von Grebmer Klaus
World Rev Nutr Diet. 2017;118:93-101. doi: 10.1159/000484463. Epub 2018 Apr 13.
In recent decades, global undernourishment rates have declined, and health and nutrition have improved. Yet the pace of progress has been shamefully slow. To break the cycle of poverty, hunger, and undernutrition, the problems of hunger and undernutrition must be addressed first. The socioeconomic costs and detrimental effects on human health of hunger and undernutrition perpetuate poverty; if they persist, there will be no end to poverty. China, Vietnam, Thailand, and Brazil have all accelerated progress toward ending hunger through either agricultural reform, social protection programs plus targeted nutrition interventions, or agricultural reform plus social protection programs and targeted nutrition interventions. In China and Vietnam, agricultural reform supported by basic social protection programs drove progress. In Brazil, social protection programs - notably, Bolsa Família - plus targeted nutrition interventions sped up progress. In Thailand, progress accelerated after the country undertook agricultural reforms as well as both social protection programs and targeted nutrition interventions. Nutrition interventions should include both nutrition-specific efforts that address the immediate causes of undernutrition and programs in other areas that address the underlying causes of undernutrition. When nutrition-sensitive programs are leveraged as delivery platforms, nutrition-specific interventions can be improved and scaled-up. The relative importance of such strategies will vary, depending on the size of a country and whether its economy is agriculture-based, transforming, or urbanized. Compact2025 was established in 2015 to end hunger in a decade and set out with 4 focus countries - Bangladesh, Ethiopia, Malawi, and Rwanda. Compact2025 leads a multistep process that includes setting priorities; analyzing relevant strengths, weaknesses, opportunities and threats to a country's food security and nutrition situation; convening roundtable meetings and recommending policies; designing M&E mechanisms; developing an innovation lab; and conducting pilot programs and policy experiments. Compact2025 has shown that, with the proper framework, committed national leadership, and adequate funding, hunger and undernutrition can be eliminated by 2025.
近几十年来,全球营养不良率有所下降,健康和营养状况有所改善。然而,进展速度慢得令人羞愧。为打破贫困、饥饿和营养不良的循环,必须首先解决饥饿和营养不良问题。饥饿和营养不良对社会经济造成的成本以及对人类健康的有害影响使贫困长期存在;如果这些问题持续存在,贫困将永无止境。中国、越南、泰国和巴西都通过农业改革、社会保护计划加有针对性的营养干预措施,或农业改革加社会保护计划和有针对性的营养干预措施,加快了消除饥饿的进程。在中国和越南,由基本社会保护计划支持的农业改革推动了进展。在巴西,社会保护计划——尤其是“家庭补助金计划”——加有针对性的营养干预措施加快了进展。在泰国,该国实施农业改革以及社会保护计划和有针对性的营养干预措施后,进展加速。营养干预措施应既包括针对营养不良直接原因的特定营养行动,也包括其他领域针对营养不良根本原因的计划。当将对营养敏感的计划用作实施平台时,特定营养干预措施可以得到改进和扩大。这些战略的相对重要性将因国家规模以及其经济是以农业为基础、正在转型还是已城市化而有所不同。“紧凑2025”于2015年设立,目标是在十年内消除饥饿,并选定了四个重点国家——孟加拉国、埃塞俄比亚、马拉维和卢旺达。“紧凑2025”引领一个多步骤进程,包括确定优先事项;分析一个国家粮食安全和营养状况的相关优势、劣势、机遇和威胁;召开圆桌会议并推荐政策;设计监测和评价机制;建立一个创新实验室;以及开展试点项目和政策试验。“紧凑2025”已经表明,有了适当的框架、坚定的国家领导和充足的资金,到2025年可以消除饥饿和营养不良。