This article is part of our special report Nutrition and Child Survival.
SPECIAL REPORT / The European Commission is calling for a more robust emphasis on the long-term nutritional needs of infants and mothers to address malnourishment, a leading cause of death in impoverished nations, a year after European auditors criticised the EU’s response to food insecurity in developing countries.
If the pledges made in the Commission’s new communication on child and maternal health are carried out, it would mark a significant shift away from treating food and nutrition as a humanitarian issue and towards development policy – in other words, moving from crisis response to long-term investment.
The communication is designed to provide guidance in overseas aid policy and comes as global efforts to reduce hunger are failing to defeat malnutrition in the most impoverished nations. Nutrition is more in the spotlight internationally: the topic of a special G8 meeting in June, and a Unicef international conference in Paris next month.
For Dr George Ameh of Unicef, the UN’s children’s agency, the shift couldn’t come sooner.
“Nutrition doesn’t attract the same level of visibility like a cholera epidemic where people die over days, or measles where they die over days. Nutrition is more of a latent, progressing problem. It’s not really that visible,” he said in a telephone interview from Bamako, Mali.
“There is international evidence now which shows that it has to be addressed as an underlying cause of child mortality around the world. I think there is overwhelming evidence now and donors and agencies are positioning themselves to respond to this situation.”
Poor nutrition is the biggest threat to human health, UN figures show, including rising levels of obesity in advanced nations. It is magnified in developing nations, where malnutrition is blamed for one-third of all child deaths and one-in-five maternal fatalities, a wasting process that can drag out over months or even years.
Millions go hungry, millions more deformed
More than 850 million people are poorly nourished, most of them in sub-Saharan Africa and South Asia, and the figures have been on the rise since the millennium began. But poor nutrition is not just a killer.
Some 165 million children – more than the populations of Germany, France and the Netherlands combined – suffer from retarded physical growth, or stunting, because of inadequate nourishment during foetal development and in infancy. There are some 5 million stunted children in Ethiopia and 2.4 million in Kenya – two countries hit hard by recent droughts and food shortages – according to the global Scaling Up Nutrition initiative backed by the EU.
In Africa’s Sahel region that includes Mali, Niger and Mauritania, some 10.3 million people lack sufficient food and 4.5 million children under five are vulnerable to severe to moderate malnutrition, EU and UN figures show. The UN estimates that 226,000 million children die every year from malnutrition in the region.
Andris Piebalgs, the EU development commissioner who launched the new communication on nutrition on 12 March, has called malnutrition “the worst form of poverty.”
Piebalgs acknowledged that “nutrition has been neglected” in development policies, including the United Nations’ Millennium Development Goals, or MDGs, which are to be replaced with a new poverty-fighting agenda after 2015.
“The current MDG framework has failed to capture this hidden tragedy sufficiently. We must redress this situation and ensure a real focus on hunger and nutrition in the future framework,” the commissioner told a conference on food and nutrition security in Dublin on 15 April.
But while praising the Commission’s efforts to elevate nutrition as a development goal, there are fears that it will not go beyond rhetoric. Tighter aid budgets could affect future initiatives, aid and health advocates say, while others are concerned that pressing world food emergencies drain funding and attention from long-term needs.
The UN’s Food and Agriculture Organisation urged donors and their partners in developing countries to reverse a two-generation-long slide in farm investment to address food as well as nutritional needs in poor states.
“The rationale for public investment in agriculture by governments and development partners rests on three interrelated benefits for society that can come from enhancing agricultural productivity: economic growth and poverty reduction, food and nutrition security, and environmental sustainability,” the FAO said in a recent report.
The report highlights a sharp decline in investment and donor aid to agriculture, with farming as a share of aid falling from 18.8% in 1980 to 5.9% in 2010 in developing and middle-income countries. In sub-Saharan Africa, farm aid has slumped from 19.6% to 7.4% in the same period.
Audit recommends changes
The European Court of Auditors, in a review of the EU’s aid for food security in sub-Saharan Africa, recommended a re-boot of aid to address food and nutrition needs. In their March 2012 report, which helped spur this year’s policy shift, the auditors said “the Commission has not placed adequate emphasis on nutrition and could have more to encourage countries to set up appropriate nutrition policies and programmes at an earlier stage.”
The Luxembourg-based auditors also noted that the Commission’s development policies could have done more “given the scale of food insecurity in the region and what is generally acknowledged as an insufficient level of funding for agriculture and nutrition by the donor community.”
The UK-based Institute for Development Studies, together with the Global Alliance for Improved Nutrition (GAIN), have introduced 'Nutritious Agriculture by Design: a Tool for Program Planning'.
“Traditional agricultural projects have focused on enhancing agricultural productivity to improve food security and increase farmers’ yields,” said John Humphrey, professorial fellow at IDS. “It was automatically assumed this would lead to improvements in nutrition. But only recently has nutrition really been considered in the early programme-planning stages of agricultural project design.”
Bonnie McClafferty, director of agriculture and nutrition at GAIN, said: “The tool consists of a detailed survey decision tree, and identifies opportunities where the nutrition benefits of agricultural interventions can be improved by addressing constraints at version levels of the value chain."
Improving education for women could dramatically reduce hunger in developing countries, says a United Nations report released on 4 March that also calls for erasing gender inequalities in land ownership and financing to help address future food security.
Women account for upwards of 30% of the food producers globally yet face major handicaps, including restrictions on land and inheritance rights, plus unequal footing when it comes to finance and technology, says the report released by the UN’s special rapporteur on the right to food, Olivier De Schutter.
“If women are allowed to have equal access to education, various pieces of the food security jigsaw will fall into place,” De Schutter said in releasing the report, ‘Gender and the Right to Food’ “Household spending on nutrition will increase, child health outcomes will improve, and social systems will be redesigned – for women, by women – to deliver support with the greatest multiplier effects.”
Health officials say good nutrition - especially in the first 1,000 days of a child’s life - is critical to the development of healthy organs and bodies and to building resilience for diseases and health challenges that come later in life.
Poor nutrition is a leading killer. In developing nations, UN figures show, malnutrition is blamed for one-third of all child deaths and one-in-five maternal fatalities, a wasting process that can drag out over months or even years. Millions more children face stunting or disabilities because of poor nutrition.
Such resilience is particularly important in developing nations, where the threat of water- and insect-borne diseases is higher and medical care may be more patchy.
- 14-15 May: Unicef holds its undernutrition conference in Paris
- 20–28 May: Sixty-sixth World Health Assembly
- 8 June: G8 Forum on nutrition in Britain
- 13-15 Nov: Food and Agriculture Organisation-World Health Organisation International Conference on Nutrition in Rome
- European Court of Auditors: Effectiveness of European Union Development Aid for Food Security in Sub-Saharan Africa
- European Commission: Enhancing Maternal and Child Nutrition in External Assistance: an EU Policy Framework
- Unicef: Child nutrition