Aid to a better approach

Save the Children's criticism of World Bank programmes to reduce rates of malnutrition in poor countries (World Bank poverty drive a failure, July 3) demands more careful assessment. The bank is portrayed as plodding down trusted paths, but where is the data for these assumptions. And where is the evidence for Save the Children's assertion that World Bank approaches are "widely discredited"? There is virtually nothing available in the peer-reviewed literature.

Your article raises other important issues. First, nutrition as an investment for improving the health, learning capacity, productivity and development of poor nations has been neglected for decades. The fashionable assumption, completely unproven, is that aid by UK governments and others should be given for "poverty reduction" and by "trickle down" will improve nutrition. Where is the evidence?

Second, the global epidemic of HIV is having a catastrophic impact. A high proportion of international aid is focused on payment for anti-retroviral drugs which are accessed by the very few.There are also crucial nutritional interventions for the prevention and management of HIV which are being neglected.

Third, there is more to nutrition programmes than education, food hand-outs and public health services. Development of the capacity of community groups to assess their own problems and implement activities was not referred to by the World Bank or Save the Children.

Instead of pitting themselves against each other, the bank and Save the Children should share, in the public domain, what data they have so that passionate but less partisan individuals and groups can draw conclusions on the effectiveness of different ways of improving nutrition in poor countries.


Prof Andrew Tomkins
Institute of Child Health