Urgent action needed to tackle the double burden of malnutrition and to achieve Universal Health Coverage and Sustainable Development Goals in Africa
Under nutrition, obesity and diet-related noncommunicable diseases are leading to catastrophic costs to individuals, to communities and to national healthcare systems in Africa. Every year, it is estimated that 11 million Africans fall into poverty due to high out-of-pocket payments for healthcare. According to experts attending a meeting in Nairobi, Kenya, nutritional status, a critical component of a person’s health and wellbeing, must be recognized as a necessary building block towards achieving Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) by 2030.
“Not only do current figures mean we are unlikely to achieve the six global nutrition targets for 2025 but also the more ambitious target of ending all forms of malnutrition by 2030, which is integral to the goal of ensuring healthy lives and promoting wellbeing for all, at all ages,” said Dr Matshidiso Moeti, the WHO Regional Director for Africa. She added that “an exclusive focus of our energies – and finances – on curative services and related medical equipment, supplies and medicines to treat diseases that often are rooted in malnutrition will limit our chances of achieving health and wellbeing for all.”
In 2016, an estimated 59 million children in Africa were stunted and 14 million suffered from wasting – a strong predictor of mortality among children under five. That same year, 10 million were overweight; almost double the figure from 2000. In a 2014 report on Africa it was estimated that 5 percent of males and 15 percent of females over 18 years of age were obese. The same report showed that 8 percent of adults above 25 years of age had diabetes and that is expected to double by 2035, while hypertension affected 46 percent.
Poverty, hunger and disease are the main drivers of malnutrition in the African region and are linked with poor living conditions, lack of education, insecure livelihoods, and lack of access to basic services including health care and healthy, safe, nutritious foods.
“The burden of undernutrition still persists across the African region, and today its impacts are being felt alongside overweight, obesity and diet-related noncommunicable diseases in many poor households,” said Dr Felicitas Zawaira, Director of the Family and Reproductive Health Cluster at the WHO Regional Office. “In recent years, we’ve rightly focused many of our energies on addressing hunger, but what we must recognize is that ending hunger does not guarantee improved nutrition”, she added.
Obesity and diet-related NCDs are largely the result of lifestyles characterized by limited physical activity and the consumption of unhealthy diets consisting of highly processed foods that are rich in calories, sugars, fats, salt and additives, but low in essential nutrients.
When micronutrient deficiencies are taken into account, Africa is in fact experiencing a triple burden of malnutrition. Micronutrient deficiencies, which often pass unnoticed, are responsible for reduced bodily resilience and resistance to infections. They compromise early child development, negatively affect reproductive health and reduce work rate capacity. It is estimated that almost 50 percent of pregnant women in Africa suffer from anaemia which increases death risk for themselves as well as their unborn babies as well as incidences of low birth weight.
According to Dr Zawaira, “improving nutrition sustainably requires consideration of how to produce, deliver, and ensure access to healthy diets and essential nutrients, not just greater quantities of food” which is the vision of the Rome Declaration and Framework of Action endorsed by Ministers of Agriculture and Health at the Second International Conference on Nutrition in 2014.
“Tackling all forms of malnutrition for the achievement of UHC and the health-related SDGs requires remedial actions from multiple sectors and on many fronts,” Dr Zawaira added. These actions, she explained, include policies and community action to control the marketing and consumption of unhealthy foods and beverages (including breast milk substitutes); setting nutrition standards and dietary goals; nutrition labelling of processed foods; policies to promote consumption of healthy foods through taxation and subsidies; initiatives to promote consumption of fresh fruits and vegetables and increased physical activity; social marketing campaigns and multi-component community-based interventions, among others .
Sector-specific recommendations by participants include:
The Experts warned that unless countries in Africa start enacting measures to tackle the double burden of nutrition affecting the continent, the road towards UHC will be marred with obstacles as will the aspiration to achieve health and wellbeing for all by 2030.
Published on WHO on April 17, 2018