Save the child …. Give breast milk!*

The World Breastfeeding Week is celebrated every year (August 1st to 7th) in more than 170 countries to encourage breastfeeding and improve the health of babies around the world. It commemorates the Innocenti Declaration made by WHO and UNICEF policy-makers in August 1990 to protect, promote and support breastfeeding (http://www.unicef.org/programme/breastfeeding/innocenti.htm).

As we all know, the first two years of a child’s life are particularly important, as optimal nutrition during this period will lead to reduced morbidity and mortality, to reduced risk of chronic diseases and to overall better development. Indeed, infant and young child feeding is one key area (or the cornerstone) to improve child survival and promote healthy growth and development.

The situation

Malnutrition is responsible, directly or indirectly for about 33% of deaths among children under five. Well above two thirds of these deaths, often associated with inappropriate feeding practices, occur during the first year of life. In fact, despite compelling evidence that exclusive breastfeeding prevents diseases like diarrhea and pneumonia that kill millions of children every year, global rates of breastfeeding have remained relatively stagnant in the developing world, growing from 32% in 1995 to 39% in 2010 (see map below to get an idea of the level of exclusive breastfeeding per country).

In reality, breastfeeding rates in the developing world have been declining until recently. This decline has been attributed to changing socioeconomic factors and the perception that infant formula is superior to breast milk. To give you a concrete example and according to UNICEF Pacific Representative, Dr. Isiye Ndombi: “In the Pacific, breastfeeding rates dropped for a number of reasons, either because mothers were being integrated into the workforce, were not supported by their spouses or were not making informed decisions about the long-term benefits breastfeeding would bring to their children. Exclusive breastfeeding (i.e breastfeeding from birth to six months) are about 40% in Fiji, Tuvalu and Vanuatu, and 31% in the Republic of Marshall Islands.”

“It’s a global trend”, says Elisbeth Sterken, national director of INFACT Canada, a non-profit agency concerned with issues around breastfeeding (http://www.infactcanada.ca/). The impact of bottle-feeding infants is different culture to culture but the long-term impact would be the same – a high incidence of obesity and metabolic diseases. Why?

For example, “in Western cultures, bottle-fed babies begin life with nutritional deficiencies that may lead to health and obesity issues later in life”, she said.

In fact, it was a real surprise to read in a book entitled “Let them eat junk” that baby formula can contain 60% more sugars than regular milk. In fact, a bottle-fed baby consumes 30,000 more calories over its first eight months than a breast-fed one. That’s the calories equivalent of 120 average chocolate bars. Given how early our tastes are formed, it is not surprising that “several research studies have shown correlations between bottle-feeding and subsequent obesity. And the problem continues in baby foods, against efforts to limits the high level of added sugars.

Is it possible to advocate for an improvement of the nutritious value of baby formula and change the current trend?

The task seems tricky. Lobbying power from food companies is huge! The battle is unequal, something similar to the idea developed by Jean de la Fontaine in one of his poems. What union can there be between a clay pot and an iron pot? Because when they collide against each other, the clay pot will be broken.

Just one example to demonstrate this unequal battle: the Thai introduced a proposal to reduce the levels of sugars in baby foods from the existing maximum of 30% to 10%, as part of the global fight against obesity. The proposal was blocked by the US and the EU, where the world’s largest sugar corporations have their home offices. This is one among other examples of the lobbying power of the sugar companies.

And what happens in the developing countries?

In developing countries the impact is more dramatic”, Sterken said. An estimated 1.5 million formula-fed babies die each year because families in developing countries can’t afford the formula and dilute it, use contaminated water to mix it, can’t properly sterilize bottles, or supplement with sugared tea, thereby depriving their children of nutrition, and introducing deadly bacteria into their food.

Another important problem is related to the high level of urbanization in sub-Saharan Africa.

Slums in sub-Saharan Africa are expanding at a fast rate, and the majority of urban residents now live in slum settlements. And in fact, urban poor settlements or slums present unique challenges with regards to child health and survival.  The slums are characterized by poor environmental sanitation and livelihood conditions. Contrary to the long-held belief that urban residents are advantaged with regards to health outcomes, urban slum dwellers tend to have very poor health indicators. Then it is not a surprise to observe thaturban mothers are less likely than rural ones to breastfeed -and more likely to wean their children early if they do begin. Low rates of breastfeeding may be attributed in part to cultural practices, access to and utilization of health care facilities, a lack of knowledge about the importance of the practice, but more importantly to the reality that poor women in urban settings who work outside the home are often unable to breastfeed.

This is an important point, how can we help women who work in developing countries to act sppropriately?  It is a necessity for them to be able to breastfeed because it is good for their babies but they also need to economically survive. A dilema!

Does malnutrition affect the quality of mother’s milk?

The 2008 Lancet Nutrition Series highlighted the remarkable fact that a non-breastfed child is 14 times more likely to die in the first six months than an exclusively breastfed child. Breast milk meets a baby’s complete nutritional requirements and is one of the best values among investments in child survival as the primary cost is the mother’s nutrition. In this context and knowing the high incidence of food insecurity in the developing countries, it seems important to ask if malnutrition (or poor nutrition) can affect the quality of mother’s milk and compromise the potential benefit of breastfeeding where it is most needed, i.e. the developing countries.

In fact, a review of the literature showed that mild or moderate malnutrition rarely affects the amount or quality of breast milk that a woman produces. The mother’s dietary intake will not generally increase how much breast milk she can produce in a day. Her nutritional status before and during pregnancy are important for milk content, but generally this has only of marginal impact since her body will ensure that the breast milk receives the available vitamins and minerals. If her diet remains inadequate for a long time, the milk may contain fewer vitamins and fats as her own body stores are used up. However, her breast milk continues to be nourishing for her child, and provides anti-infective factors that help to protect the child against infections. No breast milk substitute contains these protective factors.

The response at the micro and macro levels

It’s hard to believe that something as natural, healthy and cost-free as breastfeeding needs to be promoted by health and nutrition specialists. But as World Breastfeeding Week began on Aug. 1, breastfeeding specialists want to draw attention to the many benefits of breastfeeding to mother and baby and curb the trend toward bottle-feeding infants with commercially prepared formula.

In 2002, the WHO and UNICEF have developed a Global Strategy for Infant and Young Child Feeding (http://www.who.int/nutrition/publications/infantfeeding/9241562218/en/), which recommends that infants start breastfeeding within one hour of life, are exclusively breastfed for six months, with timely introduction of adequate, safe and properly fed complementary foods while continuing breastfeeding for up to two years of age or beyond.

Moreover, the WHO and the United Nations Children’s Fund jointly developed a code for marketing infant formula to curb aggressive marketing campaigns, especially in developing countries (http://www.who.int/nutrition/publications/code_english.pdf). However, its impact over the past 30 years has been limited because of a series of alleged violations and boycotts.

What do we need to do to reinforce exclusive breastfeeding globally?

An international governance is needed to step in and replace the voluntary marketing code. It will help to address and correct unethical marketing that could be put in place by makers of breastmilk substitutes.

It is also necessary to develop national policies that support maternity leave, not only in developed, but also in developing countries.

And finally, it is important to work at the community level. One of the strategies could be to train low-income mothers as breastfeeding counselors and assist communities in forming mother-to-mother support groups (something similar to Saving Help Group). This strategy will increase the understanding of the risks of not breastfeeding and finally, it will reinforce the practice of exclusive breastfeeding among mothers.

In fact, if the exclusive breastfeeding rate was increased significantly, as much as 13% of all deaths of children younger than 5 years could be prevented that could represent around 1 million children under five in the developing world each year. Moreover, the promotion of breastfeeding could avert 21.9 million disability adjusted life years (8.6%).

What do we mean by exclusive breastfeeding?

“Exclusive breastfeeding” is defined as giving no other food or drink – not even water – except breast milk. It does, however, allow the infant to receive oral rehydration salts (ORS), drops and syrups (vitamins, minerals and medicines). Breast milk is the ideal food for the healthy growth and development of infants; and it’s also an integral part of the reproductive process with important implications for the health of mothers.

Then, what are the benefits? Just a recap….

Exclusive breastfeeding for six months has many benefits for the infant and the mother, says the WHO. “Chief among these is protection against gastro-intestinal infections which is observed not only in developing but also in industrialized countries. Early initiation of breastfeeding, within one hour of birth, protects the newborn from acquiring infections and reduces newborn mortality. Finally, the risk of mortality due to diarrhea and other infections can increase in infants who are either partially breastfed or not breastfed at all.”

Breast milk is also an important source of energy and nutrients in children 6 to 23 months of age. It can provide one half or more of a child’s energy needs between 6 and 12 months of age, and one third of energy needs between 12 and 24 months. Breast milk is also a critical source of energy and nutrients during illness and reduces mortality among children who are malnourished.

Adults who were breastfed as babies often have lower blood pressure and lower cholesterol, as well as lower rates of overweight, obesity and type-2 diabetes.

Breastfeeding also contributes to the health and well-being of mothers. It reduces the risk of ovarian and breast cancer and helps space pregnancies — exclusive breastfeeding of babies under six months has a hormonal effect which often induces a lack of menstruation. This is a natural (though not fail-safe) method of birth control known as the Lactation Amenorrhea Method.

Moreover and from a sustainable point of view, exclusive breastfeeding contributes both directly and indirectly to sustainable development. Evidence has clearly shown that exclusive breastfeeding for the first six months of a baby’s life not only improves their future growth and educational achievement, but also significantly reduces national health costs and helps prevent chronic malnutrition. Breastfeeding helps to prevent a number of diseases in childhood and later in life. It offers protection from infections, allergies and adult-life chronic conditions like hypertension, diabetes, obesity, cardiovascular diseases and cancer that rob the national budgets of millions of dollars.

Breastfeeding needs to be valued as a benefit which is not only good for babies, mothers, and families, but also as a saving for governments in the long run.

* The theme for this year’s celebration is “Understanding the past, planning the future: Celebrating 10 years of WHO/UNICEF’s Global strategy for Infant and Young Child Feeding”. It has the slogan “Save the Child, Give breast milk”.

Resources:

http://allafrica.com/stories/201208060231.html http://allafrica.com/stories/201207051232.html

http://www.scoop.co.nz/stories/GE1208/S00003/make-breastfeeding-easier-for-mothers-says-unicef.htm

http://www.guelphmercury.com/news/local/article/771868–world-breastfeeding-week-aims-to-promote-benefits-curb-bottle-trends

http://www.unicef.org/nutrition/index_emergencies.html http://helid.digicollection.org/en/d/Js8230e/1.3.1.html

http://www.biomedcentral.com/1471-2458/11/396/

http://www.nbcchicago.com/investigations/series/target-5/target-5-sugar-baby-formula-139339308.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812877/

http://www.nutraingredients.com/Industry/Infant-formula-marketing-code-has-failed-says-expert

Book: Let them eat junk, how capitalism creates hunger and obesity – Robert Albritton

It is possible to improve food security in Sahel!

Where is located Sahel?

We have all heard about Sahel, but we don’t really know where it is located and how this region is large? Check the map below for more information.

The Sahel (in orange) is the ecoclimatic and biogeographic zone of transition between the Sahara desert (in yellow) in the North and the less arid Savannah (in green) in the South. It stretches across the north of the African continent between the Atlantic Ocean and the Red Sea. The Sahel covers parts of the territory of (from west to east) Senegal, southern part of Mauritania, Mali, southern part of Algeria, Niger, Chad, southern part of Sudan and Eritrea.

What characterizes the Sahel region right now?

The Sahel region suffers from recurrent drought events, temperatures easily crawl into the 100s. Food insecurity, hunger, death are common. Widespread drought, high food prices and poor harvests have put more than 18 million people in a situation of starvation and over a million children at risk of severe malnutrition.

But, despite this dramatic scenario of food insecurity – low rainfall and general food scarcity, some farmers have had a bumper rice yield this year. This surplus rice is no accident.

Is it a miracle?

Not at all! Over the last three years ACDI/VOCA (http://www.acdivoca.org/site/ID/home), an economic development organization, has helped some 10,000 farmers in the northern Segou region of the Sahel region located in Mali to make the transition from semi-nomadic livestock herders to sedentary farmers and landowners through the Alatona Irrigation Project, funded by the Millennium Challenge Account (MCA – an innovative and independent U.S. foreign aid agency that is helping lead the fight against global poverty (http://www.mcc.gov/pages/about).

Like for the majority of the African countries, the inhabitants of this region depend on natural rainfall to grow crops or create viable grazing grounds. For these pastoralists, one year of low rainfall, like last year, could wipe out their animal herds and create a human disaster. Indeed, it can force them to sale their livestock on which they depend for survival at a fraction of their value because it is done in response to a crisis situation. Resettling in a new village and retraining these herders has helped them transition from a subsistence lifestyle into commercial agriculture, resulting in family economic stability and regional food security.

How did they achieve these objectives – family economic stability and regional food security?

Each of the resettled families will receive title to five hectares of irrigated land (which is significantly superior to the average farm size of one hectare that a large majority of the farmers own in Mali), new housing and improved access to fresh water supplies, primary education for children, and health clinics.

Improving the quality of life of the whole family and breaking the intergenerational poverty cycle are important!

Working with local organizations, ACDI/VOCA helps train the new farmers to grow rice with careful irrigation, soil conservation and fertility practices. The farmers are also diversifying and selectively marketing second-season cash crops.

More specifically, ACDI/VOCA is organizing the distribution of agricultural starter kits to ensure success for first-time rice farmers. The kits include oxen, plowing equipment, wagons, fertilizer and certified seed. ACDI/VOCA will also provide kits for a second dry season vegetable crop exclusively for women farmers. In addition to rice, farmers are exploring markets for shallots, potatoes and forage crops for livestock feed.

Perhaps most importantly, these new farmers are learning water management, hydraulic systems, irrigation and drainage techniques as well as the best practices in terms of maintenance of a network of canals.

Access to water, appropriate equipments, technologies, savoir faire and local capacity building for long-lasting outcomes as well as diversification of the production are the keystone of any successful farming project!

As a result, Alatona farmers are producing 5.2 tons per hectare and making on average $1,000 per hectare in a country where average annual incomes are measured at $700 per year.

Everybody thought we herders were incapable of successfully developing the land that the project has given us,” Demba Diallo, a chief of one of the resettled villages remarked. “With all the positive impacts we are seeing, we are organizing ourselves to better overcome defeats.”

This project is designed to go beyond food subsistence and move into agribusiness, where farmers can invest in small threshing machines, de-hulling machines and motorized tractors.

Infrastructure development projects like the Alatona Irrigation Project can help foster food security and alleviate poverty through economic growth. And the components of this winner ticket are replicable through a holistic and integrated approach that needs to include:

A Variety of Services 

It integrates financial services, irrigation development and women’s gardens into its agricultural training program. It fosters sustainability by helping producers form farmer organizations that have market advantage whether buying farm inputs or selling the crops. 

The ownership of the Land for the farmers

The agricultural land in the project is being cultivated under a land title system, which is a first for the region. Now farmers own the land and have incentives to make improvements. As decision-makers, they put in crops the market demands.

 

Challenges still exist for the Alatona Irrigation Project, such as maintaining long-term soil fertility, sustaining the canal infrastructure, transferring know-how to younger generations and coping with the current political instability in Mali.

Sources:

http://www.huffingtonpost.com/anja-tranovich/food-security-solutions-sahel_b_1651153.html

http://www.acdivoca.org/site/ID/maliMCA-ASDA

If you would like to read more of the series of articles published by Huffington post to call attention to the crisis in the Sahel, go to:

http://www.huffingtonpost.com/news/sahel

You will find some really interesting articles….

Developing World Has Less Than 5 Percent Chance of Meeting UN Child Hunger Target

A new study published in The Lancet suggests that developing countries as a whole have a less than 5% chance of meeting the UN’s Millennium Development Goal (MDG) target for the reduction of child malnutrition by 2015(http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60647-3/fulltext#article_upsell). The Article analyses trends in the weight and height (two simple indicators that can permit to define if the malnutrition is chronic or acute) of more than 7•7 million children worldwide between 1985 and 2011 in 141 countries. They also looked how levels are likely to change if current trends continue.  It is the first large-scale study to provide a detailed examination of trends in children’s weight and growth in all developing countries.

Why this study is important?

The phenomenon of hunger does not only weigh on the individual, it also imposes a crushing economic burden on the developing world as economists estimate that every child whose physical and mental development is stunted by hunger and malnutrition stands to lose 5-10 percent in lifetime earnings. Moreover, the first two years of a child’s life are particularly important, as optimal nutrition during this period will lead to reduced morbidity and mortality, to reduced risk of chronic diseases and to overall better development. In fact, optimal breastfeeding and complementary feeding practices are so critical that they can save the lives of 1.5 million children under five every year.

Progresses are made …..

Professor Majid Ezzati, from the School of Public Health at Imperial College London, UK, and the article’s senior author, said: “Our analysis shows that the developing world as a whole has made considerable progress towards reducing child malnutrition, but there are still far too many children who don’t receive sufficient nutritious foods or who lose nutrients due to repeated sickness. Severe challenges lie ahead.”

To summarize the key results

• 61 of these 141 countries have likely a 50—100% chance to achieve the target – particularly in some parts of Asia and Latin America.

• The prevalence of moderate-and-severe stunting (insufficient growth in height for their age) declined from 47•2% to 29•9% and underweight from 30•1% to 19•4% between 1985 and 2011 in developing countries as a whole.

• In 2011, over 300 million children were mildly to severely stunted and over 250 million mildly to severely underweight, with 17 countries – mainly in sub-Saharan Africa and Oceania – seemingly undergoing no improvement in the number of children who are underweight or restricted in growth.

• Undernutrition worsened in sub-Saharan Africa from 1985 until the late 1990s, when height and weight scores began to improve. The deterioration may have been due to economic shocks, structural adjustment, and trade policy reforms in the region in the 1980s and 1990s. In Ivory Coast and Niger, nutritional status was measurably worse in 2011 than it had been in 1985.

• South Asia, the region with the worst nutritional status in 1985, has improved considerably, but undernutrition is still a major issue. About one half of the world’s underweight children live in South Asia, mostly in India.

• China has undergone the largest improvement in children’s height over the last 25 years, with Latin America and the Caribbean region also experiencing significant improvements in this area. The authors suggest that, in many of these countries, the improvements seen are down to overall improvements in the populations’ nutrition, rather than specific interventions targeting children at high risk.

• Some countries in Latin America, such as Chile, now have almost no undernutrition. The proportion of underweight children almost halved per decade in Brazil.

What’s next?

The statistics presented in this article suggest that in most countries, the improvements are due to population-wide improvements in nutrition, rather than interventions targeting high-risk children.

Moreover, according to Professor Ezzati, “There is evidence that child nutrition is best improved through equitable economic growth, investment in policies that help smallholder farmers and increase agricultural productivity, and primary care and food programs targeted at the poor. We mustn’t allow the global economic crisis and rising food prices to cause inequalities to increase, or cut back on investments in nutrition and healthcare.”

To continue in the same direction – strategies that can contribute to the improvement of the overall nutritional status of children:

In a book entitled “Just Give the Money to the Poor, The Development Revolution from the Global South”, the authors showed through a specific example that equitable economic growth at the community level permits  a population-wide nutritional improvement, among other social and economic improvements.  

In  this book, the authors discussed a new strategy – direct cash transfers (CTs). These are regular payments by the state directly to poor people, similar to welfare in developed countries.  The authors showed that this strategy can have a significant social and economic impact. CTs are affordable and the recipients use the money well and do not waste it. As a result, cash grants are an efficient way to directly reduce current poverty, and they have the potential to prevent future poverty by facilitating economic growth and promoting human development.

Something that perhaps you don’t know! And we didn’t know before reading this book.

45 countries in the Global South now give CTs to more than 110 million families. Every program is different, from universal child benefits in Mongolia to pensions in Africa to family grants in Latin America. Some grants are tiny – only $3 a month – whereas others give families more than $100 a month; some cover more than one-third of the population, and others aim only for the very poorest. The size of public spending varies from 0.1% of GDP to 4%, although most programs fall in the range of 0.4% to 1.5%.

What are the outputs/outcomes of this kind of program?

  • Social protection and security for the young, old, disabled
  • Development and economic growth – CTs give poor people the security they need to invest in higher risk/return options like new crops, or migrating in search of work
  • Breaking intergenerational poverty by ensuring children are better nourished and educated than their parents
  • Rights and equity – reducing income inequality and promoting the status of women

To give you a concrete example on how this strategy can impact the life of people

The villagers of Otjivero village (a very destitute rural community) in Namibia have received each month the equivalent of 15 US$ as part of a pilot study to evaluate the socio-economic impact of direct cash transfer.

One of the first and immediate results was the creation of a whole range of economic activities in this small village.

After two years, the program team that managed this pilot study was able to report:

• A decrease of the number of people living below the poverty line from 76 to 37%

• Less than 10% of the children were malnourished – before the experiment, almost half of children were malnourished

• 90% have finished their education – before, they were only 60%

• And crime has dropped

This pilot study has also shown that CT has an impact not only on production but also on demand. In Africa, the purchasing power is usually centered in a few centers, forcing people to leave the countryside to cities, where slums eventually spread. The CT allows rural to grow, it creates local markets and allows people to be self-sufficient.

When you know that you will recieve each month some cash to support your family, this brings some sort of financial security. This kind of initiative helps to ensure that the basic needs for the family are covered but also helps to invest in the future. It creates the first step to equitable economic growth.

Something to meditate! 

Sources:

http://www.redorbit.com/news/health/1112650992/developing-world-has-less-than-5-percent-chance-of-meeting-un-child-hunger-target/

http://www.exchangemagazine.com/morningpost/2012/week27/Thursday/12070507.htm

http://www.oxfamblogs.org/fp2p/?p=2547

http://www.courrierinternational.com/article/2010/04/29/les-miracles-du-revenu-minimum-garanti

Hunger and Obesity Are Food Security Issues ….

…. Or we can also define them as the visible outcomes of the failure of our global Food Security System…

The U.N. says nearly a billion people go to bed hungry every night. At the same time, hundreds of millions of others are obese. To solve those twin crises, we will need to know who is wielding the power over food and marketing.

Raj Patel (http://rajpatel.org/), author of Stuffed and Starved: The Hidden Battle for the World Food System (http://rajpatel.org/2009/10/27/stuffed-and-starved/) says hunger and obesity are not just a matter of eating too little or too much. It has to do with what people are eating and the systems and institutions driving consumption.
To summarize his analysis and to add some of our thoughts:

There’s growing investment in agriculture around the world to feed an expected population of 9 billion by 2050. But as emerging economies grow in Africa and Asia, consumers in those regions are switching to a more Western diet. It’s a diet many blame for obesity, as well as diabetes and cardiovascular disease. However, many others say that people have a choice as to what to eat. They don’t have to buy foods rich in fat, salt and sugar.

And are we really having the choice?

Patel said that’s no.

“When you look at the amount of money that is spent promoting food, the ratio of good food to junk food marketing is about 1 to 500. In other words, for every dollar that’s spent promoting fresh fruits and vegetables 500 is spent promoting junk food,” he said.

And this discrepancy means so much to us with the London Olympic Games that is approaching. All the big food companies are partners of this major event…. Sport is associated with junk food and not with healthy food or healthy eating behaviors.

Again for this Olympic Games, we won’t see an encouragement for healthy nutrition and how this combination – sport and good nutrition – can have a dramatic impact on health. So important for the future of children… Unbelievable!

The battle seems to be lost in advance…

Just a handful of corporations control much of the global food market. It raises the question of what’s considered normal eating?
It is true. “You have kids growing up who think it is normal to be drinking 32 ounces of soda, basically sugar and empty calories. Children who are disconnected from where their food comes from and who are being raised in some very unhealthy eating habits.” Patel said.

Evidence can clearly be found in the United States as well as in some emerging countries like Mexico, India and South Africa.

For example:

• “One in three children who were born in the year 2000 will develop type 2 diabetes. And if we’re talking about children of people of color then that’s near a one in two children will develop type 2 diabetes,”

• “India is a country that’s suffering [from] an epidemic of hunger at the same time as an epidemic of the kinds of disease that used to only happen in rich economies”.

And this is an interesting question …… what can we consider as normal eating?

Is it the same everywhere in the world or do we have major differences based on food tradition, culinary culture as well as genetic background? Can we have a universal approach to this concept?

And finally, if we take the example of Canada, country where CKi is located – what is the legitimacy of having one unique food guidance policy in a country where there are so much different ethnic groups? Recent studies have shown a dramatic level of metabolic diseases in the new immigrant population in Canada. These are some of the questions we ask and we try to answer.

In fact, modern diets are often very different from what our ancestors ate and a lot of people around the world are currently eating. Diversity in food, respect of the tradition around food as well as the culinary culture are keen and we need to value them.

There is hope for better nutrition.

“There’s an amazing kind of rebirth of the food movement in the United States and around the world of people who are excited to be reconnecting with growing their own food, with eating locally and sustainably and organically. And that’s a fight that’s well worth talking about as well, because it’s a way of reducing some of the problems associated with diabetes – the diseases of the modern food system,” he said.

Personally, I was amazed to find a local organization in Port-au-Prince – Buy Local Haiti (Kore Pwodiksyon Lokal – http://www.youtube.com/watch?v=npvx4F9JZyo) that advocates for good food and educates people to eat well based on their culture and tradition and this, despite the socio-economic difficulties in Haiti.

I met these people and I learnt a lot about the importance of the food movement, dignity and human rights, more importantly in countries like Haiti overwhelmed by American rice. In fact before 1970s, Haitian people ate rice only one time/week (mostly on Sunday); nowadays and as a result of the cheap American rice availability, it became the unique daily dish.

Buy Local Haiti has made a video showing a weekly menu based on Haitian culture and tradition. This weekly menu contains only one-time meal with rice. This was a great success on the Haitian TV….. People had water in their mouth!  It reminded them their childhood. They saw that it is possible to eat differently.

Consumers and communities around the world are realizing they have a health and economic crisis on their hands linked to diet. Patel says they’re taking action by defining their own food and agriculture policies. Haiti is also part of this movement! There is hope for a better future….

Source: http://www.voanews.com/content/decapua-food-power-27jun12/1253203.html

To read more about Raj Patel: http://www.theglobeandmail.com/news/world/who-says-raj-patel-is-the-messiah/article566168/

http://www.guardian.co.uk/books/2007/sep/15/healthmindandbody.health

Developing World Are Rapidly Consuming More Unhealthy Food

Big Food is making a big headway in the developing world, highlighting the need for researchers and policymakers to examine how the food and beverage industry markets unhealthy products implicated in chronic conditions like diabetes and heart disease.

In an interesting article, David Stuckler and al (Manufacturing Epidemics: The Role of Global Producers in Increased Consumption of Unhealthy Commodities Including Processed Foods, Alcohol, and Tobacco, June 2012; PLOS medicine – http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001235) from the University of Cambridge examined market data on processed food and soft drink sales for up to 80 countries between 1997 and 2010.

These are the key points as highlighted:

• The rate of increase in consumption of “unhealthy commodities” (soft drinks and processed foods that are high in salt, fat, and sugar, as well as tobacco and alcohol) is fastest in low- and middle-income countries (LMICs), with little or no further growth expected in high-income countries (HICs).

• The pace at which consumption is rising in LMICs is even faster than has occurred historically in HICs.

As a result, the developing world is also set to match the First World’s unhealthy commodity consumption rates within three decades.

•  Multinational companies like PepsiCo, Netsle and Danone have now achieved a level of penetration of food markets in middle-income countries similar to what they have achieved in HICs.

• Higher intake of unhealthy foods correlates strongly with higher tobacco and alcohol sales, suggesting a set of common tactics by industries producing unhealthy commodities.

• Contrary to findings from studies undertaken several decades ago, urbanization no longer seems to be a strong risk factor for greater consumption of risky commodities at the population level, with the exception of soft drinks.

• Rising income has been strongly associated with higher consumption of unhealthy commodities within countries and over time, but mainly when there are high foreign direct investment and free-trade agreements. Economic growth does not inevitably lead to higher unhealthy-commodity consumption.

o A free-trade agreement with the U.S. is associated with about a 63.4% higher level of soft drink consumption per capita for low- and middle-income countries.


o For example, Mexico experienced a rapid rise in soft drink consumption after the 1994 North American Free Trade Agreement dramatically reduced barriers for trade with the United States. As a result, the % of the Mexican population aged 15 and above who is overweighed or obese is superior to 69% (http://www.oecd-ilibrary.org/sites/factbook-2011-en/12/02/03/index.html?contentType=&itemId=/content/chapter/factbook-2011-109-en&containerItemId=/content/serial/18147364&accessItemIds=&mimeType=text/html).


o In contrast, Venezuela – which does not have a similar trade agreement with the U.S. – has maintained steady soft drink consumption rates despite high levels of economic growth.

Unfortunately, all the people in this world are not treated in the same way!

While many companies have pledged to eliminate trans fats and reduce salt, sugar and fat in foods sold in wealthy countries, these nutritional improvements are often not implemented in poorer markets.

There is a need to identify population-level social, economic and political interventions that could stem the rise of unhealthy commodity consumption, and overcome the political barriers to their implementation, as has been done for tobacco control.

It is also imperative to associate these strategies to the current initiative on food security and nutrition that was proposed during the latest G8. A focus on sustainable farming is currently a hot spot but this battle can’t have a real impact in the long term if people see “junk food” like sexy (the food that people living in developed countries love – see one of our previous blog on the same topic) or as the only affordable choice.

Their results and analysis were is part of the journal’s “Big Food” series, which is examining the influence of the food and beverage industry on public health (http://www.ploscollections.org/article/browseIssue.action?issue=info:doi/10.1371/issue.pcol.v07.i17).

Source: http://www.ibtimes.com/articles/356675/20120626/soda-big-food-developing-world-processed-nafta.htm

African child mortality – The best story in development

Africa is experiencing some of the biggest falls in child mortality ever seen, anywhere

Sixteen out of the 20 African countries whom have had detailed surveys of living conditions since 2005 reported decreases in their child-mortality rates (this rate is the number of deaths of children under five per 1,000 live births). Twelve had falls of over 4.4% a year, which is the rate of decline that is needed to meet the millennium development goal (MDG) of cutting by two-thirds the child-mortality rate between 1990 and 2015 (see chart). Three countries—Senegal, Rwanda and Kenya—have seen falls of more than 8% a year, almost twice the MDG rate and enough to halve child mortality in about a decade. These three now have the same level of child mortality as India, one of the most successful economies in the world during the past decade.

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The decline in African child mortality is speeding up. In most countries it is now falling about twice as fast as during the early 2000s and 1990s. More striking, the average fall is faster than it was in China in the early 1980s, when child mortality was declining around 3% a year, admittedly from a lower base.

The only recent fall comparable to the largest of those in Africa occurred in Vietnam between 1985-90 and 1990-95, when child mortality fell by 37%—and even that was slower than in Senegal and Rwanda. Rwanda’s child-mortality rate have halved between 2005-06 and 2010-11. Senegal has cut its rate from 121 to 72 in five years (2005-10). It took India a quarter of century to make that reduction. The top rates

of decline in African child mortality are the fastest seen in the world for at least 30 years.

One important observation is the fact that the falls have happened in countries large and small, Muslim and Christian, and in every corner of the continent. The three biggest successes are in east, west and central Africa. The success stories come from Africa’s two most populous countries, Nigeria and Ethiopia, and from tiddlers such as Benin (population: 9 millions).

Why this decline?

You might expect that countries that reduced their birth rates the most would also have cut child mortality comparably. This is because such countries have moved furthest along the demographic transition from poor, high-fertility status to richer, low-fertility status. But it turns out that is only partly true. Senegal, Ethiopia and Ghana all have majorly reduced fertility and child mortality. But Kenya and Uganda also did well on child deaths, though their fertility declines have stalled recently. So it cannot all be just about lower birth rates. Liberia, where fertility remains high, did poorly on child mortality—but so did low-fertility places such as Namibia and Lesotho. The link between mortality and broader demographic change seems weak.

What makes a bigger difference? It is some combination of broad economic growth and specific public-health policies, notably the increase in the use of insecticide-treated bed nets (ITNs) which discourage mosquitoes, which cause malaria.

Ethiopia, Ghana, Rwanda and Uganda have been among Africa’s star economic performers recently, with annual GDP growth averaging over 6.5% in 2005-10. At the other end of the scale, Zimbabwe saw its GDP fall and mortality rise. This seems intuitively right. An increase in national income should reduce mortality not just because it is usually associated with lower poverty and better nutrition but also because growth can be a proxy for other good things: more sensible economic policies; more democratic, accountable governments; and a greater commitment to improving people’s living standards.

But growth offers no guarantees. Liberia, with high-mortality rates, actually saw an impressive GDP increases whereas Senegal, whose record in child mortality is second to none, had a rather anemic growth rate by recent African standards (3.8% a year, half that of Rwanda). “The miracle of low mortality” has taken place in different circumstances suggests there can be no single cause. To look for other explanations, therefore, we can look at Kenya in more detail*.

And good riddance

Kenya is a test case. It has cut the rate of infant mortality (deaths of children under one year old) by more than any other country. It has had healthy economic growth (4.8% a year in 2005-10) and a functioning democracy, albeit after horrendous post-election violence in 2008. Moreover, it increased the use of treated bed nets from 8% of all households in 2003 to 60% in 2008. As a result, half the overall drop in Kenya’s infant mortality can be explained by the huge rise in the use of ITNs in areas where malaria is endemic.

Bed nets are often taken as classic examples of the benefits of aid, since in the past they were pioneered by foreign charities. Consistent with the view that aid is vital, Jeffrey Sachs, an American economist, recently claimed that a big drop in child mortality in his Millennium Villages project (a group of African villages that his Earth Institute of Columbia University, New York, is helping) is the result of large increases in aid to villagers. In fact, argues Mr Demombynes, a World Bank representative, the mortality decline in these villages was no better than in the countries as a whole.

The broad moral of the story is that the different sources of aid does not seem to be the decisive factor in cutting child mortality. No single thing was. But better policies, better government, new technology and other benefits are starting to bear fruit. “This will be startling news for anyone who still thinks Africa is mired in unending poverty and death,” says Mr Clemens of the Centre for Global Development. But “that Africa is slipping quickly away.”

Based on an article published in the economist: http://www.economist.com/node/21555571

Hunger eradication essential to achieve sustainable development – UN Food Agency

Sustainable development will not be achieved unless hunger and malnutrition are eradicated, stated by the United Nations food agency in a recent report.

One of the great flaws in current food systems is that despite significant progress in development and food production hundreds of millions of people are hungry because they lack the means to produce or purchase the food they need for a healthy and productive life.

“We cannot call development sustainable while this situation persists, while nearly one out of every seven men, women and children are left behind, victims of undernourishment,” said the Director-General of the Food and Agriculture Organization (FAO), José Graziano da Silva, in a news release.

In the report – entitled Towards the future we want: end hunger and make the transition to sustainable agricultural and food systems – was prepared for the UN Sustainable Development Conference (Rio+20), which will be held in Brazil next month.  The FAO stresses the need to address the flaws in the current food system so that hundreds of millions of people in developing countries have the means to produce or purchase the food they need for their own consumption and income.

“The quest for food security can be the common thread that links the different challenges we face and helps build a sustainable future,” Mr.Graziano da Silva said. “At the Rio Summit we have the golden opportunity to explore the convergence between the agendas of food security and sustainability to ensure that happens.”

The key points in this report are:

  • To establish and protect rights to resources, incorporate incentives for sustainable consumption and production into food systems, promote fair and well-functioning agricultural and food markets, and invest public resources in public goods, especially innovation and infrastructure, among other measures.
  • To help farmers who operate 500 million small farms in developing countries and whose resources are limited due to insufficient access to food and nutrition.
  • The need to change consumption patterns in the developed world to reduce food waste. FAO estimates that global food losses and waste amount to 1.3 billion tons per year, which represents roughly one-third of the world food production for human consumption.
  • To be able to feed the expected global population of nine billion people in 2050, an improved governance of the food and agricultural system is required.

“Unless purposeful action is taken, the increase in food production of 60 per cent needed to meet effective demand will still leave over 300 million people behind who are expected to suffer from chronic hunger in 2050 because they will remain without the means to access food,” FAO noted.

To read more on this issue, go to:

http://www.un.org/apps/news/story.asp?NewsID=42119&Cr=sustainable+development&Cr1

http://www.egovmonitor.com/node/50781

http://www.thisdaylive.com/articles/development-impossible-without-hunger-eradication/117305/

The Global Food Security Index – A needed tool that integrates nutrition as a key parameter

According to the UNs, the world will need at least 50% more food to feed a growing population by 2030, (expected to swell from 7 billion to 9 billion people by 2050). Another important deadline is the millennium development goal – to halve the proportion of people who suffer from hunger between 1990 and 2015. Unfortunately, the progresses for this specific goal are so far really disappointed.

In this context, global food security is more and more a top concern of many governments as illustrated by the recent G8 and G20 summits. The New Alliance for Food Security and Nutrition, announced at the Camp David G8 Summit in May, highlights the shared commitment among G8 and African leaders, private business and non-governmental organizations to achieve global food security.

Consequently, a food security index is becoming increasingly important given the growing world population and the potential limits on our ability to provide food in coming years. So any additional and long-term measures than can give an overall picture of food security are seemingly useful.

Why improving food security (and indirectly nutrition) so important?

The truth is that food security is a prerequisite to economic growth and job creation. You cannot educate a hungry child, and you cannot hope for productive employment if citizens are going without food. Moreover, according to the latest analyses that focused on child and maternal health, there is a critical window of opportunity for improving child nutrition; it goes from pregnancy through the first 24 months of life. The deficits acquired by this age are difficult to reverse later and can affect dramatically the possibility for each child to achieve his or her full potential.

As claimed by the World Bank a few years ago, it is time to reposition nutrition as central to development and part of an global food security strategy (http://siteresources.worldbank.org/NUTRITION/Resources/281846-1131636806329/NutritionStrategy.pdf).

Who takes the lead on this new set of indicators?

DuPont, a developer of genetically altered crops, commissioned the Global Food Security Index to measure hunger worldwide, and identify areas for improvement and where reforms are most urgently needed. This new index was launched by the Economist Intelligence Unit, an advisory and forecasting research firm (http://www.multivu.com/players/English/56895-eiu-global-food-security-index-dupont/) a few days ago.

As highlighted by DuPont in their press released: “We share a common goal of food security; we do not share a common language. To truly address the root cause of hunger, we must have a common path forward to tackle such pressing issues as food affordability, availability, nutritional quality and safety. Literally billions are being invested to address food security, but until today, we had no comprehensive, global way to measure food security and the impact of investments and collaborations at the local level.”

Accordingly, the Global Food Security Index addresses the underlying factors of food insecurity in 105 countries and points to areas for improvement and reforms. We hope that the Global Food Security Index will be used appropriately to promote collaboration, make better informed decisions and stimulate action necessary to feed our growing population and impact positively the growing epidemic of malnutrition, i.e hunger and obesity.

What does this new index measure?

The Global Food Security Index measures levels of food security by answering a central question: “How can consumers in each country easily access sufficient amounts of safe, high-quality and affordable food?” said Leo Abruzzese, Economist Intelligence Unit Global Forecasting Director.

This new index seems to a comprehensive tool that will help to move from rhetoric to results. It is based on 25 global indicators that measure specific aspects of food affordability, accessibility, availability, nutritional value and safety. Because food security is a politically sensitive issue, the project tries to keep these indices are independent, credible and transparent that it is possible.

What we find really important is the fact that this index uses a multidisciplinary approach and measures at different levels (micro to macro) affordability, availability as well as quality and safety (see above).  Another aspect that we really like it is the big emphasis on the quality of the diet consumes by people in the different countries. Some aspects that resonate positively to us are diet diversification, micronutrient availability and not the last, protein quality (see below the result for Ghana).

This panel of indexes will not only measure affordability and availability but it will position nutrition as a vibrant and essential component of the overall food security strategy.    

Go and explore the Global Food Security Index website at http://foodsecurityindex.eiu.com/, it is part of the public domain.

You will be amazed by the large range of graphical representations that presents the data generated for the 105 countries. It is user friendly and you will be able to create your own representation using the Food Security Index data tool (see below).

When you click on a circle that represents one country, you get of course the name of the country but also some key information on food security for this country.    In the example above, the overall score for this new index is represented in function of the overall food consumption as a share of the household expenditure. France is in orange, the other European countries are in purple and the rest of the world in Grey.

What we see? France has one of the higher overall score and food consumption represented more than 20% of the household expenditure (which is significantly superior to USA that got the highest overall score). We all know that food or “le bien manger” is really important in France.  We also can see that there is a big difference among the European countries, that includes also East Europe and Central Asia countries.

What are the first results?

• The results show that the U.S., Denmark, Norway, France and the Netherlands are the most food-secure countries in the world. • The five most impoverished nations at the bottom of the Index, indicating they are have extensive food security problems, are Madagascar, Haiti, Burundi, Chad, and Congo.

• The good news is that several of the countries at the very bottom of the index, notably Mozambique, Ethiopia, Rwanda and Nigeria, are also ones with strong economic growth, suggesting that their food situation may improve as living standards rise and as sound policies are hopefully put in place.

• The index also indicated that China experienced the least volatility of agricultural production during the last 20 years (explained by generous subsidies that create a floor for food commodity prices), while the North African countries of Morocco, Tunisia and Algeria had some of the most variance.

• The landlocked countries show only a modest increase in food insecurity, on average seven points lower on a scale to 100.

• Residents of wealthy nations have 55% more food available than people in poorer countries:  3,400 calories a person per day compared with the daily intake of 2,300 calories recommended by the United Nations to live a healthy and active life.

• People in the United States and other advanced nations consume an average of 1,200 calories per day more than those in low-income countries, but even in these wealthy nations food supplies lack enough micro-nutrients. In fact, an abundant food supply doesn’t guarantee that a nation will have the healthiest or safest diet. This is an interesting result – quantity doesn’t mean quality at all!

• Another interesting result is a strong correlation between women’s economic opportunity and access to affordable, safe food. The Global Food Security Index shows a hefty 0.93 correlation with the EIU’s Women’s Economic Opportunity Index, which measures female economic participation. “The FAO estimates that if women had access to the same productive resources as men—better seeds, fertilizers and fungicides—they could increase their yield by 20% to 30%. As women make up 43% of the world’s farmers, this would increase total agricultural output in developing countries by 2.5% to 4%, and reduce hunger globally by 12% to 17%, according to the FAO.”

• Interestingly, the correlation between food security and EIU’s Democracy Index was only 0.77, a much weaker link than with women’s labor equality. This result may suggest that what happens in the political sphere is a bit less important than what happens on the social sphere, in terms of food and nutrition security.

Great job! They validate some important evidences.

Stay in contact with us …..

Resources:

http://www.marketwatch.com/story/dupont-calls-for-common-food-security-metrics-2012-07-10

http://www.reuters.com/article/2012/07/10/us-food-report-idUSBRE8690KR20120710

http://www.guardian.co.uk/news/datablog/2012/jul/10/food-security-index#data

http://www.businessweek.com/news/2012-07-10/nations-with-most-food-may-lack-best-diets-study-finds

http://www.economist.com/blogs/graphicdetail/2012/07/global-food-security

Who is USAID Really Helping?

As hearings begin for the 2012 Farm Bill, Washington is being urged to re-think its foreign food aid policies, procedures, and spending.

Currently, food aid coming from the USA makes up about 1/2 of the world wide total. Of this large amount of cereals, pulses, and vegetable oil 40% comes from just three large firms. As it stands today, the Farm Bill (with its $2 billion budget) is set to benefit these three companies more than the world’s hungary.

At the moment, food is purchased by USAID (US Aid for International Development) in the USA and shipped to where it is needed. This transportation accounts for 60% of the total cost of aid and takes 3-6 months to arrive at its destination. Once it has been delivered, a portion of the food is sold by aid agencies at local markets to fund their development projects in the area–this is called “monetisation”. This has cyclical consequences: not all the food goes to the hungry–> local markets are flooded with American products, which are preferred by consumers–> local growers can’t sell their produce at a fair price–> local growers become impoverished and become part of the hungry. In this way, more than 1/3 of every dollar spent on foreign food aid is wasted and benefits large corporations instead of the world’s hungry.

If the world’s hunger is to be reduced, it is essential that there is a re-evaluation of budgeting and goals. Analysis of a pilot project to buy US food aid in the country it is needed showed that purchasing some grains and pulses locally would result in a +50% cost savings and would allow the products to get to their destinations 60% (14 weeks) faster than if they were shipped from the USA. This is particularly imperative with the soon expected food emergencies, such as in Sudan where the traditional model of food aid would not be able to bring enough supplies quickly enough for the 400,000+ people already displaced by clashes. Furthermore, this would create positive cyclical consequences: locally purchased foods–> local farmers benefit by selling to US aid and being able to sell their products at a fair price at local markets–> local farmers don’t go hungry–> less food aid is needed–> greater savings in USAID dollars over time. As well, this would help decrease the USA’s giant biological footprint.

Furthermore, NGOs are pushing for more “untied” USAID dollars for more sustainable and creative ways of fighting world hunger than just providing handouts. However, strong agriculture lobbying groups will prove this to be a challenge as they have in the past. For example, a push by the Bush administration in 2005 for Congress to let USAID purchase 1/4 of the food donated locally failed.

Luckily, there has been a recent international trend which is shifting towards cash-based aid and buying from producers in developing countries. Perhaps now the times will be more favourable for a long needed paradigm shift when it comes to foreign aid.

MALNUTRITION

Asma Lateef, director of the Bread for the World Institute, says USAID should also aim to meet key nutritional goals, especially for pregnant women and children under the age of two. This comes as the negative and permanent ramifications of inadequate nutrition within the first 1,000 days of a child’s existence are becoming widely recognized.

“At a minimum, we should begin to include goals on nutrition as a measure of the impact of U.S. food aid,” says Lateef. “It’s really important to have a discussion on how food aid can be better aligned with broader development goals.”

Information derived from:
http://www.trust.org/alertnet/blogs/alertnet-news-blog/washington-urged-to-stop-wasting-food-aid-dollars