7th Conference of Ministers of Finance, Planning and Economic Development March 2014

1. 7th Conference of Ministers of Finance, Planning and Economic Development March 2014

2. Introduction to COHA

3. The Time for Africa is Now

4. Global Momentum for Nutrition

5. COHA – An African Union Led Initiative in Nutrition implemented by Member States The Cost of Hunger in Africa is an African Project, led by the African Union, implemented by members states, and will help to improve the lives of Africa’s children Funding Partners • NEPAD provides technical guidance in nutrition related issues and serves as a convener to insure the integration in complementary regional actions The technical aspects are led by UNECA, Social Development Policy Division, in a South-South partnership with ECLAC as part of a regional program to develop analytical tools • The World Food Programme provides field-level expertise and support at country level through its expanded presence in Africa

6. A BRIEF RECAP OF THE COHA 1st Phase Reports in Four High-Level Events Initiation of 2nd Phase Countries Partnership to bring the LAC-CoH to COHA 2013 2014 2012 COHA Presented at AU Summit AU/ECA Mandate for COHA Declaration 898 at 5th CAMEF Addis Ababa Endorsement of Methodology by 4th ATFFND, Malawi Progress Report on initial Results at AU/ECA 6th CAMEF, Abidjan Launching of Report AU/ECA 7th CAMEF, Abuja COHA from Addis To Abidjan To Abuja

7. 12 Initial Participating Countries BENIN 1st Phase CountriesEgypt Swaziland Ethiopia Uganda ALGERIA TUNISIA LIBYA MOROCCO EGYPT MAURITANIA WESTERN SAHARA MALI NIGER CHAD SUDAN SENEGAL ETHIOPIA BURKINA FASO NIGERIA GAMBIA GUINEA SOUTH l SUDAN 2nd and 3rd Phase Countries • Burkina Faso • Ghana • BotswanaMalawi • Mauritania • Rwanda • Kenya • Cameroon GUINEA-BISSAU CENTRAL AFRICAN REPUBLIC GHANA SOMALIA SIERRA LEONE CAMEROON DEMOCRATIC REPUBLIC OF THE CONGO TOGO BENIN KENYA UGANDA LIBERIA GABON CONGO SAO TOME & PRINCIPE TANZANIA EQUATORIAL GUINEA RWANDA SEYCHELLES ANGOLA BURUNDI ZAMBIA COMOROS MALAWI MOZAMBIQUE ZIMBABWE NAMIBIA MAURITIUS BOTSWANA MADAGASCAR SWAZILAND LESOTHO This map was produced as a reference aid only. The boundaries and names shown and the designations used on this map do not imply official endorsement or acceptance by the United Nations South Africa

8. Results from 1st Phase of COHA

9. Conceptual Foundations

10. Framework for the Cost of Hunger in Africa Cost of Hunger in Africa Incremental Public and Private Cost • Lower Productivity • Higher labor absenteeism • Increased demand on social services Social inclusion problems • Lower Performance in Manual Labor Lower educational performance Higher mortality risk Higher morbidity risks: Acute and Chronic illnesses Cognitive and psychomotor underdevelopment Lower physical capacity Undernutrition Modified from Rodrigo Martínez and Andrés Fernández, Model for analysing the social and economic impact of child undernutrition in Latin America, based on consultations carried out by authors.

11. Methodological Foundations

12. Variables and Indicators Risk Probability differences (DP or DP):is the difference between the probability that a consequence (i) happens between undernourished (PU) and non-undernourished (PNU). DPi = PiU – PiNU Probability Ratio (PR): RPi = PiD / PiND Probability Odds (PO): OPi= PiD /(1- PiD) Odds Ratio (OR): OR = (PiD /(1- PiD)) / (PiND /(1- PiND))

13. Presentation of Results The following data are the results of the work carried-out by a national implementation team that collected, processed and analyzed official data, and supported the adaptation of the model to estimate the social and economic impact of child undernutrition in Africa.

14. Tendencies in the Prevalence of Stunting Source: Prepared in-house based on information from WHO Child Nutrition Database and National Surveys. Data prior to 2006, has been updated in line with new Child Growth Standards introduced by WHO in 2006 to replace the 1977 International Growth Reference, formulated by the National Center for Health Statistics (NCHS).

15. Malnutritionin children predisposes to a variety of health and developmental risks that can be reversed if tackled at the early stages of a child’s life. • For every additional case of child illness, both the families and health system are faced with additional economic costs.

16. Incremental morbidity associated with underweight children

17. Distribution of Health Costs By Age Groups Public and Private 13% 12% 14% 16% % of Cost Covered by Public system 13% 12% 24 to 59 months 14% 16% 12% 13% 14% 16% 12 to 23 months % of Cost Covered by Families Under 12 months

18. Incremental child mortality associated to underweight children

19. Any child who is undernourished, is at risk of suffering from cognitive and physical impairment, which impacts the quality of life as a child and an adult within the society. Stunted children are more likely to repeat grades in school or even drop out.

20. Economic Cost of Grade Repetition of Stunted Children * Primary education only. No data for secondary education. % of Cost Covered by Public system % of Cost Covered by Families

21. Estimations in Schooling Differential of Working Age Population -0.8 Years -1.2 years -0.2 Years -1.1 Years Source: UNECA, based on the official household surveys in each country. Note: Schooling achievement based on information of head of household. It does not represent the schooling level of the population. The higher risk of stunted children on dropping out of school resulted in lower schooling of the stunted population that ranged from -0.2 to -1.2 years

22. Theory indicates that when a child is stunted, this will impact them when they enter the labour force. On the whole, stunted workers are less productive than non-stunted workers, and are less able to contribute to the national economy.

23. Impact of Child Undernutrition in Working Age Population

24. Economic Impact of Child Undernutrition in Productivity of Working Age Population Distribution of Manual and Non-Manual Labour Losses in Productivity by type of Labour (in millions of $US) $US1,090 % Working Age Population in Manual Activities $US202 $US1,951 $US30 $US117 $US15 $US483 $US53 % Working Age Population in NON-Manual Activities

25. Impact of child mortality on working age population Working Hours Lost as % of Working Age Population Economic Value of WH lost as % of GDP (in millions of $US) 4,786 million WH $US3,396 943 million WH 37 million WH $US317 857 million WH $US40 $US988 The impact of undernutrition on child mortality rates increases in countries with higher prevalence. A percentage of the WAP is absent from the economy due to incremental risk associated to undernutrition

26. Economic Impact of Child Undernutrition . The aggregate cost estimation for Health, Education and Productivity are equivalent to between 1.9% to 16.5% of GDP

27. What are the potential savings of a reduction in child stunting prevalence?

28. Potential Savings of Reducing Child Undernutrition A ‘GOAL’ Scenario 10 & 5 by 2025 Savings to be Achieved Halving child Undernutrition by 2025 The Rise in the Economic and Social Cost of Child Undernutrition Goal Scenario

29. Summary of Savings Scenarios

30. 10 Findings from the First Phase of the Cost of Hunger in Africa Study * * based on the results from 4 pilot countries

31. Implications for Structural Transformation of Africa and Inclusive Development • The reduction of the urban/rural gap in health care • Maximizing the population dividend for Africa • Shifting towards a more urbanized society and industrialized economy

32. Policy Recommendations

33. The COHA delivers results at national, continental and global levels Looking forward, several countries have expressed interest to participate in the study, igniting a potential 4th group of countries.

34. “Child hunger is a moral issue. But as this study demonstrates, it is also a critical economic concern. These findings amount to nothing short of call to action....” Ban Ki-Moon Secretary-General of United Nations Panama City, June 2007 “The Cost of Hunger Study provides us with the evidence-base for building a case for food security, communication, advocacy and policy discourse on nutrition. The study reveals that we can no longer afford to have high prevalence rates of under-nutrition and has given the justification for increasing investment in scaling up nutrition interventions and ensure availability of food and good nutrition” Prime Minister AmamaMbabazi of Uganda, Launching of COHA Uganda Kamapala, June 2013

35. Next Steps for COHA

36. Continue the Capacity Building Process to Advocate for the Elimination of Child Stunting

37. ARISE 2025 AFRICA’S RENEWED INITIATIVE FOR STUNTING ELIMINATION 10 and 5 by 2025

38. Defining the Agenda for Inclusive Development of Africa

39. Round Table & Launching of Report Friday 11:30am