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Economic burden of undernutrition in Pakistan

Dr Tariq Mahmood Ali
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UNDERNUTRITION poses a severe challenge to Pakistan’s socio-economic development, costing the nation approximately $7.6 billion annually, equivalent to 3% of its GDP. This substantial economic burden stems from four key pathways: child mortality, diminished future productivity, reduced current productivity due to anaemia and healthcare costs related to under nutrition.

Child Mortality Attributable to Undernutrition: Every year, undernutrition contributes to 177,000 child deaths, accounting for over one-third of all child mortality in Pakistan. Maternal malnutrition, including anaemia (affecting 51.2% of pregnant women) and low body mass index (18%), significantly increases the likelihood of poor birth outcomes. Low birth weight (LBW) affects 19.3% of newborns, heightening their risk of mortality. These deaths translate into a loss of $2.24 billion annually due to the reduced future workforce.

Reduced Future Productivity: Chronic under nutrition during childhood—evidenced by stunting, anaemia, and iodine deficiency—leads to long-term cognitive and physical impairments. Childhood stunting, which affects 43% of children under five, reduces their earning potential by 10-19.8% as adults. This loss is projected to cost Pakistan $3.7 billion annually in net present value (NPV). Moreover, iodine deficiency disorders further hamper cognitive development and learning outcomes.

Diminished Current Productivity Due to Anaemia: Anaemia affects 62.1% of children under five and 50.5% of adult women, resulting in significant productivity losses. In manual labor sectors such as agriculture, industry, and construction, anaemia reduces work performance by 5-17%. The annual economic loss from anaemia-induced productivity declines is estimated at $657 million. Excess Healthcare Expenditures: Healthcare costs linked to under nutrition are staggering. Zinc deficiency, suboptimal breastfeeding practices, and LBW collectively result in excess healthcare expenditures of approximately $1 billion annually. Diarrhea, acute respiratory infections (ARI) and other illnesses driven by nutritional deficits place additional strain on the healthcare system.

National Undernutrition Prevalence: Data from the National Nutrition Survey (NNS) 2011 and the Pakistan Demographic and Health Survey (PDHS) 2013 paint a concerning picture. Over 110 million cases of undernutrition have been documented across the country, with some of the highest prevalence rates globally. Stunting, wasting, and underweight affect 43%, 15%, and 30% of children under five, respectively. Among children under five, 56% are vitamin A deficient, and 36.5% suffer from zinc deficiency, further compounding health and developmental risks.

Economic Rationale for Nutrition Investments: The “Cost of Doing Nothing” highlights the urgent need for nutrition-specific and nutrition-sensitive interventions. Globally recognized strategies, such as maternal supplementation, child feeding programs, and micronutrient fortification, have proven effective in reducing undernutrition. These programs also generate substantial economic returns. For instance, every dollar invested in improving nutrition can yield up to $16 in economic benefits.

Policy Imperatives: To achieve its Vision 2025 goals, Pakistan must prioritize nutrition investments as a cornerstone of human capital development. Scaling up comprehensive interventions can significantly reduce the prevalence of undernutrition, enhance workforce productivity, and alleviate healthcare burdens. This holistic approach will not only improve health outcomes but also foster sustainable economic growth and national prosperity.

In conclusion, addressing undernutrition is both a moral and economic imperative for Pakistan. With decisive action and adequate resources, the country can break the cycle of poverty and malnutrition, securing a healthier and more productive future for its people.

—The writer is contributing columnist.

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