Thank you very much for you invitation to this open discussion.
I am a PhD student from Institute of Tropical Medicine and Hygiene and I have been working in malnutrition and environmental enteropathy in infants from São Tomé -Africa (STP). I want to share two comments to the first question:
About undernutrition, despite of the overall picture has improved , there is still a high percentage of children in mild forms of undernutrition ( -2
In a previous study in preschool children from STP, the proportion of children with mild forms was almost twice over moderate and severe forms for underweight and stunting. ( Abstract in: Special Issue: Abstracts of the8th European Congresso n Tropical Medicine and International Health. Tropical Medicine and International Health. Volume 8 , Isusue supplemnet s1. pages 1-250).
For these reasons , I think that mild forms of undernutrition should be included as an important part of the picture, that deserve a careful approach.
Another comment is to consider the "environmental enteropathy " into the vicious cycle of malnutrition, taking account that this pathology is the result of poor environmental sanitation with ingestion of water and food contaminated , multiple enteric infections which lead to inflammatory changes and disarrangement of intestinal barrier and malabsorption. Thus, the sanitation authorities should be an important part of this framework.
Instituto de Higiene e Medicina Tropical-Lisboa.(IHTM)