Most people associate the word malnutrition with images of starving children. Hunger remains a massive problem in Africa, the only part of the world where the absolute number of hungry people is still increasing. Last year, chronic undernutrition left 58 million children below the age of 5 stunted, or too short for their age.
But Africa is also suffering the paradoxical double burden of modern malnutrition. While millions starve, the continent is on the cusp of an obesity epidemic. Eight of the top 20 nations with the fastest-growing rates of adult obesity are in Africa.
This global problem affects both rich and poor countries, with six of the top nine world health threats now related to diet. In the U.K., we spent 16 billion pounds fighting obesity in 2016, more than what we spent on the police and fire services put together. Research from Public Health England shows that nearly half of children in England are perilously overweight.
This is a policy failure: successive governments have failed to tackle the crisis. Despite efforts to introduce a sugar levy on soft drinks, the latest obesity strategy failed to enforce restrictions on junk food marketing and advertising. Supermarkets continue to heavily promote multi-buys on high-calorie food. Recently, campaigners called for a ban on television junk food advertising before 9 p.m.
As in the U.K., Africa’s children are hardest hit. One-quarter of the world’s 41 million obese children aged 5 and under live in Africa. Obesity levels have increased at a much faster rate than that at which undernutrition has been reduced. And this is projected to worsen.
African governments still have time to get ahead of this crisis with urgent, targeted policy interventions. They must learn from the mistakes made in the U.K. and other countries and regulate the content of processed food and associated advertising campaigns.
1. Educate people through information campaigns
Policies must account for changing demographics and lifestyles. The continent’s middle class has grown to 350 million people. People with busy lives and sedentary jobs are more prone to buy high-calorie, sugar-filled processed foods, rather than spending time preparing traditional foods. Western foods are also much more desirable and increasingly affordable. Education and information is needed to spell out the consequences to health of these changing habits.
The nature of poverty is also changing. With cheaper transport and rapid migration to cities, long hours of manual labor are less common, as is walking miles to school. Millions of Africa’s poor now live in urban shanty towns where fast food is commonly less expensive than fruit or vegetables. For a long time, people with expanded waist lines were perceived to be wealthy. Changing this preconception will take time and require awareness campaigns.
2. Start transforming health care systems now
The rise of obesity will place a heavy financial burden on fragile economies not yet equipped to face the challenge. For decades, Africa’s health systems have been handling outbreaks of HIV, tuberculosis, and malaria — not heart disease. In Kenya, there are estimated to be only 40 cardiologists for 48 million people; in the United States, there is one cardiologist for every 13,000 people.
Type 2 diabetes is already rising, especially in sub-Saharan Africa. It doesn’t cost a lot to treat diabetes with tablets to lower glucose. But heart attacks, strokes, blindness, and kidney failure — which can all result from diabetes — require expensive specialist equipment. African governments need to look to the future and start investing in their health systems.
3. Scale up policies that work
There is some progress being made at the policy level. South Africa is leading on implementing sugar and salt taxes, while Ghana, Nigeria, and Kenya are developing nutrition labeling. These are steps in the right direction, but they are not being taken quickly enough. All African governments must urgently look at what is working for other countries and adapt it to their own contexts, for their own people.
The Malabo Montpellier Panel, a group of agriculture and food security experts, of which I am a member, is working to help governments implement policies to beat all forms of malnutrition. We are calling on African governments to learn from the opportunities the U.K. missed and implement obesity programs that work in their context.
It can be done. Several African governments have been successful in tackling undernutrition by putting it at the top of their political agenda and creating broad partnerships across departments that bring in private sector players. Senegal, Ghana, and Rwanda all reduced undernourishment by more than half in the past decade. It is crucial that Africa’s obesity epidemic is recognized and tackled in a similar way.
About the author
Tom Arnold
Tom Arnold is chair of the Irish Convention on the Constitution, the former Coordinator of the Scaling Up Nutrition Movement, a member of the International Food Policy Research Institute’s advisory board, and also a director and governor at the Irish Times, Ireland’s leading newspaper. Tom is a graduate in agricultural economics from University College Dublin and holds master's degrees from the Catholic University of Louvain and Trinity College Dublin. He received honorary doctorates from the National University of Ireland in 2009 and University College Dublin in 2010, and a People of the Year Award in Ireland in 2013.
