence the need for a holistic and coordinated approach with a National Vision and Mission statement owned and directed by the country is a vital step in achieving food security in Eritrea. The possible frame work showing the stakeholders and the responsibility for each stakeholder is illustrated in figure 1
Current situation
At present there is a National Food and Nutrition Steering Committee composed of the Ministries of Agriculture (MoA), Ministry of Health (MoH), Ministry of Marine Resource (MMR), Ministry of Trade and Industry (MoTI), and the Eritrean Standards Institution (ESI). The committee is mandated to provide leadership and policy coordination on the formulation and implementation of the national strategy for food and nutrition. The steering committee is backed by a National Food and Nutrition Technical Committee, that includes the UN agencies, and the private sectors in addition to technical representatives from each member of the steering committee. Though this is a good start in coordinated approach to nutrition, for holistic approach in the food system (all the elements and activities from food production to consumption) involves more stakeholders that than those included in the National Food and Nutrition Steering Committee. The stakeholders, Ministries, institutes and local NGOs that are required to be included to strengthen the steering committee are the Ministry of land Water and Environment (MoLWE), Ministry of Labor and Social Welfare (MoLSW), Ministry of Education (MoE), Ministry of Information (MoI), Ministry of Justice (MoJ), and the local NGOs: National Union of Eritrean women (NUEW), National Union of Eritrean Youth and Students (NUEYS) and the Eritrean Defence Forces and PFDJ. The later due to the global food politics. Representatives from the extended steering committee could then be trained in nutrition and food science to form a strong National Nutrition-workforce that could be an initial step in forming a Nutrition Institution/Unite. Failure to involve any of the stakeholders is bound to lead to failure in achieving holistic and sustainable nutrition security in all its forms, i.e. undernutrition (wasting, stunting, underweight), nutrient deficiency (inadequate vitamins or minerals), and unbalanced diet/malnutrition and uncontrolled processed mostly unsafe imported foods (leading to overweight, obesity, and resulting diet-related non-communicable diseases. An integrated approach facilitates identifying and addressing the root causes (at the infrastructure and policy level), underlying causes (at the household social and public health level), and immediate (at personal level inadequate food and disease) of malnutrition/food insecurity. Addressing all causes of malnutrition builds a foundation for sustainable nutrition security.
The ministries in the steering committee has so far played critical individual roles in the field of nutrition, and conduct (though fragmented) commendable projects in Eritrea. However, these interventions could have benefited from an indispensable National Nutrition Strategic Plan that addresses all the causes of malnutrition, coordination, holistic approach, a consolidated national vision and mission statement for nutrition security, as well as skills and expertise in the field of nutrition to be more impactful, effective and efficient.
In conclusion A coordinated approach of all stakeholders is central to the achievement of nutrition security. Only through such structure with integrated National Nutrition Workforce/Nutrition Institution or Nutrition Unit that deals with nutrition from a holistic and multidisciplinary angle can sustainable nutrition security be achieved. The National Nutrition Institute/ Unite should directly responding to high-level political buy-in and higher officials that support and supervise the implementation of the nutrition interventions from an approved National Nutrition Strategic Plan.