A simple solution to save millions of children from wear and tear

The alarm has sounded: famine is ravaging the central Sahel and the Horn of Africa. In both regions, UNICEF predicts that some 6.4 million children will suffer from severe wasting, the painfully accurate term for what happens to children suffering from severe acute malnutrition. Globally, severe wasting is responsible for one in five deaths among children under the age of 5, making it one of the most serious threats to children in the world today.

But unlike many global problems, the solution to child waste is staring us in the face.

A daily dose of low-cost, ready-to-use therapeutic food – ATPE – will save the vast majority of wasting children, if we get to them in time.

But at least two out of three children who suffer from wasting do not have access to this cost-effective and life-saving treatment. We must remove the obstacles that stand in their way.

Global and national nutrition leaders should start by simplifying treatment protocols and putting children and families at the center of attention. In many places, nutrition programs still treat children with moderate and severe wasting with different products, through different supply chains, at different delivery points, with complex admission criteria.

Trials show that the use of a single product, RUTF and simplified approaches for children with moderate and severe wasting, is as effective as standard and more complex protocols, and costs less to deliver. Experience from high-burden countries shows that simplified treatment can achieve recovery rates of over 95%. And extensive evidence shows that focusing prevention and treatment in the community can increase access and impact.

A mother holds her malnourished baby at the Banadir Maternity and Children’s Hospital in Mogadishu, Somalia on June 1, 2022. Four consecutive seasons of poor rains have left millions of people in Kenya, Somalia and Ethiopia facing starvation.
ED RAM/AFP via Getty Images

As an industry, we must also take scale seriously by supporting country-owned and community-led efforts to reach all at-risk children. International organizations like ours are already working closely with governments and partners in high-burden countries, as we are working urgently in the Sahel and Horn of Africa regions right now. But as the threat level grows, we must fully align our technical assistance, operational support and resources behind comprehensive, nationally targeted scaling strategies. We call on our partners to join us in this approach.

The Global Action Plan on Child Wasting was developed to stimulate and support country action, using costed operational roadmaps to drive progress in more than 20 high-burden countries. National programs are already using these maps to meet the rapidly growing needs in the central Sahel and the Horn of Africa, our top priority. But organizations like ours must help accelerate its implementation so we can reach every child with life-saving treatment.

Finally, donors and country governments must pool the funding. Since July, led by an initial investment of $200 million from the United States, governments, philanthropies and private donors have pledged $377 million to respond to this growing crisis.

This urgently needed support will go a long way, but it still falls well short of the $1.2 billion we need to reach the most vulnerable children.

At the recent G7 and Nutrition for Growth summits, governments and private donors pledged billions for nutrition and food security, a welcome development.

But wheat and soy won’t cure wasted children. They need RUTF and they need it now. Nutrition programs can quickly close the gap if these donors allocate some of their pledged funds to address waste in the central Sahel and the Horn of Africa.

Children are suffering now, and it is inexcusable to let proven solutions sit on the shelf, especially when funding is on the table.

Of course, the best solution to child waste is to prevent it in the first place. The 1,000 days from conception to the second year are a window of opportunity. Ensuring that pregnant women have access to good nutrition and care, encouraging exclusive breastfeeding for the first six months, and supporting better foods and feeding practices for young children are critical.

But when prevention fails, proper treatment is the only way to save children’s lives. We may not have prevented hunger in Africa, but we can prevent children from painful deaths by bringing proven solutions now.

David Miliband is president and chief executive of the International Rescue Committee. From 2007 to 2010, Miliband was the 74th Secretary of State for Foreign Affairs of the United Kingdom.

Catherine Russell is the eighth Executive Director of UNICEF, overseeing the organization’s work for children in more than 190 countries and territories. Before joining UNICEF, Ms. Russell served in the US government as an assistant to President Joe Biden and director of the White House Office of Presidential Personnel.

The opinions expressed in this article are those of the writers.

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