KHOPOTSO: The UNICEF research surveyed more than 100 developing countries, 17 of which are in eastern and southern Africa. The report says virtually no progress was made in these African countries to address the problem of hunger, a major cause of the incidence of under-weight children. The incidence of under-weight children below the age of 5 is a major indicator to measure the progress of nations in reducing poverty and hunger. In eastern and southern Africa, progress has been stunted for 14 years. Bertie Mendis is the Senior Advisor for UNICEF.  

BERTIE MENDIS: The eastern and southern Africa region is one of the poorest in the world’€¦ Nearly a third or above 29% of the children in this region are dangerously under-nourished. The trend analysis, in fact, indicates that there has been little or no progress between 1990 and 2004.

KHOPOTSO: And the causes for this are?

BERTIE MENDIS: Due to population increase in many of these countries, the absolute numbers of under-weight children in these countries have increased. The immediate causes of under-nutrition is not only the lack of access to food, but also recurrent illness, poor caring practices at home and the lack of access to quality basic health care and safe water supply and sanitation. This is further compounded by drought, conflicts and high prevalence of HIV and AIDS in this region.    

KHOPOTSO: South Africa has not fared any better in the study. Since 2004, the proportion of under-weight children has been steadily rising by over 5% each year.    

SABA MEBRAHTU: Part of the reason is the challenge that is being faced in South Africa among the poor population and also, the prevailing high prevalence of HIV/AIDS’€¦ HIV/AIDS is having a negative impact on children ‘€“ directly and indirectly. Indirectly because if the parents contract HIV/AIDS their ability to take care of their children’€™s welfare is impaired, unless they are provided with very strong safety net support. And directly, because the increasing proportion of children that are infected with HIV/AIDS have higher caloric requirements and their growth is also impaired.      

KHOPOTSO: Saba Mebrahtu, Senior Nutrition Advisor of UNICEF eastern and southern Africa. In comparison, Botswana also faces a high prevalence rate of HIV infection.

However, the report says it’€™s the only country in eastern and southern Africa that is showing some improvement in reducing poverty and the incidence of under-weight children.

SABA MEBRAHTU: That’€™s mainly because of the national policy which has really been providing very strong safety net support to poor people and, also, the population that is affected by HIV/AIDS.

KHOPOTSO: One of the major recommendations the report makes is that women must exclusively breast-feed their children to stave off under-nutrition, especially in the initial 6 months. It points out that only a few women in Botswana are keen to do so.

SABA MEBRAHTU: Only one-third of children are exclusively breast-fed. And the recent diarrhoea out-break has shown the implication of high infant formula feeding in a context where access to safe water is not assured or hygienic practices are not very good. So, it can lead to wide out-break and, also, high case fatality rates.  

KHOPOTSO: This fact highlights the importance of breast milk for the first 6 months of a child’€™s life. Only 6 African countries have high rates of exclusive breast-feeding. Rwanda has the highest rate at 84%. Africa is known as the cradle of HIV, which can be transmitted through breast-milk. So, in a region where HIV infection is rife, is it not potentially problematic as well as a moral and scientific dilemma to encourage exclusive breast-feeding?

SABA MEBRAHTU: Exclusive breast-feeding has an important protection for children in the general population. And when we look at the proportion of children that are born to HIV-positive women vs HIV-negative women, the majority of the children are now being born from women that are HIV-negative. So, it means that it’€™s important to protect the majority of the children since we know that exclusive breast-feeding rates can enhance their immunity and can protect children from morbidity and mortality from major childhood illnesses’€¦ For women that are HIV-positive they need to be counselled on the risks and the benefits of replacement feeding vs exclusive breast-feeding’€¦ About 20% of children will contract HIV and AIDS through breast-feeding’€¦ If the mother is treated with antiretroviral drugs that can be further reduced.

KHOPOTSO: Perhaps the report can serve as a reminder to the international community of its commitment to halve the proportion of people who suffer from hunger between 1990 and 2015. The eradication of poverty and hunger is first on the list of the 8 Millenium Development Goals set by the international community.