2012 November blog

Reggie Annan

Kumasi. This month I report on the Nutrition Congress of Africa, held last month from 1-5 October in Bloemfontein, South Africa. After a two-month break from my column, as I settle into my academic work in Ghana, I start this month with flowers from Bloemfontein – the name of the city means 'fountain of flowers'.

African Graduate Nutrition Students Network

Serving communities

The theme of the congress, the largest such meeting ever held in Africa, was 'transforming the nutrition landscape of Africa'. This is what we need to be doing in Africa. The congress was jointly organised and hosted by the African Nutrition Society, the Nutrition Society of South Africa, and the South African Dietetics Association. This showed the solidarity and unity of purpose among the nutrition fraternity on the continent.

Immediately before the full congress, there was a 'pre-meeting' of the African Graduate Nutrition Students Network (AGSNet), which as I have explained before in this column, represents the younger or next generation of leaders in nutrition on the continent. As part of the pre-congress, AGSNet members embarked on a community outreach programme in Bloemfontein, delivering education, counselling and support on important topics that affect community health and nutritional well-being.

International Union of Nutritional Sciences

Unique opportunity in Africa

The opening speech of the congress was presented by my fellow Ghanaian Anna Lartey, president-elect of the International Union of Nutritional Sciences. She is the first African to occupy this position. I present below her opening speech with her permission:

Box 1

Anna Lartey's address

Here follows an edited version of Anna Lartey's address to the Bloemfontein congress. It is a great honour for me to be asked to open this congress in my capacity as IUNS president-elect. This is my first official assignment in this capacity and I am very grateful that a congress in Africa has asked me to do this…IUNS is the truly global community of nutrition sciences, with about 80 adhering and affiliated bodies. Our membership is from country and regional nutrition associations.

Nutrition improvement as a right

At the IUNS we believe that to live a life without malnutrition is a fundamental human right. The persistence of malnutrition, especially among children and mothers, in this world of plenty is immoral. We believe that nutrition improvement anywhere in the world is not a charity but a societal, household and individual right. Our mission is to promote the advancement of the science of nutrition, research and development through international cooperation globally...

Over the years we have come to see the various faces of malnutrition on our continent manifested as undernutrition, overnutrition, hidden hunger or open hunger. The characteristic feature of malnutrition, irrespective of the face it shows, is its deep-rooted damage to health, development and productivity.

Malnutrition occurring during the most vulnerable period of pregnancy through the first 12 months of a child's life has long lasting negative consequences. The UN Development Programme has this year released the Africa Human Development Report 2012, the first ever for Africa. This report clearly shows the low levels of achievement in health, education and income. The report consistently raises an issue begging for a response. Why should a continent that is so replete with natural resources – including good fertile agricultural lands and water resources, even if unequally distributed – carry most of the world's hungry persons? Africa is the continent not likely to meet the Millennium Development Goals... There is no doubt that malnutrition is our most important constraint to achieving the MDGs.

Nutrition has more opportunities now

Over the last two years we have seen unprecedented attention to nutrition at the global level. In September 2010, a high-level meeting involving the UN secretary-general and leaders from UN member states, committed to tackle undernutrition in the first 1000 days of life. The Scaling Up Nutrition (SUN) Movement came into being, and today 30 countries, including 22 countries from Africa, have signed on as 'SUN countries'. UN REACH (Renewed Effort Against Child Hunger) is helping countries to meet MDG1, which is halving hunger by 2015. The US 'Feed the Future' is seeking to improve food security and nutrition in selected African countries. In May 2012, on the eve of the G8 Summit, President Obama announced the New Alliance for Food Security and Nutrition.

In June 2012, the UN Secretary General announced his Zero Hunger Challenge to the world. In August 2012, the UK prime minister and the president of Brazil seized the euphoria and attention around the world for the Olympics, to put the spotlight on reducing undernutrition in the world. So for the first time, nutrition was at the Olympics... For the first time ever, in 2011, the UN General Assembly met to discuss the issues of nutrition and non-communicable diseases. This September, just now, world leaders at the UN General Assembly gave their commitment to scale up nutrition in high malnutrition-burdened countries. Never before has nutrition had this kind of attention at global level.

Today in this room, we have the single largest gathering of Africa's nutrition community at the congress coming from three societies: the Nutrition Society for South Africa, the Association for Dietetics in South Africa, and the Africa Nutrition Society.

We have a charge to keep, to do whatever it takes to change the nutrition landscape in Africa. Great opportunities are coming Africa's way. We need people, groups and organisations to take advantage of these global initiatives and commitments... This global opportunity for nutrition will not last forever. Now the opportunity has landed for Africa, if we let this pass us by, posterity will judge us.

The hope and future for Africa

Now I turn my attention to the students among us here. I want to take this opportunity to encourage you to develop the passion to do something for Africa, starting with your country. I remember in 1997 I attended my first IUNS-International Congress of Nutrition in Montréal, Canada. I ran into an African lady who is in this room today – Julia Tagwireyi. She asked me where I came from and what I was doing. I told her I am Ghanaian, studying at the University of California, Davis. She asked 'when you finish your course will you come home?' I said yes, and she said, 'then there is hope for Africa' I did not know what she meant by that then.

Students, I give you the same charge today. You are the hope and future of Africa. Take the opportunity to improve yourself. If you have the opportunity to study outside your country, come back home. Africa needs you. We need to build capacity at the country level to manage all these global initiatives. I am forever grateful for the opportunity to attend the first African Nutrition Leadership Programme in 2002. That was when I first met Johann Jerling, its director. He and his team have committed themselves to building leadership capacity for Africa. Today over 300 Africans have gone through that programme. This is what one person with vision can do.

My vision when I take over as president of the IUNS in September 2013 is to institute an IUNS global nutrition summer school, to focus on the science of nutrition. A lot of our nutrition societies, especially in Africa, need to be resuscitated. I hope I can work with you to do this. Distinguished guests, ladies and gentlemen, I wish us all a wonderful five days at the Nutrition Congress of Africa.

Now it is me Reggie. For me, Anna Lartey's speech says it all. It set the tone for the meeting. For me the key message is that nutrition improvement is a right and so we should all be involved. It is not just a health issue. There are opportunities – more now than ever. The whole world is taking Africa seriously and is ready and willing to provide the support to make a difference. If we do not use the opportunities we have now, we may not have them ever again.

Scaling Up Nutrition

Transforming Africa's nutrition landscape

SUN rise in Africa: advocates Jane Badham (left), SUN co-ordinator David Nabarro (centre), and UNICEF executive director Anthony Lake (at right)

This month I have chosen just one theme of the congress. This is Scaling Up Nutrition (SUN). Presentations on SUN were made by Jane Badham (South Africa), Namucolo Covic (Zambia), Beatrice Kawana (Zambia), and Mawuli Sablah (Ghana).

Jane heads the SUN communications and advocacy team. She said that though progress have been made, sub-Saharan Africa has a way to go to achieving the eight Millennium Goals, and the target year of 2015 is not far away. There are proven effective child survival nutrition interventions to help achieve the MDGs, like optimal breastfeeding and improved complementary feeding; but scaling up is the only way to realise their impacts.

Nutrition cannot be an afterthought in development priorities, she said. The Development Goals cannot be achieved without a global coordinated action on nutrition with special focus on mothers and young children. It is imperative for nutrition to be placed high on the global political and development agenda. This is the reason for the SUN movement, which is endorsed by over 100 organisations.

She reiterated the statement by David Nabarro, SUN coordinator, that 'SUN is not a new institution, initiative or financial mechanism. It is a movement that brings organisations together across sectors to support national plans to scale up nutrition by helping to ensure that financial and technical resources are accessible, coordinated, predictable and ready to go to scale'. On why the need for SUN, she quoted UNICEF executive director Anthony Lake 'It is time to recognise nutritional status not only as a marker of progress in development, but also as a maker of progress and a key to more sustainable development'. Nutrition- and gender-sensitive interventions that span across agriculture, social protection, public health, education, water, sanitation, gender equality, governance and state fragility, all need scaling up.

Leadership must come from countries. External support must add value and be demand-driven. Ongoing initiatives to improve nutrition should be linked together for greater coherence, efficiency and impact. A combination of networks and movements are needed to enable a range of stakeholders to work together and contribute to lasting results.

Namukolo Covic from the centre of excellence for nutrition at North-Western University, said there is need for an information network for SUN in Africa, as is effective partnerships involve all stakeholders, in and between the public and the private sectors. Common vision and objectives should be shared. While each country is implementing similar interventions, contextual backgrounds are different.

Using Zambia and South Africa as examples, the food situation and systems differ from country-to-country in Africa. Information needs to be collected within each country, A knowledge and information network within the SUN movement should also be formed to achieve this, and include documentation on monitoring and evaluation. Both national and regional networks should be formed. Information is needed on how to build trust, a sense of shared values and equal worthiness. Information on helpful and unhelpful cultural practices is required.

Using Zambia as an example of SUN implementation, Ms Beatrice Kawana of the Zambian national food and nutrition commission said that the Zambian government appointed the NFNC as SUN focal point institution when Zambia joined the movement as a SUN 'early riser' in 2011. Since then there has been a high level international food and nutrition consultative forum, the development of a national food and nutrition strategic plan, the establishment of a multi-stakeholder platform for nutrition, and the development of the first 1000 maternal and child development programme to be launched by the end of this year, with implementation in early 2013.

Government has provided an enabling environment for these activities. Key challenges have included getting SUN embraced by higher authorities, the limited number of civil society organisations to champion nutrition issues in Zambia, a weak nutrition monitoring and evaluation framework, and generally limited resources.

Mawuli Sablah, regional fortification coordinator for Helen Keller International, emphasised that public-private partnerships provide opportunities for SUN. Industry provides sustained access to effective and affordable nutritious products. It helps in social and commercial marketing and information, and education and communication for nutritious products, and contributes to improved nutritional behaviour, hygiene, and healthy food habits and practices.

Using food fortification in Africa as an example, public-private partnerships are vital in reaching an estimated 70 per cent of national populations, fortifying some staple foods with essential vitamins and minerals. This has helped to institutionalise mandatory food fortification. What's needed here are formal platforms for dialogues, strategic visionary plans and implementation, regulations and legal instruments to provide a favourable environment, monitoring and control and results-based evaluation approaches. To be effective, public-private partnerships should be grounded in transparency, equity and shared mutual objectives and benefits.

So finally it's me Reggie again. Once again I am calling for action, action and action. This is how we will make a difference to the nutritional well-being of the people of my continent of Africa.

Acknowledgement and request

Conflicting or competing interests: I am associated with the African Graduate Nutrition Students Network. I do not regard this as a competing interest. This column has been reviewed by Geoffrey Cannon.

Readers may make use of the material in this column if acknowledgement is given to the Association, and WN is cited. Please cite as: Annan R. Serving communities [Column]. Website of the World Public Health Nutrition Association, November 2012. Obtainable at www.wphna.org.

All contributions to this website are the responsibility of their authors. They should not be taken to be the view or policy of the World Public Health Nutrition Association (the Association) or of any of its affiliated or associated bodies, unless this is explicitly stated.

2012 November blog. Reggie Annan

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