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Continued from home page... One of the
most interesting and challenging aspects of founding
and developing a representative organisation, with –
as we now have – its own website and journal, is
ensuring that it truly is representative. For
instance, just one of the challenges is –
representative of who, and what? And on a related
issue, of balance, where is the point at which
balance is struck? These are matters of judgement.
The point of balance
Right now for us, the outstanding example is the
commentary ‘The great vitamin A fiasco’ by
Michael Latham of Cornell University, which
launched World
Nutrition last month. This has of course
caused a stir, and it’s evident that many hundreds
of copies of the
pdf of the commentary have been and are being
downloaded or copied all over the world. ‘Well
Barrie’, a senior colleague at WHO said to me in
Geneva the day we posted the May issue, ‘you
certainly started with a controversial topic’.
‘ Debates, commentary, challenges to conventional
wisdom – these are the kinds of contribution that
WN will carry’ we said in its
Manifesto, also published last month. One of the
objectives of the Association, stated in our ‘About
Us’ section, is: ‘With our members, we encourage
policy-makers and decision takers, at all levels
from global to local, to promote equitable and
sustainable access to adequate, enjoyable,
appropriate and nourishing food. This is essential
for population health and well-being, and also for
social, cultural and economic integrity, and to
conserve the living and physical world’.
These and other statements that set out the purposes
of the Association and of WN were worked out
carefully. The usual metaphor is that they are
planks in our platform. They are also our point of
balance. Will we consider publishing contributions
to WN that challenge our own core beliefs as
public health nutritionists? Of course yes, if they
are well written and well reasoned.
They help to explain why we are proud to have
launched WN with Michael Latham’s commentary.
It is the testimony of a distinguished public health
nutritionist, also a physician, with immense
experience in the field. Dr Latham is not merely
critical. His positive proposals include ‘early
exclusive, and continued breastfeeding, as now
defined by WHO; protection against pathogenic
infection and infestation; support of community and
kitchen gardens; and the promotion of increased
production and consumption of local plant and other
foods, including those that grow wild, that are good
sources of vitamin A’. Such programmes ‘make
evolutionary sense, and are biologically, socially,
culturally, economically and environmentally
appropriate. They are affordable and sustainable,
and also provide further important health and other
benefits. [They] promote family and community life,
provide employment and strengthen local economies,
prevent other diseases, and promote well-being. They
are – or should be – part of integrated primary
health care programmes. Significantly, they also
enable impoverished countries to become less
dependent’.
Can such views be challenged? Yes, from both sides
of the point of balance. There are those, whose
views are now dominant while clearly not consensual,
who continue to believe that the supply and use of
vitamin A capsules is an indispensable protection of
child health throughout the less-resourced world
(1,2). The note that we carry in WN this
month from Professor Keith West and Professor Alfred
Sommer of Johns Hopkins Bloomberg School of Public
Health, two principal architects of the vitamin A
capsule (VAC) programme, indicates that some of them
wish that Dr Latham’s commentary had not been
published.
On the other hand there are some who, in the spirit
of the former International Monetary Fund executive
Davison Budhoo, may well feel that Dr Latham has
not gone far enough, and that the real issues are
far more radical.
Influential and best-selling books to this effect
have no doubt been read by many of us as citizens,
but perhaps without seeing how what they say may
affect our teaching and practice as health
professionals (3,4).
Sometimes vigorous and engaged debate will confirm
current practice. Sometimes current practices need
to be replaced. Judging from the short
communications and letters we are publishing this
month, it does seem that Dr Latham’s radical
analysis, judgements and recommendations occupy the
central ground. Most of the contributions we publish
this month are written by distinguished scholars and
framers of food and nutrition policy, from India and
elsewhere in Asia and the Pacific region. As well as
the note from Dr West and Dr Sommer, there are two
from the USA. One of these is from Malden Nesheim,
Provost Emeritus of Cornell, the long established US
university with large departments dedicated to the
study of international food and nutrition policy.
The other, by US Secretary of State Hillary Rodham
Clinton, is highly relevant to the vitamin A issue.
We will be publishing more contributions next month,
and will welcome any that seek to justify the
current VAC programme.
The bright side
I reckon I have a naturally sunny nature. So I was
disconcerted when a couple of colleagues at WHO
Geneva asked: ‘Why are you so negative?’ It turned
out that they were referring not to me but to the
Association’s organs – this website and within it,
World
Nutrition. So I had a chat with WN
editor Geoffrey Cannon, who was quite defensive. His
reply started with him humming ‘Always look on the
bright side of life’, the song sung at the end of
the movie ‘Monty Python’s Life of Brian’ to
accompany the crucifixion scene. Staying with
movies, Geoffrey said he knew what I meant. He said
that his favourite movie role of all time is Donald
Sutherland’s Oddball, the ur-hippie World War 2
Sherman tank commander in Kelly’s Heroes.
Told once again that German Tiger tanks are
invincible, Oddball says ‘why don’t you knock it off
with them negative waves... Why can’t you say
something righteous and hopeful for a change?’ Well
yes, I said, I think that’s what my colleagues in
Geneva meant.
Thus, we publish this month in the second issue of
WN, Harriet Kuhnlein’s ‘Here is the good
news’. Against all the odds, populations and
communities of Indigenous People are surviving,
usually in extremely challenging circumstances. With
many colleagues, Harriet founded
The Centre for Indigenous People’s Nutrition and
Environment (CINE) at McGill University in
Québec, now developed into a worldwide network. The
mission of CINE is to study and also to protect the
ways of life of first nations and other remote –
remote to us, that is – populations and communities,
such as live in the Canadian Arctic, the small
Pacific islands, the highlands of Vietnam, and the
mountains plateaus of Latin America. These peoples
have a lot to tell us and, as Harriet says, much of
this is good news.
A celebration of sisters
We plan that in due course, our own website here
will include a long list of ‘sites we like’, and we
want a volunteer to create it. Please contact
Geoffrey at geoffrey.cannon@wphna.org. A couple of
years doing this job and you will be the best
networked public health nutritionist in the world.
Let’s hear from you.
Meanwhile I refer you to the ever-expanding
right-hand strip of advertisements, for ourselves
and our activities, and also for – well, those we
like. These are the items in the smart grey-green
colour.
Taking them from the top, the first is for the
unique United Nations System Standing Committee on
Nutrition (SCN), at
www.unscn.org. Founded in 1977, its purpose is
to integrate and harmonise the international
policies and programmes of all the nearly 20 UN
agencies who are in some way and another concerned
with food and nutrition. Housed at WHO in Geneva,
its lead UN partners include WHO, the Food and
Agriculture Organization of the United Nations (FAO),
the UN Children’s Fund (UNICEF), the UN World Food
Programme (WPF), and also the World Bank (which is
part of the UN family). The SCN’s twice-yearly SCN
News is a treasure-house of information. Its most
weighty and influential publication, The World
Nutrition Situation, will be published in its
sixth edition later this year. Currently the SCN is
a partnership between UN agencies, bilateral donors,
and also civil society organisation. Many
Association members have long experience of working
with or for the SCN, including Roger Shrimpton, its
most recent executive secretary; Ted Greiner and
Urban Jonsson, chair and alternate chair of the CSO
group, and Denise Costa Coitinho, who has been the
WHO representative on the SCN Council. See also this
month’s WN editorial on the SCN.
Next on the right hand side of this page is the
Young Public Health Nutrition network. As you
can see from this home page, the Association is for
professionals of all ages. We are too polite to ask
how young our columnists Fabio Gomes and Reggie
Annan are, or indeed Christopher Wharton and Tina
Karapetyan, members whose profiles appear this
month. But we are not shy to point out that part of
our mission, which we are fulfilling, is to build
capacity and confidence in young leaders. This we
are doing by giving them front-line responsibility
to state their beliefs, to say where they are coming
from, and to be prepared to defend their positions.
The gadget we have that gives us statistics about
our site and WN, tells us that Reggie and Fabio’s
columns are among the most popular features we
carry. One purpose of the YPHN is to network among
young and also less experienced people in our field.
One of its missions is ‘Building bridges between
inexperienced and experienced professionals’. Great
idea.
When we say that Public Health Nutrition,
also featured right, is the sister journal of
World Nutrition,
we say this with feeling. Many of us have published
original research papers in PHN, and will
continue to do so. As I have said already in this
Letter, I was the PHN founding editor,
serving for nine years. Association Vice-President
Roger Hughes was a PHN deputy editor for a
number of years, and Geoffrey Cannon contributed his
‘Out of the Box’ column to PHN for seven
years, completing his time also as a deputy editor.
As we state in its Manifesto, WN and PHN
have different and complementary publishing and
editorial policies. Now there is another reason to
congratulate PHN editor-in-chief, Association
Council member Agneta Yngve. With the accession as a
deputy editor of Geraldine McNeill of Aberdeen
University, we can safely say that PHN is the
first nutrition journal ever, to have an all-woman
editorial directorate. My long-standing colleague
and friend Agneta will be the first to emphasise
that this should be no big deal.
Barrie Margetts
References
-
United Nations Children’s
Fund. Vitamin A supplementation: a decade of
progress. New York: UNICEF, 2007.
-
Sommer A. Vitamin A deficiency and
clinical disease: an historical overview.
Journal of Nutrition 2008; 138:
1835-1839.
-
George S. How the Other Half Dies. The
Real Reasons for World Hunger. London:
Pelican, 1976, 1986.
-
Klein N. The capitalist ID. [Chapter 12].
In: The Shock Doctrine. The Rise of
Disaster Capitalism. New York: Henry
Holt, 2007.
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