4 July 2017

Southern Africa: Malnutrition in Southern Africa - Delivering Healthy Diets Together

Johannesburg — Despite the rapid and significant progress we have made across Africa in recent decades, significant challenges of diet-related premature death, poor development and disease remain. The risk that inadequate diets pose to mortality and morbidity worldwide is now greater than the combined risks of unsafe sex, alcohol, drug and tobacco use.

In Mozambique, 43 percent of children under five are stunted due to chronic illness and poor diets. Only one out of every 10 children under two receive the sufficient nutrients they need to be able to grow and develop to their full potential. In neighbouring South Africa, as with many other countries around the world, rates of obesity and diet-related chronic diseases like diabetes, heart disease, cancer and high blood pressure are on the rise. While some countries such as Mozambique currently have relatively low levels of overweight and obesity, there is a growing threat in the future of a malnutrition 'triple burden', where undernutrition and micronutrient deficiencies co-exist with obesity and the associated diet-related non-communicable diseases.

Tackling malnutrition is key to our economic growth and stability. Healthy, high-quality diets enable individuals to grow, learn and reach their intellectual potential. This, in turn, makes young adults more likely to innovate and succeed in the workplace. Recent reports show that malnutrition costs Africa as much as US$3.5 trillion each year, in large part due to reductions in productivity. In Mozambique alone, child undernutrition costs the country 62 billion MZN, or 11 percent of its annual GDP.

If we are to tackle this critical issue, and we must, we need to be clear about why progress has been so slow, especially in light of recognition by recent government administrations in Mozambique that nutrition matters. New government plans have been put in place but they have not yet delivered change on the ground. The challenge is primarily one of implementation.

We believe there at least two factors which are critically important here. First, as the Global Panel on Agriculture and Food Systems for Nutrition's report Food systems and diets: Facing the challenges of the 21st century, shows, our focus must shift from feeding people to nourishing them. In doing so, we must harness the power of the public and private sectors, and civil society to encourage and enable consumers to access better diets.

It is imperative therefore that policy makers pay more attention to food systems if nutrition planning is to be effectively implemented. The reality is complex. Food systems encompass all the stages from food production to consumption. Growing food crops and raising livestock, storage and transport of food products, food processing, marketing and trade - all of these must work together if they are to deliver healthy diets.

The second factor also concerns policy action. Delivering national strategies to improve nutrition at provincial and district levels can be very challenging. Much more attention needs to be given to the question of how to incentivise local authorities to give high priority to enabling their populations to access affordable, nutritious food. A food systems approach to identifying and addressing local diet gaps, particularly in vulnerable groups such as children and women of reproductive age is key. Developing local capacity and providing tools to help identify local solutions must be part of the picture.

So while there has been strong political backing from the national government in Mozambique to deliver the high-quality, diverse diets required to tackle malnutrition, there has been a lack of coordinated action and credible strategies for effective multi-sectoral, system-wide implementation. Governments alone cannot deliver healthy diets for all. Improving food systems across Africa will require government, civil society and private sector collaboration, coordinating actions across trade, education, health, agriculture, social protection, and water and sanitation.

The private sector has a critical role to play in helping to shape effective food systems, for example through improved food production, marketing and processing. The private sector's contribution to improved nutrition through fortification is well known but investments in, for example, infrastructure to improve storage will make food safer. Likewise, innovative approaches to marketing nutritious and affordable food products which are beginning to show real promise in some African countries need to be encouraged.

Consumers too can play an active role. The Global Panel's latest brief on consumer behaviour shows how today's food systems are not helping consumers make healthy diet choices. It has four messages on how stakeholders, led by government, can work in partnership, to enable consumers to make more nutritious food choices leading to healthier and more diverse diets. They should:

* Establish national standards for healthy diets;

* Educate consumers to make healthier choices;

* Enable low-income consumers to access healthy diets though social protection; and

* Engage business through public-private collaboration on labelling.

Women in particular have a critical role to play, which goes beyond traditional views of simply feeding the family. Actively engaging with women in the design and implementation of policies and actions, is essential. This is because of their practical experience and understanding of the many factors affecting family diets, as well as the many roles they play throughout food systems.

Our respective organisations, the Graça Machel Trust and the Global Panel on Agriculture and Food Systems for Nutrition, together with the Foundation for Community Development Mozambique, are bringing all these groups together this week in Maputo at a high-level event to pose some tough questions and identify collaborative solutions.

So, our message is simple.

Nutrition, particularly in women and children, must be prioritised for all governments across Africa. The economic and social rationale for doing so is clear. In countries, such as Mozambique, where nutrition is already a priority, we need to redouble efforts to ensure strong policies are effectively translated into action at provincial and district levels. By building a coalition across sectors, we must remove the barriers to effective implementation, giving provincial and district authorities the tools and resources needed to realise a shared vision of safe, affordable and high-quality diets for all. Without this renewed effort, many people will fail to fulfil their potential, and our economies will continue to be burdened by ill health. Only by doing this can we ensure that every child is not just fed, but nourished.

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