Networks of institutions, networks of solutions. (Essay).

The Human Development Report 2001 of the United Nations Development Programme (UNDP) has introduced the Technology Achievement Index, which is an aggregation of four groups of indicators relating to the creation of technology, diffusion of recent innovations, diffusion of old innovations, and human skills. Creation of technology has been measured by the number of patents per capita and receipts of royalty and license fees from abroad per capita. The emphasis is thus on the intellectual property rights of nations, evidenced by the power of proprietary science. The other indicators relate to digital, extension and educational divides. The report titled "Making New Technologies Work for Human Development" has however not drawn attention to the fact that bridging the expanding nutritional divide is fundamental to bridging the other divides, particularly that relating to intellectual property rights. The Commission on the Nutrition Challenges of the 21st Century, in "Ending Malnutrition by 2020: An Agenda for Chan ge in the Millennium", has pointed out that some 30 million infants in developing countries are born each year with intra-uterine growth retardation, representing about 24 per cent of all new births there.

Low birth-weight children are characterized by mental impairment. Worldwide, there are more than 150 million underweight pre-school children and more than 200 million stunted children. At the current rate of progress in fighting these maladies, by 2020 about 1 billion children will be growing up with impaired mental development. What will be the impact on the intellectual property of a nation of the denial to the child of opportunities for the full expression on its innate genetic potential for mental and physical development? Such denial, even at the foetal stage, is the cruelest form of inequity. The starting point in initiating a national nutrition security system is learning from successes. Thailand, Sri Lanka, Costa Rica, Cuba, China, India and many other developing countries have rich experience in operating nutritional safety net projects to address problems in the different stages of a human life cycle. Each programme has both positive and negative lessons. Future strategies should be based on learnin g from successes and failures. What is required is the building of a sustainable community nutrition security system, which I shall elaborate upon in the next pages.

A Sustainable Community Nutrition Security System

Conferring the right to food, and thereby an opportunity for a productive and healthy life on those who go to bed undernourished, is the fundamental duty of the State, as well as of the well-to-do sections of the population Thanks to the spread of democratic systems of governance at the grass-roots level and technological advances we now have opportunity to foster a community-centred and controlled nutrition security system. Such decentralized community management will help to improve delivery of entitlements, reduce transaction costs; eliminate corruption and cater to the twin needs of introducing a life-cycle approach to nutrition security and meeting the challenge of seasonal fluctuations in nutritional status. The basic guidelines for such a system are:

1. Adopt a whole life-cycle approach to nutrition security. Pregnant mothers: Overcoming maternal and foetal under-nutrition and malnutrition is an urgent task, since nearly 30 per cent of children born in countries in South Asia are characterized by low birth weight (LBW). with the consequent risk of impaired brain development. Ramalingaswamy et. al (1997) have pointed out that half of the world's malnourished children are in India, Pakistan and Bangladesh. LBW is a proxy indicator of the low status of women in the society, particularly of their health and nutrition status during their entire life cycle.

Nursing mothers: Appropriate schemes will be necessary to provide support to enable mothers to breastfeed their babies for at least six months, as recommended by the World Health Organization. Policies at work places should be conducive to achieving this goal.

Infants (0-2 years): Special efforts will have to be made to reach this age group through their mothers, since they are the most unreachable at present; 80 per cent of brain development is completed before age two. The first four months in a child's life are particularly critical, since the child is totally dependant on its mother for food and survival.

Pre-school children (2 to 6 years): A revitalized and community-controlled integrated child development service will help to cater to nutritional and health-care needs.

Youths (6 to 18 years): A nutrition-based noon meal programme in all schools (public and private, rural and urban) will help, but a significant percentage of these young people are not able to go to school due to economic reasons. Such school "push-outs" or child labourers need special attention.

Adults (18 to 60 years): The nutrition safety net to cater to this category shall consist of an entitlement programme like food stamps and a public distribution system, as well as a food-for-eco-development programme (also called "Food-for-Work" programme). The eco-development programme will promote the use of food grains as wages for the purpose of establishing water-harvesting structures (water banks) and for the rehabilitation of degraded lands and ecosystems. Thus, many downstream benefits and livelihood opportunities will be created. In designing a nutrition compact for this age group, persons working in the organized and unorganized sectors will have to be dealt with separately.

Elderly and infirm persons: This group will have to be provided with appropriate nutritional support as part of the ethical obligations of society towards the handicapped.

2. Adopt a seven-point action plan to achieve sustainable nutrition security at the level of each individual.

Identification: Identify through the local community those who are nutritionally insecure. Trained community volunteers of the kind mobilized in Thailand will be useful.

Education and information empowerment: Empower those unaware of their entitlements to the nutritional safety nets available to them and undertake nutrition education. An entitlement database can be developed for each area, and household entitlement cards can be issued, indicating how to access nutritional, health-care and educational programmes.

Overcome protein-calorie under-nutrition: Adopt the various steps indicated under the whole-life-cycle approach. The problems of child labour and persons working in the unorganized sector will need specific attention.

Eliminate hidden hunger caused by the deficiency of micronutrients in the diet: Introduce an integrated approach, including vegetables and fruits, millets and grain legumes, and the provision of fortified foods like iron and iodine-fortified salt, and oral doses of Vitamin A. The basic approach should food-based emphasizing home and community nutrition gardens, wherever socially and economically feasible.

Drinking water. hygiene and primary health care: Provide safe drinking water and improve environmental hygiene, as well as the primary health care system.

Sustainable livelihoods: Improve economic access to food through market-linked micro-enterprises supported by micro-credit, and create an economic stake in the conservation of natural and common property resources. Ensure that agreements under the World Trade Organization (WTO) provide a level playing field for products coming from decentralized small-scale production (production by masses or farmers' farming), as compared to those emerging from mass production technologies or factory farming.

Pay special attention to pregnant and nursing mothers and pre-school children: Measure progress through monitoring measles, mumps and rubella, IMR, incidence of low-birth-weight children and male-female sex ratio. Iron-folate supplements. during prenatal care should be, accompanied by steps to overcome protein-energy deprivation.

3. Community food banks as an instrument of sustainable food and nutrition security.

Community food banks (CFBs) can be started at the village level, with initial food supplies coming as a grant from Governments and donor agencies. Such CFBs can be sustained through local purchases and from continued government and international support for food-for-eco-development and food-for-nutrition programmes. The CFBs can be the entry point to not only bridging the nutritional divide but also for fostering social and gender equity, ecology and employment. They can also be equipped to cater to emergencies like cyclones, floods, drought and earthquakes. The CFBs can be organized with the following four major streams of responsibility.

Entitlements: The benefits of all government and bilateral and multilateral projects intended for overcoming undernutrition and malnutrition can be delivered in a coordinated and interactive manner (for example, as those intended for overcoming the deficiencies of macro-nutrients and micronutrients).

Ecology: Food for eco-development, with particular reference to the establishment of water banks, land care, control of desertification and afforestation.

Ethics: This group of activities will relate to nutritional support to old and infirm persons, pregnant and nursing mothers, and infants and pre-school children.

Emergencies: This activity will relate to the immediate relief operations following major natural catastrophes like drought, floods, cyclones and earthquakes, as well as to meet the challenge of seasonal slides in livelihood opportunities.

Each of these streams of activities can be managed by four separate self-help groups of local women and men that will help to generate a self-help revolution in combating hunger. The overall guidance and oversight may be provided by a multi-stakeholder community food bank council.

4. Resource centres for CFBs

For the CFB movement to succeed there is a need for training managers of CFBs and for building the capacity of the community oversight council to plan and monitor the different programmes. Training modules will have to be prepared. Accounting and monitoring software will have to be developed and members of the self-help groups will have to be trained in the use of software and in managing the computer-aided knowledge centres linked to CFBs. Four different modules, each relating to entitlements, eco-development, ethics and emergencies, will have to be developed, so that each self-help group is headed by a professionally trained person. A network of institutions which will provide the necessary managerial, technical and training support to managers of self-help groups and CFBs, will have to be organized in every country with a political commitment to ending the nutritional divide as soon as possible.

In conclusion, countries in transition, with reference to bridging the nutrition divide, have an opportunity today to leapfrog in improving the nutrition security of every individual through community-centred and controlled nutrition security systems. Such decentralized systems can take a holistic view of nutritional challenges, such as differential needs during different stages in the life cycle, as well as during different crop seasons.

The problems are known and so are the solutions. What we need now are effective delivery systems that can help to reach the unreachable and include the excluded in terms of age, gender and nature of occupation (e.g. child labour, persons working in the unorganized sector).

M.S. Swaminathan is UNESCO Cousteau Chair in Ecotechnology and Chairman of the M.S. Swaminathan Research Foundation, Madras, India.