Why Improving Nutrition Overseas is an Inexpensive Way to Protect Americans

Written by Emma Feutl Kent

Strong Global Health Security (GHS) policies are essential to protect American borders from the spread of infectious diseases. While U.S. investments in GHS have supported partner countries with vaccination and disease surveillance, researchers are increasingly demonstrating the critical role malnutrition plays in spreading infectious diseases. Good nutrition fuels stronger immune systems that help protect people from getting sick and passing on diseases that threaten the United States. Nutrition interventions are also some of the most cost-effective global aid investments, generating up to $35 in economic returns on every dollar spent. Targeted nutrition programming is a low-cost, powerful tool in the effort to prevent and contain global health threats and should be a key component of our GHS strategy.

Malnutrition makes people sicker

Decades of evidence has established that malnourished people are much more likely to get sick and die from infectious diseases than those who are well-nourished. Malnutrition causes inflammation and severely weakens the body’s ability to produce antibodies and mount an effective immune response. This is especially true for children, whose developing immune systems are especially susceptible to malnutrition and disease. For example, malnutrition is the leading risk factor for tuberculosis and children with tuberculosis who are severely malnourished are four times more likely to die than their well-nourished peers. When malnutrition is widespread across a population, it also allows infectious diseases like measles and tuberculosis to take hold and spread more quickly from person to person. It can also undermine vaccine effectiveness and blunt their impact. In our interconnected world, the rapid spread of infectious diseases puts everyone at risk, even in places like the United States where severe malnutrition is rare. 

When sick people are malnourished, viruses are more likely to mutate

Perhaps most concerningly to the health security of Americans is the ways in which malnutrition can contribute to the ability of viruses to mutate, potentially making them more contagious and deadly. Researchers demonstrated this phenomenon in one study by infecting both healthy and malnourished mice with an influenza virus. Initially, the healthy mice remained unaffected by the virus while the malnourished mice got sick and died. However, when the researchers infected healthy mice with the virus taken from the malnourished mice, they found that the virus had mutated in a way that caused the healthy mice to get sick and die along with the malnourished ones. As the researcher concludes, poor nutritional status in the host may contribute to the emergence of new viral strains. This same phenomenon was found in humans when researchers studied the impact of micronutrient supplementation on polio virus mutations and found the number of mutations higher in malnourished patients. As we saw repeatedly during the COVID pandemic, mutations can cause illnesses to spread more quickly, be more deadly, and respond less well to treatment. Anything that increases the risk of mutations is therefore a significant concern that may prolong outbreaks globally and put lives and economic interests at risk here in the United States. 

Nutrition interventions overseas can protect Americans from getting sick

Though malnutrition is a force multiplier for global health threats, a suite of high-impact, cost-effective interventions could be affordably implemented today to dramatically improve our chances of preventing future outbreaks or pandemics. For example, a recent study in Jharkhand, India showed that providing inexpensive monthly food rations and micronutrients to vulnerable households reduced cases of tuberculosis by up to 48%. Similarly, vitamin A supplementation, which is one of the most cost-effective public health interventions, drastically reduces the risk of illness and death from diarrhea and measles. These and other targeted interventions can help act as a brake on the spread of infectious diseases and prevent them from reaching the United States. 

For these efforts to be most effective, however, we need to apply them where rates of malnutrition are highest. Many of the malnutrition hotspots exist in ‘development’ settings that won’t be reached by funding that is solely targeted at humanitarian disasters. Nutrition programs are some of the least expensive “best buys” in foreign aid and stand to generate massive returns in the form of American safety and prosperity. Incorporating targeted nutrition programming to complement the US Global Health Security strategy is a smart way to shore up these investments and generate the maximum returns for the American people.