Xinhua (NY Times)

World Bank calls for coordinated international action against malnutrition

JiangGuoPeng

24 avril 2010

WASHINGTON, April 24 (Xinhua) -- The World Bank, joined by the governments of the United States, Canada and Japan, on Saturday launched a campaign against malnutrition, urging governments worldwide to invest more in halving the rate of malnutrition.

"We need to break the vicious cycle of poverty and malnutrition to give people opportunity and to achieve sustained economic growth," World Bank Group President Robert B. Zoellick told a nutrition meeting held on the sideline of the IMF-World Bank spring meetings Saturday in Washington.

The nutrition meeting, which was co-hosted by the governments of the United States, Canada, Japan, through the U.S. Agency for International Development (USAID), and the World Bank, endorsed a multi-partner effort -- Scaling up Nutrition: A Framework for Action.

The meeting described the initiative, which is aimed at fighting malnutrition by cost-effective and proven interventions to prioritize actions for pregnant women and children under the age of 24 months, as "historic" for the way in which the global nutrition community had rallied for the first time around a common agenda and solutions to the problems of malnutrition.

According to the World Bank, malnutrition is a leading cause of death of mothers and young children worldwide and even for those fortunate enough to survive it in early childhood, its harmful effects stay with them for the rest of their lives.

Also at the meeting, the USAID announced its Feed the Future strategy, a comprehensive initiative that targets the causes of hunger and aims to reduce poverty, hunger, and under-nutrition at national scale.

"We must strive to make fortified foods more available and step up proven ways to change women's and young infants' feeding and caring behavior where needed, through community-based programs," said Rajiv Shah, the USAID Administrator.

The USAID is working with governments in Africa, Asia, and Latin America to develop comprehensive, multi-sectoral plans to invest in food security and nutrition, including programs to boost agricultural productivity, expand access to markets, reduce undernutrition, and improve resilience to food security shocks.

Feed the Future priority countries include Ethiopia, Ghana, Kenya, Liberia, Mali, Malawi, Mozambique, Rwanda, Senegal, Tanzania, Uganda, and Zambia in Africa; Bangladesh, Cambodia, Nepal, and Tajikistan in Asia; and Guatemala, Haiti, Honduras, and Nicaragua in Latin America.

Canadian Medical Association Journal

Nutrition and integrated health care to highlight Canadian plan to fight child and maternal mortality, minister says

April 26, 2010

Bev Oda, Canada's international development minister, says nutrition is all too often overlooked in international efforts to tackle child and maternal mortality, which have largely focused on treating diseases such as AIDS, tuberculosis, malaria and polio.

A multibillion-dollar initiative on nutrition and “an integrated approach” to help frontline health workers will highlight the plan that Canada will recommend for adoption at this summer’s G8 meeting to help developing nations tackle maternal and child mortality, International Development Minister Bev Oda says.

Oda will unveil the detailed package of programs in Halifax, Nova Scotia tomorrow at the meeting of G8 development ministers that is being held to lay the groundwork for international initiatives to be discussed at the G8 summit in Huntsville, Ontario, June 25-27.

Oda says the Canadian plan will call upon G8 nations to adopt a Framework for Action on Nutrition that has been developed and spearheaded by a small team of Canadian experts alongside officials from the World Bank, USAID, the United Nations and nongovernmental organizations, including Bread for the World.

There is increased international interest in tackling nutrition as a determining factor in child and maternal mortality, Oda told CMAJ after a meeting with World Bank President Robert Zoellick and United States Adminstrator for International Development Dr. Rajiv Shah in Washington, DC, on Saturday.

At the World Economic Forum in Davos, Switzerland, in January, Canadian Prime Minister Stephen Harper identified improvements in child and maternal health as the government’s primary humanitarian goal for the G8 summit.

But the maternal health project has since become embroiled in controversy, particularly after United States Secretary of State Hillary Clinton waded into the fray during a G8 finance ministers meeting in March in Gatineau, Quebec, in which she chided Canada for not including access to safe, legal abortions as a component of the project.

Oda’s comments suggest that Canada hopes to essentially sidestep the controversy by asking the G8 to tackle the estimated 400,000 easily preventable maternal deaths and eight million easily preventable child deaths in poor nations primarily through expanded nutrition and health programs.

Noting that the Canadian International Development Agency (CIDA) has adopted a food security program that endorses nutrition as one of the agency’s three central aims (CMAJ 2009. DOI:10.1503/cmaj.109-3137), Oda says she “welcomes renewed international attention to nutrition as a development priority. We have been working hard with our global nutrition partners to build this momentum and will champion nutrition as part of the maternal and child health initiative at the G8 Summit in June.”

Oda adds that nutrition has too often been overlooked in international efforts to tackle child and maternal mortality, which have largely focused on diseases such as AIDS, tuberculosis, malaria and polio.

But Oda cautions it remains unclear whether Canada will be able to forge a consensus around an approach that’s focused on improving health systems and nutrition. “I don’t know whether it’s doable or not doable,” she warns. “But we are certainly going to be a proponent of health systems strengthening and nutrition as well.”

The nutrition initiative is based on a plan crafted by development economist Sue Horton, chair of global health economics at the University of Waterloo in Ontario, along with Meera Shekar, lead health and nutrition specialist at the World Bank, and a team of consultants from a wide spectrum of nongovernmental organizations and multilateral agencies (

The plan calls for governments and international agencies to spend an additional $10.3 billion a year “from public resources to successfully mount an attack against undernutrition on a worldwide scale,” explains Graeme Wheeler, managing director of the World Bank.

“This would benefit more than 360 million children in the 36 countries with the highest burden of undernutrition — home to 90% of the stunted children worldwide — and prevent more than 1.1 million child deaths,” Wheeler says. “Since early childhood offers a special window of opportunity to improve nutrition, the bulk of the investment needs to be targeted between pre-pregnancy and two years of age.”

David Morley, president and chief executive officer of Save the Children Canada, says an emphasis on maternal and child health has long been sought by nongovernmental organizations. But he adds that Canada needs to balance the emphasis on nutrition with support for community level health care workers within strengthened regional and national healthcare systems.

“We have to support more community health care programs at the village level in tackling child and maternal mortality,” he says. “That’s what we’ve been talking about as the way to go.”

Morley argues that $364 million budget increase that the government provided to CIDA this year should be devoted to the G8 pledges for child and maternal health. “The big question is: Are is are they going to put new money on the table?”

Jenilee Guebert, director of research for the G8 and G20 research groups with the global health diplomacy program at the Munk School of Global Affairs at the University of Toronto in Ontario, also cautions that the G8 often does not act fully on its commitments.

For example, she notes that although the G8 pledged $20 billion for food security in 2009, so far, Canada is one of the only countries to act on the promise.

Similarly, Guebert notes that at the 2000 summit in Okinawa, Japan, G8 leaders made commitments to: reduce the number of HIV/AIDS-infected young people by 25% by 2010; reduce TB deaths and prevalence of the disease by 50% by 2010; and reduce the burden of disease associated with malaria by 50% by 2010.

At the 2005 summit in Gleneagles, Scotland, the leaders called for an AIDS-free generation in Africa and near-universal “access to treatment for all those who need it by 2010.”

“As of 2008, just over 4 million were receiving ARVs [antiretrovirals], which was about one million more than those receiving treatment in 2007,” Guebert says. “However, more than half of those who need ARVs are still without.”

— Paul Christopher Webster, Toronto, Ont.

Canadian Medical Association Journal

International experts laud Canadian child and maternal health plan

April 29, 2010

Canada’s proposed G8 child and maternal health plan may have ignited a Parliamentary brouhaha over its failure to support funding for abortion but it is also drawing favourable reviews from international health and academic experts.

In fact, researchers and health leaders in the field of child and maternal health in developing nations say that the rough outline for a Canadian strategy unveiled at the G8 meeting of development ministers in Halifax, Nova Scotia, amounts to a highly promising boost for evidence-based international health programs.

Canadian International Development Minister Bev Oda pledged at the conclusion of the G8 ministers meeting yesterday to promote a wide range of interventions across the continuum of care for both mothers and children, including training and support for frontline health workers; better nutrition and provision of micronutrients; treatment and prevention of diseases such as pneumonia, diarrhea, malaria and sepsis; screening and treatment for sexually transmitted diseases, including HIV/AIDS; proper medication; family planning; immunization; clean water and sanitation.

The G8 ministers agreed to a provisional framework within which to tackle these objectives, according to a summary of the Halifax meeting (

Although details remain sparse, researchers addressing child and maternal health in poor countries, where an estimated 400 000 mothers and 8.5 million children die annually from easily preventable causes, say that the framework sounds like a promising approach toward helping to achieve the Millenium Development Goal of significantly reducing child and maternal deaths by the year 2015.

“The list of interventions is good, and relates well” to Millenium Development Goals, says Sue Horton, chair of global health economics at the University of Waterloo in Ontario.

Jean Chamberlain, executive director of Save the Mothers, a medical education program focused on maternal and child survival in Mukono, Uganda, concurs. “I applaud the focus on child and maternal health, which are inseparable,” she says.

Dr. Henry B. Perry, an associate in the department of international health at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland, says the Canadian strategy appears well-grounded.

“The evidence indicates that health systems need to develop the capacity to work with communities to carry out routine home visits, to hold participatory women’s groups, to provide community case management of serious childhood illness, and to provide outreach services from peripheral health facilities,” Perry says. “These same approaches will greatly expand the effectiveness of programs to detect and treat HIV and tuberculosis and to expand access to family planning.”

Caroline Riseboro, maternal health spokesperson for World Vision, notes that an estimated 10 000 children died from pneumonia during the G8 ministers meeting “and that is only 19% of the total 50 000 that died while the development ministers met here in Halifax. We can no longer tolerate sacrificing women and children’s lives while we debate ideologies. We’re glad to see the side debates fizzling down, consensus growing and an understanding of the importance of such a long overdue rescue package for the world’s most vulnerable.”

Venkatesh Mannar, president of the Ottawa, Ontario-based Micronutrient Initiative, says the framework’s focus on nutrition, and the integrated approach advocated by Canadian officials, is “the right way to to go.”

“We think the focus on vitamin A coverage that Canada leads with for 200–300 million kids is contributing to falling mortality,” Mannar says, adding that Canada now needs to continue working with the G8 to shape approaches to implementing its emerging strategy (CMAJ 2010. DOI:10.1503/cmaj.109-3246).

Mannar also recommends that Canada support Scaling up Nutrition: A Framework for Action, a plan developed by the Center for Global Development, the European Commission and the International Conference on Nutrition, the United Nations Standing Committee on Nutrition, USAID, UNICEF, the World Health Organization and the World Bank (

Chamberlain says it’s vital that the framework addresses a range of issues and advocates that Canada should add emergency obstetrical care to the framework’s list of interventions, as well involve a range of organizations in the delivery of programs.

“We want to move away from vertical programs which are not cost-effective and which cause duplication,” Horton advises. “A lot of work is being done by international agencies on cost-effective packages of services. These may require investment in primary care level personnel. Delivery can involve both government and NGOs [nongovernmental organizations].”

Ron Labonte, research chair in globalization/health equity at the University of Ottawa, says that Canada must also respect commitments made in 2007 to implement the Paris Declaration on AID Effectiveness. “Key to this is increasing and making more predictable and long-term health aid to government budgets in ways that respect recipient countries’ needs and planning, and that build its public systems rather than multiply the already bewildering number of competing and confusing individual health projects,” Labonte wrote in an email.

According to the summary of the Halifax meeting, the G8 ministers will request guidance from the World Health Organization, the United Nations Children’s Fund, the United Nations Population Fund, the World Food Programme and the World Bank to “develop a common set of concrete goals and associated indicators” and a “common methodology to determine the most effective and affordable basket of integrated interventions based on and adaptable to country-specific needs.”

— Paul Christopher Webster, Toronto, Ont.

The Post Newspapers Zambia

Zambia among USAID nutrition project strategy beneficiaries

By Mutale Kapekele in Washington DC on Monday 26 April 2010, 03:20:00 CAT (266 Reads)

Zambia has been selected as a beneficiary for the USAID Feed the Future strategy, a comprehensive initiative that aims at reducing hunger and under-nutrition at national level.

Following a meeting on malnutrition between the World Bank, Japan, USAID and Canada on Saturday, it was announced that 12 priority countries, including Zambia, were going to benefit from the Feed the Future strategy.

USAID’s Feed the Future strategy is a comprehensive initiative that targets the causes of hunger and aims to reduce poverty, hunger, and under-nutrition at national scale.

USAID is working with governments in Africa, Asia, and Latin America to develop comprehensive, multi-sectoral plans to invest in food security and nutrition, including programs to boost agricultural productivity, expand access to markets, reduce under nutrition, and improve resilience to food security shocks.

Feed the Future priority countries included Ethiopia, Ghana, Kenya, Liberia, Mali, Malawi, Mozambique, Rwanda, Senegal, Tanzania, Uganda, and Zambia in Africa; Bangladesh, Cambodia, Nepal, and Tajikistan in Asia; and Guatemala, Haiti, Honduras, and Nicaragua in Latin America.

With malnutrition causing the deaths of as many as three million mothers and young children every year, ministers, heads of development agencies, and civil society organisations attending the World Bank and IMF Spring Meetings are appealing to governments worldwide to invest more in halving the rate of malnutrition, one of the 2015 Millennium Development Goals (MDGs).

The meeting for a high-level nutrition roundtable in Washington—co-hosted by Canada, Japan, the United States, through the US Agency for International Development (USAID), and the World Bank heard how better nutrition, called the "forgotten MDG" for its historical neglect by aid donors, would not only sharply reduce hunger and malnutrition but also would significantly improve the health of mothers and children worldwide since research shows that malnourished mothers cannot deliver healthy children, and undernourished children are more likely to die.

Bread for the World Joins International Effort to Battle Malnutrition

Bread for the World; PR Newswire

382 words

26 April 2010

15:32

PR Newswire (U.S.)

PRN

English

WASHINGTON, April 26 /PRNewswire-USNewswire/ -- Bread for the World praised a new global framework of action to reduce malnutrition, which causes the deaths of 3 million mothers and young children in developing countries each year.