Malnutrition: A preventable global health crisis in plain sight

By Aaron Merchen

The words “global health crisis” evoke the image of aid workers rushing to prevent the spread of a pandemic disease or virus such as Ebola or Zika — a widespread emergency. Governments take drastic steps like airport closures, and global agencies call for millions of dollars for triage and research. Emergencies and crises demand preparation, investment, and instantaneous reaction. Member states of the United Nations must seriously consider this relative to the global crisis of malnutrition as the 71st World Health Assembly begins in Geneva today

Malnutrition is a global health crisis of epic proportions that is linked to 45 percent of deaths among children under five years of age in low- and middle-income countries. Lack of appropriate nutrition extends the cycle of poverty; exposes the world’s youngest children to more death and disease; and inhibits physical, cognitive, and emotional development. For the more than 155 million children around the world who live with “stunting,” every day is an emergency.

Stunting refers to a child’s length or height being two “standard deviations” below the median for their age, and the effects of malnutrition rob children of the opportunity to grow in body and mind to their full potential and continue throughout the rest of an individual’s life.

Longitudinal studies have found that stunting impedes physical and cognitive growth, leading to a cruel domino effect. Stunting usually causes poor overall health and a greater risk of degenerative diseases, like diabetes. Children with stunted growth who do survive often receive less schooling and have lower academic achievement. Poor health and education, in turn, leads to lower household incomes and a much greater probability of living in poverty as adults.

This staggering human rights tragedy has also been quantified from an economic perspective. The World Bank estimates that the effects of poor nutrition and the resulting loss of national productivity can cost a nation anywhere from 2 to 11 percent of Gross Domestic Product (GDP), with the poorest countries suffering the greatest GDP losses.

A Preventable Crisis

Stunted and normal growthOne of the greatest frustrations is that malnutrition is preventable. As the World Bank states “Malnutrition is one of the world’s most serious but least-addressed development challenges.” The World Health Organization lists iodine, vitamin A, and iron as the most important micronutrients to prevent it, noting that “their deficiency represents a major threat to the health and development of populations worldwide, particularly children and pregnant women in low-income countries.” The lack of these nutrients and its deleterious effects often begin in the womb and often among women living in poverty, who are themselves malnourished.

The period from pregnancy to a child’s second birthday lays the vital foundation for all future development. The body and brain grow fastest during this window, and the gap in development between children with stunted and normal growth is almost never closed. So vital are those early days and months that some well-meaning interventions introduced after 24 months of age can have unintended negative consequences. If a child who has experienced stunting goes through a rapid weight gain after age two, chances of obesity (another form of malnutrition), diabetes, heart disease, and stroke substantially increase.

The Emergency Response

Women and children rarely cope solely with malnutrition, so interventions must be multi-faceted and the response must happen now. For example, investments must be made in improving sanitation. Unsafe water leads to chronic health problems, including diarrhea, which robs already susceptible populations of precious nutrients.

Most urgently, investing in the health and education of young women is both essential for progress and is the most effective way to curb poor nutrition in children. Twenty percent of childhood stunting is caused by maternal undernutrition, and a mother’s education level is proven to be an indicator of a child’s nutritional status. Simple but effective strategies, such as educating mothers about the benefits of exclusive breastfeeding until six months of age, are incredibly effective tools in preventing newborn stunting.

Investing in nutrition benefits everyone. For every $1 invested, a country can expect up to $18 in return. Direct and targeted interventions must be scaled up. The Bill & Melinda Gates Foundation estimates it will cost US$8.50 per child under age five, per year, to meet the Sustainable Development Goal 2: reducing stunting by 40 percent by 2025. That is roughly $6 billion per year. It may seem like $60 billion is an astronomic price tag, but the cost of inaction is far greater — on people and nations.

To address the global health crisis of poor nutrition, the world must blare the sirens, rush to action, and commit to investing the time and resources necessary to save and improve the lives of hundreds of millions of children.

Aaron Merchen is a senior associate for global policy and advocacy at RESULTS and RESULTS Educational Fund, an international non-profit committed to ending poverty. Before joining RESULTS, Aaron worked on disability inclusion projects with UNICEF – Jamaica and Special Olympics – Jamaica.