WN Development. Hot StuffSafety nets, SUN and MOON
Access April 2015 Feedback George Kent on trade here
Access April 2014 Shamim Hayder Talukder on vitamin A supplementation here
Claudio Schuftan writes:
Two letters in last month’s Feedback section, George Kent on ‘Trade – free for whom?’ and Shamim Hayder Talukder on ‘The MOON also rises’, need discussion.
In George Kent’s very good letter what struck me only was his last paragraph:
It is possible to add elements to trade agreements to protect the vulnerable. Rather than relying on ‘free trade’ to improve living conditions for the poor, trade agreements could include measures such as social safety nets that protect and improve their living conditions. Those who think that safety nets for the poor will not be needed should have no hesitation about providing them, as a kind of insurance. Packaging trade proposals together with protective programmes of this kind might increase the likelihood that poor communities would support them.
‘Safety nets’ perpetuate poverty
‘Safety nets’ are insufficient and unacceptable, particularly now, with the growing global multi-centric economic crises. Safety nets eventually break and have just not worked for the poorest and marginalised groups. Poverty and equity issues must instead be faced frontally. Also, impoverished communities have the internationally sanctioned right to be included in discussions and policy-making on issues of societal disparity reduction, rather than continuing to be treated as objects of charity and handouts. [Impoverished communities have a right to reductions in economic and other disparities.REDUNDANT. DELETE]
In short, ‘safety nets’ are bad policy. Support of individual vulnerable groups basically means: ‘Go for the worst cases, fix them, and improve the statistics’. Rather, what is needed, are permanent changes to avoid the recurrence of the same problems. It is not by chance that ‘safety nets’ are a main option proposed by the World Bank and other major funding agencies.
Moreover, such schemes are often put in place insincerely, as a political manoeuvre to make predatory ‘market-based’ policies more ‘palatable’ I INSIST. Individual targeting has never been made to work equitably. Furthermore, providing a package of services to target groups is wastefully expensive. It is a dangerous path to follow. It creates a ‘mirage of equity’ that leaves the perennial determinants of impoverishment untouched
Additionally, this illusion of promoting equity stigmatises impoverished communities, creating second-class citizens who can be manipulated. Waiver schemes for those rendered poor have proven mostly catastrophic. [Individual] Targeting is not a substitute for a more redistributive public policy. Safety net interventions are a last emergency measure only. As used, targeting policies tacitly blame the most vulnerable for being where they are, and are to be seen as a technique to attenuating social unrest. Altogether, they are part of the problem. So on this point I see things differently from my respected colleague George Kent (1).
The SUN and the MOON
Shamim Talukder’s letter includes a, for me, new definition of nutrition-sensitive interventions (2) as
Interventions or programmes that address the underlying determinants of foetal and child nutrition and development – food security; adequate care-giving resources at the maternal, household and community levels; and access to health services and a safe an hygienic environment – and incorporate specific nutrition goals and actions.
He objects to this definition, using the example of the SUN Initiative. I agree with him fully. In the hope that I am not quoting him out of context or paraphrasing him incorrectly, I have extracted the following:
The Scaling Up Nutrition initiative has a part to play in [applying this definition] as do other UN programmes. SUN states that it is an inclusive and country-led movement. So it should have potential to reduce malnutrition. After all, it has top-level backing, committed political leadership, apparently vibrant civil society support, and partnerships with donors and groups linked with big business such as the Global Alliance for Improved Nutrition.
A reality check is needed here though. The overall [ongoing] governance proposed by SUN is weak, at best. The nutrition programmes proposed may include, as partners, people and entities in the business of ultra-processed products, otherwise known as junk food. The risk? Priority [is] often given to commercial products that ignore the impact on chronic diseases and impede sustainable locally grown policies.
To be sustainable, nutrition-sensitive development goals must focus on human development, not just business development, and must consider environmental, social and economic issues. Shamim Talukder asks for the MOON, a needed and timely movement that could eclipse the SUN.
He calls for genuinely nutrition-sensitive interventions. These need to ensure appropriate distribution of resources measures and must include initiatives that may be overlooked or neglected by SUN, such as –to mention only one- the degradation of food supplies with oily fatty salty ultra-processed junk products. He rightly denounces SUN policies that require a top-down imposed system. He adds that there is need to overcome corporate-led nutrition interventions. This will involve recognising the nutrition-sensitive issues that are neglected by SUN attributable to the power and influence of its corporate partners. I applaud all he says. The MOON approach he proposes is an inspiration for a world yearning for nutrition equality, not a world of nutrition traders.
Political power-plays
I have an additional proposition. As defined and applied, nutrition-sensitive interventions are a clever response to the call by progressive public health nutritionists to tackle the commercial and deeply rooted and unfair social determinants of malnutrition. But, instead, it is the underlying power-play of politics that must be identified and confronted.
Corporate globalisation, including the unleashing of the crudest forms of greed, does not have a human face. It is a process we cannot wish away. Markets enrich those with purchasing power or commodities or services to sell. Impoverished communities and nations have neither. The current brand of unregulated capitalism is morally unacceptable and economically inefficient. The SUN initiative is not helpful here. Its concept of nutrition-sensitive interventions has the not unfounded risk of influence by the inveterate enemies of public health nutrition and public goods as a whole. This can only deepen the present situation of global inequity, inequality and of unabated poverty and relentless paths to impoverishment.
Claudio Schuftan
People’s Health Movement
Ho Chi Minh City, Vietnam
Email: cschuftan@phmovement.org
References
1 Schuftan, C. Can significant major equity be achieve through targeting? Health Action 2000, Vol.13, No.12, December, 24-27.
2 Ruel M, Alderman H and the Maternal and Child Nutrition Study Group. Nutrition-sensitive interventions and programmes: How can they help accelerate progress in improving maternal and child nutrition? The Lancet 2013, 382. 9891, 536-551.
Schuftan C. Safery nets, SUN and MOON. [Development. Hot stuff]
[Feedback] World Nutrition May 2015, 6, 5, 423-425