Aid programmes for malnutrition and the role of the nutritionist.

The preface to the 6th edition of Human Nutrition and Dietetics (Davidson & Passmore, 1975) begins with the statement that ‘At the present time a knowledge of nutrition is of growing importance because of the increase in world population. In 1974 the World Food Conference in Rome (United Nations, 1975) and the World Population Conference in Bucharest (United Nations, 1974) reflected the concern of all people in all countries that we can no longer take our food supplies for granted. In many underdeveloped areas as large a proportion of the population as ever does not receive enough food of the right kinds for full physical development and good health’. After 17 years, a time during which the world population has grown by about one billion and on the threshold of a second International Conference on Nutrition, the same introduction might apply, changed only perhaps to the extent that public concern has increased still further. In the interim, what have international nutrition programmes and the nutritionist contributed to maintaining or improving the nutrition of the poor? The title of the present paper offered two possible themes. The first would be a review of the world’s nutrition problems and the various technical approaches being taken to address them. The second, which I have chosen, is to examine more critically the current role of the nutritionist in development. As a non-nutritionist who has over several years been drawn into international nutrition activities, I am struck that in recent years the contribution of ‘nutrition’ to the food and nutrition problems of poor countries has been slight; and that ‘nutrition’ is becoming increasingly irrelevant to the problems of development. This marginalization, which is not wholly unique to nutrition (to a degree it affects much ‘subject’ science in development) is in my view due to a combination of institutional and historical factors. But because of its particular nature, nutrition is affected by these to a disproportionate degree. The elements of this view are hardly original. They had been clearly identified as early as the 1930s (Burnet & Akroyd, 1935), and have been restated regularly since. In summary they are that nutrition is fundamentally an area of biological science, which involves some narrow specialist field skills; it is not a subject organized to put knowledge into practice. The usefulness of nutritional knowledge is to be measured by the degree to which it is relevant to, and is employed by, other more practical disciplines. By contrast,