Forty years ago the Alma Ata Declaration on Primary Health Care became one of the first global frameworks to consider health in the context of development.[i] Specifically the Declaration stated that, “Economic and social development, based on a New International Economic Order, is of basic importance to the fullest attainment of health for all and to the reduction of the gap between the health status of the developing and developed countries.” Within that, 8 essential services were articulated. One was “Promotion of food supply and proper nutrition,” and another emphasized, “Prevention and control of locally endemic diseases.” This set the stage for future efforts that could place malaria control and food security on an integrated platform.
Twenty years later world leaders came together to establish the Millennium Development Goals (MDGs),[ii] an 8-goal framework for tackling the most pressing development challenges. As part of Goal 1, Eradicate extreme poverty and hunger, Target 1.C aimed to halve, between 1990 and 2015, the proportion of people who suffer from hunger, which was thought to be best understood by analysing the different dimensions of food security. One dimension was “Nutritional failures are the consequence not only of insufficient food access but also of poor health conditions and the high incidence of diseases such as diarrhoea, malaria, HIV/AIDS and tuberculosis.” Thus Goal 6, Combat HIV/AIDS, malaria and other diseases,” set Target 6.C to have halted by 2015 and begun to reverse the incidence of malaria and other major diseases.
While recognizing some major successes in the MDGs, the global community again came together to conceptualize a new framework to take off after the MDG process ended in 2015. The new Sustainable Development Goals (SDGs) had 17 components and many sub-goals with the purpose of painting as full a picture of a desired social, economic, environmental, health and political landscape as possible.[iii] Goal 2 focused on ending hunger, achieving food security and improving nutrition, and promoting sustainable agriculture. Unlike Alma Ata and the MDGs, the health goal appears a bit diffuse: Goal 3 was to ensure healthy lives and promote well-being for all at all ages. Among 13 sub-goals was 3.3 that stated by 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.
A thorough reading of the three mentioned documents/frameworks importantly shows that malaria and food security do not exist in isolation. Their potential interaction and intersection happen in a context of poverty, the environment and climate change.
[i] World Health Organization and UNICEF. Declaration of Alma-Ata, International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978. http://www.who.int/publications/almaata_declaration_en.pdf
[ii] United Nations. The Millennium Development Goals Report 2014. New York, 2014. http://www.un.org/en/development/desa/publications/mdg-report-2014.html
[iii] United Nations. Transforming Our World: The 2030 Agenda for Sustainable Development. A/RES/70/1. sustainabledevelopment.un.org