Views from ANEC 8 – Part 2

The 8th African Nutrition Epidemiology Conference (ANEC) was held in Addis Ababa, Ethiopia from October 1st to 5th 2018. It is the largest gathering of African nutritionists on the continent and hosts several international nutrition experts. The following is a reflection on points raised by various speakers throughout the conference.

Part 2

Enough evidence exists to show that a nutritionally compromised environment during the first 1000 days of life (conception to two years), can not only affect a person’s growth and development, but also increase their likelihood of developing chronic disease in adulthood (1). On top of this, the nutritional status of women and men even before conception might also have a lifelong impact on their future child’s health (2). It turns out that the nutrition environment of this peri-conceptional window can positively or negatively affect both the sperm and the egg; according to Professor Andrew Prentice in his talk “Before the first 1000 days”. Thus, applying a nutritional lens to family/pregnancy planning is important, as it can highlight the need for good nutrition even before pregnancy.

There must be a reason behind the failure of so many stunting interventions in recent years. Were the interventions too late? Were the timelines too short? Could the markets have played a mediating role? Addressing these points raised by Dr Suneetha Kadiyala, from LSHTM can shed some light on the issue of why such low success rates. Dr Habiba Hassan-Wassef, MD believes that the emerging evidence of the complexity of stunting and its determinant factors will provide some answers.

Whilst stunting is defined within the context of malnutrition, environmental factors also contribute to its high prevalence. For example: aflatoxin exposure from contaminated grain, and intestinal inflammation from environmental pathogens can both lead to stunted indiviuals. (1). The sad part is that both these factors will be exacerbated by climate change. Temperature fluctuations will affect the ability to store grain effectively, and climate disasters will affect water and sanitation conditions, thus increasing the risk of diarrheal infections (3). This was echoed by Prof Andrew Prentice, who affirmed that stunting is far more complicated than just not being fed well; and is largely driven by infections from unsanitary conditions, which can only be resolved by improving socioeconomic conditions.

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“Stunting resolves as countries develop” Prof Andrew Prentice #ANEC8 #Day3

Prof Jaques Delarue mentioned in his talk on fatty acids that fish availability in Africa is very low; and called for investment in aquaculture to boost consumption of marine omega-3 fatty acids. According to the FAO, Africa’s fish supply in 2016 was estimated at 9 kg per capita per annum, compared to the global average of 20 kg capita per annum (4). Efforts to increase this supply may be hampered by the fact that many commercial fish stocks are already depleted; making Africa a net importer of fish. It is expected that fish consumption will increase everywhere except Africa, as population growth will outweigh production (5).

Prof Mary Murimi defined health literacy as the degree to which individuals have the capacity to obtain, process and understand basic health information. This requires health professionals to acknowledge the cultural beliefs, health practices and attitudes of the communities they serve. For the most part health literacy in Africa is still low; therefore, it is important to acknowledge that disease burden is not expected to decline should people continue to not understand the health information being presented to them.

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“Health information can overwhelm people with low literacy skills” Prof Mary Murimi

 

References

  1. Hobbs A, Ramsay M. Epigenetics and the burden of noncommunicable disease: a paucity of research in Africa. Epigenomics. 2015;7(4):627–39.
  2. Sun C, Velazquez MA, Fleming TP. Chapter 3 – DOHaD and the Periconceptional Period, a Critical Window in Time. In: Rosenfeld CS, editor. The Epigenome and Developmental Origins of Health and Disease [Internet]. Boston: Academic Press; 2016 [cited 2018 Oct 15]. p. 33–47. Available from: http://www.sciencedirect.com/science/article/pii/B9780128013830000037
  3. Ly S, Carpenter C. Environmental and Climate Factors in Childhood Stunting: Moving beyond Nutrition. Adv Nutr. 2017 Jan 1;8(1):14–14.
  4. AU-IBAR, 2016. The Continental Aquaculture Development Action Plan 2016 – 2025. Stakeholders’ perspectives for implementing the Policy Framework and Reform Strategy for Fisheries and Aquaculture in Africa
  5. Fish projections in the OECD-FAO Agricultural Outlook 2017-2026 | GLOBEFISH | Food and Agriculture Organization of the United Nations [Internet]. [cited 2018 Oct 19]. Available from: http://www.fao.org/in-action/globefish/news-events/details-news/en/c/1032635/

 

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“Can’t we all just feed each other?” The agricultural relationship between Africa and China

Can China help boost Africa’s food security, or will Africa become China’s breadbasket?

Perhaps both?

 

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With mounting anxiety over the China-Africa relationship, particularly fears of Africa falling into a debt-trap reminiscent of its not-so-recent past; one question often raised is: how exactly does Africa benefit from its partnership with China? Agriculture is one area where China and Africa have a history of engagement; which can be mutually beneficial given China’s need to access more agricultural land, and Africa’s need to access more agricultural technology.

The story of Chinese agriculture and how it maintains China’s food security is an interesting one. Despite having around 20% of the world’s population; China only has 8% of the world’s  arable land (about 122 million hectares) (1).  Yet they managed to transition from being heavily food insecure to a global leader in food production; simply by utilising  technology to achieve considerably higher yields per hectare (2).

By 2005, food availability in China was about 8% higher than the global average (as high as 3,040 kcal per day), and 14% higher than other developing countries. However, such gains were proving unsustainable in the face of   challenges such as water constraints, population growth, and changes in consumer consumption patterns – (increased demand for meat and dairy products). However, its most important challenge is its lack of land access to meet its growing food demands. China has responded  to  these challenges by increasing its land investments in developing regions including Africa, as well as its use of technology to maximise the use of existing farmland in China. (3)

Meanwhile, Africa’s story still has not changed. Africa remains the most food insecure region on the planet; despite the fertile soil, favourable climate conditions and the (once) generous water basin. Africa is believed to possess up to 60% of the world’s  arable land, but less than 10% of it is under irrigation (2). Around 40% of Africa’s gross national product (GNP) comes from agriculture, including 40% of  exports; while up to 80% of all employed people in Africa are somehow involved in agriculture (4). Yet the agricultural sector hasn’t experienced much gains in terms of production and utilisation. For instance, grain production  increased by only 60% between 1960 and 2005; compared to a 220% increase in East Asia within the same timeframe (4). Reasons for this stagnancy have essentially boiled down to issues of insufficient technical capacity and waste-of-space political leadership. Despite  being Africa’s largest employer and despite long-standing food insecurity issues, agricultural expenditure reduced from 7.3% to 3.8% during the Reagan/Thatcherism and Structural Adjustment Programme  eras (1980s to 2000s); which still saw Western donors slash  funding for African agriculture from 18.5% to   3.5% (4). Although this seriously undermined the sector’s productivity, it is still surprising to hear that most African countries do not achieve even a quarter of their full yield potential. In fact, by 2011 Africa as a whole was still importing up to $30 billion in basic grains; and spending nearly $2 on agricultural imports for every $1 earned from agricultural exports (5). This import bill has since risen to $35 billion, with expectations of  reaching $110 billion by 2025 (6).

The agricultural relationship between Africa and China is not a new one. As far back as the 1950s China provided food aid to Africa as a form of developmental assistance. This still forms part of their agricultural aid programme but has since been accompanied by technological support. During the 1960s and 70s, China designed “demonstration farms” in Africa to promote technological transfers and farmer training. Fast forward to 2009, and over 200 agricultural projects were completed; including 23 fisheries eleven research stations, over 60 agricultural investment projects, and close to 1000 agricultural experts were dispatched across the continent. From 2003 to 2008, well over 4000 Africans were in  China  studying agriculture-related programmes  (7). The Chinese Academy of Tropical Agricultural Sciences have sent 32 Chinese agricultural experts to Africa since 2016, to provide technical assistance and training to individuals from the agricultural sector (8)  At the most recent Forum on China-Africa Cooperation (FOCAC) Summit in September 2018, agricultural modernization appeared to be integral to President Xi Jinping’s Beijing Action Plan (2019-2021), so it is likely that such support will continue.

Random Fact: By 2013, China already invested over $300 million in African agriculture; a five-fold increase since the turn of the 21st century (7)

 

At the first FOCAC summit in 2006, the Agricultural Technology Demonstration Centers (ATDCs) were announced in Beijing. The purpose of the ATDCs are twofold: (1) to modernize African agriculture, and (2) to provide Chinese companies access to emerging African markets. Therefore, the main objectives of the ATDCs include technology transfer (for Africa), business development (for China), and overall sustainability via increased public-private partnerships. There are  currently 23 ATDCs operating across Africa  (9).  The Chinese government provides incentives to Chinese agribusinesses to invest in African agriculture as either state-owned entities or joint projects with African SMEs at the grassroots level  (3). Although ATDCs vary from country to country, they have a general set-up: the first one to two years focus on building infrastructure; followed by three years of technical cooperation, then finally ensuring financial sustainability by handing the ATDC over to a company. This goes beyond the typical aid model from Western countries that has pervaded Africa for so long (9).

To date, results of ATDC projects have shown that benefits of technology transfer were mainly at the local level; while Chinese agribusiness companies have seen moderate development; and for the most part the overall projects remain unsustainable. These issues have been primarily linked to poor policy design and ineffective bilateral relations between respective governments  (3)

 

Random Facts:

#1  According to the China Africa Research Initiative, China has apparently acquired over 6 million hectares of agricultural land in Africa. This land is specifically for agricultural projects involving more than 500 hectares. However, only about ¼ million (252,901) hectares of this land has been claimed to date (10).

#2 China has been Africa’s largest trading partner since 2012, with over $200 billion worth of trade between the two (7).

 #3 Like their other business interests, China’s agricultural investments are not exclusive to Africa. In 2016, China invested  $26 billion in agricultural projects  spread across 100 countries. (11)

 

Concern has been expressed that China is simply preparing to use Africa to feed its own growing population, in light of  its current land restrictions. This is something China currently denies, and most agricultural projects are said to focus on meeting local and regional food needs. Yet Africa becoming the breadbasket of China can very well be a possibility in the future (7). This will depend on the decisions made by African governments and civil societies. Indeed, China has made considerable land investments in Africa, however they are not the major players in the game of African land grabs when compared to Europe,  USA, Japan and South Korea (12)

President Xi Jinping promises that no political strings will be attached to the US$60-billion pledged for Africa at the last FOCAC summit, yet critics are still worried that these funds may come with restrictions such as heavy-handed censorship of media and opposition. For example, Kenyan scholar Professor Patrick Lumumba was denied entry to loan-indebted Zambia, allegedly due to the anti-China rhetoric of his speeches (13). Both China and Africa should be mindful of this, as such actions play into the neo-colonialism narrative coming from Western countries; and may underplay the contribution China is making to Africa’s overall economic development. In 2017, it was reported that several million jobs were created by Chinese projects in Africa, 89% of which employed African people (12). This is in addition to the skills training and technology transfers provided by Chinese enterprises. The vast majority of Chinese loans to Africa were allocated towards developing infrastructure such as transport and power generation; and come with low interest rates and long-term repayment plans. Also, many of Africa’s least developed countries have already received debt relief (12).

Success in the agricultural sector will be a key determinant factor in Africa’s development going forward. The question to now pose is: How can Africa maximise China’s involvement in African agriculture to redress the poor policies and planning of the past?  Given that China has its own development agenda to think about, the answer will undoubtedly depend more on Africa and less on China.

Quotes:
“Zambia is endowed with favourable natural conditions for the development of agriculture. On the other hand, China has a cutting edge in capital, technology and experience. That means the two countries are highly complementary for agricultural cooperation.”
– Mr. Yang Youming, the Chinese Ambassador to Zambia, on Zambian agriculture, and the potential for partnership. (14)
“We will support Africa in achieving food security in general by 2030, work with Africa to formulate and implement a program and action to promote China-Africa cooperation on agricultural modernization. We will implement 50 agricultural assistance programs, provide one billion RMB of emergency humanitarian food assistance to African countries affected by natural disasters, send 500 senior agriculture experts to Africa, and train young researchers in agri-science and entrepreneurs in agri-businesses”
– President Xi Jinping  at the Forum on China-Africa cooperation (FOCAC) in September 2018. (15)

 

“Through China’s support in developing roads and railway lines, unreachable parts of the continent where initially people took two days to reach have become reachable within 10 hours of traveling… China’s cooperation with Africa has offered farmers an opportunity for selling their crops and livestock in time hence making profit” 
– Gabriel Rugalema, FAO’s representative in Kenya. (16)

 

References:

 

  1. Bräutigam DA, Xiaoyang T. China’s Engagement in African Agriculture: “Down to the Countryside.” The China Quarterly. 2009;(199):686–706.
  2. Agriculture a priority area in China-Africa relations | Knowledge for Development. Available from: https://www.sardc.net/en/southern-african-news-features/agriculture-a-priority-area-in-china-africa-relations/
  3. China Africa in agriculture: a background paper on trade, investment and aid in agriculture | Eldis. Available from: http://eldis.org/document/A63348
  4. China’s role in African agriculture | International Centre for Trade and Sustainable Development. Available from: https://www.ictsd.org/bridges-news/bridges-africa/news/china%E2%80%99s-role-in-african-agriculture
  5. Sy A. What do we know about the Chinese land grab in Africa? Brookings. Available from: https://www.brookings.edu/blog/africa-in-focus/2015/11/05/what-do-we-know-about-the-chinese-land-grab-in-africa/
  6. AfricaNews. Why is Africa importing $35bn in food annually? – AfDB boss asks. Africanews. 2017. Available from: http://www.africanews.com/2017/04/21/why-is-africa-importing-35bn-in-food-annually-afdb-boss-asks/
  7. Kuo L. China is on a mission to modernize African farming—and grow a market for its own companies. Quartz Africa. Available from: https://qz.com/africa/788657/a-chinese-aid-project-for-rwandan-farmers-is-actually-more-of-a-gateway-for-chinese-businesses/
  8. Forum on China-Africa agricultural cooperation opens in Hainan. Available from: https://www.focac.org/eng/zfgx_4/jmhz/t1591123.htm
  9. Xu X, Li X, Qi G, Tang L, Mukwereza L. Science, Technology, and the Politics of Knowledge: The Case of China’s Agricultural Technology Demonstration Centers in Africa. World Development. 2016 May 1;81:82–91.
  10. Data: Chinese Agricultural Investments in Africa. China Africa Research Initiative. Available from: http://www.sais-cari.org/data-chinese-agricultural-investments-in-africa/
  11. Understanding China’s foreign agriculture investments in the developing world. Devex. 2018. Available from: https://www.devex.com/news/sponsored/understanding-china-s-foreign-agriculture-investments-in-the-developing-world-92639
  12. Why fears of China’s neocolonialism in Africa ring false in the face of numbers that tell a different tale | South China Morning Post. Available from: https://www.scmp.com/comment/insight-opinion/united-states/article/2165489/why-fears-chinas-neocolonialism-africa-ring
  13. China flexes its political muscles in Africa with media censorship, academic controls. Available from: https://www.theglobeandmail.com/world/article-china-flexes-its-political-muscles-in-africa-with-media-censorship/
  14. Speech at the China Africa Agriculture Cooperation and Development Summit By Chinese Ambassador H.E. Mr. Yang Youming. Available from: http://zm.chineseembassy.org/eng/sgxxx/dsjh/t1482810.htm
  15. AfricaNews. China to help Africa attain food security by 2030- Xi. Africanews. 2018. Available from: http://www.africanews.com/2018/09/04/china-to-help-africa-attain-food-security-by-2030-xi/
  16. Food Insecurity Affects 821 Million, UN Official Lauds China’s Africa Plan. Available from: https://www.telesurtv.net/english/news/Food-Insecurity-Affects-821-Million-UN-Official-Lauds-Chinas-Africa-Plan-20180913-0003.html

Views from the 8th African Nutrition Epidemiology Conference

The 8th African Nutrition Epidemiology Conference (ANEC) was held in Addis Ababa, Ethiopia from October 1st to 5th 2018. It is the largest gathering of African nutritionists on the continent and hosts several international nutrition experts. The following is a reflection on points raised by various speakers throughout the conference.

Part 1

As Mr Kelbesse Urga, President of the Food and Nutrition Society of Ethiopia (FoNSE) pointed out in his opening address, Nutrition Epidemiology is still a young discipline. Evidence on the role of nutrition in disease onset and prevention is still mounting; and nutrition interventions at policy and community level are still being developed and evaluated. The study of the human diet, what influences it, and how it contributes to human health does indeed require multidisciplinary thinking, but also appropriate methodological approaches that cater for the unique challenges facing this field (1). Despite the debate of whether pharmacological methods are suitable to determine nutrition outcomes, RCTs remain the gold standard for generating sufficient evidence of disease association and intervention efficacy to develop a case for policy intervention; and should be used  accordingly (1). Yet actually translating this evidence into policy within the African context remains as challenging as it is critical. Still, this evidence-to-policy translation must be championed – such was the sentiment of Dr Amos Laar, President of the African Nutrition Society.

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Dr Amos Laar, President of the African Nutrition Society.

Nutrition evidence should not only be used to develop nutrition policy, but should also influence other policies such as agriculture, education, social protection and public health, to become more nutrition-sensitive (2). This may be the multisectoral approach that Africa needs to make real gains in eradicating malnutrition, which Professor Nnam Ngozi, President of the Federation of African Nutrition Societies (FANUS) was referring to.

Unfortunately, Africa’s nutrition problems are far from straightforward and are influenced by numerous factors; which makes successful project outcomes less forthcoming. Two of the most notable factors are climate change and conflict. It is known that well over half of African countries have experienced violent conflict to some extent, which disrupts the entire food system; causing a myriad of issues from market distortion, to economic losses, population displacement and in extreme cases outright famine (3). These notable factors will undoubtedly slow any progress being made, as noted by Dr Gerda Verburg, UN Assistant Secretary-General and Coordinator of the Scaling Up Nutrition (SUN) Movement; and should be incorporated into nutrition intervention schemes where relevant.

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Dr Gerda Verburg, UN Assistant Secretary-General and Coordinator of the Scaling Up Nutrition (SUN) Movement

Light was cast on the economic importance of improving nutrition when Dr Verburg referenced the 2016 annual meeting of the African Development Bank (AfDB), where eradicating malnutrition was prioritised as an economic necessity. At the side event titled “Developing Africa’s Grey Matter Infrastructure: Addressing Africa’s Nutrition Challenges”, the links between nutrition, cognitive development and economic growth were solidified, and it was stressed that the need to invest in mental infrastructure is equally if not more important than the need to invest in physical infrastructure. This led to the conceptualisation of the African Leaders for Nutrition (ALN), which aims to gather and engage African Heads of State on prioritizing and financially committing to addressing malnutrition (4).

Economist Professor Lawrence Haddad suggested that marketing companies should also be involved in the discussion of shifting consumer behaviour towards more nutritious products, not just food companies. The global consulting firm Hystra was commissioned by the Global Alliance for Improved Nutrition (GAIN) to report on marketing nutrition for the base of the pyramid (low-income consumers). Results from the report will be rolled out by GAIN at the country level to support local companies with developing and improving access to nutritious products for the entire population (5).

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Professor Lawrence Haddad, Executive Director of GAIN

Companies also need to be assured that investing in nutrition is financially profitable, therefore evidence is needed to convince them of this, according to Prof Haddad.  In a UK report titled “Battle of the Wallets: the changing landscape of consumer activism”, it was found that 83% of US and UK consumer activists think it is “more important than ever” to support companies that engage in social responsibility versus 59% that favour simply boycotting companies that don’t (6). Similar research is needed in Africa to incentivise companies to make decisions that would positively impact nutrition outcomes.

Part 1

References:

  1. Satija A, Yu E, Willett WC, Hu FB. Understanding Nutritional Epidemiology and Its Role in Policy. Adv Nutr. 2015 Jan 1;6(1):5–18.
  2. Multi-sectoral Approaches to Nutrition: nutrition-specific and nutrition sensitive interventions to accelerate progress. UNICEF. Available from: https://www.unicef.org/eapro/Brief_Nutrition_Overview.pdf
  3. Kwach J. Causes of conflict in Africa [Internet]. Tuko.co.ke – Kenya news. 2018. Available from: https://www.tuko.co.ke/286140-causes-conflict-africa.html
  4. Promoting grey matter infrastructure is a game-changer in Africa’s development agenda – African Development Bank. Available from: https://www.afdb.org/en/news-and-events/promoting-grey-matter-infrastructure-is-a-game-changer-in-africas-development-agenda-17016/
  5. Marketing Nutrition for Base of Pyramid [Internet]. Global Alliance for Improved Nutrition. 2014. Available from: https://www.gainhealth.org/knowledge-centre/marketing-nutrition-base-pyramid-3/
  6. Battle-of-the-wallets-report-UK-1.pdf [Internet]. Available from: http://webershandwick.scot/wp-content/uploads/2018/01/Battle-of-the-wallets-report-UK-1.pdf

 

 

Adapt or Die: Africa’s Vulnerability to Climate Change

Climate change may lead to the undoing of tireless efforts made over the years to boost agricultural production and improve food security.

The consequences of climate change are likely to be felt by the world’s poorest regions first and most severely. This may explain why efforts by high-income countries (arguably the largest greenhouse gas emitters) to slow or reverse this impact has been lacklustre at best.  Sub-Saharan Africa is particularly vulnerable to climate change on many levels, including the threat of freshwater sources becoming depleted and hunger and malnutrition levels becoming exacerbated. Therefore, it may be left up to Africa and the rest of the developing world to begin adapting to climate change or be left to deal with the impending devastation.

Image result for greenhouse emissions from rich countries

Since the 1970s, land temperatures across Africa have been increasing consistently at around 0.4 °C per decade 1. Future temperatures are also expected to rise, but at a rate that is twice that of the rest of the world (between 2°C and 6°C); especially in the interior parts of the continent like the Sahel region1.  Sea temperatures are also rising, although this time increasing less than the global average (0.6°C to 0.8°C). This is seen in the northern Atlantic, the north-west and south-west Pacific, and the Indian Oceans 2. At the 2015 UN Climate Change Conference (before Trump pulled the US out), attendees agreed to limit temperature increases to “well below 2°C above pre-industrial levels”, so as to avoid the most extreme worst-case climate scenarios3. However, temperature increases are unfortunately expected to continue for the foreseeable future, regardless of whether greenhouse gas emissions were to stabilize or decline altogether 4.

Alongside rising temperatures is the problem of erratic rainfall. Africa now experiences rainfall patterns that are both above and below normal levels; leading to extremities of wet and dry periods that cause droughts and flooding 5. For instance, while Southern Africa is experiencing decreased rainfall, some parts of East Africa, especially the highland areas, are facing heavier rainfall. This variation can even be observed in the same country.

Random Fact:            

Should the average global temperature rise by 2 °C above pre-industrial levels, rainfall could be up to 25% lower in semi-arid regions.

Such climate variability can be detrimental to the livelihoods of small-scale farmers, who carry out the bulk of agricultural activities in Africa. Farmers often lack the capacity to adapt quickly enough to climate change, mainly due to poor infrastructure. When you add climate change to the existing stresses that farmers already face (low market access, inefficient transport networks, inadequate postharvest facilities), the negative impact on food security and public health can be catastrophic. Small-scale farming communities make up two-thirds of the three billion people in rural areas across the developing world; and their contribution to the global food supply is substantial 6. However, according to all indicators, the negative impact of climate change on smallholder agriculture is real. For example, yields of rain-fed crops are expected to decline: up to 22% for maize and 8% for cassava 7. This is significant for Sub-Saharan Africa, when considering that 95 percent of crops grown in the region are rain-fed 8.

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Small-scale farmers face the threat of decreased crop yields, which will affect the food security of the entire continent.

 

Many of Africa’s staple crops such as maize, rice, sorghum, wheat, millet and cassava are expected to one day reach their upper thermal limit; meaning the temperature at which yields will start to decline. Current estimates place yield losses anywhere between 2 ½ and 16 percent for every 1°C of seasonal temperature increase 9. Add this to the fact that the excess carbon dioxide in the atmosphere may affect the nutrient content of many crops, rendering them deficient in key micronutrients like zinc and iron 9. This will only fuel the already high disease burden, which will come with its own consequences.

Agriculture will not be the only sector to suffer; as climate change is also very much a public health issue. For example, warmer conditions in some regions will likely increase the incidence of vector-borne diseases like malaria; while increased flood conditions can create a thriving environment for water-borne infections like cholera, and other diarrhoeal infections that already kill millions of children from poor families 9. It is safe to say that these public health problems will be magnified by existing conditions such as poverty, lack of health and hygiene infrastructure, and of course food insecurity. Undernutrition (often used synonymously with “malnutrition”) refers to the insufficient intake of both nutrients and energy for an individual to remain healthy 10. This is already a long-standing problem in Africa; and with climate change threatening to destroy what is left of rain-fed agriculture, it is likely to get a ton-load worse 9 . Around 10 million more children across the world will become undernourished because of climate change 9 . A child’s mortality rate in Sub-Saharan Africa is 14 times higher than that of a high-income region; so, you can guess where most of these undernourished cases will be from 9.

 

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Climate change is likely to lead to more children suffering from undernutrition

 

 

Climate change will also affect water availability. A combination of increased temperatures and irregular rainfall makes water resources extremely vulnerable. For instance, longer dry seasons could mean a depletion of surface water. Observations show that freshwater sources in Sub-Saharan Africa are already scarce, and current water management systems leave much to be desired. In dry topical areas, freshwater is expected to decline by anywhere between 10% and 30%2. This is likely to intensify the frequency of droughts, which apart from the obvious impact on agriculture and health, will also affect the use of hydropower to generate electricity – especially in Southern Africa where it contributes significantly to the power grid 11. Further, decline in rainfall across Southern Africa will almost certainly deplete surface water; and higher temperatures will almost certainly increase groundwater evaporation 12. This will most certainly cause problems for sustainable agricultural production to bolster food security going forward 13. Rising temperatures may cause most rainwater to evaporate before it even gets the chance to replenish the groundwater. Up to 70% of rainfall will evaporate before ever reaching crops; crops that directly depend on moisture from the rain that remains in the soil 14.

Random Fact:

The Central African region, which includes the Democratic Republic of Congo (DRC) is said to be ‘the wettest place on Earth’ during its rainy season. The Congo Basin is the largest water catchment in Africa and the Congo rainforest is the second largest tropical forest in the world.

While some regions are expected to suffer from a lack of water, many coastal regions will find themselves having too much of it; as they face rising sea levels that is likely to contaminate what’s left of the freshwater needed for agriculture and to manage the ecosystem 2. Then there are the extreme weather events like flooding; which will undoubtedly cause loss of life and damage to infrastructure, which disrupts and further delays economic development. Between 1980 and 2016, Southern Africa got hit with a bill of $10 billion dollars due to climate-related disasters; as well as the headache of rehousing 2 ½ million people that lost their homes, plus another 140 million people that were otherwise affected 2.

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The frequency and intensity of climate-related disasters are likely to increase 

In a nutshell, climate change is likely to reduce the availability of freshwater sources, increase the incidence of flooding and droughts, decrease the yield and nutrient content of major staple crops, and lower the productivity of the entire ecosystem. Sadly, this list is far from exhaustive, but the full magnitude goes beyond the scope of this article. However, provided that appropriate adaptations are made, increases in agricultural production despite climate change is a possibility 8.

According to “Climate Risk and Vulnerability: A Handbook for Southern Africa” 2, there are several proposed strategies worth exploring in an attempt to adapt to the changing climate. These include but are not limited to:

  • Developing and promoting drought-tolerant crop species
  • Soil conservation – (tree planting, grass cover, terrace farming, trenches, mulching, alternative cropping)
  • Exploiting renewable energy sources (less reliance on wood energy)
  • Natural forest conservation
  • Investment in value-addition and post-harvest technology
  • Increasing water supply (irrigation, rainwater harvesting)

Of particular interest is rainwater harvesting, which is a useful but often overlooked method for ensuring a sustainable supply of water to cultivate rain-fed crops – the backbone of African agriculture.

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Domestic rainwater harvesting underground tank in South Africa. Water collected from the ground surface is channelled into an underground tank 

Rainwater harvesting can be done on a small-scale using several methods like terracinga, which helps retain soil moisture; or by building dams/ditches, which help funnel run-off water into crop fields; or simply storage systems (tanks, ponds etc.) to conserve water 14. These methods are already being practised in East African countries like Eritrea, Ethiopia, and Sudan 14. Rainwater harvesting projects in Kenya and Tanzania dating back to the 1980s have already shown the ability of the method to improve crop yields and even quadruple per hectare productivity 15. Used together with irrigation systems like dripb, spatec, and sprinklers, rainwater harvesting has the potential to significantly improving water usage in agriculture.  Given the long dry spells many farmers already face, they can indeed benefit from this and other innovative systems that improves the way rainwater is utilized; therefore, ensuring farmers achieve a more sustainable harvest in the long term.

References:

    1. Engelbrecht, F., Adegoke, J., Bopape, M., Naidoo, M., Garland, R., Thatcher, M., McGregor, J., Katzfey, J., Werner, M. & Ichoku, C. (2015). “Projections of rapidly rising surface temperatures over Africa under low mitigation”, Environmental Research Letters, vol. 10, no. 8, pp. 085004.

     

    1. Davis-Reddy C, Vincent K. (2017). Climate Risk and Vulnerability: A Handbook for Southern Africa (2nd Edition). CSIR, Pretoria, South Africa. Available at: https://www.weadapt.org/sites/weadapt.org/files/2017/november/sadc_handbook_second_edition_final_full_report.pdf

     

    1. Nino, F.S., (2015). UN Climate Change Conference Paris 2015. United Nations Sustainable Development. Available at: https://www.un.org/sustainabledevelopment/climatechange/

     

     

    1. Stocker, T., Qin, D. & Platner, G. (2013), Climate Change 2013: The Physical Science Basis.  Working Group I Contribution to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change.  Summary for Policymakers, Cambridge University Press, Cambridge, UK.

     

    1. MacKellar, N., New, M. & Jack, C. (2014), “Observed and modelled trends in rainfall and temperature for South Africa: 1960-2010”, South African Journal of Science, vol. 110, no. 7 & 8, pp. 51-63.

     

    1. Innovation Forum (2018). What does the future look like for sustainable smallholder farms? Innovation Forum Editorial Team. Available at:  https://innovation-forum.co.uk/analysis.php?s=what-does-the-future-look-like-for-sustainable-smallholder-farms

     

    1. Campbell, M.M., Casterline, J., Castillo, F., Graves, A., Hall, T.L., May, J.F., Perlman, D., Potts, M., Speidel, J.J., Walsh, J., Wehner, M.F., Zulu, E.M., (2014). Population and climate change: who will the grand convergence leave behind? The Lancet Global Health 2, e253–e254. https://doi.org/10.1016/S2214-109X(14)70021-X

     

    1. Müller, C., (2013). African Lessons on Climate Change Risks for Agriculture. Annual Review of Nutrition 33, 395–411. https://doi.org/10.1146/annurev-nutr-071812-161121

     

    1. USAID (2017). Risk Expands, But Opportunity Awaits: Emerging Evidence on Climate Change and Health in Africa. weADAPT. Available at: https://www.weadapt.org/sites/weadapt.org/files/2017/may/170414_atlas_project_ssa_health.pdf

     

    1. Maleta, K., (2006). Undernutrition. Malawi Med J 18, 189–205.

     

    1. Field, C.B., Barros, V.R., Mach, K. & Mastrandrea, M. (2014). “Climate change 2014: impacts, adaptation, and vulnerability”, Working Group II Contribution to the IPCC 5th Assessment Report – Technical Summary, pp. 1-76.

     

    1. Gordon, C., Nukpeza, D., Tweneboah-Lawson, E., Ofori, B., Yirenya-Taiwiah, D., Ayivor, J., Koranteng, S., Darko, D. & Mensah, A. (2013). “West Africa – Water Resources Vulnerability Using a Multidimensional Approach: Case Study of Volta Basin. Climate Vulnerability: Understanding and Addressing Threats to Essential Resources”, Elsevier Inc., Academic Press, 283–309.

     

    1. UN-Habitat (2013). State of the World’s Cities 2012/2013. Prosperity of Cities, United Nations Human Settlements Programme, Nairobi, Kenya.

     

    1. Rockström, J., Falkenmark, M., (2015). Agriculture: Increase water harvesting in Africa. Nature News 519, 283. https://doi.org/10.1038/519283a

     

    15.  Rockström, J., Falkenmark, (2000) Semiarid Crop Production from a Hydrological Perspective: Gap between Potential and Actual Yields. Crit. Rev. Plant Sci. 19, 319–346

Shea butter: nutritional possibilities – A Brief

Shea butter added to a Lipid Nutrient Supplement (LNS) for treatment of moderate to severe acute malnutrition was found to improve the firmness/texture of the LNS, while increasing the essential fatty acid content and maintaining storage stability.

 

Shea butter is obtained from the shea nut, a seed of the fruit from the karite tree. The karite tree is indigenous to the African Savannah region, a tropical grassland that covers up to 27 countries (Chawla et al., 2011). Shea butter use in the cosmetic and food industry is based on its non-saponifiable lipid content (5-15%); which is a rich source of the natural antioxidant vitamin E (Segman et al., 2012). The micronutrient content of shea butter includes vitamin A and E, beta carotene, calcium, magnesium, potassium, zinc, and iron. Shea butter also contains essential fatty acids including oleic acid and linoleic acid. Upon analysis, shea butter was shown to contain no heavy metals or microbial contaminations. Yellow shea butter (as opposed to beige) was observed to have a higher viscosity than the mean value of most vegetable oils (Megnanou and Niamke, 2015). Owing to this nutrient composition, shea butter may contain antioxidant and anti-inflammatory properties. However, products made from shea butter may vary considerably in their biochemical profile (Honfo et al., 2014).

 

In a study by Sloffer et al. (2017), shea butter was added to a Lipid Nutrient Supplement (LNS) used for treatment of moderate to severe acute malnutrition. It was found that shea butter improved the firmness/texture of the LNS, while increasing the essential fatty acid content and maintaining storage stability.

Generally, shea butter is manually produced by boiling, drying, crushing and roasting the shea nut to form a paste; which is then purified, heated and mixed with water. The fat that rises to the surface of the water is what hardens and forms the butter (Honfo et al. 2014; Chawla et al., 2011).  It may be possible to produce shea oil by regulating the temperature between warming of the solid butter and cooling of the melted butter. Extremely stable whipped oils of high foamability can then be produced by aerating the crystal dispersions. Although the majority of literature highlights the use of this procedure in coconut oil, the same can be applied to shea butter; as each fat has an optimum temperature in which foaming occurs, where the solid fat content reaches close to 30% (Binks and Marinopoulos, 2017).

Despite this, heating shea butter may prove problematic, as oxidation of the unsaturated fatty acids may occur; leading to an accumulation of peroxide compounds (free radicals). Also, some micronutrients such as vitamins A and E and beta-carotene may be destroyed during the heating process (Megnanou and Niamke, 2015).

 

References

  1. Binks, B.P., Marinopoulos, I., 2017. Ultra-stable self-foaming oils. Food Res. Int. Ott. Ont 95, 28–37. https://doi.org/10.1016/j.foodres.2017.02.020
  2. Chawla, K.K., Bencharitiwong, R., Ayuso, R., Grishina, G., Nowak-Węgrzyn, A., 2011. Shea butter contains no IgE-binding soluble proteins. J. Allergy Clin. Immunol. 127, 680–682. https://doi.org/10.1016/j.jaci.2010.10.022
  3. Honfo, F.G., Akissoe, N., Linnemann, A.R., Soumanou, M., Van Boekel, M.A.J.S., 2014. Nutritional composition of shea products and chemical properties of shea butter: a review. Crit. Rev. Food Sci. Nutr. 54, 673–686. https://doi.org/10.1080/10408398.2011.604142
  4. Megnanou, R.-M., Niamke, S., 2015. Improving the optimized shea butter quality: a great potential of utilization for common consumers and industrials. SpringerPlus 4. https://doi.org/10.1186/s40064-015-1454-0
  5. Segman, O., Wiesman, Z., Yarmolinsky, L., 2012. 17 – Methods and Technologies Related to Shea Butter Chemophysical Properties and to the Delivery of Bioactives in Chocolate and Related Products, in: Cocoa Butter and Related Compounds. AOCS Press, pp. 417–441. https://doi.org/10.1016/B978-0-9830791-2-5.50020-7
  6. Sloffer, E.M., et, 2017. Development and Physico-Chemical Characterization of a Shea Butter-Containing Lipid Nutrition Supplement for Sub-Saharan Africa. – PubMed – NCBI [WWW Document]. URL https://www.ncbi.nlm.nih.gov/pubmed/29117103 (accessed 11.29.17).

 

Share a Coke, Share Diabetes – Coca-Cola consumption in Africa and the growing diabetes epidemic

With an advanced distribution system, subsidised prices, aggressive marketing to younger people, and a lack of nutrition knowledge regarding health risks; Coca-Cola products can fuel the growing diabetes epidemic in Africa to unprecedented proportions.

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Consumption Levels

Africa is an important market for the major players in the beverage industry such as Coca-Cola, which is the continent’s largest private-sector employer [1]. In 2015, Coca-Cola saw net operating revenues of nearly $2.5 billion across Africa and the Middle East [2]. South Africa is responsible for the majority of Coca-Cola product consumption in Africa. In 2012, the average South African consumed 260 (237ml) servings of Coca-Cola products per year; an 80% increase over a 20-year period. When compared to the global average of 94, this places South Africa in the top ten Coca-Cola product consumers worldwide [3]. Regarding annual consumption, South Africa alone was responsible for 14% of unit case volume consumption, compared to 16% for Central, East and West Africa combined [4]. Hence other parts of the continent have enormous opportunities for growth in the number of consumers. For example, in largely populous Nigeria, annual per-capita consumption was only 27 per person in 2011; making the country a highly attractive market for expansion [5].

Affordability and Accessibility

In Africa as with other developing regions, the price of Coca-Cola products is kept strategically low to ensure affordability. This is possible due to the subsidies Coca-Cola receives from the International Finance Corporation, a unit of the World Bank Group [6]. In addition, Coca-Cola’s incredibly advanced distribution system is the envy of even the Bill and Mellinda Gates Foundation, as it boasts of the ability to reach remote areas of Africa where basic essential medicines are inaccessible [7].

Considerable research has been conducted on the link between sugary drink consumption and obesity, which increases the risk of diabetes and other non-communicable diseases. The average 330ml serving of sugar-sweetened soda or fruit juice contains anywhere between 40-45g of sugar [8]. These drinks contribute to a considerable proportion of total per capita sugar and energy consumption [8]. Thus, ease of access coupled with affordability and insufficient nutritional and health knowledge, Coca-Cola products and other sugary drinks can indeed fuel diabetes and other non-communicable disease epidemics to unprecedented proportions.

 

Diabetes Burden

Africa’s disease burden has grown significantly due to the increased prevalence of non-communicable diseases such as type-2 diabetes [9] In 2012/2013 Africa was said to have approximately 7.4% of the global diabetes burden (27.5 million out of 371 million people). This was predicted to increase to 9% by 2030 (49.7 million people) [10]. It is very likely that the full extent of diabetes burden may be underestimated due to poor disease surveillance [9,10]. By 2030, diabetes is expected to grow by 67% in the world’s poorest countries, and only 27% in the world’s richest [11]. It is also predicted that nine out of 10 countries with the highest rates of diabetes will be in Africa [11]. In fact, by 2030 the total burden of non-communicable diseases in Africa is expected to surpass that of infectious diseases.

Marketing to Younger People

With regards to the marketing of its products to younger people, Coca-Cola has explicitly made the following claims: “We do not advertise to children under 12 years old”; and “We do not place advertising in media where the audience is over 35% children under 12 years old.” [12]. However, data is now available that show the contrary. Moodley et al. [13] used a digital camera and a global positioning system to map the locations of sugary drink advertising in relation to schools within a specified area in Soweto, South Africa; and found that 14 out of 28 primary and secondary school properties were branded with Coca-Cola advertising. Thirteen of these advertisements were on the school sign itself. In addition, researchers utilised spatial analysis to determine that within each square kilometre of the study area contained one school, four Coca-Cola advertisements, and five vendors, three of which sold sugary drinks [13]. Such early brand recognition will carry on into adolescence and adulthood, thus ensuring life-long product consumption.

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Beverage industry giants including Coca-Cola and PepsiCo signed up to reduce the calorie content in products destined for the US market by 20% by 2025 [14]. Similar pledges have not been made for products to be sold on the African market. Companies are instead clamouring to increase consumption of the same high calorie products [15]. Coca-Cola projected an expansion of retail sales by over $600 billion by 2020; fulfilling its commitment made in 2010 to doubling its African investments. Should the beverage industry wish to minimise its contribution to obesity, diabetes and the remaining non-communicable disease burden in Africa, it can and should consider adhering to nutritional guidelines and regulatory measures, including smaller portion sizes, warning labels, and reduced marketing to children; including the use of celebrity endorsements [6, 14].

 

 

Reference list available on request

Crisis and Causes Part 1 – South Sudan

South Sudan, the world’s youngest country, marked its sixth birthday on the 9th of July this year; but not with celebrations. The country was only recently taken off the famine list, and is now said to be experiencing just a “severe food crisis”. The last famine to be declared in Africa prior to this was in Somalia (2011), where harsh weather conditions induced by climate change led to one of the worst droughts in 60 years. In South Sudan however, conflict is blamed for this nutrition emergency. Conflict has contributed to the overall economic collapse of the country; with inflation reaching a record 836% – the highest in the world.

In order for a famine to be declared, the food situation needs to get from bad to worse to catastrophic.

Before you can even use the word “famine”, at least 20% of households in an area must face extreme hunger; over 30% of people must be visibly wasted; and the mortality rate must be above two people per day per 10,000 people.

So by the time a famine is declared, many people would have already died from starvation. Only when it gets to this stage does the world get to hear about it; and even then, the UN or any of their member states are under no binding obligation to take action. For the agencies that do mobilise and respond, arriving at this late stage makes it extremely difficult to entertain any type of prevention or early recovery strategies.

Politically-motivated fighting in South Sudan between the People’s Liberation Army and the Liberation Army have escalated since 2013.

These two groups, despite the lack of creativity in choosing names, have managed to wreak considerable havoc: destroying crops, property and entire livelihoods; resulting in the largest refugee crisis on the African continent.

The fighting itself is not new. Civil war in Sudan has been raging for 42 of the 60 years of its independence. The conflict continued even after the formation of the new country South Sudan in 2011.

Ongoing conflict can erode the very fabric of a society. Citizens are unable to access basic services such as food, water and sanitation; placing them at risk of death from hunger and diseases. The UN has officially declared South Sudan as the largest humanitarian disaster it has seen since it was founded in 1945. Estimates place the number of people killed since the new wave of fighting at 20,000; with a further 3.5 million displaced either within Sudan or in neighbouring countries. According to the World Food Programme (WFP) and UNICEF, well over 40% of the South Sudanese population, anywhere between 4.9 and 5.5 million people, are in desperate need of food aid. Given the current situation, providing support to these people may be little short of a logistic nightmare.

The region itself was already experiencing drought conditions; so the conflict has essentially exacerbated existing problems. Displacement led to a total disruption of the agricultural system, causing the price of food to sky-rocket. Supply routes for much needed aid were also blocked, and agencies were not able to access vulnerable populations. Aid workers have also been attacked, making it difficult to recruit more staff. Let’s face it, Sudan is not the most popular region. It took a massive A-list celebrity endorsement to draw attention to the first round of fighting in the early 2000s. Current aid appeals only managed to reach 0.9% of its target. Thus its safe to infer that the public is either unaware, uninterested or uncertain of the usefulness of financial aid.

Neighbouring countries such as Uganda are also feeling the effects of this conflict. More than 2000 Sudanese refugees cross over into Uganda every day. A total of 500,000 crossed in 2016; higher than the amount crossing the Mediterranean to get into Europe. Uganda maintains an open door policy to refugees. Still, providing food aid for “the world’s fastest growing refugee crisis” can cost nearly US$1.4bn just up to the end of 2017, according to the UN High Commissioner for Refugees. This target is unlikely to be achieved, especially given that the United States, the UN’s largest donor, has reduced its funding under the Trump administration. The US also has both South Sudan and Yemen (the other country where a famine was declared) included in the list of countries on the recently implemented travel ban.

With the approach of the rainy season, agencies like Food and Agriculture Organisation (FAO) are making attempts to provide seeds and other inputs to get agricultural production off the ground. However, the food crisis has been so severe that many farmers are reported to be eating the seeds out of necessity.

Here are a list of agencies currently working in South Sudan

  1. UNICEF

  2. Save the Children

  3. World Vision

  4. Water for South Sudan

  5. Sudan Relief Fund

  6. Oxfam

  7. Action Against Hunger

  8. CARE

  9. International Medical Corps 

  10. Norwegian Refugee Council