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Responding to the crisis in sub-Saharan Africa: the role of nutrition

Published online by Cambridge University Press:  02 January 2007

Mickey Chopra  and
Ian Darnton-Hill
Mickey Chopra*
Affiliation:
Director, Health Systems Research Unit, Medical Research Council of South Africa, School of Public Health, University of the Western Cape, Cape Town, South Africa
Ian Darnton-Hill
Affiliation:
Senior Adviser, Nutrition Section, United Nations Children's Fund, New York, NY, USA
*
*Corresponding author: Email [email protected]
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Abstract

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In the chapter dealing with education and health, the report of the influential Commission for Africa prioritises basic health systems, HIV/AIDS, malaria and tuberculosis. In contrast, nutrition is given less than half a page and is reduced to parasite control and micronutrient support. Such neglect of nutrition is hard to understand in the context of increasing hunger and malnutrition across the continent. Sub-Saharan Africa is the only region in the world where the proportion of underweight children has stagnated and the absolute numbers have actually increased in the last decade. It has been pointed out that if current trends continue sub-Saharan Africa will achieve the Millennium Development Goal for child mortality around 2115 – one century after the target date. Quite clearly those concerned with nutrition need to more powerfully advocate the role of nutrition in lifting Africa out of the spiral of poverty. The present paper argues that to achieve this requires an understanding not just of the critical role of nutrition for health and development (both individual and national), but also of how recent global changes are interacting with changes in food production and supply, other determinants of maternal and child health, and the role and capacity of the state to tackle malnutrition in Africa. It concludes by suggesting some responses that nutritionists could now be making.

Keywords

NutritionHealthAgricultureGlobalisationSub-Saharan Africa
Type
Research Article
Information
Public Health Nutrition , Volume 9 , Issue 5 , August 2006 , pp. 544 - 550
Copyright
Copyright © The Authors 2006

References

1Commission for Africa Report. Our Common Interest. London: Penguin Books, 2005 Also available at http://www.commissionforafrica.org/english/report/introduction.html. Accessed 25 July 2005.Google Scholar
2Ezzati, M, Lopez, AD, Rodgers, A, Van der Hoorn, S, Murray, CJL. Selected major risk factors and global and regional burden of disease. Lancet 2002; 360: 1347–60.CrossRefGoogle ScholarPubMed
3United Nations (UN) Administrative Committee on Coordination, Sub-committee on Nutrition. The 5th Global Nutrition Report. Geneva: UN System Standing Committee for Nutrition, 2004.Google Scholar
4Black, RE, Morris, SS, Bryce, J. Where and why are 10 million children dying every year? Lancet 2003; 361: 2226–34.CrossRefGoogle ScholarPubMed
5United Nations Development Programme (UNDP). Sub-Saharan Africa–The Human Costs of the 2015 'Business-as-Usual' Scenario. New York: Human Development Report Office, UNDP, 2005. Also available at. http://hdr.undp.org/docs/events/Berlin/Background_paper.pdf. Accessed 13 July 2005.Google Scholar
6World Food Programme. Ending Child Hunger Initiative. A discussion paper for the World BankUNICEF and WFP. Unpublished draft, 2005.Google Scholar
7United Nations Children's Fund (UNICEF). Nutrition. In: State of the World's Children 1998. New York: UNICEF, 1998.Google Scholar
8United Nations Development Programme (UNDP). Millennium Development Goals: A Compact among Nations to end Human Poverty Human Development Report 2003. New York: UNDP, 2003.Google Scholar
9Yach, D, Kellogg, M, Voute, J. Chronic diseases: an increasing challenge in developing countries. Transactions of the Royal Society of Tropical Medicine and Hygiene 2005; 99: 321–4.CrossRefGoogle ScholarPubMed
10United Nations (UN) Millennium Project 2005, Task Force on Hunger Halving Hunger: It Can Be Done Report prepared for UN Millennium Project's report Investing in Development: A Practical Plan to Achieve the Millennium Development Goals. London: Earthscan 2005. Also available at. http://www.unmillenniumproject.org/documents/Hunger-lowres-complete.pdf. Accessed 20 August 2005.Google Scholar
11Grantham-McGregor, S, Ani, C. A review of studies on the effect of iron deficiency on cognitive development in children. Journal of Nutrition 2001; 131: 649S–66S.CrossRefGoogle ScholarPubMed
12Pinstrup-Andersen, P, Babinard, J. Globalisation and human nutrition: opportunities and risks for the poor in developing countries. African Journal of Food and Nutritional Sciences 2001; 1: 9–18.Google Scholar
13Darnton-Hill, I, Margetts, BM, Chopra, M, Nishida, C, Bloem, MW, Globalization, economics and nutrition–where are we going? Paper presented at the International Union of Nutritional Sciences MeetingDurban, South Africa19–23 September 2005; 7 pp.Google Scholar
14Chopra, M. Food Security, Rural Development and Health Equity in Southern Africa. Discussion Paper No. 22. Harare: Regional Network for Equity in Health in Southern Africa, 2004.Google Scholar
15Institute for Agriculture and Trade Policy (IATP). US Dumping on World Agricultural Markets. Minnesota: IATP 2004. Also available at http://www.tradeobservatory.org/library.cfm?refID=. library.cfm?refID=48538. Accessed 23 August 2004.Google Scholar
16Diao, X, Diaz-Bonilla, E, Robinson, S. How Much Does it Hurt? Impact of Agricultural Polices on Developing Countries. Washington, DC: International Food and Policy Research Institute, 2003. Also available at http://www.ifpri.org/media/trade/trade.pdf. Accessed 14 August 2004.Google Scholar
17Food and Agriculture Organization of the United Nations (FAO). The State of Food Insecurity in the World 2003. Rome: FAO, 2003.Google Scholar
18Beintema, N, Stads, G-J. Investing in Sub-Saharan African Agricultural Research: Recent Trends. 2020 Conference Brief 8. Washington, DC: International Food and Policy Research Institute, 2004. Also available at http://www.ifpri.org/pubs/ib/ib24.pdf. Accessed 15 May 2005.Google Scholar
19Devereux, S. Transfers and safety nets. In: Devereux, S, Maxwell, S, eds. Food Security in Sub-Saharan Africa. London: ITDG Publishing, 2001.CrossRefGoogle Scholar
20World Bank. From Action to Impact. Discussion Paper, the Africa Region's Rural Strategy Rural Development OperationsNew YorkWorld Bank2002.Google Scholar
21Nieuwoudt, L, Groenewald, J. The Challenge of Change: Agriculture, Land and the South African Economy. Durban: University of Natal Press, 2003.Google Scholar
22Madeley, J. Food for All. The Need for a New Agriculture. London: Zed Books, 2002.Google Scholar
23Statistics South Africa. The People of South Africa Population Census, 2001. Census in Brief. Pretoria: Statistics South Africa, 2001. Also available at http://www.statssa.gov.za/census2001/census2001.htm. Accessed 20 August 2004.Google Scholar
24United Nations Development Programme (UNDP). South Africa: Human Development Report 2000 [online], 2000. Available at http://www.undp.org.za/sahdr2000/hdr.contents.pdf. Accessed 25 March 2004.Google Scholar
25Labadarios, D. ed. The National Food Consumption Survey (NFCS): Children aged 1–9 years, South Africa. Pretoria: National Department of Health, 1999.Google Scholar
26 Statistics South Africa. October Household Survey 1999. Statistical Release P0317 [online], 2004. Available at http://www.statssa.gov.za/Statistical_releases/Statistical_releases.htm. Accessed 20 July 2005.Google Scholar
27Sachs, JD. Macroeconomics and Health: Investing in Health for Human Development. Geneva: World Health Organization, 2001.Google Scholar
28United Nations Children's Fund (UNICEF). Progress for Children: A Child Survival Report Card, volume 1. New York: UNICEF, 2004; 21 pp. Available at http://www.unicef.org/publications/files/29652L01Eng.pdf. Accessed 25 August 2005.Google Scholar
29United Nations (UN) Millennium Project. Who's got the Power? Transforming Health Systems for Women and Children. Summary version of the report of the Task Force on Child Health and Maternal Health. New York: UN, 2005; 24 pp.Google Scholar
30Morris, JT. Africa's food crisis as a threat to peace and security. Statement of the Executive Director to the Security Council. Rome: World Food Programme, 30 06 2005.Google Scholar
31Dare, L, Buch, E. The future of health care in Africa. British Medical Journal 2005; 331: 1–2.CrossRefGoogle ScholarPubMed
32Smith, LC, Ramakrishnan, U, Ndiaye, A, Haddad, L, Martorell, R. The Importance of Women's Status for Child Nutrition in Developing Countries International Food Policy Research Institute (IFPRI) Research Report No. 131. Washington, DC: IFPRI/Department of International Health, Emory University, 2003.Google Scholar
33Darnton-Hill, I, Webb, P, Harvey, PWJ, Hunt, JM, Dalmiya, N, Chopra, M. Micronutrient deficiencies and gender: social and economic costs. American Journal of Clinical Nutrition 2005; 81(Suppl.): 1198S–205S.CrossRefGoogle ScholarPubMed
34Quisumbing, AR, Haddad, L, Peña, C. Are Women Overrepresented among the Poor? An Analysis of Poverty in Ten Developing Countries. FCND Discussion Paper No. 115. Washington, DC: International Food Policy Research Institute, 2001; 66 pp.Google Scholar
35Coombes, R. Developed world is robbing African countries of health staff. British Medical Journal 2005; 330: 923 pp.CrossRefGoogle ScholarPubMed
36MacDonald, R. Prioritising neglected diseases related to poverty. British Medical Journal 2005; 331: 12.CrossRefGoogle ScholarPubMed
37Doyal, L. Gender and the 10/90 gap in health research. Bulletin of the World Health Organization 2004; 82: 162.Google ScholarPubMed
38Brettingham, M. Developing countries may not get benefits of GM food. British Medical Journal 2005; 331: 11.CrossRefGoogle Scholar
39Moszynski, P. Armed conflict is a leading cause of hunger, says FAO. British Medical Journal 2005; 330: 1286.CrossRefGoogle ScholarPubMed
40Kneen, B. Invisible Giant. London: Pluto Press, 1996.Google Scholar
41ActionAid. GM Crops–Going Against the Grain [online], 2003. Available at http://www.actionaidinternational.it/site/download/GM%20crops%20-%20Going%20against%20the%20grain.pdf. Accessed 24 August 2004.Google Scholar
42Yorley, B. Food Inc. Corporate Concentration from Farm to Consumer. London: UK Food Group, 2004.Google Scholar
43Lambrechts, K, Barry, G. Why is Southern Africa Hungry? The Roots of Southern Africa's Food Crisis. Policy Briefing. London: Christian Aid, 2003. Available at http://www.christianaid. org.uk/indepth/0307safrica/index.htm. Accessed 20 July 2005.Google Scholar
44Hunt, J. The potential impact of reducing global malnutrition on poverty reduction and economic development. Asia Pacific Journal of Clinical Nutrition 2005; 14: 10–38.Google Scholar
45Chopra, M, Darnton-Hill, I. Tobacco and obesity epidemics: not so different after all? British Medical Journal 2004; 328: 158–60.CrossRefGoogle ScholarPubMed
46Torlesse, H, Kiess, L, Bloem, MW. Association of household rice expenditure with child nutritional status indicates a role for macroeconomic food policy in combating malnutrition. Journal of Nutrition 2003; 133: 1320–5.CrossRefGoogle ScholarPubMed
47Godlee, F. Untangling a skein of wool. British Medical Journal 2005; 331: (23 07). Available at http://bmj.bmjjournals.com/cgi/content/full/331/7510/0-9CrossRefGoogle Scholar
48Pokhrel, S, Hidayat, B, Flessa, S, Sauerborn, R. Modelling the effectiveness of financing policies to address underutilization of children's health services in Nepal. Bulletin of the World Health Organization 2005; 83: 338–44.Google ScholarPubMed
49World Bank. Overview. In: Repositioning Nutrition as Central to Development. A Strategy for Large-scale Action. Directions in Development Paper Washington, DC: World Bank, 2006.Google Scholar
50United Nations Children's Fund (UNICEF). Progress on undernutrition Draft prepared for Progress for Children: A Report Card on Nutrition, Number 4. New York: UNICEF, 2006.Google Scholar
51Chopra, M, Galbraith, S, Darnton-Hill, I. A global response to a global problem: the epidemic of overnutrition. Bulletin of the World Health Organization 2002; 80: 952–8.Google ScholarPubMed
52United Nations (UN). Standing Committee on Nutrition (SCN). The human right to adequate food. UN SCN, 32nd Session, Brasilia, 14–18 03 2005. Available at www.unsystem.org/scn/. Accessed 30 July 2005.Google Scholar
53Aguayo, VM, Ross, JS, Kanon, S, Ouedraogo, AN. Monitoring compliance with the International Code of Marketing of Breast milk Substitutes in West Africa. Findings from a multi-site, cross-sectional survey in Togo and Burkina Faso. British Medical Journal 2003; 326: 127–30.CrossRefGoogle Scholar