D I P L O M AT I C A| QUESTIONS A SKED Joel Spicer, president and CEO of Nutrition International
‘Nutrition is something that’s intimately connected to the stability of our world.’
Diplomat magazine: What effect has COVID had on the state of nutrition worldwide? Joel Spicer: It’s been fairly catastrophic, actually. To begin with, just in terms of setting the framework, before COVID, you had a situation where one of three people on the planet suffered from some form of malnutrition, where one of every four children suffered from stunting, where there were almost 50 million cases of children being wasted. Then you throw a bomb like COVID on top of that, on top of a lot of people that were experiencing vulnerability and pre-existing conditions, and you’ve got the perfect storm of a malnutrition crisis. Just to get into the hard numbers, recent modelling came out from the Standing Together for Nutrition Consortium. They’re forecasting that over the next two years, there will be an additional 2.6 million cases of stunted [from malnutrition] children, an additional 2.1 million cases of maternal anemia, which is particularly dangerous because anemia is one of the major contributors to maternal deaths, due to hemorrhage [and] an additional 9 million cases of wasting [where one becomes emaciated from hunger.] When you look at all of these numbers on top of a scenario where of the five million children under five who die from preventable
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causes every year — what people haven’t clicked into is that 45 per cent of those deaths have malnutrition as the underlying cause. And that’s before COVID. There are all these mismatches in terms of how we allocate funding in order to create good. We’re going to see more than a decade of progress wiped out in a very short period of time. COVID is a health crisis, but it’s set up as an economic crisis, which is a perfect storm for a malnutrition crisis. Why? Two reasons: The first is that people who already didn’t have very much now have even less, so their ability to care for themselves and their families, their ability to purchase nutritious diets, has tanked. At the same time, the fiscal space of governments and donors has shrunk because of the need to shift everything to COVID treatment. The damage from trade impacts is going to shrink the amount of money they have to spend on the social sector, which was already not enough. [And] you see people who are afraid to access health-care services, so there’s a reduction in health-seeking behaviour. We’re seeing that in Canada, too. People are waiting until they’re almost dead before going to the hospital. All of these things together are setting up a very bad situation that threatens to cause a lost generation. DM: You used the words ‘malnutrition
crisis’ — are we there? JS: Yeah, I think for people who have been [working] in this area for a long time, they’ll be banging their heads against the wall because they’ve been flagging a silent emergency and the world hasn’t stepped up. It’s one of the issues where our capacity to do good is so high and yet our lack of will to do anything about it is equally high. There are some reasons for hope as you look at the map — it’s not all doom and gloom — but it was bad before and it’s significantly [worse now.] All those areas where we’ve made progress are at risk of going down. It’s absolutely a crisis and it is on fire now. And it’s not going to get better because the rate of vaccine WINTER 2021 | JAN-FEB-MAR
JAMES PARK
Joel Spicer is a global health leader who has led initiatives and partnerships in nutrition, maternal and child health, TB, HIV, innovative finance and resource mobilization. Over his career, he has worked for the Canadian International Development Agency, UNICEF, the WHO, Stop TB Partnership and the World Bank. He attended the Harvard School of Public Health on a Fulbright scholarship, where he obtained a master’s in international health policy and management, and also the London School of Economics and Political Science, where he earned a master’s of science in development studies.
