03 October 2012

The African Nutrition Congress: Declare the end of the 22nd Century Mindset

Days 2 and 3 and the African Nutrition Congress are generating lots of good ideas, evidence and connections, but I wonder how much influence it is generating?

It is interesting that not too many people here are talking about the Scaling Up Nutrition (SUN) movement. For example, when asked why they had not signed up to SUN, senior nutrition representatives from the South African Government said they were waiting for an invitation. Of course they don’t need an invitation—that’s the point.

There may be political reasons for South Africa not signing up--they don’t need the money, they might think the hassle of dealing with donors is not worth it, and making yourself accountable to a wide audience is not an easy decision to make—but I found the disconnect rather stunning.

We had a good session from Jane Badham on SUN 101 (Jane is South African and the lead of the SUN Advocacy and Communications Team), but the fact that the Congress needed a 101 session is telling. I think this may say as much about the Congress community as it does about SUN.

SUN is beginning to be driven by countries (see the latest progress report from the SUN Secretariat—although it would be good to have an independent progress assessment). Rubber is hitting roads, but it is taking time—and I would like to see Jane’s Advocacy and Communications Team work more at the national level.

But the Congress members need to find more ways to link to debates outside their countries—and I know this is not easy for many because of lack of staff, job responsibilities, freedom of expression, lack of travel opportunities and lack of IT access. The Congress is a good way of doing this, of course, but, admittedly as an uninformed outsider, I get the feeling that the Congress is not making the most of its potential clout.

For example, there is no "Declaration" coming out of the Congress.

Where else do we have 800 nutrition professionals, the vast majority being from Africa? This is a fantastic opportunity to put pressure on African governments to do more to accelerate declines in stunting rates.

Remember that if stunting were an MDG indicator, based on current rates of progress–about 1 percentage point a decade (see De Onis et. al. 2011 in Public Health Nutrition)--Africa would meet its 2015 target in the 22nd Century.

And it is not as if there are no dynamic African nutrition leaders—there are many here (some I have met Anna Lartey, Beatrice Kawana, Esi Colecraft, Joyce Kinabo, Paul Amuna, Namukolo Covic, Julia Tagwireyi, Bridget Okoeguale, Brenda Namugumya and others)--but the job of a Congress is to make the whole greater than the sum of the parts.

What would a declaration look like? Some thoughts:

“We the 800 participants of the African Nutrition Congress call on Governments throughout Africa to:

• Recognise the centrality of the nutrition status of your citizens to the success of your nation. Nearly one third of child deaths will be prevented by improved nutrition status. The economic growth and poverty reduction of tomorrow depends on child growth today. Tackling infant undernutrition today will prevent health epidemics of middle age.

• Make nutrition one of your top priorities. Champion it at the highest levels. Create a space for it within decision making. Create a nutrition budget line item and commit to spending 10% of your budgets to it. Sign up with SUN.

• Spend a high percentage of the nutrition budget on strengthening national and subnational capacity to scale up nutrition. This means working with households, frontline workers, NGOs, researchers, private sector and policymakers to dispel myths and enable action.

• Monitor the activities of the private sector within your countries. This sector can be a force for good but it can also be a force for bad. Monitoring what they do and spend is difficult, but we can monitor what they say. If it is responsible, let’s applaud. If not, let’s expose.

• Monitor nutrition outcomes on an annual basis, just as you monitor economic progress year by year. Allow civil society to applaud progress or criticise lack of progress. Allow yourselves to be guided by new evidence. Allow others to monitor your commitments—it is a way of building trust with your citizens. Let us see if you do as you say before you ask anyone else to do as you say.”

Of course, the language might have to be more diplomatic!


Antonio Kevin said...

Influence is definitely the issue here. No matter what century the mindset is or how great the plan, everything is useless without the participation of the people.

Maurice Tanner said...

Africa should really focus on reducing their sickness rate. They're a developing nation and developing nations need to be in tip top shape. Something i have learned from my friend that works as a fireman, he tells me that there is not a day where he's missed taking his nutrient boosters as his body is on the line every time he's called into action.