Contested evolution of nutrition for humanitarian and development ends

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This working paper reports on a workshop organised by the Food Studies Centre at SOAS, University of London and the Refugee Studies Centre at Oxford University, and held at SOAS. The workshop aimed to explore and debate how and why humanitarian and development nutrition came to be dominated by medical science, what the effects have been for aid agencies and beneficiaries, and how historical conditions have shaped humanitarian and development practices more broadly. Over the past century malnutrition has become increasingly medicalised. Current interventions tend to treat it as a decontextualized, biological problem amenable to the technical administration of nutrients. The main approaches to addressing it now include the provision of specialised food products, new agricultural technologies, and the promotion of behaviour change in feeding and hygiene practices. The success of new treatment methods in the early 2000s, such as Community Managed Acute Malnutrition and Ready to Use Therapeutic Foods such as Plumpy’nut, has diverted attention from alternative approaches to nutrition, particularly social nutrition. Social nutrition, which took a more holistic approach by examining its social, political and economic causes, was prominent in the 1930s and again in the 1980s and 1990s but has been in decline since. Medicalised, technical and behavioural approaches are now widely promoted as part of global Public Private Partnerships such as the Scaling Up Nutrition movement and the New Alliance for Food Security and Nutrition. Most donors and aid agencies see these approaches as progress, in part because they have been justified by a series of papers in the Lancet in 2008, which reported that a standard set of nutrition interventions at individual or household level could lead to substantial reductions in undernutrition. Medicalised approaches have been criticised because they focus on nutrition itself as the object of policy rather than its wider social and political causes, for preventing more flexible and people-centred approaches, and because new nutrition and agricultural technologies promote the interests of business rather than the malnourished. These issues were the subject of discussion at the workshop.