Why the global health community can’t afford to ignore nutrition and agriculture

Ndidi Nwuneli is among the 2018 class of the Aspen New Voices Fellowship, an initiative supported by the Bill & Melinda Gates Foundation that is designed to amplify expert voices from the Global South in the global development discussion.

Ndidi Nwuneli bristles at the world’s prevailing picture of Africa—the one that features images of children living at the brink of starvation. That picture helped convince people that Africa is a disaster zone, incapable of addressing its own needs and charting its own future.

Ndidi grew up in a prosperous Nigerian community where starvation was as distant and unfamiliar as it would have been to middle-class children in the United States or Europe. Her home state is not only blessed with ample rains, good soils and productive crops, it is also home to hard-working entrepreneurs and savvy business owners who are helping to catalyze sub-Saharan Africa’s economic growth.

No doubt, some regions of sub-Saharan Africa remain highly vulnerable to acute food crises. War, civil conflict and natural disasters in North-Eastern Nigeria, Somalia and Southern Sudan continue to put millions of families at direct risk of famine. But she is also concerned about the nearly 400 million people in Africa who live in extreme poverty (measured by households that live on an income of $1.90 or less each day). This is where Africa’s fight with “hidden hunger” is focused.

While mothers and children living in low-income households often have enough food to fill their stomachs, they frequently lack access to foods that are rich in the essential vitamins and nutrients everyone needs to live a strong, healthy and productive life. This makes mothers vulnerable to preterm birth and other severe health complications, and it makes newborns more susceptible to infectious disease and to developing lifelong physical and cognitive disabilities.

Ndidi is determined to tackle that challenge. The first step, she says, is to dispel the myth that Africans can’t help themselves. And the next step is for African entrepreneurs to step forward as problem solvers. We recently caught up with Ndidi to learn more about what she is doing to make a difference.

On the food challenges across West Africa

I grew up in Nigeria where 60 percent of the population works in agriculture—we have arable land and bountiful harvests—so starvation was not part of my everyday existence.

As an adult, when I moved to the U.S. for university, I was shocked that the face of Africa was that of a starving child. And that compelled me to create a different paradigm. As I became more involved in the development sector, the disparity and the numbers were glaring in my country, including the rising and hidden hunger in urban communities.

Even among net exporters in West Africa, like Cote D’Ivoire who export cocoa, we are all struggling with having enough food crops for staples and food. So I decided to devote my life to unlocking the agriculture and nutrition potential of the region, and to change the face of this continent.

On bridging the gap between poverty and nutrition

There's an urgent need for the continent to address the nutrition challenge. The first one thousand days of a child's life and can make or break their future, because a malnourished child cannot live their highest potential, cannot attend school...and will struggle throughout life with getting employment and being able to be productive. Through my companies, we’re trying to address these challenges one citizen at this time, but also through some large scale interventions.

On how food interventions are changing lives for vulnerable children

My company AACE Foods processes a complementary food for toddlers under five that fights moderate nutrition—it’s a blend of ingredients including soy and corn, and is a complete meal. We’ve not only partnered with nonprofits and government agencies, but we've also led initiatives to donate food to internally displaced people (IDP) all across northern Nigeria.

At an IDP camp, I met Fatima, a young baby who weighed 3 kilograms (6.6 lbs) at 6 months old. It was shattering—I have two kids of my own—and meeting her mother who got pregnant as a refugee, and also the number of newborn babies in that camp for whom a little bout of malaria, diarrhea or even a cold could kill these children. it was very sobering. We introduced the complementary food I talked about. When I returned to the camp in 6 months, Fatima was moving around, she was vibrant...she had so much energy! It showed me how a little intervention could make a big difference.

On the potential of homegrown solutions

I was really proud that this was a homegrown solution that has far-reaching impact. So I’m buying this maize and soybean from Nigerian farmers, many from the same regions in northern Nigeria where these IDP camps are. It’s been so encouraging to see the beneficiaries of the work we do and seeing the transformative impact it has on their lives. And that homegrown solutions can be beneficial in the long term has kept me going, even in the face of challenges.

On why the global health community must focus on nutrition

It’s an amazing phenomenon that nutrition and agriculture have been so disconnected from health. If you look at just the challenge of malnutrition and infant mortality—children are dying because they are malnourished. When they are malnourished, it affects their ability to withstand any small illness; malaria or common cold or diarrhea. So it's a no-brainer that you cannot create a wealthy, healthy population if families are malnourished.

Even maternal mortality; a woman who's malnourished has a much higher chance of dying during childbirth. In those situations, we've looked at dispensing medicine without looking at nutrition, but we fail to consider how does the body process medicine when you haven’t had enough to eat?

When we looked for funding from health intervention programs to address moderate malnutrition, they said to us, ‘we don’t have funding for nutrition as a health intervention.’ I was shocked that we were all so disconnected trying to solve related problems.

Now I think there's a growing recognition globally that it's so critical to link agriculture and health. There’s an urgent need for healthcare providers to look at nutrition as a key silver bullet to really address many of the large-scale health challenges on the African continent, and even tackling some of the Sustainable Development Goals around infant mortality.

On breaking down silos in Global Health

I think we treasure working in silos in development, but how can you treat malaria and TB without looking at the nutrition component of the patients? How come water, health and sanitation programs don’t talk with agriculture programs when we know agriculture needs water, but also families need safe access to water or to be healthy? It’s high time that we actually start working more closely together on interventions. Not just from a policy perspective or from a planning perspective. And the truth is, unless we have these cross sector collaborations, we will not see the impact we are looking for.

Videos of Nwuneli

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