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Executive Summary
Up to two-thirds of all Africans in east and southern Africa (ESA) live in rural areas, three-quarters of them living below the poverty line. Agriculture contributes 35% to the southern African regional GDP and 13% of total export earnings. In addition, about 70% of the population of the region depends on agriculture for food, income and employment. The recent widespread food crisis in the region that pushed more than sixteen million people into severe food shortage is further evidence that agriculture and food security still play a fundamental role in determining the development and health of the poorest in the region.
The Regional Network for Equity in Health in Southern Africa (EQUINET) recognising the importance of food security in health equity, commissioned a paper that explores equity concerns around food security and nutrition within the SADC and East Africa region, drawing information from available secondary data. The paper aims to analyse the current food security and nutrition situation in the region and the health and equity issues and policy concerns arising. EQUINET has commissioned this analysis of the determinants of the current situation, and the policy influences that enhance or undermine equity in food security and nutrition, to propose areas for policy and programme engagement and for research and debate by EQUINET.
This paper argues that there are at least five good reasons why food security and nutrition should be given high priority in actions to improve health equity and socio-economic development across the region:
- Poverty, hunger and under-nutrition are getting worse in ESA, even though they are improving in almost every other region. This undermines the achievement of UN Millenium Development Goals in this region.
- Instead of the potential virtuous cycle that could be created between improved nutrition and improved economic wellbeing, ESA is currently caught in a vicious cycle of worsening poverty, hunger and under-nutrition accentuating income and health inequalities and increasing vulnerability.
- Proven effective interventions indicate that public policy can make a difference, that nutritional improvements can be effected, even under conditions of poverty, and that these can have positive impacts on economic wellbeing.
- Implementing public policies that address food security provides an opportunity to deal with the demands of AIDS, the challenges of the competing signals from global trade to health and development and the challenges to equitable public policy in the current governance of the food supply system.
- Confronting hunger and nutrition provides one further area where alternatives can be built that promote policy objectives of justice and equity. This calls for interventions that build a multi-disciplinary and integrated response to food security and nutrition, especially focused upon gender inequalities, community control over productive resources and fair trade – ie one that is shaped on food sovereignty.
This analysis suggests that equity in health will be difficult to achieve in this region unless there more explicit attention is paid to the underlying nutrition and food security determinants. These in turn are being shaped by larger forces such as trade rules, corporatisation of the food supply chain, HIV/AIDS, gender inequalities etc. However we can start to identify areas of common action that would strengthen equity in food security, nutrition and health outcomes.
At a minimum an equity programme should focus on:
- Building civil – state alliances around a programme of action that links a food sovereignty perspective with the equitable public policy that supports this.
- Promoting further assessment of the links between trade and health in the region to feed into advocacy for trade policies and agreements that strengthen public health.
- Supporting, informing and evaluating policies and initiatives that provide safety nets to those most affected by negative effects of trade and agricultural policies and of HIV and AIDS.
- Continuing to identify how gender inequalities exacerbate the impact of globalisation and HIV and AIDS on the poorest families and decrease the efficiency of policy responses and propose programme and policy responses for these problems.
Introduction
Addressing rural poverty and agricultural failure is central to any response for addressing inequalities in eastern and southern Africa (ESA). Up to two-thirds of all Africans in this region live in rural areas, trying to make a living from often marginal land with little opportunity to earn wages. Three-quarters of those living in rural areas also live below the poverty line. Agriculture contributes 35% to the southern African regional GDP and 13% of total export earnings (SADC, 2004). In addition, about 70% of the population of the region depends on agriculture for food, income and employment. The impact of immediate factors such as drought, flooding and unseasonal weather have combined with underlying factors such as continual poverty, effects of structural adjustment programmes and HIV/AIDS to undermine food security and the state’s capacity to respond to household food insecurity. In 2003 this pushed more than sixteen million people in southern Africa into suffering from food shortages. More than half the Zimbabwean population, over a third of the populations of Malawi and Lesotho, a quarter of all Zambians and one in twenty Mozambicans needed emergency assistance up to the harvests in 2003 (Lambrechts & Barry, 2003).
This paper will argue that there are at least five good reasons why food security and nutrition should be given high priority in actions to improve health equity and economic development across the region (adapted from Devereux & Maxwell, 2001)
- Poverty, hunger and under-nutrition are getting worse in ESA, even though they are improving in almost every other region. This undermines the achievement of UN Millenium Development Goals in this region.
- Instead of the potential virtuous cycle that could be created between improved nutrition and improved economic wellbeing, ESA is currently caught in a vicious cycle of worsening poverty, hunger and under-nutrition accentuating income and health inequalities and increasing vulnerability.
- Proven effective interventions indicate that public policy can make a difference, that nutritional improvements can be effected, even under conditions of poverty, and that these can have positive impacts on economic wellbeing.
- Implementing public policies that address food security provides an opportunity to deal with the demands of AIDS, the challenges of the competing signals from global trade to health and development and the challenges to equitable public policy in the current governance of the food supply system.
- Confronting hunger and nutrition provides one further area where alternatives can be built that promote policy objectives of justice and equity: This calls for interventions that build a multi-disciplinary and integrated response to food security and nutrition, especially focused upon gender inequalities, community control over productive resources and fair trade – ie one that is shaped on food sovereignty.
Each of these five reasons will be analysed, backed up by empirical evidence, to illustrate the changes in policies, institutions, relationships and actors involved in food security at different levels from global to household and their impact on the general and equity issues and dimensions. It will then go onto outline the implications for policy, advocacy and research. In particular to assess broadly, and in relation to pro-equity aspects:
- public sector policy and programmes – for example to broaden from a focus on household food security towards an emphasis on food policy that recognises the broader changes taking place in production, distribution and marketing of agricultural products and how this impacts upon public health and health equity
- civic education and civil society advocacy around food security and the public policies that support it
- knowledge and evidence gaps in support of these policies and programmes and the research agenda that this implies.
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