A new report shines a spotlight on what the UN World Food Programme describes as the “crushing impact” of child undernutrition on Africa’s emerging economies – and urges policy-makers to invest in healthcare and education so the children of today are equipped to build the Africa of tomorrow.
Africa is home to the world’s fourth largest economy, Nigeria. The continent holds one-third of the world’s mineral reserves and one-tenth of its oil. Over the past decade, economic growth in Africa has been among the highest anywhere in the world, at an average of more than 5% per year. Yet of the estimated 868m people affected by hunger and food insecurity worldwide, nearly a third are in Africa. And there are more children that are stunted – meaning that they are short for their age, an indicator of chronic malnutrition – in Africa than there were 20 years ago, a situation that poses a major risk to future economic development.
Now a report published by the African Union Commission and backed by the UN World Food Programme focuses for the first time on the economic impact of stunting – and the findings make for sobering reading. According to The Cost of Hunger in Africa (COHA), child undernutrition is costing countries anywhere between 1.9 and 16.5% of their gross domestic product (GDP) every year, and putting massive pressure on healthcare services, schools and individual families.
This is a period of unprecedented opportunity: Africa is experiencing what the report describes as its most important period of growth in 30 years. There is huge potential for the continent to move towards a more industrialised and urbanised society, with a highly skilled workforce. But such a transformation depends on investing in human capital – and that means recognising that a healthy childhood is an essential foundation for future social and economic development.
Currently, the impact – both on the individual and on wider society – is being felt at every stage. The first phase of the COHA team’s research focused on four countries – Egypt, Ethiopia, Swaziland and Uganda – and highlighted some common findings. Children that are undernourished before the aged of five are more vulnerable to anaemia, diarrhoea, fever and respiratory problems, putting pressure on already inadequate health services, and leading to premature death. At school, they are at higher risk of repeating grades and dropping out. Later on, poor health and lack of education impacts on performance on the workplace and on productivity.
The bottom line
Financially, that translates into annual losses running into the billions of dollars. Data from 2009 puts the cost from just under 2% of GDP in Egypt (equating to around USD 3,7 billion) to more than 16% of GDP in Ethiopia (equating to around USD4.7 billion). The report looks at the impact on health services – anywhere between 1 and 11% of total health costs go to dealing with the long-term effects of undernutrition – and the education system, where schools must absorb the cost of children repeating grades.
In the longer term, adults who suffer stunting as children are less productive than their non-stunted counterparts, and therefore less able to make a positive contribution to the economy. They also earn less, impacting on their ability to provide for their own families. Then there is also lost productivity from those children who die prematurely and therefore never become part of the workforce. The report estimates that between 8 and 28% of child mortality is associated with malnutrition. In Ethiopia, for example, that translates into the loss of around 8% of the total workforce.
The report is clear that finding a solution will require collaboration between all sectors – health, education, social care and infrastructure to work together – and that tackling undernourishment is key to ensuring future development in all areas:
- Health: Eliminating inequalities in healthcare is key to the transformation agenda. In practice, this means extending and improving services in rural areas in particular, although this runs the risk that those services will then be swamped. Tackling undernourishment is essential to keeping demand at manageable levels.
- Education: Raising levels of education is a crucial step towards increasing productivity – and therefore competitiveness and innovation. The underlying causes of low performance and early drop-out must be addressed – and undernourishment is a significant barrier to both attendance and retention.
- Building a modern economy: More than half the population of Africa is expected to live in cities by 2035, representing a major shift from rural to urban economies. With this comes a growing need for a more highly skilled workforce – which means avoiding the losses in physical and cognitive capacity that reduce individual’s ability to work effectively and realise their potential. There is also a need to strengthen rural economies, including by developing strong value chains for strategic agricultural commodities.
Clearly, there is no simple solution. Bringing about an end to child undernourishment will require strong national capacity, careful monitoring and, crucially, long-term commitment and significant investment. But what is clear is the magnitude of the potential benefits. The report looks at the potential impact of two scenarios: 1. halving the prevalence of child undernutrition by 2025, and 2. reducing stunting to 10% and the proportion of underweight children to 5% by 2025. In each case, the economic benefits run into the millions of dollars – and for some countries the hundreds of millions of dollars each year. Is this an issue that policy-makers can afford to ignore?
What the future looks like
The Cost of Hunger in Africa sets out two possible scenarios for reducing undernourishment, and calculates the potential economic benefits of each:
Scenario 1: Reduce prevalence of undernutrition among children under five by half by 2025 delivers projected annual savings of:
- Egypt – $133m
- Ethiopia – $376m
- Swaziland – $3m
- Uganda – $88m
Scenario 2: Reduce stunting to 10% and the proportion of underweight children to 5% by 2025 delivers projected annual savings of:
- Egypt – $165m
- Ethiopia – $784m
- Swaziland – $4m
- Uganda – $132m
Key findings from The Cost of Hunger report
- There are more stunted children in Africa today than 20 years ago
- Between 69 and 82% of cases of child undernutrition are not properly treated
- Stunted children achieve between 0.2 and 1.2 years less in education than their non-stunted counterparts
- Between 40 and 67% of working age people suffered stunting as children
- The annual costs associated with child undernutrition amount to anything between 1.9 and 16.5% of annual GDP