Scaling Up Nutrition Action for Africa

Transcription

1 Scaling Up Nutrition Action for Africa Where are we and what challenges are need to be addressed to accelerate malnutrition? Lawrence Haddad Global Alliance for Improved Nutrition

2 Why should African political leaders care about malnutrition? What needs to happen?

3 Good nutrition prevents 45%.....of all death under 3 years of age that is related to malnutrition

4 Good nutrition wires the circuits

5 Poor nutrition reduces the economic wealth of nations % of GDP lost each year AUC/WFP Cost of Hunger Studies

6 Demographic Dividend for Africa? With stunting? Forget about it. 2 Ratio of working age to dependent population, sub Saharan Africa Data from Bloom and Canning 2011

7 And the Development Bank Leaders Know It We need to invest in gray matter infrastructure. Akin Adesina President of the African Development Bank 2016 Neuronal infrastructure is quite possibly going to be the most important infrastructure. Jim Kim President, World Bank 2016

8 Scaling Up Nutrition. Where Are We?

9 All African countries have serious malnutrition problems 25% have serious under and over nutrition problems Under 5 Stunting Ethiopia, Rwanda Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Comoros, Congo (Republic of The), Côte d Ivoire, Democratic Republic of the Congo, Djibouti, Eritrea, Gambia, Guinea, Guinea-Bissau, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Niger, Nigeria, Sao Tome and Principe, Sierra Leone, Somalia, Sudan, Togo, Uganda, Tanzania, Zambia, Zimbabwe Botswana, Egypt, Equatorial Guinea, Lesotho, Libya, Namibia, South Africa, Swaziland Algeria, Gabon, Morocco, Seychelles, Tunisia Women s Anemia Ghana, Senegal Adult Overweight

10 What is the rate of progress? Highly variable but there is cause for hope

11 Number of African countries at stages of progress against global targets on nutrition Missing data Off course, little/no progress Off course, some progress On course, at risk On course Stunting children under Wasting children under Overweight children under Anemia women aged years Exclusive Breastfeeding, <6 months Adult Overweight + Obesity (BMI 25) 54 Adult Obesity (BMI 30) 54 Adult Diabetes (Raised blood glucose) 53 1 Global Target

12 Progress against Malabo Declaration target for stunting reduction 39 How many African countries will attain stunting rates of 10% by 2025? 4 6 On course Off course, but making progress Off course, not making any progress

13 What Needs to Happen? Commitmen t Coverage Coherence Cash

14 Must make the issue hard for African heads of state to ignore

15 Many African countries are members of Scaling Up Nutrition (SUN) Movement but not all

16 But commitment is not measured by membership alone. Setting & working to meet SMART targets is key.

17 There are not enough SMART targets in African nutrition country plans Percent of 40 African Nutrition Plans with SMART Targets for Stunting Exclusive breastfeeding Wasting Anaemia in women Low birth weight Under 5 overweight

18 Few African Countries have Targets for Diet Related NCDs Percent of 40 countries with targets for % Obesity Diabetes Salt Reduction Source: Unpublished self-reported data from the NCD Country Capacity Survey, provided by the WHO Surveillance and Population-based Prevention Unit, Department for Prevention of NCDs. Printed with permission.

19 Nutrition Program Coverage?

20 Coverage of Nutrition Programs is too Low Coverage of nutrition-specific interventions remains highly variable across African countries Exclusive breastfeeding <6 months Minimum dietary diversity (6-23 months) Zinc treatment Iron-Folic acid for diarrhoea (U5) suppl. 90+ days (pregnant women) Iron suppl. (U5) Vitamin A suppl. (U5) Salt iodization (household)

21 Coherence

22 Coherence: Underlying determinant dashboard for Kenya Gov Exp on Health, Ed, Ag (as % of budget) 37.7 Gender inequality rank (1=best) 122 Unimproved or no sanitation (%) Unimproved water (%) % girls not enrolled in secondary school Nurses and Midwives/1000 people % Food insecure (FAO) 24

23 Cash: Invest more and allocate better

24 Big chunks of African government budgets go to nutrition relevant sectors % of government budgets, Africa, 2010

25 Cash: yet too little is spent on % of General Government Expenditures nutrition from related sectors Budget allocations to nutrition sensitive actions in these countries are relatively low Source: OPM and SUN SMS

26 Conclusions Some countries are on course to meet targets. Many more are making some progress. Need more: commitment coverage coherence cash Malnutrition is not destiny. Ending it is a political choice supported by SMART commitments for accountability.

27 Ghana is re-writing the African story % Stunting rate of under 5 children, Ghana

28 Three things you can do Challenge decision makers with evidence on the slow pace of malnutrition reduction Make those essential but challenging alliances for nutrition with those outside your immediate circle Make SMART commitments for nutrition and ask others to do the same

29 Thank you