Closing the Gap on Acute Malnutrition

As we reach the final stage of the Millennium Development Goals, and decision makers are considering what the successors should be, we must not overlook acute malnutrition. As a matter that has been historically typecast as an emergency issue, civil society is calling for acute malnutrition to be firmly embedded within the development process – starting with the Post-2015 development framework.

Acute malnutrition, commonly known as wasting because of the rapid and severe weight loss it involves, affects 52 million children at any given time. Not only is it responsible for 1 million child deaths a year [1] - making it the most deadly form of malnutrition - but it hampers the ability of children to reach their full potential. Children who survive being wasted may face an increased risk of stunted growth, long-term health problems and poor educational performance.

Yet acute malnutrition has been among the most neglected issues in development; in part due to the historical view that it is a by-product of famine or conflict. In reality, most children who suffer from this life-threatening condition live in stable, non-emergency countries.

The 'unfinished agenda'

As we reach the final stage of the Millennium Development Goals (MDGs) it becomes increasingly apparent that nutrition was one of the greatest missed opportunities of the past 15 years. Progress in reducing hunger and undernutrition broadly has been uneven, with levels remaining persistently high across many regions and countries. Progress in acute malnutrition specifically has been even worse, with no significant decline in the global burden since 1990.[2]

While there are no 'magic bullets' in development, nutrition is a foundation for better health and has the potential to springboard progress in a range of development issues. In fact, the chronic lack of investment in nutrition has resulted in slow gains in a number of MDGs and a key reason why many will not be met by the looming 2015 deadline.[3] It is fair to say that nutrition is the biggest 'unfinished agenda' of the MDGs.

A new ambition

Over the next year global leaders will be involved in critical discussion that will define the future priorities in health and development. There is growing momentum for the Sustainable Development Goals (SDGs) to have a nutrition goal and related new targets. There  are very positive signs this will be so, yet advocates and governments must make sure this is the case before the final goals are agreed in September 2015.

We must maintain the nutrition momentum and continue to call on governments all over the world to safeguard the lives of millions of children by ensuring that the nutrition agenda is finally tackled in the Post-2015 development framework.

The importance of this framework cannot be underplayed. It will shape global priorities for the next 15 years.

The proposed goal and targets for nutrition – which includes achieving the World Health Assembly (WHA) target to "reduce and maintain childhood wasting to less than 5 per cent by 2025" – are a good starting point but insufficient, insofar as the WHA target runs only to 2025. This would mean there would effectively be a five-year “implementation gap” (2026-2030) during which no action was expected of countries on acute malnutrition - and by the same token for stunting too. What’s more, if the 2025 targets are met, around 31 million children will remain acutely malnourished and at high risk of death.

In seeking greater ambition for nutrition, a new report by Generation Nutrition - 'Closing the Gap: Towards a 2030 Wasting Target' - recommends at minimum governments agree on a new target that aims to reduce the number of children suffering from acute malnutrition by at least half. The current ambition would bring global rates of acute malnutrition from eight per cent to five per cent. But a natural projection of the WHA target by five years could reduce that rate by another one per cent, bringing the rate of acute malnutrition to less than 4 per cent.

That may not sound like much, but one per cent in the global rate represents an additional seven million fewer children with acute malnutrition. By 2030 this would see the number of children suffering from acute malnutrition fall by 28 million. That's 28 million children's lives protected from the devastating impacts of malnutrition.

Now is the time to see acute malnutrition firmly embedded within the development process – starting with the Post-2015 development framework.

[1] Joint Statement on Community-based Management of Severe Acute Malnutrition, WHO, WFP, UN Standing Committee on Nutrition, UNICEF, 2007. This figure is the best estimate available of annual under-five deaths due to SAM because it also factors in incidence

[2] WHO progress report on 2012 WHA nutrition targets. December 2013

[3] Improving Nutrition Through Multisectoral Approaches, World Bank, 2013