According to the latest Global Nutrition Report, released in early November, the world remains off-track on meeting nutrition targets, and financing to address malnutrition is not adequate to meet the needs of the problem.
In Africa south of the Sahara, the report finds that severe food insecurity (defined by the FAO Food Insecurity Experience Scale as “experiencing hunger”) remains at around 30 percent, while moderate food insecurity (defined by the FAO Food Insecurity Experience Scale as “compromising quality and variety of food, reducing food quantity, and skipping meals”) is close behind at around 26 percent. This situation has been exacerbated in recent months by famine and near-famine conditions in Nigeria, South Sudan, and Somalia, plus Kenya and Ethiopia.
In addition, while child stunting rates have decreased globally since 1990, the report finds that the prevalence of child stunting has actually increased in Africa south of the Sahara – from 47 million children in 1990 to 59 million in 2016. Child wasting throughout the region remains at “poor” levels, defined in the report as between 5 and 10 percent of children under the age of five; this number ranges from 5.5 percent in Southern Africa to 8.5 percent in West Africa.
During the same period, the number of overweight children also rose in the region, from 6 million to 10 million; this finding highlights the challenge in simultaneously addressing multiple forms of malnutrition, including undernutrition and overweight and obesity.
Malnutrition in adults also remains a significant problem, both globally and regionally. Anemia among women of reproductive age ranges from 20 percent to 40 percent; the report points out that this is an important indicator not only because it reflects the health of adult women but also because anemia among women can affect the health and long-term physical and cognitive development of those women’s children. Poor maternal and child health and nutrition can have long-term consequences for a country’s education system, labor force, and economic development.
While adult obesity rates in Africa remain much lower than in developed regions, they are still a significant concern and will continue to be so as incomes in the region rise. Obesity among male adults over the age of 18 was 6 percent in 2014; for women of the same age, the rate was 16 percent. Prevalence of diabetes among both male and female adults was around 8 percent in 2014; diabetes and other non-communicable, diet-related diseases are on the rise globally and pose a significant public health threat.
The report emphasizes that important data gaps still exist that need to be filled in order to properly track and monitor progress on nutrition goals. These gaps apply not only to nutrition indicators like stunting and obesity but also to the coverage of important national and regional nutrition interventions. The data shows that for 12 interventions related to maternal and child nutrition (such as early and exclusive breastfeeding and iron supplementation), the countries with the lowest coverage include Chad, Djibouti, Suriname, Burkina Faso, Ethiopia, Central African Republic, South Sudan, Senegal, and Tanzania. However, many countries do not have adequate data with which to track these coverage rates, making it difficult to truly capture how nutrition interventions are working and whether they are reaching vulnerable populations.
The report also highlights the need for a coordinated, multi-pronged approach to address all of these forms of malnutrition. It calls for using the Sustainable Development Goals (SDGs) to address not only malnutrition itself but also the root causes. This will require a shift in global perspective to acknowledge the links between malnutrition and broader development goals, such as the elimination of poverty, the promotion of gender equality and education, the protection of natural resources and the environment, the establishment of sustainable food systems, and the improvement of crucial infrastructure.
Finally, spending on nutrition by both national governments and international agencies and donors is dramatically lacking, the report finds. Funding for nutrition interventions varies widely by country. For example, in 2017, Chad allocated 19 percent of its general government spending to nutrition-specific and nutrition-sensitive interventions; this represents a strong commitment to ending malnutrition. On the other hand, Uganda and Zambia allocated only a small fraction of their budgets to nutrition interventions in 2017 – 0.4 and 0.5 percent, respectively.
In addition, the report finds that funding for interventions to address obesity and diet-related diseases does not reflect the rising burden of these issues. It suggests that further efforts need to be made by both governments and donors to examine how investments can be made to tackle multiple forms of malnutrition simultaneously.
By: Sara Gustafson, IFPRI