Nutrition’s Power 4 and Pandemic Response

Photo Source: UNICEF/UNI316644/Frank Dejongh

By Emma Feutl Kent, Global Policy and Advocacy Manager, 1,000 Days & Karin Lapping, Nutrition Technical Director, FHI Solutions

Last week, a new article in the Lancet medical journal painted a stark picture for us: in the coming months, disruptions to food and health systems caused by the COVID-19 pandemic are projected to cause 6.7 million additional cases of child wasting. Kids who are severely wasted are 12 times more likely to die before their fifth birthday compared to healthy children.

Unfortunately, this projection represents only a fraction of the overall malnutrition-related death toll COVID-19 is likely to cause. Add these additional deaths to the 3.1 million children who already die of severe malnutrition each year – a number larger than the entire population of Chicago – and you have the makings of a global health disaster that may be more deadly than the pandemic itself.

Worse still, the destruction of this malnutrition epidemic will go far beyond the astronomical death toll. For young children, even a short bout of malnutrition can change the fundamental architecture of their brains and have devastating lifelong consequences including susceptibility to illness, disease, and stunted cognitive development. The indirect effects of this pandemic risk the lives and potential of an entire generation.

Now, more than ever, it is critical that we act quickly to implement a targeted package of preventative and curative essential nutrition interventions:

  1. Supplying all pregnant women with prenatal vitamins;
  2. Supporting breastfeeding mothers;
  3. Continuing large-scale Vitamin A Supplementation; and
  4. Providing lifesaving therapeutic foods to wasted children

These four interventions are especially critical today because they are cost effective, backed by research, and implementable at scale. COVID-19 has disrupted the health systems that often deliver these interventions, and it has become much more challenging to access the populations they serve. Fortunately, every day practitioners are finding new and innovative ways to deliver these services in the complex context of this global emergency.

Here is why they are each so critical:

Prenatal Vitamins: supplying pregnant women with a full dosage of multiple-micronutrient supplements (MMS) protects mothers from pregnancy complications and significantly increases the chances a baby will be born at a healthy weight and survive to his or her second birthday.

Supporting Breastfeeding: Babies get the best start at life when they consume nothing but breastmilk until they are 6 months old, and continue breastfeeding until they are 2 years old. On top of improving a child’s lifelong health and cognitive ability, breastfeeding also protects infants from illness and disease, which is especially critical in the midst of a pandemic. This is why the United Nations recommends mothers continue to breastfeed, even if they are sick with COVID-19. In the midst of the global emergency, breast milk is also, importantly, both a sanitary and low-cost way to feed infants.

Vitamin A Supplementation: Supplying a child with two high doses of Vitamin A every year is one of the most cost-effective ways to protect children from blindness, diarrhea, and other fatal illnesses. Traditionally, Vitamin A supplementation is delivered along with routine vaccination efforts. In many areas, experts have recommended that Vitamin A supplementation be temporarily suspended during the pandemic due to the nature of how it is administered. It is critical that supplementation efforts resume as soon as it is safe to do so.

Therapeutic Foods: Some children who lose a dangerous amount of weight become wasted and require treatment through an energy-dense product called Ready-to-Use Therapeutic Food (RUTF) to stay alive. Though the first priority of any nutrition program should be to prevent children from ever becoming malnourished, the pandemic has dramatically increased the number of children who are wasted. Even before COVID-19, the coverage for this essential service was much too low, with less than a quarter of children with even the most severe cases receiving treatment. By pre-positioning stocks of RUTF in places that are projected to suffer the most severe impacts, countries can avoid stock-outs during critical times.

Not only have the interventions on this list been highlighted by USAID and the four largest United Nations hunger-fighting organizations as essential to our global response to malnutrition in the COVID-19 context, but investing in these interventions will also pay dividends for years to come. Around the world, leading scientists and economists have consistently demonstrated that global nutrition interventions are some of the most successful, cost-effective, and scalable development investments, yielding up to $35 in economic returns for every $1 spent.

The United Nations has announced that a minimum of $2.4 billion dollars is needed immediately to roll out an initial package focused largely on these four lifesaving interventions. If we do not act now to roll out this largely prevention-focused emergency package, the cost will be significantly higher down the line.

As the development community responds to the global impact of COVID-19, we cannot allow the emerging and concurrent malnutrition pandemic to be overlooked. The stakes are too high. For the sake of the children whose lives are at risk today, and the entire generation that risks losing out on tomorrow, these interventions are of the utmost importance.