Ending Malnutrition: A year of action

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A trained volunteer educates a community on nA trained vutrition, breastfeeding, improved food handling and growth monitoring, and helps promote the creation of kitchen gardens to help reduce malnutrition in Rwanda. Juozas Cernius/Global Communities/USAID

By Michele Learner

2021 is a critical year for global action against malnutrition for two key reasons. As you might expect, one is that the COVID-19 pandemic has caused significant setbacks, and active recovery strategies are essential. The other reason is more proactive: countries are coming together this year for the Nutrition for Growth Year of Action.

This yearlong effort aims to mobilize new commitments and continue to build momentum to make faster progress on malnutrition. Later this year, world leaders will meet for a high-level event on Nutrition for Growth (usually known as N4G), hosted by the Japanese government.

Also, this fall the U.N. Secretary General will host a Food Systems Summit. “Food systems” means simply the various steps involved in producing, transporting, preparing, and consuming food. It is sometimes summed up as “farm to fork.” The goal of the summit is to alert the global community to the need to identify sustainable solutions to the major problems of the global food system and build partnerships to implement them.

In addition to ending hunger and all forms of malnutrition, action areas include shifting to sustainable consumption patterns, advancing equitable livelihoods, and building resilience to shocks. The U.N. is inviting communities everywhere to hold their own independent dialogues and has set up a way for groups to contribute their ideas to the Summit.

The Lancet, a U.K. medical journal, released its 2021 report on maternal/child nutrition on March 8. The report helps lay the groundwork for global leaders and other stakeholders to set priorities for the Year of Action and beyond. The evidence base that supports a list of key effective nutrition actions has been updated and new items added.

The report emphasizes that the knowledge to end childhood malnutrition exists—but it remains for governments to commit to putting this knowledge into practice and respond to the world’s broad and unfinished nutrition agenda.

The last year-end data before the pandemic, i.e., the statistics as of December 31, 2019, indicated that 144  million children were living with stunting due to chronic malnutrition in early childhood, and 47 million were affected by wasting. About 30 percent of the cases of wasting were classified as severe.

According to The Lancet report, globally 149 million children under 5 are affected by stunting, and nearly 50 million (49.5 million) children are affected by wasting, or acute malnutrition.

While the statistics may vary slightly–particularly depending on whether researchers attempted to include the impact of the pandemic, which would mean that those numbers are preliminary–the more important point is that both forms of child malnutrition are dangerous. Nearly half of all preventable deaths of children under 5 are caused by malnutrition.

Children affected by stunting have survived early childhood malnutrition but will likely face lifelong health problems and physical and cognitive delays. Wasting is caused by acute hunger. Children with wasting are far too thin for their height. Severe acute malnutrition, if not treated in time, often leads to death. Nearly 5 percent of children in low-income countries are affected by both stunting and wasting, meaning that they are up to eight times as likely to die as children who are not malnourished.

Bread for the World has been particularly active on nutrition issues since The Lancet published its first report on maternal/child nutrition in 2008. It is hard to overstate the influence that this landmark report has had on the nutrition community, including anti-hunger advocates.

The report established that the most critical time for human nutrition is the “1,000 Days” window between pregnancy and a child’s second birthday. Very young children are far more likely to die of malnutrition than older children or adults. Those who survive are very likely to suffer from the lifelong impacts of stunting.

The Lancet reports synthesize vast amounts of research data to compile a list of the most effective actions to prevent and treat malnutrition during this 1,000 Days period. These cost-effective, relatively straightforward nutrition actions can prevent malnutrition or identify and treat it early on.

Despite a far clearer understanding of what works, progress has been far too slow. Little was accomplished in the several years leading up to the COVID-19 pandemic, and no country is on track to meet all 10 World Health Assembly targets for 2025.

The significant gains of previous decades are now being reversed by the pandemic’s secondary effects. These include, for example, lockdowns to slow the spread of the virus and decisions to divert healthcare resources and providers to treat COVID patients.

Since March 2020, many young children and pregnant women have had only intermittent access, or none at all, to lifesaving health and nutrition services. Children have missed regularly scheduled screenings to identify and treat malnutrition before significant harm is done. Many have also missed key windows for vaccinations against childhood diseases that routinely take the lives of children in many countries.

This is why the Nutrition for Growth Year of Action is so important. Armed with knowledge, the global community needs to mobilize to stop further reversals of nutrition gains and resume moving forward as soon as possible.  

Michele Learner is managing editor with Bread for the World Institute.

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