Mastering the last mile to food security

By Alice Marks, @alicemarks0

IFPRI, Milo Mitchell

Is there light at the end of the tunnel for achieving food and nutrition security? According to Roberto Ridolfi, Director for Sustainable Growth and Development at the European Commission, there is not far left to go, but the journey still presents many obstacles to overcome. To him, the last mile is “the last inch between the fingers of the farmer and the seed in the soil.” On June 14^th, the eve of the European Development Days, delegates congregated in Brussels at a workshop entitled Going the Last Mile: Accelerating Progress in Food Security and Nutrition. The evocative title conjured up different images for each speaker, which combine to create a path along this mile:

Step one: use the brain

For a long-distance runner, like Stineke Oenema from the United Nations Standing Committee on Nutrition, “the last mile of a marathon can be the hardest to complete”. The last mile is when the brain must be engaged to mentally, as well as physically, push towards the finish line. Similarly, now is the time to engage the knowledge of scientists, engineers, and experts in order to overcome the final barriers, such as lack of access to a varied diet or improved seeds, which allow food insecurity and malnutrition to persist.

Credit: Scott Wallace, World Bank

Indeed, in order to create sustainable agricultural growth research is desperately needed, for instance to generate improved varieties of crops. An excellent example of the impact that this can have was delivered by HarvestPlus Country Manager for Rwanda, Joseph Mulambu, who discussed their biofortified high-iron beans. Not only can a portion of the biofortified beans provide half of the daily requirement of iron, but the beans have been shown to be drought resistant, inferring an extra advantage to those who grow them. Using conventional breeding techniques, HarvestPlus scientists have contributed a crop that is nutritious and can reduce iron deficiency while at the same time improves farmer resilience to droughts, which are likely to become more severe and more frequent due to climate change. This is exactly the kind of innovation that helps the finish line come into view.

On this Africa Day, we need to talk about nutrition

By Alice Marks, @alicemarks0. Originally posted by the Institute of Global Health Innovation, Imperial College London

As we celebrate Africa Day 2016, it’s time to reflect on the state of nutrition in Africa and the weighty effect malnutrition has on the continent’s ability to prosper. Progress has been made over the past decades, for example through the Millennium Development Goals (MDGs), to reduce extreme hunger and starvation. However, it is the quality of food that people consume and a lack of variety that is of increasing concern. A few weeks ago, Roger Thurow, a Senior Fellow at the Chicago Council on Global Affairs, released a new book, The First 1,000 Days: A Crucial Time for Mothers and Children—And the World. The book lays out that nutrition, or lack thereof, in the first 1,000 days of life – from conception to the age of two – has a profound and lasting influence on a child’s ability to grow, learn, develop and work.

Stunting is a measurable impact of malnutrition, but the height of a child doesn’t tell the full story. The development of the child’s brain is also affected, so stunted children are more likely to fall behind in school, fail to achieve decent incomes, and perpetuate the cycle of poverty for the next generation. The cumulative effect of widespread malnutrition in a group of people can therefore directly impact, and limit, a society’s ability to develop and prosper. Thurow’s book highlights Uganda in particular, where half of women of childbearing age are anaemic and about 35% of children suffer stunting due to malnourishment. Indeed, a staggering 40% of all under-five deaths in Uganda are caused by malnutrition. Tragically, Uganda is not an isolated case in sub-Saharan Africa, where 40% of all children under the age of five are stunted.

6 indirect approaches to improving nutrition – part one

Malnutrition, in its various forms, is thought to affect over 2 billion people in the world and, as such, has far reaching consequences for societies, economies and livelihoods. Tackling poor nutrition is both complex and opportunistic in that there are links between nutrition and a whole other range of factors. In other words by tackling nutrition directly we may positively contribute to other developmental problems but there are also multiple ways to address undernutrition indirectly. While there is broad consensus on the need to take direct nutrition interventions such as promoting exclusive breastfeeding or biofortification of crops with micronutrients such as vitamin A or zinc, there is also an urgent need to tackle the underlying and inter-related determinants of malnutrition. The Lancet, for example, suggests that direct nutrition interventions, even if implemented at 90% coverage in high-burden countries would only reduce global stunting by 20%.

So-called nutrition-sensitive approaches are gaining popularity and the importance of including nutrition in a wide variety of sectors and policies is becoming better understood. Here we discuss some of the alternative routes through which malnutrition is impacted and thus could be reduced.

1. Agriculture

The contribution of agriculture to meeting the nutritional needs of the population cannot be overstated, and the nutrition component of agricultural policies and investment plans needs to be strengthened. In Africa, agricultural development has been primarily focused on boosting production and developing markets with little attention given to nutrition. But agriculture is at the heart of addressing malnutrition. Its products provide us with the energy, protein, vitamins and minerals our bodies need. And in many developing countries the majority of people who are malnourished live in rural areas and depend on smallholder farming for their livelihoods. In fact, demographic and health survey (DHS) data shows that individuals living in rural areas are between 1.3 and 3.3 times more likely to be stunted than people in urban areas, which indicates that agriculture still has a long way to go in providing the global population with the right nutrition and adequate calories. It also indicates that by improving agricultural diversity and productivity in rural farming areas, malnutrition could be significantly reduced, although evidence on the impact agriculture can have on nutrition is currently limited in formal literature.

So how does agriculture need to change in order to better serve the world’s nutritional needs? The food system needs to provide access to enough nutritious foods, promote social norms that foster good nutrition practices and provide adequate income to purchase nutritious foods. Ensuring nutritious foods are affordable, accessible and available is essential and has typically been overlooked in the agricultural sector, rather being the domain of development and health. Home and school gardens, small livestock production, aquaculture and marketing policies which keep the prices of such foods at affordable levels are examples of food-based nutrition improvement initiatives. Some argue that the entire food chain needs to be put under a “nutrition lens” in order to identify areas for intervention such as “expanding and diversifying food production, improving food processing, preservation and preparation of foods, reducing losses and waste and assessing intervention impact on dietary consumption”.

The Soils, Food and Health and Communities (SFHC) project, used participatory research methods and awareness raising activities in Ekwendeni village in Northern Malawi to help smallholder famers select and test mixtures of diverse legume species for growing in combination with maize. Project results show that the intercropping of maize with legume mixes has led to improved nutrition for children in communities where the project is being implemented (over 9000 farmers have adopted this technology so far).

Making progress on nutrition

A new report was launched last week in the Houses of Parliament which lays out progress made in tackling nutrition in several counties, as well as the challenges still ahead. “What works for nutrition? Stories of success from Vietnam, Uganda and Kenya”, a joint publication from RESULTS UK, Concern Worldwide and the University of Westminster, discusses these countries success in the context of global nutrition targets and concludes with key recommendations for government and civil society to build on this success and learn from their experiences.

Despite considerable progress in reducing hunger and the physical signs of malnutrition (the number of hungry people has been reduced by 200 million since 1990 and stunting in children under age five by 40%), malnutrition still places a heavy burden on survival and overall development. Some two billion people, for example, are estimated to suffer from micronutrient deficiencies (about 27% of the global population), which can have wide ranging long-term and irreversible consequences for their health and livelihoods. Undernutrition can reduce GDP and an individual’s earnings by as much as 10%. Progress in tackling malnutrition has also been uneven and inequitable: children in rural areas, for example, as twice as likely to be stunted as those in urban areas. But global initiatives are improving awareness of global malnutrition, and in 2012, the World Health Association (WHA) endorsed six targets on nutrition to be achieved by 2025.

1. Achieve a 40% reduction in the number of children under-5 who are stunted;
2. Achieve a 50% reduction of anaemia in women of reproductive age;
3. Achieve a 30% reduction in low birth weight;
4. Ensure that there is no increase in childhood overweight;
5. Increase the rate of exclusive breastfeeding in the first 6 months up to at least 50%;
6. Reduce and maintain childhood wasting to less than 5%.

Financing for nutrition has been growing recently, although evidence indicates donors need to quadruple their financial pledges and governments need to at least double the amount allocated to nutrition in order to meet the WHA target on stunting in 37 high burden countries. And nutrition is a good investment: every dollar invested in nutrition yields more than 16 in return.

4 ways to reduce malnutrition

Image courtesy of [rakratchada torsap] at FreeDigitalPhotos.net

Tackling undernutrition is, as the full extent of malnutrition and micronutrient deficiencies becomes apparent, critical for human wellbeing and development. In the past we have tended to focus, with limited success, on ensuring people have enough to eat, on making the world “food secure” and on fighting hunger but now we are beginning to understand that if we are to lead healthy, productive lives, it is also about having enough to eat of the right mix of nutrients. And unlike hunger, often viewed as a more common problem in developing countries, poor nutrition, whether through famine or feasting, can be universal.

In 2008, when The Lancet published their Series on Maternal and Child Undernutrition, global policymakers began to take notice and the Scaling-Up Nutrition movement was born. Today this momentum is continuing and the new Sustainable Development Goals focus more on nutrition and non-communicable diseases than the Millennium Development Goals did. We are also learning more and more about what can be done to lessen the burden of malnutrition. Here we discuss four approaches, all of which will be needed for malnutrition to significantly decline: the scaling up of successful and cost-effective direct interventions; prioritisation of the first 1,000 day window in a child’s existence; the development of food systems that deliver enough healthy food and prioritise human health; and coordination and collaboration across government sectors to put nutrition at the heart of relevant policies and programmes.

Scale-up direct interventions where they work

Nutrition, while impacted by agricultural productivity, poverty and income, is unlikely to be improved through more general programmes aimed at bringing about economic and social development. Income growth alone will not reduce rates of malnutrition, and so we need direct interventions to tackle malnutrition. Things such as vitamin, mineral and micronutrient supplementation; delayed cord clamping after birth, kangaroo mother care, early initiation of breastfeeding, promotion of dietary diversity, fortifying staple foods, cash transfer programmes, community-based nutrition education, and school feeding programmes.

Africa Day for Food and Nutrition Security

By Katy Wilson

This Friday (30^th October) marks the 6^th annual Africa Day for Food and Nutrition Security (ADFNS). This year the day will be commemorated in Kampala, Uganda, where, at the 15^th Ordinary Session of the African Union Summit in 2010 it was first declared. Since then the day has been commemorated in Malawi, Ethiopia, Niger and the Democratic Republic of Congo.

In 2014 at the 23^rd session of the AU summit, African Heads of State committed to ending hunger by 2025 and reducing stunting to 10% in the same period. This commitment is one of seven forming the Malabo Declaration. ADFNS provides an opportunity to reaffirm this goal and report on progress that has been made in reaching this commitment, among other objectives. The UN Food and Agriculture Organisation 2015 State of Food Insecurity in the World report asserts that, as projected for 2014-2016, the prevalence of undernourishment in sub-Saharan Africa is estimated to be 23.2%%, down from 23.8% between 2012-2014.

The main aim of ADFNS is to bring together a range of stakeholders to intensify pressure to tackle food and nutrition security challenges in Africa, motivate financial commitments and bring greater awareness to the progress being made on the continent and the barriers still being faced. Additionally the day serves as a platform to facilitate sharing of experiences and knowledge, support for learning and measurement of progress.

The key objectives of ADFNS are:

• To increase awareness of the importance of investing in the value-chains for nutritious foods and agricultural commodities in Africa and the benefits of doing so for social and economic development;
• To facilitate a discussion between a variety of high-level national stakeholders as well as other governmental, not-for-profit and private sector actors such as farmers’ organisations, private businesses and academic and research institutions. With the hopes that the diverse points of view and cooperation will help shape an action plan to end hunger and malnutrition;
• To share new technologies and best practices for empowering women;
• To build women farmers’ awareness of market opportunities for local and indigenous foods and their role in diversifying diets and boosting food and nutrition security;
• To promote the production and consumption of high quality, nutritious foods such as those fortified with micronutrients, or diverse nutrient dense vegetables and fruits as well animal source foods.

This year, the 6^th ADFNS is centring on the theme of women, following the announcement made at the 24th Ordinary Session of the AU Summit that 2015 is the Year of Women Empowerment and Development towards Africa’s Agenda 2063. As has long been known, women are key to ending hunger and malnutrition, contributing a significant proportion of farm labour and household care.

Climate Change, Nutrition and Food Security: How to keep the ship afloat – CFS 2015

By Alice Marks and Katrin Glatzel

Credit: FAO, G. Carotenuto

Last week, delegates from over 100 countries, civil society organizations and the private sector convened in Rome for the 42^nd meeting of the Committee on World Food Security (CFS). In light of the 2015 development agenda dominated by the adoption of the new Sustainable Development Goals (SDGs) and the international climate negotiations taking place in early December, this year’s CFS focused on the cross-cutting theme of food and nutrition security. In her keynote address, Mary Robinson used the sinking of the Titanic as a metaphor for the oncoming food crisis; when the ship sinks it will not only be those in steerage who drown. What she meant was that we should all show interest in nutrition and food security, because it will affect rich countries as much as it will affect poorer, developing ones. Over- and under-nutrition currently affects 1 in 4 people in Africa, a worrying statistic that has repercussions far beyond the shores of the continent.

Credit: FAO G. Napolitano

A side event that we hosted in cooperation with the Global Panel, The Food, Agriculture and Natural Resources Policy Analysis Network (FANRPAN) and John Kufuor Foundation looked specifically at Climate Change, Food Security and Nutrition. Tom Arnold, a member of both the Global Panel and the Montpellier Panel, expanded upon Mary Robinson’s warning using the example of the food price crisis of 2007/8. The crisis demonstrated that as people are no longer able to afford to buy food for themselves and their families – be it due to rising prices or lower incomes – they not only go to bed hungry, but the food they do eat is of a lower quality with less nutritional value. This is a big challenge and particularly problematic for pregnant women and young children.

Why an ambitious climate deal is key to achieving zero hunger

By Katrin Glatzel

As climate negotiators and delegates from nearly 200 countries gather in the beautiful city of Bonn for a last time before the international climate negotiations take place in Paris in early December, much is at stake. Not only do we hope to reach an agreement that will put our world on course to limit global warming to 2°C above pre-industrial levels, we also need to reach an agreement that makes the poorest of the poor more resilient to weather extremes in the coming years.  This is a tall order. And as if it wasn’t already enough, we also need to overcome poverty and hunger. “Good news” is that these two challenges go hand in hand.

©UNICEF Ethiopia

The two biggest challenges we are confronted with this century is managing climate change and ending poverty and hunger. As Lord Stern recently put it: if we fail at one, we will fail on the other. We cannot achieve a world of zero hunger if we do not tackle climate change. Climate-related disasters, such as floods and droughts, increase food insecurity and malnutrition, when agricultural land is affected and essential food supplies are no longer available.

The Budongo Forest Landscape: Diets, Food Security and Nutrition

Around the Budongo forest, expanding sugarcane production, the establishment of tree plantations and forest loss have altered the landscape. In this rural area where nearly all households have a home garden or farm and, as such, rely, to varying degrees, on the food produced on their own land, such land use change can have a dramatic impact on livelihoods, diets and nutrition. Be it because of an increased incidence of crop raiding, unreliable weather patterns and seasons, or soil erosion, all thought to be a result of forest loss in the area, the changing landscape is a cause for concern among those who live there. A key element of the research in this landscape is to try to understand the links between land use change and food and nutrition security. As a first step this included investigating current levels of food insecurity, the diets of local people, how households characterise food security and what the drivers of food insecurity might be.

In Uganda, 48% of households were food energy deficient between 2009 and 2010 and the number of people suffering from hunger has increased from 12 million in 1992 to 17.7 million in 2007, mainly due to high population growth.

Deaths in children attributed to malnutrition	40%
% of children under the age of five who are stunted	38%
% of children under the age of five who are underweight for their age	25.5%
Prevalence rate of vitamin A deficiency	5.4%
% of the population affected by iron deficiency anaemia	>50%
Total goitre rate due to iodine deficiency	>60%
Average calorie consumption as a per cent of recommended requirements	75-90%
% below minimum recommended levels for protein consumption	33%
% below minimum recommended levels for fat consumption	20%

Source: MAAIF & MIH, 2005

In the Budongo Forest landscape, individuals and communities were asked about their ability to access and produce enough food. Many people reported that due to decreasing soil fertility, land exhaustion, high food prices and unpredictable or extreme weather such as droughts and floods, they were not able to produce enough food for their families year round. Many families (just under 50% of the 540 households interviewed) shared that they had experienced food shortages in the last year, with 3 to 6 months being the most common length of time such food scarcity occurred for. During these times coping mechanisms, apart from eating less, included turning to a neighbour or family member for help or trying to obtain a job on someone else’s land as a labourer. Income earned off the farm is then used to buy food or rent land to produce more food.

The State of Food Insecurity in the World 2014

The UN Food and Agriculture Organisation’s annual report, The State of Food Insecurity in the World (SOFI) aims to raise awareness about global hunger issues, to identify causes of chronic hunger and malnutrition and to record the progress being made towards reaching global hunger reduction targets.

This year’s report, Strengthening the Enabling Environment to Improve Food Security and Nutrition, provides not only current estimates of undernourishment around the world and progress towards the Millennium Development Goal (MDG) and World Food Summit (WFS) hunger targets but also presents the experiences of seven countries (Bolivia, Brazil, Haiti, Indonesia, Madagascar, Malawi and Yemen) in developing an enabling environment for food security and nutrition.

As the report states, 805 million people, or 1 in 9, are estimated to be chronically undernourished in 2012–14. This is a reduction of over 100 million people over the last decade and 209 million fewer than in 1990-1992. In the last two decades, the prevalence of undernourishment has dropped from 18.7% to 11.3 % globally and from 23.4% to 13.5% in developing countries alone. Latter figures show progress towards the MDG of reducing the proportion of people suffering hunger by half is within reach but in terms of the WFS target of halving the number of people chronically hungry, we are still a long way off.

Progress towards these targets is uneven geographically with only Latin America and South Eastern Asia having reached the WFS target. The highest numbers of hungry people live in Asia while the highest proportions live in sub-Saharan Africa, a region that is seeing relatively low levels of progress in tackling hunger.

The report also explores a range of indicators of hunger that try to encompass the multiple components of food insecurity, namely:

Availability or the quantity, quality and diversity of food. Indicators include the average protein supply and the average supply of animal-source proteins.

Access or physical access and infrastructure. Indicators include railway and road density and economic access, represented by domestic food price index.

Stability or the exposure to food security risk and the incidence of shocks. Indicators include cereal dependency ratio, the area under irrigation, domestic food price volatility and fluctuations in domestic food supply.

Utilization or the ability to utilize food and outcomes of poor food utilization. Indicators include access to water and sanitation and wasting, stunting and underweight measures for children under five years old.

Results from this wide range of indicators show that food availability in still a problem in poorer regions such as sub-Saharan Africa. Access has improved considerably in many places largely where economic growth, rural infrastructure development, social protection programmes and poverty reduction have occurred. Utilisation is identified as the largest challenge for food security and levels of stunting, wasting and malnutrition in children remain high. Stability is also challenge particularly in regions that are heavily dependent on international food markets for domestic supplies and have limited natural resources with which to produce food such as the Middle East and North Africa. The report summarises that “the greatest food security challenges overall remain in sub-Saharan Africa, which has seen particularly slow progress in improving access to food, with sluggish income growth, high poverty rates and poor infrastructure, which hampers physical and distributional access”.