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A New Approach to End Malnutrition in Africa

By Mercy Lung’aho

Africa is the only continent in the world where poverty and malnutrition are on the rise. Between 1990 and 2014, the number of stunted children increased by 14 percent in East and southern Africa, and 41 percent in West and Central Africa. Of the 34 countries in the world with the most children suffering from malnutrition, 22 are in Africa. In addition, African governments are losing up to 16.5 percent of their gross domestic products annually as a result of poor nutrition. Unless action is taken now to reverse this trend, by 2030 a majority of the continent’s projected 200 million children under the age of five will be malnourished.

Akinwumi Adesina, president of the African Development Bank and the recent winner of the World Food Prize, has said, “stunted children today result in stunted economies tomorrow.” Most governments and donors know that good nutrition is a requirement for economic growth. For $1 invested in nutrition, a country can get $16 in return, providing an incentive for governments, donors, and research institutions to focus on improving nutrition outcomes in Africa.

Despite the clear advantages to addressing this problem, the measures being taken now aren’t working. According to research from The Graduate Institute Geneva, current “early warning systems” are only set up to detect food crises that are already underway. The U.N. Food and Agriculture Organization, for instance, runs the Global Information and Early Warning System on Food and Agriculture, which continuously monitors food supply and demand and food security, issuing warnings of impending food crises at the country or regional level. The U.S. Agency for International Development-led Famine Early Warning Systems Network (FEWS NET) is also a leading provider of early warning and analysis on acute food insecurity. But for malnutrition to end, we must do things differently: We need a system that is better able to monitor and predict nutrition risks, enabling a swift and effective response.

First, we need to look at all the data that is relevant to nutrition. Nutritionists agree that there are numerous factors that explain poor nutrition, but we’ve fallen victim to what’s been called “filter failure”—where we only look at the causes of extreme food crises and discount chronic malnutrition. We need to consider the broader picture. Rather than just tracking changes in climate, food prices, and instability, we need to look at factors such as access to health care, as children who do not receive routine immunizations are susceptible to infectious diseases that can lead to poor nutrition and early death. The fact that malnutrition has been increasing on the continent is evidence that existing tracking systems ignore or miss key details. We need a system that can handle large volumes of information and identify data that could help us develop strategies to combat malnutrition.

We also need a way to track this data over time in order to be proactive when it comes to nutrition crises. A good example of this is the World Health Organization’s serial measurements of a child's growth, which are plotted on charts to identify and assess patterns, such as evidence of chronic malnutrition. The early warning systems that already exist do not address the underlying problem of chronic malnutrition, where long-term inadequate nutrition inhibits normal growth. With broader and longer-term tracking, could we have prevented the acute malnutrition—which leads to rapid weight loss—caused by the current food crisis devastating Yemen, South Sudan, Somalia, and Nigeria from progressing this far? We need foresight and warnings, even years in advance, to alert decision-makers to nutrition risks like drought and political instability. If we tracked the data over time, we could anticipate these cases and stop them before they become full-blown emergencies.

Finally, we can continue to learn from solutions that have worked. Success stories on the continent can aid us in the fight against malnutrition. For example, Rwanda and Mali have comparable wealth status, yet the death rate among babies in Rwanda is half that of Mali (18 deaths per 1,000 live births in Rwanda, compared to 37 in Mali). Rwanda has seen progress in nutrition as a result of improved access to primary care and community health-care workers who support the adoption of healthy behavior, including adequate prenatal care. By making use of information like this, we can review and transfer best practices from one country to another to improve nutrition outcomes. Success leaves clues, and we don’t have to waste time and money to reinvent solutions that already exist.

According to the United Nations, the current food crisis in Africa is the biggest famine facing the world since 1945. We must get better at managing both food and nutrition security while building long-term resilience in Africa’s food systems. To address this challenge, a growing number of scientists from the International Center for Tropical Agriculture, the Modeling Early Risk Indicators to Anticipate Malnutrition (MERIAM) project, and elsewhere have begun the conversation on the merits of a Nutrition Early Warning System. It will utilize big data, machine learning, and predictive modeling to advise on ways to avert nutrition emergencies. We must end malnutrition in Africa, and for that to happen we need a system that can help us prevent crisis, not just react to it. 

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Mercy Lung’aho is a nutritionist at the International Center for Tropical Agriculture (CIAT) and a 2017 Aspen Institute New Voices Fellow.

[Photo courtesy of  TKnoxB]

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