New Efforts Focus on Economic Benefits of Improved Nutrition
Malnutrition places a significant economic burden on African countries, costing between 3 and 16 percent of annual GDP, according to a new working paper from the Global Panel on Agriculture and Food Systems for Nutrition (GLOPAN). Thus, improving nutrition in the region should not be viewed as just another development outcome; rather, nutrition interventions should be seen as potential drivers of development and economic growth in and of themselves. The paper was commissioned by GLOPAN and the African Development Bank (AfDB) and was released in May of this year as part of the AfDB’s annual meeting. The two organizations have also called for the establishment of a new high-level policymaking body (the African Leaders for Nutrition) to address malnutrition in the region.
Addressing malnutrition is particularly critical in Africa south of the Sahara, where 36 percent of children under the age of 5 are chronically undernourished, 41 percent of children under the age of 5 are vitamin A deficient, 24 percent of children under the age of 5 are zinc deficient, and 20 percent of children under the age of 5 suffer from iron-deficient anemia. As of 2013, no country in the region had a child stunting (low height for age) prevalence rate of less than 19 percent. In addition, Africa south of the Sahara is also seeing more of a relatively new form of malnutrition – obesity. This triple burden of malnutrition – undernutrition, overnutrition, and micronutrient deficiency – leads to higher child mortality rates, high rates of ill health and premature death among adults, lower physical and cognitive development, and lower labor productivity and income generation.
To put it more optimistically, however, properly addressing the challenge of malnutrition can have significant economic benefits. The GLOPAN paper finds that for a set of 15 African countries, meeting the 2025 World Health Assembly (WHA) target for stunting (a 40 percent reduction in the number of children under 5 who are stunted) will add a total of US$ 83 billion to national incomes. For Ethiopia, this will amount to 15.9 billion, for Uganda 7.5 billion, and for Nigeria 29.3 billion. The paper also states in Africa, every dollar invested in reducing chronic undernutrition in children yields a US$ 16 return.
The paper cites recent research that identifies ten nutrition-specific interventions that can reduce undernutrition in children and women (two prioritized groups) in a cost-effective manner:
1. Universal salt iodization
2. Multiple micronutrient supplementation during pregnancy
3. Calcium supplementation during pregnancy
4. Energy protein supplementation during pregnancy
5. Vitamin A supplementation during childhood
6. Zinc supplementation during childhood
7. Breastfeeding promotion
8. Complementary feeding education
9. Complementary food supplementation
10. Management of severe acute malnutrition
The paper takes Senegal as an example to determine the impacts of this package of interventions. If Senegal implemented this full package in 2016, its main beneficiaries (children under the age of two) would enter the work force in 2034 at the age of 18. For that year, median average income in Senegal without these interventions is projected by the author to be $2,592. With these interventions fully implemented, however, the author projects that median incomes in 2034 would be 11.3 percent higher.
Clearly, nutrition-specific interventions have the potential for huge economic payoffs. The paper points out, however, that these gains alone will not be enough to reach the WHA nutrition target of a 40 percent reduction in child stunting by 2025. To hit that goal, countries will also need to implement complementary nutrition-sensitive interventions – i.e., interventions that do not specifically focus on nutrition goals but that nonetheless support those goals.
In Africa, such interventions most often fall under the social protection and agriculture sectors. Many countries have programs, such as food or cash transfers, designed to improve household food security; by building nutrition components into these programs, governments can ensure that food security gains come along with improved nutrition. For example, Ethiopia has recently incorporated a nutrition target (improving the quality of diets in children ages 6-24 months) into its Productive Safety Net Programme; now attendance by adult men and women at health and nutrition training days counts toward households’ public work requirements under the program.
In the agricultural sector, the paper emphasizes that nutritional quality needs to be a government focus, in addition to just improving agricultural yields. This can include encouraging the production of biofortified crops to help fight micronutrient deficiency and improving educational campaigns to teach people, particularly women with children, about proper nutrition and child feeding practices.
To successfully implement the interventions needed to reach all of the WHA nutrition targets by 2025, funding will need to be stepped up, from both governments themselves and from international donors. The paper suggests that most of the prioritized interventions listed previously could be implemented across SSA with an additional $203 million per year from African governments and $400 million per year from donors.
By: Sara Gustafson