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Africa’s coming years: Food security, sustainable nutrition and the importance of research to our children.

12 Apr 2013
Annamarie Kruger, Africa Unit for Transdisciplinary Health Research (AUTHeR), Faculty of Health Sciences, North-West University, South Africa,
e-newsletter #2/2016 - Cash improved diet diversity
It is no secret that sub-Saharan Africa (SSA) will not meet the UN Millennium Development Goals (MDG) set for 2015 with specific reference to MDG 1: Eradicate extreme poverty and hunger, and MDG 2: Reduce child mortality.

Many questions are raised around why food and nutrition security remain pressing problems in SSA, amid rapid economic growth that has eradicated many pockets of poverty and hunger. And yet a new health hazard now affects an alarming number of Africans - that of obesity and the accompanying rise of cardiovascular disease and diabetes mellitus. This leaves SSA with a twin challenge - a double burden - of malnutrition (undernutrition and obesity).

There is a history of thought about food security over the decades: from the perspective of global food security, followed by the perspective that food production on its own does not assure food consumption. This leads to ‘the African famine’ where impetus was placed on action to alleviate hunger and its causes - the livelihood approach - followed by the concept of poverty eradication as an intervention to achieve food security.

With the emphasis on interventions to achieve food security, many agriculture-driven projects arose based on the concept of increased bio-diversity (including African leafy vegetables), different farming practices and diversified production at community and household level. Education is regarded as more and more important and interventions aimed at nutrition and dietary strategies became the practice. Nutrition education changed from a nutrient-based diet towards a food-based approach. Despite all these novel initiatives, hunger did not disappear and malnutrition remains the single biggest contributor to child deaths in SSA.

It becomes evident from a review of the literature that there are many shortcomings in the available data derived from nutrition research in SSA. There are many fragmentations, lack of an evidence base for prioritised action, evidence of institutional and other systemic problems affecting implementation and execution of policies, and a failure to link up developments across stakeholders in the field of nutrition. Furthermore, the local communities are seldom regarded as an important actor in nutrition-related priorities.

Literature reviews of nutrition research conducted in Africa showed that evidence-based nutrition research from Africa is limited and focused mainly on treatment and technical solutions to the nutritional problems of the continent. It is important to take note of these as, by implication, one can draw the conclusion that real evidence-based research from Africa to guide African policy makers and to form the basis for Africa-specific interventions, is barely available. Well-designed and conducted intervention studies are essential to generate an evidence base for decision makers to identify effective policy options that are likely to impact on nutrition in Africa. In addition, there is an absence of cross-African linkages and a relative lack of African clusters driving the research.

The recent SUNRAY (www.sunrayafrica.co.za) study presented at the World Public Health Nutrition Conference in Rio, 2012, reported results from key stakeholders in the nutrition arena of SSA. They were invited to appraise a set of research policy options, including ecological nutrition, nutritional epidemiology, evaluating community nutrition interventions, behavioral nutrition, therapeutic/clinical nutrition and molecular nutrition;, and to judge how well these would perform in improving nutritional status in Africa in the years to come. The striking results showed that there was little to no consensus between these stakeholders. Maybe this lack of consensus is an indication that all of these policies have a place and importance in actions to end poverty and hunger? In recent times, several possible solutions to ensure food security in SSA were proposed taking cognizance of the environmental challenges, political unrest, migration and rapid urbanization, and socio-economic dynamics of SSA.

Although it seems that the nutrition research community is beginning to reflect on a holistic approach by considering the relation between these challenges and nutrition in Africa, it still lacks integration between different interest groups and stakeholders and remains a one-sided picture from the viewpoint of a single discipline or interest group. Research can only lead to sustainable nutrition interventions in food security and resilient livelihoods if links are strengthened and integration of knowledge is established between all stakeholders tasked with the eradication of poverty, hunger, and thus also a decline of child mortality.

The progress Africa is making towards a quality future for our children through optimal nutrition is without any doubt too slow. To learn from the past is one thing. To change the status quo is another. There is, however, one very important fact: if we want to tackle hunger and malnutrition, it is essential to accept that it is everybody’s business and should be everybody’s priority. This involves the whole spectrum of role players in a country including political leaders, policy makers, service providers, religious leaders, academics, researchers, consumer organizations, NGO’s, industry, communities, every individual, and more.

However, even if every individual in SSA accepts their responsibility towards food security practices, the sustainability of food security will still be at risk if it is not accompanied by an enabling environment provided by governments with the support of all stakeholders. In my opinion, there should be a political will to appoint an independent "driver" in each country who should facilitate a holistic approach through transdisciplinary teams including all stakeholders concerned with food security and the eradication of poverty.

Instead of an argument about whom and what is important, it is necessary that all stakeholders meet around a table to work collaboratively towards solutions. There is an urgent need for good evidence-based information to guide holistic interventions towards the eradication of malnutrition, with a healthy SSA population as an essential outcome.

References

1- Ciati, R. & Ruini, L. 2012. Double pyramid: Healthy food for people and sustainable for the planet. (In Burlingame, B. & Dernini, S. eds. Sustainable diets and biodiversity. Directions and solutions for policy, research and action. 2010 Proceedings of the International Scientific Symposium. Biodiversity and sustainable diets united against hunger. FAO Headquaters, Rome. Rome, IT: FAO. P. 280-293).
2- Devereux, S. & Maxwell, S. 2001. Food security in Sub-Saharan Africa. Pietermaritzburg: University of Natal Press. Grant J. Aaron, Shelby E. Wilson and Kenneth H. Brown. 2010. Biographic analysis of scientific research on selected topics in public health nutrition in West Africa: Review of articles published from 1998 to 2008. Global Public Health, 5(S1):S42-S57.
3- Hammond, R. A. & Dubé, L. 2012. A system science perspective and transdisciplinary models for food and nutrition security. Proceedings of the National Academy of Sciences, 109(31):12356-12363
4- Huffman, S.L. & Schofield D. 2013. Enhancing young child nutrition and development in developing countries. Maternal & Child Nutrition, 9 (Suppl. 1):6-11.
5- Thompson, B., Cohen, M. J. & Tirado, M. C. 2012. Policies and programmes for improving nutrition. (In Thompson, B. & Cohen, M. J. eds. The impact of Climate change and bioenergy on nutrition. Dordrecht: Springer Science and Business Media. P. 77-78).
6- Traoré, M., Thompson, B. & Thomas, G. 2012. Sustainable nutrition security. Restoring the bridge between agriculture and health. Rome, IT: Food and Agriculture Organization of the United Nations.
7- Uusiku, N. P., Oelofse, A., Duodu, K. G., Bester, M. J. & Faber, M. 2010. Nutritional value of leafy vegetables of sub-Saharan Africa and their potential contribution to human health: A review. Journal of food composition and Analysis, 23(6):499-509.