More facts have emerged on how the novel coronavirus (COVID-19) pandemic has exposed the weakness of food and health systems, disproportionately impacting already vulnerable populations.
According to the 2020 Global Nutrition Report released during an online global launch, on Tuesday, May 12, if no action is taken, the effects of the pandemic will only make it harder for vulnerable populations to protect themselves against malnutrition. “Malnutrition affects our immune system, leaving us more susceptible to infection, and the socio-economic impact of the pandemic could, in turn, drive malnutrition globally,” it noted.
The report observed as inequalities and malnutrition continue to sweep the world and Africa, there is need to address malnutrition in all its forms by tackling injustices in food and health systems is now more urgent than ever.
It provided updated data and analysis on the state of malnutrition globally, including Africa, and highlighted significant challenges faced by countries in the region, as well as progress made towards tackling them.
The Global Nutrition Report (GNR) is the world’s leading independent assessment of the state of global nutrition. It provides the best available data, in-depth analysis and expert opinion rooted in evidence to help drive action on nutrition where it is urgently needed.
A multi-stakeholder initiative comprising global institutions, experts in the field of nutrition, lead the GNR. The GNR was established in 2014 following the first Nutrition for Growth summit, as an accountability mechanism to track progress against global nutrition targets and the commitments made to reach them.
Through a comprehensive report, interactive Country Nutrition Profiles and Nutrition for Growth Commitment Tracking, the GNR sheds light on the burden of malnutrition and highlights progress and working solutions to tackle malnutrition around the world.
The GNR found that malnutrition in all its forms has become the leading cause of poor health and death, and the rapid rise of diet-related chronic diseases is putting an immense strain on health systems that are already fighting diseases like COVID-19, Ebola or malaria.
According to the report, despite this assessment, nutritional actions only represent a minuscule portion of national health budgets although they can be highly cost-effective or even cost-saving solutions.
In most countries, health checks do not cover diet quality and national surveys rarely comprehensively assess diets and the nutritional status of populations. The distribution of trained nutrition professionals is inequitable, and these experts are not widely accessible. Globally, the median number of nutrition professionals stands at 2.3 per 100,000 people, 0.9 per 100,000 people in Africa, and some countries have none.
Co-Chair of the report and Research Associate Professor at the Friedman School of Nutrition Science and Policy at Tufts University, Renata Micha, said: “Good nutrition is an essential defence strategy to protect populations against epidemics, release the burden on our health systems, deliver Universal Health Coverage and ultimately save lives. The findings of the 2020 Global Nutrition Report make clear that tackling malnutrition should be at the centre of our global health response.”
The GNR noted that processed food sales are still high in high-income countries and growing fast in upper-middle and lower-middle-income countries, while sales are low in low-income countries.
According to the report, most countries in the world must now be equipped to fight both sides of malnutrition at the same time.
Some progress has been made both in Africa and globally, but this remains too slow. The region has made considerable effort to reduce the prevalence of stunting among children under-five years of age. In Ethiopia, this has fallen significantly from 57.6 per cent in 2000 to 38.4 per cent in 2016. The same applies for Burundi that has managed to reduce stunting levels from 64.0 per cent in 2000 to 55.9 per cent in 2016.
However, Africa remains the region by far the hardest hit by overlapping forms of malnutrition. Of 37 countries that struggle with three forms of malnutrition – childhood stunting, anaemia in women of reproductive age and overweight among women – 27 were in Africa.
According to the Report, Obesity and overweight levels are also on the rise across the continent. The prevalence of overweight in adolescents is greater in girls (17.7 per cent) than boys (11.2 per cent). This trend continues into adulthood, where the overweight prevalence in adults is greater in women (41.1 per cent) than men (25.8 per cent).
It noted that despite these figures, countries are often unprepared to face the global nutrition crisis. Also, strong government nutrition coordination is often lacking; lower-income countries tend to deprioritise overweight, obesity and other diet-related chronic diseases.
The GNR found that financial commitments also do not match the scale and nature of the issue: increases in domestic resources for nutrition have been marginal at best and nearly impossible in fragile states, while obesity and overweight have been largely ignored in aid allocations.
Associate Professor at the University of Cape Town’s African Centre for Cities, Jane Battersby-Lennard, said: “We have seen significant progress to tackle malnutrition in Africa, but the COVID-19 pandemic could reverse these gains. COVID-19 is expected to increase this disparity, which means that now is the time to scale up our efforts and support communities and people most affected.”
The Report called for new perspective: redirecting resources to communities and people most affected is the right and the smartest thing to do.
Also, global and national patterns hide significant inequalities within countries and populations, with vulnerable groups being the most affected. The Report found clear links between levels of malnutrition and population characteristics like location, age, sex, education and wealth, while conflict and other forms of fragility compound the problem.
According to the Report, in Africa, differences between communities at the sub-national level are striking. Underweight is a persisting problem of the poorest countries, while overweight and obesity are prevailing in wealthier communities. In the Democratic Republic of Congo, the prevalence of overweight is 2.2 per cent in poorer households and 9.7 per cent in richer ones.
The Report observed gaps in food systems: Poor diets are not simply a matter of personal food choices. The Report calls for a change in food systems.
According to the Report, existing agriculture systems still focus on staple grains like rice, wheat and maize, rather than producing a broader range of more diverse and healthier foods, such as fruits, nuts and vegetables.
Fresh or perishable foods are less accessible and affordable in many parts of the world compared to staple grains. In Burkina Faso, egg calories are 15 times more expensive than calories from staples, whereas they are 1.9 times more expensive in the United States.
Processed foods, especially ultra-processed food, are available, cheap and intensively marketed, with sales high and growing fast in many parts of the world. In sub-Saharan Africa, the growth of supermarket chains is diminishing the role of informal traders and has affected people’s food choices. These changes demand policy and planning resources to promote desirable nutrition outcomes.
Solutions have started to emerge in Africa and across the world: increased public investment for healthier food products, support for shorter supply chains for fresh-food delivery programs, use of fiscal instruments, limiting advertising of junk food, and food reformulation, or the use of front-of-pack labelling (FOPL) to inform consumers and influence industry behaviour adopted by Chile and the United Kingdom (U.K.). However, much more remains to be done.
Co-Chair of the Report and Special Adviser on Nutrition to the Tata Cornell Agriculture & Nutrition Initiative, Venkatesh Mannar, said: “At a time when COVID-19 has further revealed the gaps in our food systems, we now have a unique opportunity to act in coordination to address them and ensure that healthy and sustainably produced food is the most accessible, affordable and desirable choice for all.”