The Johannesburg Resolution

“CARING FOR SEVERE MALNUTRITION (SM) OF INFANTS AND YOUNG CHILDREN AS
A CORE COMPETENCY FOR PAEDIATRIC HEALTH PROFESSIONALS”

INTERNATIONAL MALNUTRITION TASK FORCE, IMTF (International Paediatric Association/International Union of Nutrition Sciences in collaboration with WHO/UNICEF/IAEA)
Pre Congress Symposium to the 26th IPA Congress of Paediatrics, Johannesburg August 4th, 2010

The group in their deliberations noted with great concern that malnutrition continues
to be a major cause of death and disability for young children: 1 out of 3 deaths and 20
% of the lost healthy life years are attributable to malnutrition in all its forms. The final
cost in terms of death and lost healthy life years is dwarfed by the impact on lifelong
lost productivity with a major negative impact in social capital and economic
development. The impact on economic development has been quantified recently as 7-
8 % of GDP in severely affected countries. Some progress in Latin America and Asia is
being made, however the situation in sub Saharan Africa has gotten worse. The impact
of the recent food price crisis on hunger and poverty has led to an increase in the
number of hungry and food insecure people globally. If we fail to take the necessary
actions the nutrition related MDGs (1-hunger and poverty 4-infant mortality) will not
be met. The existing evidence demonstrates that effective interventions are available,
which if implemented to scale would reduce by 30-50 % the burden of death and
disability within a 3-5 year period for most countries. As an example if exclusive breast
feeding from birth to six months was achieved for all children the expected impact
would include a reduction of severe/moderate malnutrition by 30-50 % leading to a
reduction of 11 % in mortality of children < 5 yrs of age. The treatment of severe
malnutrition following standard guidelines has proven efficacious and if implemented
to scale would by itself reduce childhood mortality by 30 %. An important cause behind
failure of treatment is the limited competency of health professionals. Paediatricians as
effective advocates for children are uniquely placed to meet the challenge of
eradicating this significant cause of death and disability of children. In order to do this
effectively Pediatricians must not only be knowledgeable but competent in the
practice of treating severely malnourished children.

Pediatricians meeting at the 26th IPA Congress of Pediatrics called on the IPA to resolve:

  1. Paediatricians and related health professionals take responsibility for leadership
    in addressing the problem of severe malnutrition in all its forms as a major
    cause of death and disability of children that requires urgent action by all
    relevant social actors.
  2. IPA members societies should assure that all Paediatricians and related health
    professionals have the identification and treatment of severe malnutrition as a
    core competency and be certified accordingly.
  3. National Societies should examine the curriculum, training activities and
    evaluation processes to ensure the inclusion of the identification and treatment
    of severe malnutrition as a core competency.

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