Need to Fix Food Aid to Tackle the Crisis of Childhood Malnutrition

Valérie Batselaere/MSF
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Symposium on malnutrition brings hundreds of international experts to Columbia University Medical Center

New York, NY, September 11, 2008—Hundreds of international food aid and nutrition experts, representatives from donor institutions and aid organizations, and political leaders gathered in New York today to try to better tackle the scourge of global childhood malnutrition—a neglected crisis that contributes to the unnecessary deaths of 3.5 to five million children under five every year and leaves millions more with life-long disabilities.

The two-day symposium, titled "Starved for Attention: The Neglected Crisis of Childhood Malnutrition," is being hosted by Doctors Without Borders/Médecins Sans Frontières (MSF) and Columbia University's Institute of Human Nutrition (IHN). Participants will examine why, despite domestic and international efforts, including billions of dollars in donated food aid every year, current nutrition programs do not adequately target childhood malnutrition. They will discuss ways to overcome barriers to improving diet quality and nutrition programming, particularly in malnutrition hotspots such as Southeast Asia, the Sahel and Horn of Africa.

"It is unacceptable that current food aid is not providing adequate, nutrient-rich food for the most vulnerable children,” said Dr. Susan Shepherd, nutrition advisor for MSF's Access to Essential Medicines Campaign. "It is a double standard that we send food aid to children in low-income countries that we would never feed to our own children. If we are serious about preventing the deaths, illnesses, and disabilities caused by childhood malnutrition, it's time we fix a broken food aid system. Making food aid more effective will mean changing what we provide."

For infants and young children, good nutrition depends on breast feeding and nutrient-rich complementary food. It is an issue of diet quality—nutrients and energy density—as much as quantity. But for poor families living in regions devastated by malnutrition, attaining nutrient-rich foods on a daily basis, particularly animal-source foods, is not possible. Yet at the international policy level, nutrition programs have not paid sufficient attention to addressing deficits in diet quality for infants and young children.

Current food aid for children consists largely of corn or wheat/soy-blended porridge, the ingredients of which can inhibit absorption of essential minerals, such as zinc, which are vital to childhood development and survival. These enriched flours also have no animal-source content, which is important for rapidly developing children. The milk component of fortified flours in U.S. overseas food aid targeted at young children was actually eliminated in the late 1980s for economic reasons.

"As we saw with HIV/AIDS, only when assistance is driven by desperate needs and not by economic interests do we mobilize sufficient resources to even begin to address a crisis of this magnitude,” said Stephen Lewis, co-director of AIDS Free World, and keynote speaker for the first day of the symposium.

Arguably the most important innovation in recent years has been an outpatient strategy based on milk-based, nutrient fortified, energy dense therapeutic foods to treat severely malnourished children in the most resource-limited settings. While strategies need to be adapted to local contexts in places where infrastructure and resources are limited, a strategy this simple, affordable, and direct can reach children in areas where malnutrition is chronically at crisis levels.

“There is no one solution to overcoming malnutrition, but there must be the political will and commitment to act," said Dr. Richard Deckelbaum, director of Columbia University's Institute of Human Nutrition. "We have to ask ourselves: what is the cost of doing nothing?"