Poverty and health

Impact of drought and HIV on child nutrition in Eastern and Southern Africa
Mason JB, Chotard S, Bailes A, Mebrahtu S and Hailey P: Food Nutrition Bulletin 31(3 Suppl):S209-18, September 2010

In this study, researchers aimed to determine short- and long-term trends in child malnutrition in Eastern and Southern Africa and how these are affected by drought and HIV. An analysis was conducted of data from national surveys, generally from the mid-1990s to the mid-2000s. Results indicated that overall trends in child nutrition are improving as national averages; the improvement is slowed but not stopped by the effects of intermittent droughts. In Southern Africa, the prevalence rates of underweight showed signs of recovery from the 2001–03 crisis. As expected, food production and price indicators were related (although weakly) to changes in malnutrition prevalence; the association was strongest between changes in food production and price indicators and changes in malnutrition prevalence in the following year. Despite severe intermittent droughts and the HIV and AIDS epidemic (now declining but still with very high prevalence rates), underlying trends in child underweight are improving when drought is absent. Preventing effects of drought and HIV could release potential for improvement and, when supported by national nutrition programmes, help to accelerate the rates of improvement, now generally averaging around 0.3% per year, to those needed to meet Millennium Development Goals (0.4 to 0.9% per year).

Is malaria illness among young children a cause or a consequence of low socioeconomic status? Evidence from the United Republic of Tanzania
De Castro M and Fisher MG: Malaria Journal 11(161), 9 May 2012

Malaria is commonly considered a disease of the poor, but there is very little evidence of a possible two-way causality in the association between malaria and poverty. This study aimed to address this gap. In the study, results show that households with a child who tested positive for malaria at the time of the survey had a wealth index that was, on average, 1.9 units lower. If malaria is indeed a cause of poverty, as the findings of this study suggest, then malaria control activities, and particularly the current efforts to eliminate/eradicate malaria, are much more than just a public health policy, but also a poverty alleviation strategy, the authors argue.

Maternal, infant and young child nutrition: Draft comprehensive implementation plan
World Health Organisation: 26 April 2012

According to this draft comprehensive implementation plan, the World Health Organisation acknowledges that nutrition challenges are multi-faceted, effective nutrition actions exist but are not expanded sufficiently and new initiatives have been launched to address nutrition, such as the Scaling Up nutrition movement. The plan sets five global targets and a time frame. The plan aims to alleviate the double burden of malnutrition in children, starting from the earliest stages in development. It contains five key actions. 1. To create a supportive environment for the implementation of comprehensive food and nutrition policies. 2. To include all required effective health interventions with an impact on nutrition in national nutrition pans. 3. To stimulate development policies and programmes outside the health sector that recognise and include nutrition. 4. To provide sufficient financial resources and staff for the implementation of nutrition interventions, 5. To monitor and evaluate the implementation of policies and programmes.

Achieving food security in the face of climate change: Final report from the Commission on Sustainable Agriculture and Climate Change
Beddington J, Asaduzzaman M, Clark M, Fernández A, Guillou M, Jahn M et al: CGIAR Research Programme on Climate Change, Agriculture and Food Security (CCAFS), 2012

This report by the Commission on Sustainable Agriculture and Climate Change contains its recommendations to policy makers on how to achieve food security in the face of climate change. The Commission’s recommendations are designed to be implemented concurrently by a constellation of governments, international institutions, investors, agricultural producers, consumers, food companies and researchers. They call for changes in policy, finance, agriculture, development aid, diet choices and food waste as well as revitalised investment in the knowledge systems to support these changes. The Commission recommends significantly raising the level of global investment in sustainable agriculture and food systems in the next decade; sustainably intensifying agricultural production on the existing land base while reducing greenhouse gas emissions; and reducing losses and waste in the food system. The Commission urges governments attending the Rio+20 Earth Summit in June 2012 to make financial commitments for regionally-based research, implementation, capacity building and monitoring to improve agriculture and food systems.

Brazil to work with South Africa against hunger
Southern African Press Association: 10 April 2012

Brazil has agreed to assist South Africa on social development issues, particularly in fighting against poverty and hunger. Brazil is aiming to help 16.2 million Brazilians out of extreme poverty with its comprehensive national poverty alleviation plan, ‘Brasil Sem Misera’. The plan includes cash transfer initiatives, and increased access to education, health, welfare and sanitation. South Africa has expressed a desire to learn about Brazil’s national alleviation plan and its successful Zero Hunger programme.

Linking migration, food security and development
Crush J (ed): Southern African Migration Project, Migration Policy Series No. 60, 2012

In this report, the authors argue that food security in Southern Africa needs to be "mainstreamed" into the migration and development agenda and migration needs to be "mainstreamed" into the food security agenda. They set out to promote a conversation between the food security and migration agendas in the African context, focusing on the connections in an urban context. Four main issues are singled out for attention: the relationship between internal migration and urban food security; the relationship between international migration and urban food security; the difference in food security between migrant and non-migrant urban households; and the role of rural-urban food transfers in urban food security. Findings indicate that most poor households in Southern African cities either consist entirely of migrants or a mix of migrants and non-migrants. Rapid urbanisation, increased circulation and growing cross-border migration have all meant that the number of migrants and migrant households in the city has grown exponentially. This is likely to continue for several more decades as urbanisation continues. Policymakers cannot simply assume that all poor urban households are alike. While levels of food insecurity are unacceptably high amongst all of them, migrant households do have a greater chance of being food insecure with all of its attendant health and nutritional problems.

Sorting out the what, how, and who for regional action on agriculture in Africa
Afun-Ogidan D: European Centre for Development Policy Management blog, 30 March 2012

Many African countries and regions have programmes to boost their agricultural productivity to ensure food security, with the pan-African Comprehensive Africa Agriculture Development Programme (CAADP) being the most comprehensive. On 5 March 2012 members of the CAADP Development Partners Task Team met in Brussels to discuss and explore how to facilitate and support greater involvement of regional stakeholders that are important for CAADP implementation at the regional level. Participants discussed how to achieve faster progress on implementing the programme and stressed the need to identify concrete regional actions for faster progress. They also emphasised the importance of deciding on roles and responsibilities of different regional actors, and of improving coordination among development partners, and between development partners and Regional Economic Communities. Although these ideas do not represent formal positions, they could be used to guide discussion between development partners, Regional Economic Communities and other actors during the Eighth CAADP Partnership Platform meeting, due to be held 3-4 May 2012.

The association between malnutrition and the incidence of malaria among young HIV-infected and -uninfected Ugandan children: A prospective study
Arinaitwe E, Gasasira A, Verret W, Homsy J, Wanzira H, Kakuru A et al: Malaria Journal 11(90), 27 March 2012

In this study, a cohort of 100 HIV-unexposed, 203 HIV-exposed (HIV negative children born to HIV-infected mothers) and 48 HIV-infected children aged six weeks to one year were recruited from an area of high malaria transmission intensity in rural Uganda and followed until the age of 2.5 years. All children were provided with insecticide-treated bed nets at enrolment and daily trimethoprim-sulphamethoxazole prophylaxis (TS) was prescribed for HIV-exposed breastfeeding and HIV-infected children. Monthly routine assessments, including measurement of height and weight, were conducted at the study clinic. The researchers found overall incidence of malaria was 3.64 cases per person year. Mild stunting and moderate-severe stunting were associated with a similarly increased incidence of malaria compared to non-stunted children. Being mildly underweight and moderate-severe underweight were not associated with a significant difference in the incidence of malaria compared to children who were not underweight. There were no significant interactions between HIV-infected, HIV-exposed children taking TS and the associations between malnutrition and the incidence of malaria. The researchers point out, in conclusion, that they were unable to disentangle the relationship between malnutrition and the incidence of malaria, and their findings do not necessarily indicate any causal connections between malaria and malnutrition.

Harvesting controversy: World Bank's agriculture projects under scrutiny
Bretton Woods Project: 7 February 2012

The World Bank is preparing a new agriculture action plan to cover 2013-2015. This paper argues that its market liberalisation focus has been criticised, pointing to strongly critical reports on World Bank agriculture projects such as in Peru and Papua New Guinea, and crtique of its lack of gender focus. Critics argue that the Bank is too narrowly focused on private equity investment in agriculture, instead of taking an approach that includes local communities and smallholder farmers. At the same time, the Bank has failed to acknowledge the impact of financial speculation on volatility in food prices, despite many analysts suggesting this is a major contributor to food insecurity. By promoting investor access to land, the authors argue that Bank threaten rather than improve food security and local livelihoods in developing countries.

Regional approaches to food security in Africa: The CAADP and other relevant policies and programmes in COMESA
Rampa F, Afun-Ogidan D and van Seters J: ECDPM Discussion Paper 128a, February 2012

In 2003 the Comprehensive Africa Agriculture Development Programme (CAADP) was established by the assembly of the African Union (AU) aiming to raise agricultural productivity by at least 6% per year and increasing public investment in agriculture to 10% of national budgets per year. This paper evaluates progress in CAADP negotiations in the Common Market for Eastern and Southern Africa (COMESA) region. There is in general full support in the region for an effectively multidimensional regional CAADP, anchored in ongoing programmes implemented by COMESA. But so far, there has not been enough consultation with relevant non-state stakeholders, like farmers’ organisations, and the authors urge government to include them in the process, as well as to address past failures to communicate effectively and timeously with regional stakeholders about CAADP. They also call for greater integration between regional and national stakeholders and development partners to help mainstream CAADP into ongoing regional programmes and other sectors relevant to food security. More regular dialogue is needed between COMESA, AUC-NPCA and DPs around the implementation of regional CAADP plans. The authors argue that it is very important to ensure coherence between regional policies and investments in food security and in other sectors of regional cooperation.

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