Nutritionists from Africa and from many countries outside Africa meet this month in Abuja, Nigeria, for the second Federation of African Nutrition Societies (FANUS) conference. The food crisis and famine in East Africa are major stories for the print and electronic media globally. The FANUS conference is timely. What should we expect from this meeting taking place during the current crisis? This is the focus of my column this month. Before starting, take some time to enjoy the richness of Africa's beaches. This serene blue water and sky with white sand beaches pictured above is in Tanzania, East Africa. Even at stormy times there is peace somewhere.

FANUS conference, Abuja

Accelerating nutrition action in Africa

'Accelerating Nutrition Action for Africa's Development'. That's the theme of the Federation of African Nutrition Societies (FANUS) conference taking place in Abuja this month from 11 to 15 September. The first conference was in Quarzazate, Morocco, in 2007. Specific themes at Abuja include global food and financial crises, nutrition insecurity in Africa, need for professional capacity, gender equity and nutrition, socio-cultural issues in achieving nutrition security, the double burden of malnutrition and health, nutrition, infection and the environment, and micronutrient nutrition and national development.

Just a glance at these topics tells me what the conference can help to achieve. With the current food crisis and famine in the Horn of Africa, where many are dying from starvation and severe malnutrition, the first theme is so essential. Also vital is the second theme. We need to build local capacity in Africa. That is the only way to ensure sustainability. Providing food and technical support and treating those who are malnourished is just managing the problem. The sustainable approach is to build the necessary capacity in Africa to addressing the deeper issues that perpetuate this situation. In that way, Africa will be equipped to solve Africa's problems. If external support is required, it should be to strengthen systems and structures, including the local capacity needed to promote good nutrition and health.

Large and quick interventions

As the conference title indicates, what we need in Africa is action and acceleration, and scaling-up. Accelerating and scaling up together means: 'To go fast and to go big'. We know what to do and which interventions work. In my last commentary, I wrote about effective strategies on maternal and child undernutrition. (http://www.wphna.org/reggieannanjuly2010.asp). My key message there is that: 'Effective interventions are available to reduce underweight, stunting, micronutrient deficiencies, and child deaths. Among the currently available interventions reviewed, breastfeeding counselling, appropriate complementary feeding, and vitamin A and zinc, have the greatest potential for reducing child deaths and future disease burden related to undernutrition. Interventions to reduce iron and iodine are important for maternal survival and for children's cognitive development, educability, and future economic productivity'.

We know what to do. The conference should focus on accelerating and scaling up known interventions, rather than try to find new interventions. We know the length, breadth, depth and height of nutrition and health problems facing Africa. We should discuss why actions are not being taken and if we find out why, we should suggest ways to overcome whatever the barriers to taking actions are.

I propose that at Abuja, African nutritionists and their national nutrition societies should commit to agreed policies and actions – and go and implement them in our different African countries. If this is done we will be able to come to the third FANUS in 2115 to celebrate its theme of 'Celebrating our success and doing more'

Famine in the Sahel

Why does starvation persist in Africa?

Yes there is a food crisis in East Africa, and yes it is happening in this 21st century. All over the print media and our internet and television screens, images like the starving woman with her severely wasted child above are so common that maybe we are not moved by them any more. So many people are struggling to survive. Even if severely malnourished children survive, they may be permanently incapacitated.

This is one of the worst food crises, it is reported. The worst hit countries are Kenya, Ethiopia and Somalia. Crops have failed. The cost of cereals is very high. Impoverished households are unable to access basic food supplies needed for survival. The level of severe acute malnutrition is above 20 per cent in the region. More than seven million people needed humanitarian assistance (1).

Why is this happening in our new technologically advanced age? Why is it that Africa so often seems to be moving backward rather than forward? How are we Africans and African leaders addressing crises such as this, with the help of the external world? Or have we left the external world to solve the problem while we look on? The questions are endless. We should leave Abuja, with answers to at leas some of these questions. I think this should be Abuja's number one priority.

Fundamental causes

Much of the Sahel region is now close to a state of perpetual famine. The picture above shows the severity of the situation. Such is the seriousness of the drought that the livestock pictured are dying, too weak to stand or walk due to starvation. This is really a sad image. Compare this picture with the one that introduces my column this month. The contrast is so sharp and glaring and it makes me shudder.

So what are the causes? Please refer to last month's news story on the Association's website: 'Africa's pastoralists: being left to die?' (2). In it Urban Jonsson, who has lived in East Africa for many years, said: 'The people of the Sahel will continue to need emergency aid. But the underlying and basic causes of this perpetual crisis need to be recognised and addressed, not just as a matter of charity to communities in distress, but as a fundamental issue of human rights and entitlements. One cause of acute food insecurity in the Sahel is climate change, in turn caused by the overuse of resources in materially rich countries. Another cause is political and economic programmes forced on African countries in return for extortionate foreign loans, which require food to be grown not for the people of those countries, but for export, in order to earn dollars. The aid that Africa needs, above all, is lifting of its foreign debt burden'.

Claudio Schuftan, with extensive experience working in Africa, added: 'We should not just think that poverty, and all that comes with poverty, is just "one of those things" that will always be with us'. Taken all together, the food produced in the Sahel is enough for everybody in the region. It is the social and other basic determinants of undernutrition and starvation at work in Africa that need addressing. He continued: 'This is in good measure a consequence of the policies and practices of powerful countries. Certainly food and medical aid is needed. What is needed above all, are conditions of mass social mobilisation that lead communities to stand up for their rights'.

Where should the finger point?

Coming from Africa, and from a country whose northern region is Sahelian, I always tell my colleagues and friends that I do not entirely blame external forces for Africa's woes. If anything, we allow them. I agree with the news story that: 'The basic causes of the Sahel crisis are not natural'.

We who come from the region, and those who live in the parts of the region afflicted by the famine, have roles to play. African governments, especially within sub-Saharan Africa, also have a role to play. Sometimes our governments are slow to act and sometimes they don't care enough. There is so much corruption among our leaders, leading to the wealth that belongs to Africa being wasted, or hidden in overseas accounts that will never be recovered. Armies engage in wars leading to instability, and destruction of the systems and structures need to sustain society. Maybe such armed forces are standing up for their rights, or opposing wrong policies, but always it is the common people who suffer most. We as Africans cannot blame external policies or forces entirely for our problems, because we allow them.

We in Africa must help ourselves

The US Government's Famine Early Warning Network issued a series of special alerts in June. These called the Sahel crisis 'the most severe food security emergency in the world today...exacerbated by extremely high food prices, reduced coping capacity, and a limited humanitarian response'. The alert warned that 'large-scale emergency assistance is urgently needed across the eastern Horn of Africa in order to save lives, treat acute malnutrition, and prevent further asset losses'. Emergency appeals throughout the region only received half of the US $1·293 billion in requested funding for Djibouti, Kenya, Ethiopia, and Somalia (3).

Is the fault that of global leaders for failing to act promptly in response to this crisis? G8 leaders have been accused of neglecting a pledge to fight hunger in impoverished countries (4). An anti-poverty group said that the crisis in east is a 'wake-up call' to governments who pledged to help feed the hungry in Africa two years ago.A spokeswoman from the group said leaders of the rich world meeting at the G8 summit in Italy in 2009 pledged $US 22 billion to go towards agricultural projects designed to put Africa on the road towards food self-sufficiency, rather than on emergency aid during famines and disasters.

Maybe early warning systems were not heeded, and pledges not met. But what were African leaders doing? Unless we as Africans ourselves decide to turn the situation around, however much help we receive, these crises will continue. Pledges like those given by the G8 to feed the hungry in Africa are not sustainable, especially when high-income countries have their own domestic issues to deal with. I prefer the pledge made in Italy, which included support to design agricultural projects that would put us on the road to food self-sufficiency. Treating emergencies with food aid and support is not enough.

Issues, causes, solutions

Nicholas Crawford of the UN World Food Programme, and Tajudeen Abdul-Raheem, director of Justice Africa, have debated what is causing Africa's deepening food crisis and what the solutions might be. Their views are valid now.

Nicholas Crawford said the causes of food crisis in Africa were multi-fold. Countries in conflict or emerging from conflict and trying to rebuild their capacity; countries beset with chronic environmental challenges combined with population growth; countries ravaged by the HIV/AIDS crisis, which in turn is further damaging agricultural and economic productivity; weak governance afflicting many of the countries that have faced food crises over the past decade; and international trade barriers that weaken incentives for agricultural production (5).

Solutions? He suggested political will to carry out what we know can halve hunger by 2015 and eliminate hunger altogether. Policies and actions include: Investment in Africa's agriculture and rural sector; dismantling of trade barriers and investment in African expertise to take advantage of trade opportunities; reducing malnutrition among mothers and children so that the generational cycle of poor nutrition and poverty is broken; improving and expanding basic education; adoption of governance policies that ensure accountability to citizens, including the vulnerable; and empowering the African Union and other regional bodies to take responsibility for peace and security on the continent (5).

Tajudeen Abdul-Raheem said: 'Drought can and does happen in other places; wars do happen with equal ferocity in other places. What turns drought and other natural or unnatural disasters into famine, chronic hunger, and mass death, is the power relation between the victims and those who control, govern, rule or misrule them. No African country has ever refused to go to war (many of them unjust) because the International Monetary Fund or the World Bank, or Western non-government organisations or so-called donors say there is no money. It is only when it comes to feeding our peoples, educating our children, building roads and hospitals, creating jobs and looking after the welfare of our peoples, that our governments plead lack of resources. Until we are able to transform the seemingly infinite capacity of our states for war, into one for peace and prosperity for our peoples we will remain victims' (5).

Think about it. The rulers and other forces in Africa have enough resources to go to war, but do not have resources for basic amenities like water, electricity, agricultural inputs and health care. The solutions Nicholas Crawford suggested and the issues Tajudeen Adbul-Raheem mentioned require minimal external help. Our leaders should rise up to address them. Political leaders, industry, scientists, civil society, and youth leaders alike need to join in all together. We will need some external help. But to go on relying on external aid – which is most of the time is not forthcoming or else comes when it is too late – is not the way forward for Africa.

References

1. BBC News Africa. East Africa faces 'world's worst food security crisis'. 8 June 2011. Accessible at http://www.bbc.co.uk/news/world-africa-13691898.
2. Association website. Africa. Sahel. Famine. Africa's pastoralists: being left to die? Accessible at http://www.wphna.org/2011_aug_hp2_sahel_crisis.htm.
3. Loewenberg L. Global food crisis takes heavy toll on east Africa. The Lancet (2011): 378 (9785);17-18
4. G8 'neglecting hunger fight pledge'. Belfast Telegraph. 11 July 2011 Obtainable at: http://www.belfasttelegraph.co.uk/news/local-national/uk/g8-neglecting-hunger-fight-pledge-16021724.html#ixzz1RoLGlGqf
5. BBC News. Head-to-head: Africa's food crisis. Accessible at http://news.bbc.co.uk/1/hi/world/africa/4670744.stm

Acknowledgement and request

You are invited please to respond, comment, disagree, as you wish. Please use the response facility below. You are free to make use of the material in this column, provided you acknowledge the Association, and me please, and cite the Association’s website.

Please cite as: Annan R [Column]. Accelerating nutrition action in Africa, and other items. Website of the World Public Health Nutrition Association, September 2011. Obtainable at www.wphna.org.

The opinions expressed in all contributions to the website of the World Public Health Nutrition Association (the Association) including its journal World Nutrition, are those of their authors. They should not be taken to be the view or policy of the Association, or of any of its affiliated or associated bodies, unless this is explicitly stated.

This column is reviewed by Geoffrey Cannon.