Punjab’s Chief Minister, Maryam Nawaz, launched the province’s first school nutrition programme on 5 September at a Government Primary School in Dera Ghazi Khan. The Chief Minister’s School Nutrition Programme is a pilot project designed to combat malnutrition in three districts of southern Punjab — Dera Ghazi Khan, Rajanpur, and Muzaffargarh. Under this initiative, more than 400,000 malnourished students across 3,527 schools will receive daily milk packs.
Nutrition is a subject of paramount importance globally. Its significance is underscored by its inclusion in the United Nations’ Sustainable Development Goals (SDGs), specifically focusing on eradicating malnutrition by 2030. Originally framed as the ‘Global Nutrition Targets 2025,’ this initiative was extended to 2030, reflecting nutrition’s critical role in health and development.
Across the world, governments and organisations are working tirelessly to address nutrition-related issues such as malnutrition, anaemia, stunting, and wasting – problems that have been identified as the root causes of numerous health complications, both before birth and throughout life. However, Pakistan is still catching up on its nutrition targets. Malnutrition stands as one of the most formidable barriers to the equitable development of all Pakistani children. With a global acute malnutrition (GAM) rate of 17.7 per cent, Pakistan is grappling with a crisis that far exceeds emergency thresholds.
According to UNICEF, nearly 30 per cent of children are underweight, 44 per cent are stunted, 17.7 per cent suffer from wasting, and 49 per cent of women experience moderate anaemia. With a population exceeding 235 million, Pakistan ranks fifth globally in population size but 99th out of 126 countries on the Global Hunger Index (GHI 2023). Approximately 8.6 million people, or 24 per cent, face acute food insecurity, with staggering rates of stunting, particularly in Balochistan, Sindh, and Khyber Pakhtunkhwa.
This malnutrition epidemic begins in the womb with anaemic mothers, intensifies during lactation, and manifests critically in the first thousand days of life — an essential period for neural and sensory development. The cycle of malnutrition is both pervasive and deeply entrenched, with long-term consequences for the nation’s future.
A 2006 World Bank report titled ‘Repositioning Nutrition as Central to Development’ warned that malnutrition is costing poor countries up to 3 per cent of their yearly GDP, while malnourished children are at risk of losing more than 10 per cent of their lifetime earnings potential.
Nutrition is a critical aspect of the United Nations’ Sustainable Development Goals (SDGs), particularly under SDG 2: Zero Hunger, which aims to end hunger, achieve food security, improve nutrition, and promote sustainable agriculture by 2030. It also intersects with SDG 3: Good Health and Well-Being, which focuses on ensuring healthy lives and promoting well-being for all ages. Nutrition plays a significant role in reducing child mortality, improving maternal health, and combating diseases linked to malnutrition. Additionally, SDG 12: Responsible Consumption and Production emphasises the importance of sustainable food systems that provide healthy diets for all.
According to the 2015 Global Nutrition Report, every US $1 spent on nutrition gives a US $16 return. PML-N has stood out for addressing this global concern in successive tenures. Pakistan became a member of the Scaling Up Nutrition (SUN) movement in 2013, which was launched by the UN Secretary-General in 2010. Saira Iftikhar, then a PML-N member of the Punjab Assembly, raised the issue of child health and nutrition on the assembly floor, which resulted in the establishment of the SUN secretariat at the Planning and Development Department.
PML-N governments at the Centre and Punjab took several initiatives to provide children with adequate nutrition. The Punjab government approved the Multi-sectoral Nutrition Strategy in 2015. In 2017, the then-chief minister of Punjab, Shehbaz Sharif, initiated the Khadim-e-Punjab Child Nutrition and Stunting Reduction Programme to address mother and child health. The same year, the Government of Punjab launched a Health and Nutrition Conditional Cash Transfers pilot project in two districts – Muzaffargarh and Bahawalnagar – using data from the Benazir Income Support Programme to reach pregnant and lactating women from disadvantaged groups. This was followed by a National Nutrition Survey by the Federal Government and Pakistan Dietary Guidelines for Better Nutrition in collaboration with the Food and Agriculture Organisation in 2018. As a result of these initiatives, Punjab’s nutrition indicators started improving compared to other provinces. PML-N legislator Saira Iftikhar was given the SUN Nutrition Champion Award in 2017 in recognition of her tireless advocacy for better nutrition.
Shehbaz Sharif’s government also initiated a phased ban on loose milk sales, which spreads pathogens. However, these projects were either stopped or rebranded when the PTI government took the reins of power in 2018 in Punjab and Centre. For example, Health and Nutrition Conditional Cash Transfers was rebranded as Ehsaas Nashonuma.
The PML-N prominently addressed the issue of child nutrition in its 2024 election manifesto. Soon after the party came into power in Pakistan’s largest province, the government notified the Punjab Nutrition Board – a pivotal move to address nutrition-related challenges and develop effective policies based on real-time data and the needs of the local population, with rightful authority for proper implementation. This was closely followed by the School Nutrition Programme inaugurated by the chief minister earlier this month.
The Punjab Nutrition Board operates under the Ministry of Primary & Secondary Health, with Health Ministers Khawaja Salman Rafique and Khawaja Imran Nazir, showing keen interest in advancing this vital agenda under the leadership of Chief Minister Maryam Nawaz. The board comprises both health ministers, health secretaries, the director general of Health Services, the director general of the Punjab Food Authority, and the programme director of Integrated Reproductive, Maternal, Neonatal and Child Health & Nutrition Programme, among other esteemed heads of departments, principals, academics, and experts who share the board’s vision, including Dr Adnan, a renowned cardiologist, and former MPA and SUN Nutrition Champion Saira Iftikhar. The board holds the authority to welcome new members as needed, further enhancing its ability to address evolving challenges in nutrition policy implementation.
The Punjab Nutrition Board has outlined several key objectives and terms of reference. These include the review, modification, and provincial implementation of the National Nutrition Policy (2018-2025). The board aims to manage severe acute malnutrition and moderate acute malnutrition (SAM & MAM) by enhancing the production and availability of ready-to-use therapeutic foods (RUTF) and developing local alternatives through research and development. It also seeks to recommend legislation for the fortification of essential staple foods and ensure food safety in collaboration with the Punjab Food Authority.
The board focuses on improving nutrition indicators across all age groups, scaling up the Chief Minister’s Stunting Reduction Programme, and integrating multi-sectoral and innovative approaches like the SUN initiative. Additionally, the board emphasises strengthening partnerships with federal bodies, international organisations, and other stakeholders, while ensuring effective resource mobilisation, advocacy, and capacity-building efforts. Regular reviews, nutritional screening, and disease prevention strategies are also key priorities, alongside targeted interventions to combat anaemia and other malnutrition-related issues.
In the inaugural meeting of the Punjab Nutrition Board, held on 30 July 2024 at the Project Management Unit, Primary & Secondary Health Department in Lahore, several critical decisions were made to set a clear path for the effective implementation of nutrition policies. The meeting, attended by board members, saw active participation from key stakeholders in nutrition, including representatives from WHO, UNICEF, WFP, NI, FAO, GAIN, and WaterAid Punjab. These stakeholders shared their concerns and identified key areas requiring urgent intervention. Recognising the complexity of the nutrition landscape, the board resolved to broaden its scope by forming additional committees under its umbrella, each focused on specific aspects of nutrition policy implementation. This strategic move aims to enhance the board’s capacity to address the diverse challenges linked to malnutrition across the province.
Furthermore, the health ministers emphasised the necessity of establishing a dedicated working directorate within the board, tasked specifically with driving its agenda forward and ensuring that the policies are implemented effectively and efficiently across Punjab.
As an honorary member of this prestigious board, I have had the privilege of witnessing firsthand the unwavering commitment of Punjab’s health ministers, working in alignment with CM Maryam Nawaz Sharif’s vision to transform Punjab into a well-nourished province. Saira Iftikhar has championed this cause relentlessly, advocating for it at every level, from parliament and policy-making platforms to international forums and the corporate sector. Her tireless efforts in advocating for the formation of the Punjab Nutrition Board have already shown tangible progress.
With such a dedicated platform in place, I am optimistic that by 2030, Pakistan will be among the nations that have met their nutrition targets, and the Punjab Nutrition Board will have played a crucial role in this achievement.
The writer is a political activist and works in youth development.
