Here's a statistic to digest - 30 percent of children under five in Asia-Pacific are underweight. In sub-Saharan Africa, a region many associate with images of starving children, the figure is 28 percent.

India, Bangladesh and Pakistan together account for half the world's underweight children, says the United Nations Children Fund (UNICEF) in its first regional report on child mortality, released this month.

Those three countries may be known for high malnutrition rates, but even without South Asia the numbers are dire.

If you remove India, Bangladesh and Pakistan from the equation, the under-five malnutrition rate stands at 14 percent - which doesn't sound too bad until you realise the average is kept in check by the growing prosperity of China.

"But take away the statistics for China and the situation is almost as bad as sub-Saharan Africa," said Anupama Rao Singh, UNICEF's director for the region. "About 26 percent of all children (in East Asia and the Pacific) under five suffer from some form of malnutrition in East Asia and Pacific."

While malnutrition itself may not kill children, it is the underlying cause for many of the preventable diseases that can lead to a child's death.

Asia-Pacific encompasses half of the world's population, so anything that threatens the region's development threatens the rest of the world.

So why don't we hear more about malnutrition in the region, and how is it that the neighbourhood of some of the fastest growing economies in the world is still struggling with the issue?

For one thing, national averages mask provincial troubles. Take China. The percentage of underweight children in Beijing and Shanghai hovers close to zero, rising to almost 6 percent in other provinces and deteriorating further in Hebei province in the north, according to the UNICEF report, The State of Asia-Pacific's Children 2008.

For another, it's easier to get a mental handle on malnutrition in arid sub-Saharan Africa, where food shortages are common. Asia-Pacific's image as a global food basket just doesn't square with the statistics.

"Malnutrition isn't only confined to places with food insecurity," said Karen Codling, a public nutrition expert in Bangkok. "The idea that malnutrition is about health care and woman empowerment and caring behaviours in the home are less commonly recognised causes."

CAUSED BY INEQUALITIES

Malnutrition is also about political will. It is a reflection of inequalities in a country and the growing gap between rich and poor. In fact, Asia-Pacific is home to half of the world's slum population, says UNICEF.

Being malnourished can mean different things, from being "wasted" (too skinny) to "stunted" (too short), said Codling.

"Underweight is the commonly available data globally, but stunting is considered to be the figure that is most related to national economic development. A child's height at 2 years is a good indicator of his future earning potential."

According to the Lancet medical journal, stunted children complete fewer years of schooling and earn less income as adults, hindering their cognitive growth and economic potential.

"Stunting actually starts in the womb," said Dr. Stephen Atwood, a public health expert in Bangkok. "It starts with malnutrition right from the very beginning of the pregnancy - probably in the first three months."

Stunting is common in Asia-Pacific. Almost half of children born in South Asia and East Timor are stunted, and even in Vietnam, the newest Asian tiger, the figure is 35 percent. UNICEF says the effects of stunting are largely irreversible.

Worse, malnutrition is a repetitive, vicious cycle. According to the Lancet, the consequences of insufficient nutrition continue into adulthood and are passed on to the next generation as undernourished girls and women have children of their own.

BREAKING THE CYCLE

"If the trends of economic growth and development continue, Asia is going to have what it takes in resources, financial and human, to actually achieve social development goals that they have committed to," UNICEF's Singh said. "It's a question of having political will and knowing what actions to take."

This year marks the midway point for achieving health targets set by the world community under the so-called Millennium Development Goals, and UNICEF is urging countries to meet the targets with "equity". In other words, to address those inequalities that are fuelling malnutrition.

Given the correlations between nutrition, child mortality, maternal health and national economic development, experts say the first step is educating and empowering women.

"If we don't get to the underlying causes of gender inequity then we are just putting a big band-aid on the problem," said Atwood. "Women need a better deal. It's an underlying problem that crosses all boundaries and countries."

In many countries in Asia-Pacific, families continue to value boys more than girls, and UNICEF says a disproportionate ratio of males to females contributes to poor child survival. Education is another key factor - children born to educated mothers have a much higher chance of survival than those born to uneducated mothers.

Atwood said it was also important to reach women pre-pregnancy and teach them about nutrition. Most mothers tend to visit health centres only in their second trimester.

Once the child is born, the first 24 months of a child's life is "the critical window of opportunity" to prevent malnutrition, according to the Lancet. This can be done through a variety of means including breastfeeding counselling and providing necessary vitamins.

It all sounds feasible. All that is needed is the political will.

Reuters AlertNet is not responsible for the content of external websites.