Food riots around the world early in 2008 brought into sharp relief the impact of rising food prices on communities as far as apart as Haiti, Bangladesh, and Ivory Coast. Less visible, though more deadly and pervasive, was the ongoing crisis in childhood malnutrition. While combating hunger depends on having access to food in sufficient quantity, conquering malnutrition also means assuring foods of adequate nutritional quality. For young, malnourished children, foods rich in nutrients, vitamins, and minerals are essential to survival and development.
The figures are shocking. The World Health Organization (WHO) estimates there are 178 million children suffering from undernutrition across the globe. All told, malnutrition contributes to 3.5 to 5 million deaths in children under five each year. According to UNICEF, the situation is actually getting worse in 16 high-burden countries. In the world’s “malnutrition hotspots,” the Horn of Africa, the Sahel and South Asia, many families simply cannot afford to provide nutritious food—particularly animal source foods such as milk, meat, and eggs—that young children need to grow and thrive. Instead, they struggle to survive—far from the media spotlight of high-profile humanitarian emergencies—on a diet of little more than cereal porridges of maize or rice, amounting to the equivalent of bread and water.
For the tens of millions of children who do receive assistance international food aid and nutrition programs have had limited impact in preventing their downward spiral into life-threatening malnutrition. This failure is due to assistance programs built on foods that are nutritionally inappropriate to rehabilitate malnourished children. The main foods—fortified blended flours made from either corn or wheat plus soya —do not meet the minimum nutritional needs of the most vulnerable children between 6 and 24 months. MSF is advocating that governments and international agencies adjust the products in food aid to better meet the needs of the people it aims to help by providing child-appropriate foods of high nutritional value such as supplemental ready-to-use foods (RUF).
At any given moment 20 million children are suffering from the most deadly form of severe acute malnutrition and up to five million children under five years of age die each year of complications related to malnutrition. Yet just slightly more than seven percent of these severely malnourished children receive the UN-recommended treatment with nutrient-dense therapeutic foods.
In recent years, advances in nutritional therapies for the severest forms of malnutrition have allowed MSF and other aid agencies to successfully demonstrate that severely malnourished children can recover rapidly by taking a short course of therapeutic RUF that mothers can provide at home. MSF, alone, has treated more than 300,000 malnourished children over the past 2 years in 22 countries.
These energy-dense dairy-containing pastes and biscuits are high-quality foods that deliver the nutrition children need for catch-up growth and to ward off infection. Community-based and outpatient feeding programs have the potential to treat millions of malnourished children using RUFs. Now it must become a reality.
“ Children shouldn’t have to deteriorate to the point of severe malnutrition to “qualify” for ready-to-use food, which is far more nutritious than the fortified blended flours prescribed and supplied by the United States and other international donors for moderately malnourished children. Yes, ready-to-use food may cost more, but it provides the milk that fortified flours do not….We need to focus on the food quality, not just the quantity. ”
Dr. Susan Shepherd
MSF medical advisor