Roughly two billion people consume little or no iodine, causing severe physical handicaps and the loss of up to 15 IQ points. Vitamin A deficiency affects 60 percent of the population in some African countries and can cripple the immune system and even cause blindness. Iron deficiency, the most common form of malnutrition, affecting up to 80 percent of the world’s population leads to anemia, thus reducing the mental and physical preparedness of four-fifths of the global workforce. These acute micronutrient deficiencies are no longer suffered in the industrialized world, but they still plague sub-Saharan Africa and most of Asia and South America. Despite many similarities to its counterpart malnourishment—better known as hunger—malnutrition is a distinct problem facing the world today, more powerful, but also more curable, than most people realize.

A Vicious Cycle
    Malnutrition occurs when people have access to food but do not receive the vitamins and nutrients necessary for human life. Its primary effects around the world are disastrous, killing more than six million children every year and causing tens of millions of birth defects, not to mention the damage done to the 500 million adults with clinical symptoms.
    The secondary effects of malnutrition on the economic and social development of affected regions are in some ways just as harmful. The United Nations Standing Committee on Nutrition estimates that iron deficiency lowers annual GDP growth by two percent in no fewer than ten countries, with a staggering 7.9 percent drop in Bangladesh. Add iodine, vitamin A and protein deficiencies to the equation, and malnutrition may actually knock off double-digit GDP growth from dozens of countries.
    The resulting cyclic effect is inescapable for many countries. “The greatest impediment to the eradication of malnutrition in the underdeveloped world is low levels of income for the rural and urban poor,” Ian Campbell, the Legislative Assistant for International Relations for Congressman Gregory Meeks (D-NY), told the HPR. Since these poor economic conditions are in turn exacerbated by malnutrition, the situation looks bleak. Short-term improvements in global nutrition, however, can break the vicious cycle and trigger massive growth in both health and income.
Old Obstacles, New Solutions
    Many of the obstacles to ending malnutrition are the familiar culprits of so many third world woes: corrupt governments, poor infrastructure and regional conflicts preventing the efficient production and distribution of the vital micronutrients. There are other subtler problems as well, such as the poor state of the health care systems in these regions and the lack of female education. European fears about genetically modified organisms also complicate matters, since African countries with a large portion of GDP depending on exports to Europe cannot fortify their food staples without potentially damaging trade relations.
    Considering the complexity of these problems, the relative simplicity of many of the solutions is striking. Robert Rotberg, Adjunct Lecturer of Public Policy at Harvard’s Kennedy School of Government, told the HPR that “the remedies are obvious, the cost trivial, yet nothing happens.”
    Among the most effective and cost-efficient solutions is the large-scale fortification of food. In the Western world we have grown accustomed to vitamins and minerals being added to regularly eaten foods, but in the developing world this is not yet common practice. In fact, it was not until after 1990 that the Universal Salt Iodization Program successfully influenced countries to iodize their salt, a method that costs less than a dollar per person per year and eliminates the risk of Iodine Deficiency Disorder. Technology now allows iron supplements to be added to the salt  as well. All that is required is a one-time—though expensive—investment in an iodization plant. Advancements in genetic technology have also opened the door to a sustainable method of diet enrichment. The DNA of maize, cassava, rice and other such staples can be altered so that the plants produce certain vitamins naturally and then reproduce without intervention.
The Infrastructure of Success
    While generous aid from the United Nations or other donors can temporarily overcome the prohibitively high cost of these undertakings, a general lack of infrastructure impedes long-term success. Consider the variety of infrastructural requirements for even the most basic agricultural processes: irrigation systems must precede crop-planting; laws and regulations must precede any major alterations in the process of food and nutrient distribution; and roads must precede the delivery of fluoride or iodized salt. The recent progress made in genetic modification technology also presents difficulties because, as Campbell told the HPR, “for countries to gear up to importing or developing this technology, they must establish prerequisite bio-safety laws and institutional mechanisms that allow for science-based risk assessment and risk management.”
    Kennedy School of Government Professor Calestous Juma stressed to the HPR just how important such infrastructure is: “[Investment in infrastructure] should be pursued with some vigor and seriousness and should involve both private and public institutions. Little will be achieved without major investments.” This investment is important not only for nutrient distribution, but also for the recovery of these struggling economies, a recovery without which the problem of malnutrition may never be fully remedied.

A Hopeful Future
    While there are still great challenges to be faced in the battle against malnutrition, the first steps towards many of the necessary solutions have already been taken, and in many cases have already begun to make a difference. The main focus now must be fully implementing these solutions and raising awareness around the world. As Mark Fryars, the Director of Program Services for The Micronutrient Initiative, told the HPR, “It’s not just about involving the government; it’s about getting consumer organizations, private sector industries, and academics to make malnutrition a priority and focus on the problem to mobilize resources.” If governments, NGOs and industry can form a cohesive campaign against malnutrition, the campaign for world health may finally gain the momentum it needs to achieve the success that so many millions of lives depend on.