Not a lack of food but a lack of access.

• Author: Gopalan, C.
• Position: National nutrition policies and world population increases

During the last fifty years, there has been a phenomenal rise in world population. According to available projections, the world population figure for 1997 will increase by 1,297 million by the year 2015. A great part of this increase is expected to take place in those very areas of the world that are currently most hard-pressed for food. Thus, as much as 820 million of the projected 1,297 million is expected to occur in Asia. (1) Apart from this disturbing growth, the per capita requirement for food is also expected to rise, as millions who are currently trapped in poverty cross the poverty line to join the ranks of an expanding "middle class". The scope for further expansion of land resources for food production being limited, increased food production to meet growing population needs must be achieved through a significant increase in production per unit of land.

Developmental transition during the last few decades has also brought about a significant "qualitative' change in the demographic nutrition profile. As a result, there has been a progressive though painfully slow movement of the population away from poverty and towards affluence in many developing countries. This ascent to affluence has been more marked in some countries than in others. The striking immediate results of this transition have been:

An expanding pool of sub-standard survivors. These are children who in earlier years would have died but now manage to "survive" and reach adulthood.

The emergence of an expanding relatively affluent urban middle class (the first-generation rich), among whom there is an alarming escalation of nutrition-related chronic degenerative diseases.

Strategies for the achievement of nutrition security must be adapted to suit this change. "Survival" is not synonymous with good health/optimal nutrition. Strategies to ensure survival must give place to strategies to ensure child health and optimal nutrition.

The time has come when there must be a paradigm shift in national nutrition policies in recognition of this changing nutrition profile.

The earlier strategies, which were largely in the nature of "holding operations" that had helped to buy precious time and hold Malthusian fears at bay, were based on such limited goals as freedom from hunger, child survival and "safe motherhood", and are no longer appropriate. Children must "live", not just "survive"; mothers must be educated, productive and resourceful, not just safe for reproduction; and people must be optimally nourished, not just "free from...