Hunger, science, and politics : FAO, WHO, and Unicef nutrition policies, 1945-1978
Out of the chaos of W.W.II emerged three United Nations agencies-FAO, WHO, and Unicef-endowed with the joint responsibility to help conquer hunger and malnutrition. Seminal nutritional research before the war along with idealistic policy makers and nutritionists afterwards set the stage for the first international initiatives to address nutritional issues in developing countries. This dissertation relies mainly on an array of primary sources and oral histories to elucidate the evolving position of nutrition in FAO, WHO, and Unicef. Nutritionists at the UN agencies, research institutes, the UN agency-supported Protein Advisory Group, and expert committees contributed substantially to the shape and focus of international nutrition policies. Alongside developments in nutritional science, administrators at FAO, WHO, and Unicef implemented complementary policy changes. During the early-1950s, nutritionists began applying lessons learned from the treatment and prevention of malnutrition during W.W.II to recently discovered nutritional problems in developing countries. Consequently, the agency plans for the developing countries usually entailed dried skim milk distribution and production projects since these had been successful in Europe. Throughout the 1950s and 1960s nutritionists concentrated on protein malnutrition and its clinical manifestation, kwashiorkor. Caloric deficiencies, which in severe cases led to marasmus, were of secondary importance as was emerging knowledge about the complex interactions of nutrition and infection. The apparent prevalence of protein malnutrition led nutritionists to draw attention to pre-school children and to develop high-protein dietary supplements. Agency policies reflected these developments and emphasized nutrition education projects, supplementary food distribution, and other schemes designed to tangibly impact nutritional status, especially of children. The lack of progress against global hunger and malnutrition inspired the agencies during the late-1960s and 1970s to promote national development plans that prioritized the nutritional needs of the population. During the same period, many nutritionists drew attention to the declining protein intake of the poor and called for monumental efforts to increase protein production and availability. Although nutrition policies initially took note of this protein deficit, within a few years the nutritionists' fears were considered to have been reactionary. As a result of this and the largely uneven results of nutrition policies, the administrators tired of the influence of the nutritionists and created a new hierarchy that placed nutritionists lower on the ladder of power. Toward the end of the 1970s, nutritional enterprises lost their singular importance and were increasingly integrated with primary health care endeavours.