Tuesday, 2 October 2012

...so let’s make the technical more political – time for a Sure Start on global child nutrition?

by Nick Nisbett 

I’ve just returned from an event IDS hosted at the UK’s Labour Party conference in Manchester. At our roundtable, we asked Labour MPs, MEPs, NGOs and the corporate sector how we can put an end to global undernutrition by 2020 and discussed the UK’s role in ensuring that tackling undernutrition remains a global priority.
The debate followed a recent report by Action Against Hunger  authored by IDS fellow Stephen Spratt. We wanted innovative ideas for how we might find the funding (approx US$10-12 billion a year) to pay for a package of direct nutrition interventions shown to be effective in reducing child mortality and illness in the highest burden countries.
It was an inspiring meeting, but with some disheartening undertones for those of us who see the current global interest in nutrition as an opportunity to build a once in a lifetime consensus on ‘what is to be done’.
Inspiring, because of the depth of knowledge around the room from people returning frequently to the wider (past, present and future) structural factors underlying poverty and undernutrition. These include the neglected role of women, agriculture, food prices, commodity trade and global markets, biofuels and landgrabbing, current and future impacts of climate change, growing global and national levels of inequality, the powerlessness of the poor, and finding the right balance of state and corporate power.
As my colleague, Allister McGregor, pointed out last week, it’s critical that we avoid a technocratic and depoliticised vision of development which ignores the role of power, politics and access to resources.
Disheartening, because what governments and development agencies urgently need to do at a bare minimum in providing basic public health nutrition is still too easily characterised as a technocratic solution whilst these (essential, all encompassing, yet partial) debates roll on. I’m anxious that a new found fluency in the politics of the global food system might lead us to neglect a more nuanced understanding of nutrition which includes food access, care practices and wider health and sanitation.

Narrative gaps – and their consequences

This should not be a case of either/or. Perhaps this is a failure of the nutrition community to settle on a convincing narrative able to bridge the politics/root causes of undernutrition and the range of direct and indirect measures available to prevent and tackle it? Ok, to those in the know, it’s all there in the original UNICEF framework. But how frequently do we hear nutritionists explain convincingly the ‘ideological and political structures’ mediating communities’ access to resources at the bottom of the framework?
However, I would caution others against applying the technocratic label to what is, at its heart, a persistent, and therefore structural, inequality of access to the full range of basic goods and services which determine nutrition holistically.
We don’t hear anyone - at party conferences or elsewhere - arguing to hold back the UK’s public health provision while we solve the root causes of poverty or sort out the food system. But this is sometimes unwittingly implied in these more common development narratives – particularly when food is part of the picture.
There may be chink of light opening around a new narrative. Following the IDS event, Shadow International Development Minister, Tony Cunningham, spoke to us about the idea that the UK’s Sure Start programs (which try to deliver integrated services to children) could provide a model for championing early years development in developing countries. Just a few hours later Shadow Secretary of State Ivan Lewis announced in his speech to conference that Tessa Jowell and Sarah Brown will be spearheading a campaign to put an integrated approach to early childhood at the heart of a post-2015 development framework.
The idea is not all new - we’ve seen approaches like Sure Start put into practice, to varying degrees of success, in a number of countries (think India’s Integrated Child Development Services). But there’s great potential to build a new consensus around this narrative. By seeing nutrition as part of a wider package of services that all children deserve in equal measure – not in contrast to tackling the wider structural causes of poverty - but as part of a wider global push on equality of opportunity - we might start to shift the debate beyond the either/or of ‘technical’ and ‘political’ solutions to undernutrition.