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Global malnutrition

Malnutrition is a major cause of preventable deaths in developing countries. The World Health Organisation says it is “the main cause of death and disease in the world.” While 1.9 billion adults are overweight or obese, 462 million are underweight. Among children, 52 million under-fives are suffering from wasting, where they have a low weight for height.

Even seemingly wealthy countries are sometimes unable to adequately tackle mal and under-nutrition especially among marginalised communities.

For example, in 2015 in India

the national prevalence of under-five overweight is 2.4%, which has increased slightly from 1.9% in 2006. The national prevalence of under-five stunting is 37.9%, which is greater than the developing country average of 25%. India’s under-five wasting prevalence of 20.8% is also greater than the developing country average of 8.9%

The Global Nutrition Report 2020 focuses on inequities which are preventing most countries from reaching the 2025 global nutrition targets.

It points to:

  • Inequities in food production and consumption systems— the vast majority of people today cannot access or afford a healthy diet;
  • The climate emergency is affecting food production systems and is skewed towards unhealthy food production
  • And, inequality in access to measures for the prevention and treatment for malnutrition

UK Government policy

On 2 September, the first day of the newly created Foreign, Commonwealth and Development Office (FCDO) the Foreign Secretary launched a new fund to help tackle hunger and malnutrition in the context of the coronavirus pandemic. In a written statement, Dominic Raab:

  • urged countries to step up alongside the UK to fight back against coronavirus and growing risk of famine in developing countries
  • announced a new £119 million aid package to combat threat of coronavirus and famine as the UK takes on the G7 and COP26 Presidencies
  • appointed former Department for International Development Acting Permanent Secretary, Nick Dyer, as UK’s first Special Envoy for Famine Prevention and Humanitarian Affairs

The Independent Commission for Aid Impact (ICAI) reported on DFID’s results on nutrition in September 2020. It said that while the Government had “beaten its goal of reaching people in some of the world’s poorest countries with nutrition services – but with malnutrition set to rise as a result of the COVID-19 pandemic, it should do more to help the most vulnerable.”  

In particular, ICAI recommended that the FCDO should:

  • capture and communicate progress against all goals in its nutrition strategy, including strengthening systems and leadership for improved nutrition.
  • strengthen statistical capacity and quality assurance in-country and centrally, to support more accurate measurement of programme coverage and convergence, and to use the data to improve nutrition programming.
  • strengthen systems for identifying and reaching the most marginalised women and children within its target groups.
  • more consistently gather citizen feedback to help improve and tailor its nutrition programmes.
  • scale up its work on making sustainable and nutritious diets accessible to all, to help address the double burden of malnutrition, through nutrition-sensitive agriculture and private sector development.
  • work more closely with its partners to achieve the convergence of nutrition interventions, by aligning different sector programmes to focus on those communities most vulnerable to malnutrition.

Covid-19

The coronavirus (Covid-19) pandemic is exacerbating the immediate and underlying causes of malnutrition and significantly threatens the potential for the global nutrition targets to be achieved.

An article in the Lancet looks in detail at the impact and reports that:

The pandemic poses grave risks to the nutritional status and survival of young children in low-income and middle-income countries (LMICs). Of particular concern is an expected increase in child malnutrition, including wasting, due to steep declines in household incomes, changes in the availability and affordability of nutritious foods, and interruptions to health, nutrition, and social protection services

That article also reported that the International Food Policy Research Institute estimates an additional 140 million people will be thrown into living in extreme poverty on less than US$1·90 per day in 2020. And the World Food Programme says that the number of people in low and middle income countries facing acute food insecurity will nearly double to 265 million by the end of 2020.

Sharp declines are expected in access to child health and nutrition services, similar to those seen during the 2014–16 outbreak of Ebola virus disease in sub-Saharan Africa.

Early in the pandemic, UNICEF estimated a 30% overall reduction in essential nutrition services coverage, reaching 75–100% in lockdown contexts, including in fragile countries where there are humanitarian crises.

On 5 November, the Government re-iterated its commitment to tackling hunger and malnutrition responding to a parliamentary question:

Prevention and treatment of malnutrition remains a priority for the UK as part of our commitment to end the preventable deaths of mothers, newborns and children, particularly as malnourished people are likely to be more severely affected by COVID-19. The wider impacts of COVID-19 are also predicted to increase malnutrition across Africa and Asia in particular.

The FCDO does not itself deliver the aid and humanitarian assistance but relies on developing country institutions, multilateral organisations and NGOs to do this.

A comparison with the global response to the Ebola outbreak in 2014 in parts of sub Saharan Africa noted that UN agencies and NGOs found themselves unprepared for a crisis of this nature, withdrawing personnel and closing down operations. The report notes:

This raises serious concerns about the overall capacity of the existing humanitarian system and agencies to respond to health-related crises.

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