Commentary: Adverse perinatal outcomes in the SHINE cluster-randomized trial: another dark facade of the House of Hunger?

Maternal mortality and child survival are unsolved Millennium Development Goals business.1 Of the under-five mortality rates, neonatal mortality has shown the least improvement between 1990 and 2015 with a mere reduction of 42% compared with 50% for post-neonatal and childhood mortality.2 It is therefore striking that the new 3.2 Sustainable Development Goal has the ambition to end all child preventable deaths, lower neonatal mortality below 12 deaths per 1000 livebirths and reduce under-five mortality to below 25 per 1000 live births, by 2030. These short-term goals represent a failure to consider equity and set an impossible agenda for the poorest countries, especially those bending under the yoke of debts and economic sanctions. The most recent update of the Global Burden of Diseases (GBD) Study predicts that for more than two-thirds of the 204 participating countries (including all but one sub-Saharan African country), these objectives will be unmet regardless of which of the six forecasting scenarios are implemented.3 Among sub-Saharan African countries, Zimbabwe, formerly known as the food reserve of the southern part of the continent, seems particularly disadvantaged. The economy has collapsed following three decades of political recklessness, with the country still struggling to recover. Over the same period, this landlocked state has experienced unprecedented drought and subsequent regular heat waves for almost a decade, which weigh heavily on the national food supplies and consequently place 60% of its population in food insecurity.