The world’s most comprehensive report on nutrition highlights the worrying prevalence and universality of malnutrition in all its forms. In its fifth edition, it provides a concrete overview of progress made and calls on all stakeholders to act now to address malnutrition.
The Report provides new and expansive data highlighting the changing face of malnutrition in Africa. It also sheds light on new initiatives from across the continent designed to respond to this greater and more diverse challenge.
The burden of malnutrition is unacceptably high.
Africa is the region by far the hardest hit by overlapping forms of malnutrition. Of 41 countries that struggle with three forms of malnutrition – childhood stunting, anaemia in women of reproductive age and overweight among women – 30 are in Africa, or 73%.
Corinna Hawkes, Co-Chair of the Report and Director of the Centre for Food Policy, said: “The figures call for immediate action. Malnutrition is responsible for more ill-health than any other cause. The health consequences of overweight and obesity contribute to an estimated four million deaths globally. The uncomfortable question is not so much “why are things so bad?” but “why are things not better when we know so much more than before?”
Progress to date is simply not good enough.
Significant steps are being made to address malnutrition. Globally, stunting among children under five years has fallen from 32.6% in 2000 to 22.2% in 2017. Yet, while stunting in children under five years of age is declining at a global level, the numbers in Africa are increasing. Driven by population growth, despite the decrease in stunting prevalence in Africa, the number of stunted children has steadily increased from 50.6 million in 2000 to 58.7 million in 2017.
Data shows an overall increase in both overweight and obesity in Africa. At the same time, the region is undergoing significant growth in consumption of packaged foods.
At the global level, none of the countries with sufficient data are on course to meet all nine targets on malnutrition. Africa is no exception:
- Of the nine global nutrition targets assessed in 2018, there are five targets for which none of the 54 African countries are on track.
- Africa was the only region not to experience an overall increase in the rate of under-5 overweight, experiencing stagnation in overweight prevalence since 2000.
- However, in children aged 5-19 levels of overweight and obesity in both girls and boys have increased, with girls registering a faster increase than boys.
- Spending around nutrition at the national levels is inconsistent, with governments just as likely to increase future spending as to decrease it.
- Overall, total nutrition-related official development assistance allocated to Africa has increased over the last five years.
New data also highlights that national statistics are not enough to understand the extent of the challenge. A geospatial analysis of undernutrition in 51 African countries, conducted by the Institute for Health Metrics and Evaluation, reveals a striking heterogeneity in levels and trends of undernutrition at national and subnational levels. Even where countries appear to be on track to achieve global targets, the picture is different at the subnational level (see more details below).
We are better equipped to end malnutrition. Across Africa there have been steps taken to reduce malnutrition, which can act as models and catalysts of change.
The 2018 Global Nutrition Report highlights that solutions already exist but finds effective ideas are not being adopted at scale:
- We see examples of countries building multisectoral plans to deliver on their targets. In Tanzania a wide range of targets has been adopted – seven in all, including for stunting, anaemia and low birth weight. These targets form part of the National Multisectoral Nutrition Action Plan 2016–2021, an ambitious five-year action plan to reduce multiple burdens of malnutrition. The plan was set up under the direct leadership of the Prime Minister’s office to reduce all forms of malnutrition associated with both deficiency and excess/imbalances. Its broad goal is to scale up high-impact interventions among the most vulnerable people, including children under five years of age, adolescent girls and pregnant and lactating women. It does this by calling for action across sectors, from social protection to education and food. More information can be found on page 41.
- New data is a game changer and can drive more effective action. In 2018 the journal Nature published the results of a comprehensive geospatial analysis of child growth failure, which covers stunting, wasting and underweight, in 51 African countries from 2000 to 2015. It draws from more than 200 geo-referenced household surveys representing more than 1.2 million children, drilling down to unprecedented levels of detail. It shows that many localities are off track, and that no country in Africa is likely to achieve all the WHO global nutrition targets in all of its territory if current trends continue. More information can be found on pages 46 and 47.
- Governments are showing commitment and stepping up to lead action. The Ethiopian government’s commitment to end child undernutrition by 2030 has taken a significant step forward with the recently developed National Food and Nutrition Policy. This accountable, legal framework emphasises the right of children to adequate nutrition and normal growth and strengthens actions outlined in the National Nutrition Programme. Between 2000 and 2016 the rate of stunting in children dropped by a third. However, there is more to do as the prevalence of stunting, wasting and anaemia remain high. More information can be found on page 103.
The world is off track but the opportunity to end malnutrition has never been greater, nor has the duty to act.
To translate solutions into action, the report’s authors urge critical steps in the following areas:
- Breaking down existing silos to tackle malnutrition in all its forms;
- Prioritising and investing in data to identify key areas of action;
- Scaling up and diversifying funding for nutrition programmes;
- Immediately taking action on healthy diets by making healthy foods affordable across the globe;
- Implementing more ambitious commitments that are designed for impact through SMART targets.
Jessica Fanzo, PhD, Co-Chair of the Report and Bloomberg Distinguished Associate Professor at Johns Hopkins University, said:
“While malnutrition is holding back human development everywhere, costing billions of dollars a year, we are now in a position to fight it. From policies such as sugar taxes, to new data that enables us to understand what people are eating and how we can best target interventions, the global community now has the recipes that work.”
David Beasley, Executive Director, World Food Programme, added:
“The information in the Global Nutrition Report goes far beyond facts and figures. What is really behind these tables and graphs are stories of potential: the potential of more babies seeing their first birthdays, of children achieving their potential in school and of adults leading healthy and productive lives – all on the foundation of good nutrition. The information collected, analysed and shared in the Global Nutrition Report is never an end in itself, but a means that allows us to save lives, change lives and ensure that nobody is left behind.”
Henrietta H Fore, Executive Director, UNICEF, said:
“The 2018 Global Nutrition Report offers forward-looking steps to strengthen the ability of global and national food systems to deliver nutritious, safe, affordable and sustainable diets for children. This paradigm shift – food systems that contribute to prevent malnutrition in all its forms – will be critical for children’s growth and development, the growth of national economies, and the development of nations.”