Africa’s own WMD (Weapon of Mass Destruction)
Toronto 2006 has come and gone. From South Africa, I watched in horror as our dysfunctional nutrition debate was ‘aired’ on the international HIV stage. Meanwhile the war is being lost as infections and deaths mount and Africa’s health crisis gets worse. No appropriate strategy and little ‘functional’ leadership mean little effective action to halt the carnage in communities.
The nutrition issue has been marginalised by a damaging public media debate that has ‘insanely’ set up nutrition as an alternative to medicine. This has polarised apart proponents of ARV’s, Malaria and TB drugs on the one hand and known nutritional sciences on the other. It has resulted in an ‘either/or’ debate that is specious. Both need to be mobilized in tandem using the latest cutting-edge understandings if we are to win the ‘war’.
On the positive side of our “circus of shame”, protagonists must take credit for putting nutrition firmly on the international HIV agenda. For the thousands who did not need to die, it is tragically all too late.
The term ‘nutrition’ or a ‘well balanced diet’ in the African context is used with little understanding of what it means. Valuable resources continue to be spent promoting ineffective nutritional interventions and outdated approaches. The evidence of 40 years of failure is a growing global nutritional crisis that has disabled over half of those living on our planet. Our communities are experiencing health problems not seen by our grandparent’s who in many cases themselves lived in poverty.
The causes of failure are not addressed because international interventions ‘remain in denial’ of their failures and promote the illusion that their programs ‘are working’. Critical issues are ignored on the basis that the ‘cheapest’ components must be used. The approach is rationalized by ’International experts’ who argue that a ‘little is better than nothing’ or that there are just too many mouths and not enough budget – even if the ‘interventions’ do not address nutritional requirements. The problems grow and on-going failure results in donor fatigue and requests for more resources.
The nutritional reality is that there cannot be a part or ‘poor solution’ to addressing nutritional requirements. Effective nutrition is not just a label claim or a full stomach, a hand out of animal feed or seeds for the proverbial vegetable patch. It can never be a monthly food parcel fortified with the cheapest inorganic chemical nutrients and used as a ‘nutrition’ tool just because it is ‘donated’.
It is my view – those who have imposed the International nutritional specifications in interventions for the past 40 years have little understandings of the nutritional realities of Africa. Sadly, those responsible take no responsibility for the tragic consequences and the failures continue. The specifications, now part of Africa’s demise, are all well documented for the historians one day to better understand the role they played in issues of unsustainable development and health.
Our bodies are designed to require daily quantities of nutrient’s, minerals and vitamins from food we eat. Modern food processes and agricultural practices remove nutrients from the food chain. As a result, we can no longer rely on what is often referred to, as a balanced diet, to deliver the nutrients the body requires. In the context of the South African nutrition debate, garlic, lemon juice, beetroot, African potato and olive oil contain important food nutrients needed by our body. To promote these foods as the basis of ‘good nutrition’ or a substitute for drug regimes do a disservice to the science of nutrition and medicine.
Those who believe that Africa’s health problem is solvable by only demanding cheap or free hand outs of drugs or only research for a new drug or “magic bullet” need a wake up call. South Africa is planning 1.2 million ARV treatments by 2010 at a cost of R12 billion. What about South Africa’s 2010-projected queue of over 9 million people living with HIV and not being planned for? What about the millions of victims living in African societies that do not have resources to implement costly drug regimes? The South African Minister’s warnings of the dangers of using strong drugs on malnourished people with empty stomachs are valid.
On the positive side, after wasted years of sterile debate, all now agree that nutrition is essential. Understanding what this means and ensuring effective nutrition interventions are factored into programs is now our challenge. In the African context – telling poor people to eat a balanced diet, are as appropriate as asking them to ‘fly to the moon’. Relying only on interventions that come with ‘strings’ that impose sterile products that do not address our nutritional crisis is not going to win our war. We need real, practical, workable African solutions that deliver nutritional ‘fixes’ that work if we are to win this war of survival.
The latest science supporting bio-available nutrition should be the basis of modern health care. When people are nutrient replete, they are better able to defend themselves against opportunistic infections. Where strong drugs are required, compliance and effectiveness is improved. This reduces pressure on health systems in a cost-effective way. All obvious and known ‘understandings’. The reality is just ‘lip service’ using the cheapest nutritional technologies that do not work or focus only on drug regimes without effective nutrition.
The American President Mr. Bush’s recent announcement to extend International help to eradicate malaria in Africa highlights the issues raised. Bush and his wife declare in their media announcements that, and I quote, the ‘experts’ tell them that with drugs, mosquito nets and insecticides, malaria can be addressed. There is no mention of the word “nutrition.” and so the effectiveness of billions of dollars of Bush et al interventions is in question. Not incorporating the latest understandings of nutrition will ensure the Presidents commendable initiative ‘will fail’ from a cost dose perspective.
Children in Africa remain dysfunctional because of iron deficiency (Mozambique – 90% of children under the age of 5 are victims of Iron Deficiency Anemia). This condition suppresses medical conditions making it difficult for thin medical skills on the ground to identify and treat medical afflictions such as malaria and TB. The rampant spread of drug resistant TB initiated by the HIV pandemic is in my view a direct result of a lack of nutrition in programs. The link between drug resistance, a lack of drug compliance and nutrient deficiencies is an issue that warrants urgent investigation.
Africa has lived with malaria for centuries. Why the experts miss the obvious of what role the food chain play in this crisis is a mystery. More important, why the ‘experts’ do not engage state of the art bio-available nutrition so that they better understand the role it could play in helping manage the sudden upsurge in the African health pandemics is an even greater mystery.
International Interventions in Africa are failing. It is my view, the ‘so called’ experts who implement the aid have ‘mind sets or vested interests’ that place themselves firmly on one side of the polarized ‘debate’ and as a result priorities a ‘drug focus’ approach. Africa’s nutritional crisis is not taken into account. The NGO industry who depend on these experts have lost the ‘plot’ on a fundamental issue that makes many interventions part of the problem.
It is my understanding that with good nutrition – people will be more resistant themselves to malaria and TB and will make drug regimes more effective. This ‘understanding’ is not incorporated into interventions.
Confront a doctor on this issue – they will all agree – all this is ‘not rocket science’ and it is of course ‘completely obvious’. Getting doctors to engage nutrition as a ‘hard’ science and to act with something practical on the nutrition issue – well………. maybe this issue should be left to “grannies in long skirts”.
It is an irony – nutrition is NOT a medicine and so many ‘medical experts’ are not able to bring themselves to ‘dispense’ appropriate food and nutrition to treat in concert with palliative medicine. Arguments are made that food/nutrition are a ‘private issue’ and if handed out – must be cheap. It is sometime argued that food creates dependence and therefore should ‘not’ be done.
Africa’s nutritional crisis is not being seen heard or understood. Africa has moved away from their traditional foods without any understanding of the role the present food chain plays in compounding the issues facing our continent. In many cases – imported food aid commercially grown and processed are dumped with little understanding of the nutritional implication. The result – Africa’s demise on issues of health and long-term sustainable development.
The reality is our continent has now run out of time. If we are to survive as a continent, we are going to have to make our people nutrient replete. We have to ‘stop the boat’ and start a new approach.
If I were given one ‘magic wish’ to save our continent from an inevitable demise, I would ‘wave my magic wand’ and raise the priority of a primary nutritional approach that mobilizes and implements available funds for state of the art cutting edge nutrition. Making Africa’s children and people nutritionally replete would be my New Year wish for 2007.
To all NGO’s and those vested with the responsibility of intervening on our continent – my prayer for the New Year – stop and re-evaluate what you are doing with eyes focused on the latest understandings on nutrition. Perhaps then the ‘lights will go on’ and the reality of what your interventions are doing to our continent and its peoples will be clearer for you all to see a ‘new way forward’.
Bring on the drug regimes, bring on the ‘International experts’, bring on the US Presidential initiatives and bring on Bill Clinton and Bill Gates on nutrient replete human beings. Only then, will the tide change for the better so that we can all get on with the job of rebuilding our continent with empowered involved citizens so that Africa can take its rightful place as part of the global village.