Each year, nearly five million children under the age of five die from preventable causes worldwide. Thirty million children’s lives are now at stake by 2030, nearly 60% of them in Africa and malnutrition contributes to almost half of these deaths.

Recent shifts in foreign policy and development assistance, including sharp reductions in external support, are projected to result in millions more preventable child deaths globally by the end of this decade unless we act decisively to change course.

As African leaders, it is our responsibility to spare no effort to protect the lives of our people, especially women and children, who are among the most vulnerable in our societies. And this should start with nutrition.

Maternal and child nutrition interventions have a direct and unparalleled link to preventable death. Each year, an estimated 35 million children are born too small and too soon worldwide. Around 10 million of these small and vulnerable newborns are born in Africa, entering life already at heightened risk of death and lifelong impairment.

Women of reproductive age bear a disproportionate burden of anaemia, with prevalence remaining above 40 percent in many African countries. In sub-Saharan Africa, up to 80% of women are affected by at least one micronutrient deficiency. These deficiencies weaken immunity, impair growth, and leave children dangerously exposed to infections.

But a clearly defined set of basic proven maternal, newborn, and child nutrition interventions, which should be provided from conception through a child’s fifth birthday, is proven to significantly reduce mortality and lifelong disability. These include adequate maternal nutrition and micronutrient supplementation before and during pregnancy; the prevention and treatment of maternal anaemia; early initiation and exclusive breastfeeding; appropriate complementary feeding with continued breastfeeding; vitamin A supplementation for young children; and the management of acute malnutrition.

These interventions are not experimental they are among the most established and cost-effective actions in public health. They cost little, save lives quickly, and deliver high economic returns and have a healthy nation.

Yet, with our social and economic systems under strain, they are often the last ones to be prioritized, even though they could do their best. Their absence drives lifelong and irreversible consequences: maternal deaths, stillbirths, neonatal mortality, impaired cognitive development, reduced productivity, stunting, increased health expenditures and a cycle of disadvantages that repeats across generations and thus, deteriorates health from generation to regeneration.

The cost of inaction far exceeds the cost of action.

Scaling up maternal, newborn and child nutrition interventions across sub-Saharan Africa over the next decade would require approximately US $3.4 billion per year. This is equivalent to about US $13 per pregnant woman and US $17 per child under five annually. This is one of the most affordable lifesaving investments available to us today. The question, therefore, is not whether we can afford to act, but whether we are willing to prioritize what saves lives. The bulk of these resources must come from our own national commitments. While international solidarity remains essential, current levels of domestic investment in nutrition across our continent remain far below what is required not because solutions are unclear, but because priorities are misaligned.

In my capacity as the African Union Nutrition Champion, I am convening a high-level dialogue on this issue on the margins of the upcoming African Union Heads of State Summit.

This dialogue is not intended as another review of known problems, nor an appeal for charity. It is a call for leadership. It is an opportunity to reaffirm that child survival is not a peripheral social concern, but a core political and development priority. It is a moment to recommend prioritizing the interventions that save the most lives, to align domestic financing, accordingly, align domestic legislation with the SDG 2 that addresses hunger and to ensure that maternal, newborn and child nutrition is fully integrated within primary healthcare and national development strategies. This further articulates the development of a child from the first day of birth to Early Child Care and Development (ECCD) as it mainly focuses on holistic development for children aged 0 to 5.

These actions do not require new institutions or untested approaches. They require political resolve, clear prioritization, and disciplined execution. If we act decisively now, Africa can prevent millions of avoidable deaths and strengthen the foundations of its future human capital and economic resilience while at the same time contributing to the health of a child.

I call on my fellow leaders in Africa today on behalf of the millions of children and mothers across our beautiful continent who face death, disease, or lifelong disability from causes that are entirely preventable. I cannot forget the fathers who are the protectors and providers of the family. That means, we all, holistically act in solidarity for the betterment of our continent.

I urge fellow Heads of State to place child survival and nutrition at the Centre of national development agendas, to protect and scale proven, cost-effective interventions, and to speak with one voice in reminding the world of a simple truth: the first obligation of any government is to safeguard those at the dawn of life.

At a time when global cooperation is fraying and moral clarity is in short supply; Africa has an opportunity and a responsibility to lead. The moral test of leadership lies in how we treat our children, the vulnerable, and those least able to protect themselves. On that test, history will judge us by the choices we make now. Hence, the reason we should stand firm is to employ our responsibility and authority to change the world for the betterment of our coming generation. We must look beyond the existing challenges.

Our collective commitment under African Union’s Agenda 2063 to build a prosperous, healthy, and resilient Africa cannot be realized if millions of children continue to die from causes, we already know how to prevent. Let us lead with clarity, urgency, and resolve, and ensure that every one of our children, from the beginning, is fully protected and ready to learn and resist patience.

His Majesty King Letsie III is a globally recognized advocate and the African Union (AU) Nutrition Champion

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