Despite the general worldwide reduction in food insecurity,(2) Africa’s food security and nutrition situation is growing worse. Africa has been experiencing several episodes of acute food insecurity causing an immense loss of life and livelihoods over the past decade.(3) African countries have collectively made the least progress towards achieving the Millennium Development Goal of reducing hunger by half by 2015,(4) and currently close to one third of its population lives in chronic hunger.(5) In particular, the Sahel and Horn of Africa regions in West and East Africa are experiencing the worst food crises in recent years - 23 million people in 11 countries in the regions are affected by acute food insecurity and are facing malnutrition.(6) Factors that have contributed to this situation include exceptionally high population growth rates, political conflicts, climate changes and the endemic poverty in some regions.
The food security outlook in Africa is worrisome, as Africa’s population is expected to increase from 1.01 billion in 2009 to 2 billion in 2050 if current demographic conditions remain constant. Much of this growth will be concentrated in sub-Saharan Africa (SSA), where annual population growth rates are expected to range from between 1.6% to slightly more than 2.4% between 2010 and 2050.(7) How will Africa be able to cope with its food security challenge? This paper examines the scope, current trends and the vulnerabilities of Africa to the causes and consequences of food insecurity and malnutrition.
The definition of food security and malnutrition
The World Food Summit of 1996 defined food security as existing “when all people, at all times, have physical and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life.”(8) This definition is based on four dimensions: the availability of sufficient quantities of food of appropriate quality; access by individuals to adequate resources for acquiring appropriate foods for a nutritious diet; utilisation of food through adequate diet, clean water, sanitation and healthcare to reach a state of nutritional well-being where all physiological needs are met; and the ability of populations, households and individuals to have access to adequate food at all times.(9)
A household is said to be food secured “if it can reliably gain access to food in sufficient quantity and quality for all household members to enjoy a healthy and active life.”(10) It is possible, however, for individuals in food-secure households to have deficient or unbalanced diets.(11) Thus, malnutrition occurs when an individual’s diet does not provide adequate calories and protein for growth and maintenance, or if they are unable to fully utilise the food they eat due to illness.(12)
Malnutrition is a direct consequence of food insecurity; however, even if a person consumes enough calories, this does not guarantee adequate intake of essential micronutrients – vitamins, minerals and trace elements.(13) Insufficient calorie consumption often goes hand-in-hand with micronutrient malnutrition and can have grave public health consequences.(14) Nutrition security, a relatively newer concept is said to be achieved when secure access to food is coupled with a sanitary environment, adequate health services and knowledgeable care to ensure a healthy and active life for all household members.(15)
Causes of food insecurity and malnutrition in Africa
The causes of food insecurity and malnutrition in Africa are diverse, multi-factorial and interlinked. Poverty and food shortage are the main catalysts of food insecurity in the world; unfortunately, they occur in a vicious cycle. In 2004, 121 million sub-Saharan Africans lived on less than a meagre US$ 0.50 a day. People living on less than US$ 1.00 per day are unable to pay the prices they would need to buy all of the staple food they require and meat and fish consumption for the many poor Africans is a luxury. Although the share of the population living in extreme poverty in SSA declined by more than 10% to 48% between 1999 and 2008,(16) SSA still has the highest concentration of the ultra poor in the world.(17) Despite the rapid economic growth rate in SSA over the past decade, there is historical evidence that this has not been converted into poverty reduction as effectively as in other developing regions, like East Asia and the Pacific.(18)
Poverty also constrains the ability of farming households to invest in productive assets and agricultural technologies, resulting in insufficient agricultural productivity. In addition, African importers are unable to profitably bring in the food needed to make up national food deficits, simply because poverty is so great that insufficient demand is expressed through the market system.(19)
Poverty is compounded by factors such as conflicts, disease epidemics and climate change, such as droughts. Violent conflicts have thwarted all efforts to establish food and nutrition security in Central and East Africa. Violent conflicts, as well as ethnic unrest involving fights over water and grazing resources, the stealing of women and livestock and quarrels over border lines, have contributed to the displacement of people, disruption of transportation and market transactions and subsequently, lack of access to food.(20) sub-Saharan Africa is responsible for 88% of the global conflict death toll between 1990 and 2007, in addition to over 9 million refugees and internally displaced people. In contrast to the case of conflict ridden countries, countries that have ended their conflicts, such as Rwanda and Uganda, have seen substantial economic recovery as well as a reduction in the prevalence of extreme poverty and malnutrition.(21)
Food insecurity and malnutrition are linked to disease in a vicious cycle. “The two interact in a vicious downward spiral. Inadequate food consumption heightens vulnerability to infectious diseases. In turn, infections, particularly malaria, measles, persistent diarrhoea and pneumonia, can keep the body from absorbing adequate food.”(22) Insufficient access to safe water and poor sanitation work in conjunction with diseases such as HIV & AIDS and malaria to further perpetuate food insecurity in SSA. For example, a child infected with HIV is more vulnerable to acute malnutrition than a healthy child. “Not only does HIV & AIDS precipitate and exacerbate food and nutrition insecurity, but the spread of the virus is accelerated when people — because of their worsening poverty — are forced to adopt ever more risky food provisioning strategies.”(23)
Over the past 30 years, Africa has become subject to erratic weather patterns and is often plagued by prolonged droughts followed by floods. These natural shocks trigger adverse consequences, including widespread food insecurity.(24) SSA is the second-most severely affected region for climatological disasters among the developing regions of the world. This is because the temperatures are generally already high, and most of the region’s inhabitants depend on rain fed agriculture for their livelihoods.(25) Only 4% of cropland in SSA is irrigated, compared with a global level of almost 20%.(26) Furthermore, the rural farming populations are the most affected because of their extremely low adaptive capacity, which is linked to acute poverty levels.
It is believed that prolonged drought experienced in certain regions of the continent frustrated the expected reduction in poverty and food insecurity, despite the economic growth experienced across the continent over the last decade. Drought related acute food shortage in the Sahel region of West Africa and the Horn of Africa have resulted in the deaths of tens of thousands of people, while about 18.7 million and 11.7 million people respectively are in need of emergency assistance. The global rise in food prices further compounds these crises.(27) Food crop production is not increasing at a rate necessary to meet population growth, currently averaging 2.4% annually across Africa.(28) Therefore, it is expected that food scarcity will drive up food prices in certain regions of the continent.
Consequences of food insecurity and malnutrition
Food insecurity and malnutrition give rise to many consequences for health and development, with mothers and children most vulnerable to the devastating effects. Malnourished mothers are at a greater risk of dying in childbirth and of delivering low-birth-weight babies who fail to survive infancy. Undernourished babies who make it through infancy often suffer stunting that cripples and shortens their lives. Subsequently, they transfer the broad economic disadvantages of malnutrition in their own lives to the next generation thereby perpetuating the vicious cycle of low human development and destitution.
Children are vulnerable to the consequences of food insecurity and malnutrition because of their physiology and high calorie needs for growth and development. Malnutrition is the underlying cause of death of more than 2.6 million children each year, a third of under-five deaths, and a third of total child deaths worldwide.(29) It is a silent killer that is under-reported, under-addressed and consequently under-prioritised. The United Nations Standing Committee on Nutrition (SCN) 5th report describes malnutrition as the largest single contributor to disease, taking a particularly severe toll on preschool children.(30) One in three developing country preschoolers – 178 million children under the age of five – suffers from stunting as a result of chronic malnutrition. Eighty percent of these children live in just 20 countries in Africa and the Asia Pacific region.(31)
While the prevalence rates of stunted preschool children in Africa have reduced by 2.1% between 1990 and 2010, the absolute number of stunted pre-school children has actually increased by more than 14.5 million, to 60 million, between 1990 and 2010 - projected to reach 64.2 million in 2020.(32) Ethiopia, Nigeria and the Democratic Republic of the Congo account for 40% of all the stunted preschoolers in Africa; hence, any effort to reduce the level of chronic malnutrition on the continent must target these countries. The July 2012 executive brief of the Food and Agriculture Organisation of the United Nations (FAO) on the acute food crises in the Sahel region of West Africa, estimated that about 1 million children under the age of five are at risk of severe acute malnutrition.(33) It is a devastating epidemic that puts affected children at greater risk of medical complications and death from illness, infections and micronutrient deficiencies within a short time.
The link between micronutrient deficiency and food security illustrates the challenges in using food properly in SSA. In many countries, the common diets lack diversity and the traditional food consists mainly of cereal or root staples with very little micronutrient-rich animal-source proteins, vegetables and fruits.(34) One-third of the disease burden attributable to childhood and maternal under-nutrition in Africa is due to micronutrient deficiencies in the food.(35) Four micronutrients are especially vital for good nutrition and human development: vitamin A, iron, iodine and zinc. Deficiency in Vitamin A is a leading cause of preventable blindness in children and increases the risk of severe infections. It impairs the immune system and contributes to the deaths of more than half a million African children annually.(36) Iodine deficiency has been identified as the world's greatest single cause of mental retardation and brain damage.(37) Across SSA, some 58 million children consume less than the recommended amount of iodine.
Iron deficiency contributes to the deaths of young women during pregnancy and childbirth and is a leading cause of anaemia. SSA has the highest prevalence of anaemia among preschool-age children and both pregnant and non-pregnant women. Although Zinc deficiency has proven difficult to quantify, even with incomplete data, sub-Saharan African countries have among the highest risk of zinc deficiency.(38)
Considerable progress has been made in Africa over the past 15 years in addressing such micronutrient deficiency diseases. This is because the solutions to addressing these deficiencies are relatively inexpensive to implement. These solutions include salt iodisation, fortification of commonly consumed commercial foods, and supplemental doses of vitamin A and iron for women and children.(39) Educational campaigns that promote the importance of a balanced diet will go a long way to accelerate the progress made so far.
Apart from the cost of human suffering, the UN SCN 5th report on the world nutrition situation (40) identified nutrition as the foundation for development and malnutrition as an obstacle to human development, inflicting irreversible damage on individuals early in life and imposing large economic and social losses on countries for years to come (see Figure 1.1). According to the report:
Good nutrition underpins progress towards each of the first six Millennium Development Goals (MDGs). The evidence suggests that good nutrition status reduces poverty by boosting productivity throughout the life cycle and across generations (Goal 1), that it leads to improved educational outcomes (Goal 2), that dealing with malnutrition typically empowers women (Goal 3), that malnutrition is associated with over 50% of all child mortality (Goal 4), that maternal malnutrition is a direct contributor to poor maternal health (Goal 5), and that good nutrition status slows the onset of AIDS in HIV-positive individuals, increases malarial survival rates (Goal 6) and lowers the risk of diet-related chronic disease (related to Goals 1, 4 and 6).(41)
The relationship between food security and human development (Fig 1) (42)
In terms of economic consequences, food insecurity debilitates society by increasing mortality, disease and disability. It inflates the direct economic costs of coping with the health impacts and enormous reduction in human potential and economic productivity, brought about by hunger and malnutrition. Similarly, “hungry children make poor students and are prone to drop out of the educational system. Hungry and malnourished adults are unable to be fully productive workers and are more likely to be ill, increasing the burden on often overstretched health systems.”(43) The aggregate costs of food and nutrition insecurity in Africa impose a heavy burden on efforts to foster sustained economic growth and improve general welfare.(44) It is no surprise that of the 187 countries with a human development index (HDI) for 2011, the 15 lowest ranked are in SSA. Among the 30 countries ranked at the bottom, only Afghanistan and Haiti are outside the region.(45) Once solutions can be proffered to the food insecurity and malnutrition challenges in SSA, under-development will not be an issue on the continent.
Roles of Governments and development partners
Despite the recognition of access to food as a right by the Universal Declaration of Human Rights (1948), Article 25,(46) food security is still not universally treated a basic human right.(47) Other conventions such as the International Covenant of Economic, Social and Cultural Rights (1966), Article 11,(48) the Rome Declaration on World Food Security (1996),(49) and the United Nations Millennium Declaration (2000)(50) all reaffirmed “the right of everyone to have access to safe and nutritious food, consistent with the right to adequate food and the fundamental right of everyone to be free from hunger.”(51) By their agreement to these global commitments, African Governments and their development partners have recognised that they have a duty to respect, protect, facilitate, and, if necessary, provide for the food and nutrition needs of all of the hungry and malnourished in Africa.
Some countries have made an impressive effort at tackling their food security challenges. For example, Ghana and some North African countries have shown exemplary leadership in this regard, by meeting the target of halving the proportion of people suffering from hunger and making a giant step into achieving the first MDG based on its stable good governance and sound policies.(52) Ethiopia has been able to mitigate the impact of drought by deploying multi-year investments in safety nets and making significant advances in health and nutrition. These have saved countless lives and protected millions from the famine experienced elsewhere in the Horn of Africa, according to the UN Office for the Coordination of Humanitarian Affairs.(53) Uganda has also experienced encouraging economic growth over the past decade and agriculture has been the focus of its growth strategies. It has a relatively productive agriculture sector, with sufficient food available to citizenry - despite conflicts in the north and northeast part of the country.(54)
Contrary to the case of Ghana, many Africans believe that their Governments are not doing enough as policies and plans to tackle food insecurity have not always been successful. The policies of national Governments and international institutions over past decades have neglected SSA’s rural and agricultural development. Policies such as structural adjustment programmes that aimed to close budget gaps, created large human development deficits, especially among the vulnerable poor, and skewed allocations of national revenue and foreign aid so that agriculture and nutrition were neglected.(55)
The first attempt to address the problem of food insecurity through more than just food aid in SSA was through the ‘Freedom from Hunger Campaign’, initiated by the FAO and other development agencies. The campaign sought to involve developing countries in analysing the causes of food crises and malnutrition, and to find sustainable solutions. However, nearly six decades later, that worthy intention has not been fulfilled in all parts of the world. Early attempts by African Governments to tackle the food security situation on the continent, such as the Lagos Plan of Action (1980-1985) and Regional Food Plan for Africa (1978-1990), also failed due to organisational and financial difficulties.(56) However, with the dawn of the new millennium, many African Governments have committed to increasing public spending on agriculture by signing the Maputo Declaration on Agriculture and Food Security in 2003.(57)
International donor commitments to tackling food insecurity and poverty in Africa have been threatened by the global economic crisis over the past three years. Thus, there is an increase in the funding gap for food crisis interventions in places like the Sahel region and Horn of Africa. According to the FAO’s Horn of Africa update (58) an estimated US$ 163 million is still needed by the organisation to support the region, while another US$ 93 million is needed in the Sahel region to support 8 million people and to combat locusts destroying their crops. Similarly, the Office for the Coordination of Humanitarian Affairs (OCHA), estimated a total funding gap of US$ 825 million to support 18.7 million people in the Sahel region.
In May 2012, the United States Government announced a US$ 3 billion plan to boost food security and farm productivity in Africa through increased investment by US private companies in Africa.(59) Similarly, the British Government committed to improve food supply and farming across Africa, and help pull 50 million people out of chronic poverty over the next ten years, in conjunction with the private sector. It will also provide support to the World Bank’s Global Agriculture and Food Security Programme (GAFSP) fund in order to expand agricultural investment in low-income countries.(60) It is hoped that these new commitments will stimulate more official development assistance focused on food security and malnutrition in Africa.
Future challenges and solutions
The future challenges in the fight against food insecurity and malnutrition are enormous. While fertility trends around the world will decline between 2010 and 2050 worldwide, women in SSA will still give birth to children in larger numbers compared to women in other parts of the world. “During this period, Sub-Saharan Africa’s Total Fertility Rate (TFR), on average, will still be the highest in the world and will account for a 60% increase in its childhood population below age five.”(61) At the same time, more people will migrate to the cities, thereby increasing the demand for food and good nutrition. Total cereal demand in SSA is projected to almost double to 317 million metric tons by 2050; 24% of the increase is expected for maize, 20% for millet, 19% for wheat, 18% for sorghum, 14% for rice and 5% for other grains.(62) As more people move to the cities, they have fewer opportunities than rural people to produce their own food and so must rely on purchases and the cash economy to eat. This will result in a sharp increase in food prices and have a large impact on people who rely almost entirely on cash income, especially the poor.
Simultaneously, combating the threats of climate change and erratic weather patterns will be a major challenge for the future. Climate change plays an important role in the spatial and temporal distribution of vector borne diseases such as malaria. Most of the projected climate-related disease burden will result from increases in diarrheal diseases and malnutrition.(63) Drought represents a constant threat to world food security and ranks as the single most common cause of severe food shortages, particularly in developing countries, and represents one of the most important natural triggers of malnutrition and famine.(64)
African Governments need to be at the centre of this fight. The role of the Government in all matters affecting the citizenry cannot be over-emphasized. Although, individuals should be responsible for their own nutrition security, improved nutrition is a public good. Therefore, the responsibility for ensuring that individuals are able to attain food security must ultimately lie with national Governments. Hence, proactive and sound policies need to be put in place if Governments are to win the fight against food insecurity and malnutrition.
First and foremost, broad-based agricultural development remains the principal route to long-term food security; policy effort should be made by national Governments and development partners to encourage agricultural research and technology assisted food production. African Governments must also have agricultural policies that give incentives to farmers to produce in large scale in order to meet the food needs of future generations. Concurrently, the best way to relieve pressure on the region's natural resources is to slow the rate of population growth;(65) hence, Governments, non-governmental organisations (NGOs) and civil society groups should encourage family planning practices, especially among the region’s poorest populations.
To tackle climate causes of food insecurity, Governments in sub-Saharan African countries need to shift from a reactionary approach to more proactive approach by providing forecasting mechanisms and safety net measures to avert the terrible outcome of their unfavourable weather patterns. Peace and security are also conditions upon which any progress can be made in the fight against food shortage in Africa. Where wars, civil unrest, insecurity, large numbers of refugees and warlords dominate the scene, no development can be expected.(66) The relationship between famine and war in Africa suggests that we should address the chronic and rapidly growing problems of refugees and internally displaced persons (IDPs). Therefore, an effort should be made by regional organisations like the African Union to resolve regional conflicts so that people have can live in peace and have a means of livelihood.
Finally, Governments must also assume full responsibility for eliminating food insecurity by ensuring such conditions as good governance, health and educational services and the empowerment of their people. The links between poverty and hunger are unambiguous, which means that poverty alleviation efforts must play a major role in securing access to food and proper nutrition for all. A rights-based approach that recognises access to food and freedom from hunger as fundamental human rights must be implemented by national Governments and international development partners. National Governments need to organise systems for protecting those in immediate need and must create a safe and enabling environment for humanitarian organisations to help the people in the regions affected. Similarly, social safety nets that focus on child malnutrition prevention through feeding programmes in schools and clinics in the poorest areas can be cost effective.(67) In addition, educational campaigns that promote the importance of balanced diet will go a long way to accelerate the progress made so far.
Africa’s food and security situation should be seen as a global problem with severe consequences. The fight to combat food insecurity in Africa is a tough but not an insurmountable one. Future efforts will require both active Governments and multilateral and bilateral donors pledging long-term funding to commit to national efforts to end famine and food insecurity at a level that is commensurate with the scale of the problem.(68) Only then can Africa overcome its food security challenges.
Written by Temitope Folaranmi (1)
(1) Contact Temitope Folaranmi through Consultancy Africa Intelligence's Public Health Unit (firstname.lastname@example.org)
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(46) ‘Universal Declaration of Human Rights Article 25’, United Nations, http://www.un.org.
(48) ‘International Covenant on Economic, Social and Cultural Rights, 1966’, OHCHR, http://www2.ohchr.org.
(50) ‘United Nations Millennium Declaration 2000’, United Nations, http://www.un.org.
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(61) Thomas, J.A. and Zuberi, T., ‘Demographic Change, the IMPACT Model, and Food Security in Sub-Saharan Africa’, UNDP Regional Bureau for Africa Working paper, 2012.
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