The document discusses the critical state of malnutrition in Africa, highlighting the economic and health impacts, with an emphasis on the need for commitment and effective interventions. It outlines the variable progress across African nations in addressing malnutrition and sets forth recommendations to enhance coverage, coherence, and government funding for nutritional programs. Ultimately, it stresses that addressing malnutrition is a political choice that can be influenced by smart commitments and accountability.

1. Scaling Up Nutrition Action for
Africa
Where are we and what challenges are
need to be addressed to accelerate
malnutrition?
Lawrence Haddad
Global Alliance for Improved Nutrition

2. • Why should African political
leaders care about
malnutrition?
• What needs to happen?

3. Good nutrition
prevents
45%..
.....of all death under 3 years of age
that is related to malnutrition

4. Good nutrition “wires the
circuits”

5. Poor nutrition reduces the
economic wealth of nations
16.5
11.5
10.3
7.7
6.3
5.6
3.1
% of GDP lost each year
AUC/WFP Cost of Hunger Studies

6. Demographic Dividend for Africa?
With stunting? Forget about it.
1
1.25
1.5
1.75
2
Ratioofworkingagetodependent
population,subSaharanAfrica
Data from Bloom and Canning 2011

7. Akin Adesina
President of the African
Development Bank 2016
“We need to
invest in gray
matter
infrastructure.”
“Neuronal
infrastructure is
quite possibly going
to be the most
important
infrastructure.”
Jim Kim
President, World Bank 2016
And the Development Bank Leaders
Know It

8. Scaling Up
Nutrition.
Where Are We?

9. Under 5 Stunting
Women’s
Anemia
Adult
Overweight
Ethiopia, Rwanda
Ghana, Senegal
Angola, Benin, Burkina Faso,
Burundi, Cameroon, Central
African Republic, Chad, Comoros,
Congo (Republic of The), Côte
d’Ivoire, Democratic Republic of
the Congo, Djibouti, Eritrea,
Gambia, Guinea, Guinea-Bissau,
Kenya, Liberia, Madagascar,
Malawi, Mali, Mauritania,
Mozambique, Niger, Nigeria, Sao
Tome and Principe, Sierra Leone,
Somalia, Sudan, Togo, Uganda,
Tanzania, Zambia, Zimbabwe
Algeria,
Gabon,
Morocco,
Seychelles,
Tunisia
Botswana,
Egypt,
Equatorial
Guinea,
Lesotho, Libya,
Namibia, South
Africa,
Swaziland
• All African countries have serious malnutrition
problems
• 25% have serious under and over nutrition
problems

10. What is the rate of
progress?
Highly variable—but there is cause for hope

11. 9
Stunting
children under 5
Wasting
children under 5
Overweight
children under 5
Anemia
women aged
15-49 years
Exclusive
Breastfeeding, <6
months
Adult Overweight +
Obesity (BMI≥ 25)
Adult Obesity
(BMI≥ 30)
Adult Diabetes
(Raised blood glucose)
3465
3
7
1
16
17
23
1
23
34
987
52
312
54
54
53 1
Global Target
Missing data Off course, little/no progress Off course, some progress On courseOn course, at risk
Number of African countries at stages of progress against global targets on
nutrition

12. Progress against Malabo
Declaration target for stunting
reduction
4
39
6
On course Off course, but
making progress
Off course, not
making any
progress
How many
African
countries will
attain stunting
rates of 10% by
2025?

13. What Needs to Happen?
• Commitmen
t
• Coverage
• Coherence
• Cash

14. Must make the issue hard for
African heads of state to ignore

15. Many African
countries are
members of
Scaling Up
Nutrition (SUN)
Movement—but
not all

16. But commitment is not measured by
membership alone.
Setting &
working to
meet SMART
targets is key.

17. There are not enough SMART targets in
African nutrition country plans
75 73
55
45
35
10
Stunting Exclusive
breastfeeding
Wasting Anaemia in
women
Low birth
weight
Under 5
overweight
Percent of 40 African Nutrition Plans with SMART Targets
for…

18. Few African Countries have Targets
for
Diet Related NCDs
Source: Unpublished self-reported data from the NCD Country Capacity Survey, provided by the WHO
Surveillance and Population-based Prevention Unit, Department for Prevention of NCDs. Printed with permission.
%
Percent of 40 countries with targets for…
40
35
15
Obesity Diabetes Salt Reduction

19. Nutrition
Program
Coverage
?

20. Coverage of nutrition-specific interventions
remains highly variable across African countries
0
10
20
30
40
50
60
70
80
90
100
Exclusive
breastfeeding <6
months
Minimum dietary
diversity (6-23
months)
Zinc treatment
for diarrhoea (U5)
Iron-Folic acid
suppl. 90+ days
(pregnant women)
Iron suppl. (U5) Vitamin A suppl.
(U5)
Salt iodization
(household)
Coverage of Nutrition Programs
is too Low

21. Coherence

22. Coherence: Underlying determinant
dashboard for Kenya
24
0.792
39
44
122
37.7
% Food insecure (FAO)
Nurses and Midwives/1000 people
% girls not enrolled in secondary school
Unimproved water (%)
Unimproved or no sanitation (%)
Gender inequality rank (1=best)
Gov Exp on Health, Ed, Ag (as % of budget)
http://globalnutritionreport.org/files/2014/11/gnr14_cp_kenya.pdf

23. Cash: Invest more
and allocate better

24. % of government budgets, Africa, 2010
Big chunks of African government budgets
go to nutrition relevant sectors
www.globalnutritionreport.org

25. Source: OPM and SUN SMS
Cash: yet too little is spent on
nutrition from related sectors
Budget allocations to nutrition
sensitive actions in these
countries are relatively low
4.8
2.1
1.5 1.4 1.2 1.2 1.1 1 0.8 0.6 0.6 0.5
0.1
%ofGeneralGovernmentExpenditures

26. Conclusions
• Some countries are on course to meet
targets. Many more are making some
progress.
• Need more:
– commitment
– coverage
– coherence
– cash
• Malnutrition is not destiny. Ending it is a
political choice—supported by SMART
commitments for accountability.

27. Ghana is re-writing the African
story
Stunting rate
of under 5
children,
Ghana
%

28. Three things you can do
• Challenge decision makers with
evidence on the slow pace of
malnutrition reduction
• Make those essential but challenging
alliances for nutrition with those outside
your immediate circle
• Make SMART commitments for nutrition
and ask others to do the same

29. Thank you