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After recent developments, impactful leadership in nutrition is needed now more than ever. The United Nations (UN) Decade of Action on Nutrition* ends this year and USAID funding to Africa and other developing countries has come to an abrupt halt.

Africa is stepping up. “We need responsible and proactive leadership in line with the United Nations’ Sustainable Development Goals to carry the baton forward for healthy nutrition in Africa and the rest of the world. The North-West University (NWU) has been driving impactful change in the sector for more than 22 years, and we will continue to lead from the front,” says Dr Christine Taljaard-Krugell, senior lecturer in Nutrition.

Putting this promise into practice, the university is hosting the 23rd annual African Nutrition Leadership Programme (ANLP) from 11 to 21 March.

This NWU programme focuses on leadership, communication, advocacy, networking and conflict management, among other things, in a response to the dire need for impactful leadership in the nutrition field. Nutrition is of the utmost importance to reach the UN’s Sustainable Development Goal 2. This goal aims to find sustainable solutions to end hunger by 2030.

The aim of this UN goal is to ensure that everyone has enough good-quality food to lead a healthy life. More than 500 applications for the programme, which can only accommodate 30 participants at a time, streamed in from all over Africa. This response clearly shows that nutrition professionals realise the impact meaningful leadership training has on health and well-being. It also speaks to the standing of the programme on the continent and the value it has added over the years.

Henry Ng’ethe from Kenya, one of last year’s participants, describes the impact the ANLP programme has had on him. “I will be a better person and leader now (that I have completed the programme). I am aware of who I am through the feedback, and for that I am forever grateful.”

Gaëlle Rabakoarison from Madagascar echoed Henry’s sentiments: “It is an intensive workshop that makes people push their limits and understand more about their strength and weaknesses. It is an enriching experience with a group of multisectoral people and emphasises the importance of communication and empowerment if we want to be good leaders.”

Prof Johann Jerling, an NWU expert in nutrition leadership development and director of the ANLP, highlights the intention of the ANLP. “Leading change in nutrition is central to what we do. The recent ANLP programmes in Malawi helped us to gain crucial insight into matters in that country and we are now working with all the teams in all districts that are fighting malnutrition there,” he says.

“As our African network expands, more and more organisations are interested in developing leadership capabilities in their efforts to effectively reduce deaths due to malnutrition.”

Prof Robin Macleod of the Centre for Excellence in Nutrition (CEN) at the NWU, says she had the privilege of attending the 9th African Nutrition Congress in Cape Coast, Ghana, last year in October. “Seeing so many ANLP alumni from the programme in various capacities – presenting, organising and leading initiatives and debates – was incredibly inspiring. They truly embody the call to ‘lead from where you stand’, and their collective impact on Africa’s nutritional landscape is evident at events like that.”

According to Dr Thabo Putu, this year’s ANLP is set against the backdrop of the withdrawal of USAID and other aid funding by the United States.

“This withdrawal has severely impacted numerous health and food security programmes. Most African countries have relied heavily on USAID for healthcare initiatives, food aid and agricultural support.”

He says the ANLP is widely recognised throughout Africa for developing participants’ leadership capabilities, strategic thinking skills and abilities to create innovative solutions to challenges.

One such challenge is reducing dependency on foreign aid by finding local solutions to funding challenges. The ANLP enables participants to establish networks of collaboration not only within their own countries but also internationally. Networks such as these are ideal for investigating and pursuing leadership opportunities to solve problems such as funding.

Gavi, the Vaccine Alliance, in collaboration with UNICEF and WHO, has allocated nearly 200 million additional doses of key, life-saving vaccines aimed at contributing to the vaccination of approximately 50 per cent of children in Gavi countries missed during the pandemic.

Targeted funding of US$290 million in support of the “Big Catch Up” initiative was approved by the Gavi Board in December 2023, and today’s announcement indicates that all country requests received during the application window for this special effort can now move to the implementation stage.

Nearly 32 million doses have already been shipped to 13 countries* as part of the effort so far, and another 10 million doses are set to be shipped by the end of this month. Of the 35 lower-income countries targeted by the initiative, many are already conducting catch-up activities, with others poised to launch efforts imminently.

“Lower-income countries made unprecedented efforts to vaccinate their populations during the C-19 pandemic, but this emergency response strained their health systems. Now, our priority is twofold: help countries regain lost ground in routine immunisation coverage and build more resilient and equitable vaccination programmes for the future,” said Thabani Maphosa, the Managing Director of Country Programmes Delivery at Gavi. “Gavi and our partners are acting swiftly to support this critical public health mission, recognising that strong immunisation systems are the foundation for combating disease outbreaks and saving lives.”

The Big Catch-Up was launched by partners in April 2023 to address the decline in childhood vaccination rates observed during the COVID-19 pandemic as a result of overburdened health systems and disrupted access to medical care.

The latest global immunisation coverage data (WUENIC) for 2023 highlighted significant variations across Gavi implementing countries, with improvements in 22 countries, offset by sizeable declines in a smaller number of countries. Immunisation coverage in Gavi-supported countries remained stable – mirroring the global trend – despite a growing birth cohort as Gavi implementing countries vaccinated a near record number of children.

The data also pointed to an increase in the number of zero-dose children in Gavi implementing countries, highlighting the need for further efforts to reach these and under-immunised children.

The gaps in coverage caused by the pandemic have led to increased outbreaks across multiple countries, further highlighting the critical need to address immunity gaps.

For instance, data from WHO-CDC shows that from December 2022 to November 2023, 51 countries experienced significant or disruptive measles outbreaks, with the high levels of coverage required to prevent outbreaks a challenge for many health systems.

Another challenge is the rate of population growth in regions such as Africa, meaning countries must reach more children each year to maintain coverage levels.

Through this extraordinary catch-up effort, Gavi and partners aim to help lower-income countries close immunisation gaps, restore immunisation coverage to pre-pandemic levels, and strengthen immunisation systems in the longer term. The review and allocation process was aimed at providing support to all countries that applied within the funding window, including by strengthening plans to achieve better outcomes.

Big Catch Up funding is already supporting countries identify and immunize unimmunized children, particularly in some of the most hard-to-reach contexts.`

For example, in April 2024, the Syrian Arab Republic rolled out a campaign with an aim to reach an estimated 360,000 children.

Around 15,000 health workers and vaccinators were deployed to more than 1,000 sites to screen children’s vaccination status and immunise those who are unvaccinated.

In another example, Somalia is using Big Catch-Up support as a driver to address some of the country’s widest gaps, administering measles vaccine, inactivated poliovirus vaccine (IPV) and diphtheria, tetanus and pertussis-containing vaccine to ward against deadly outbreaks of these diseases.