Global crises impacting health and nutrition for millions

New analysis published in the scientific journal Nature by global nutrition leaders, reveals that the war against Ukraine threatens to increase the number of malnourished people who have already suffered from reduced diets and health systems support due to COVID-19. Global events are affecting women and children globally by: (1) directly impacting food security and quality of the diet through increased food prices and reduced food availability and access; (2) reducing the reach of humanitarian assistance and services for mitigating acute food insecurity and preventing and treating malnutrition; and (3) reallocating nutrition budgets to other priorities. International leaders, donors and national governments must act now to scale up critical nutrition investments and actions to prevent even greater harm to a generation of children already weakened by the COVID-19 pandemic, climate events and other conflicts.

While the global community has recognized the impending crisis due to rising costs and reduced supply of wheat and fertilizer—for which both Ukraine and Russia are leading global producers, urgent action is needed given the speed at which the crisis is affecting food and nutrition security in both humanitarian and non-humanitarian settings.

Global nutrition leaders call for five urgent actions to prevent a malnutrition crisis

In their analysis of this urgent situation, global nutrition leaders from Standing Together for Nutrition (ST4N), a multi-disciplinary consortium of more than 35 nutrition, economics, food and health systems experts, and the Scaling Up Nutrition (SUN) Movement, which supports the nutrition goals of 65 SUN Countries, called for immediate actions to address a potential malnutrition crisis in millions of vulnerable mothers and children worldwide. 

They call on governments to take urgent actions to, firstly, reduce unnecessary trade restrictions and domestic hoarding to allow greater accessibility of essential nutritious foods. Secondly, protect the most vulnerable with safety net programs such as food vouchers aiming at improving nutrition. Thirdly, protect national nutrition budgets and continue to provide essential nutrition support, including essential nutrition services for women and children—particularly during pregnancy and the first 1,000 days of life. Fourthly, to honor their financing commitments to nutrition and not reallocate budgets. Fifth, invest in more robust data monitoring systems to better target interventions. And finally, they call for more resources for humanitarian assistance to address both rising hunger and malnutrition.

“This food price crisis does not happen in isolation”, states Dr. Saskia Osendarp, lead author and Executive Director of the Micronutrient Forum. “It comes after two years of households and governments trying to cope with the shocks caused by the COVID-19 pandemic, climate change related events, and other conflicts. We cannot afford to lose an entire generation of children due to the consequences of malnutrition, and we don’t have to, if we act now.”

To prevent the worst effects of the crisis on the most vulnerable, governments should take action to reinforce essential nutrition services and products delivered through health and social protection systems, including specialized nutrition products to prevent and treat the worst forms of malnutrition.

Urgent and longer-term investments are needed as well to improve the availability and affordability of nutrient-rich foods, including assistance to improve diverse and nutritious food value chains like milk, eggs, legumes, fruits, and vegetables. Preventing food waste by reducing food losses by investing in transport and market infrastructure and food processing is also key. Programs to fortify food staples like wheat and maize with essential vitamins and minerals are critical to improving nutrient intake, and fortified foods should be prioritized for distribution through social safety net programs.

Donors should ensure that the World Food Programme (WFP), UNICEF and NGO partners have the resources they need to support immediate responses in the most at-risk countries. These organizations will need to play a key role in delivering food and nutrition assistance, and in providing logistical support for the wider humanitarian response. Unequal intra-household food allocation also disproportionately affects women and children, which means that assistance needs to be targeted to be effective. Given the likely detrimental impact on nutritional status of women and children, additional support should be provided for the procurement and distribution of specialized nutritious products for these groups, including ready to use therapeutic food (RUTF) to manage incidence and treatment of acute malnutrition in young children, and specialized food supplements for pregnant and lactating women.

“Given the enormous consequences of adverse exposures in pregnancy and early infancy, some of the consequences of the Ukraine conflict on women and young children affected by the conflict and its global fall out, will be felt for years to come; impacts on fetal growth, perinatal and early childhood nutrition can likely have long-term consequences for health and human development far outweighing anything currently visible,” said Dr. Zulfiqar Bhutta, co-director at the Centre for Global Child Health, The Hospital for Sick Children in Canada and a coauthor of the Nature commentary. If global leaders don’t act soon, the consequences of this war on the most vulnerable may be felt for years to come.

A crisis upon crises with potential lifelong impacts to children born into an era of complex global challenges

Russia and Ukraine are among the world’s largest producers of wheat, fertilizer, and fuel. Even before the Russian invasion, global food prices were at an all-time high and the war against Ukraine has further increased the prices of all commodities by 12.6% in March compared to February 2022. After nearly two months of conflict, wheat commodity prices have increased by 19.7%. Already, increased costs of fertilizer, energy, and shipping costs are impacting food costs, making foods unaffordable and inaccessible to the world’s most vulnerable populations and increasing acute levels of hunger.  

The United Nations Food and Agriculture Organization (FAO) reported on 8 April 2022 that food prices are 34% higher than this time last year and have never been this high since FAO started recording them.

Poorer households cope against rising food costs by shifting to less costly and less nutrient-dense foods as they are priced out of healthy diets—placing them at risk for life-threatening forms of malnutrition, including wasting, stunting and micronutrient deficiencies. In addition to being one of the leading preventable causes of child death, poor nutrition is a driver of poor health and reduced physical growth and cognitive development. Children who are stunted in their first two years of life go on to complete fewer years of schooling and earn less over their lifetimes.

Vulnerable mothers over the past two years faced a triple challenge of food insecurity, disrupted health systems, and income losses due to the global COVID-19 pandemic. The World Bank conservatively estimated that the pandemic led to 97 million more people thrown into poverty in 2020, a historically unprecedented increase. The Standing Together for Nutrition Consortium made similarly sobering estimates for the impact of the pandemic on nutritional outcomes: estimating that the pandemic could lead to 13.6 million more children with wasting by 2022, and 141 million more people added to the 3 billion who could not afford a healthy diet in 2019.

Resources are being stretched as needs dramatically rise

The war has also threatened the reach of humanitarian assistance programs and nutrition interventions at a time when they are most critical. Higher food prices also increase the price of food assistance programs – the cost of the same selection of foods was observed to be 30-50% higher in March 2022 than in 2019. WFP projects that 323 million people will be food insecure in 2022.   

Rising food costs also impact the cost of nutritious therapeutic foods that provide critical life-saving support to children who suffer from wasting, a life-threatening malnutrition where children become dangerously thin and are high risk for death. Even prior to this new crisis, such nutrition interventions were beyond the reach for a vast majority of vulnerable children. In 2021, less than 1 in 4 of children suffering from wasting had access to treatment with therapeutic foods.

Re-double nutrition investments and actions to safeguard those most in need

“Developing countries are now facing tough decisions as they battle multiple crises including the continuing COVID-19 pandemic and rising food and fuel costs – while at the same time they are forced to cut further into their national budget to pay back foreign debts. It is crucial that the global community immediately step up with mechanisms like debt swap options for countries to transfer their debt and apply the funds to investments in nutrition and food systems,” said Gerda Verburg, United Nations Assistant Secretary-General and Coordinator of the Scaling Up Nutrition Movement.

The global community must come together to safeguard the nutritional well-being of vulnerable women and children, including their access to nutrition services and safe, nutritious foods. This is not the time to shift away resources and commitments from those most in need but to re-double actions to protect the nutrition and health of women and children. Preventing a malnutrition crisis and subsequent intergenerational losses of future productivity and human capital requires immediate investments, innovative finance schemes, and actions by all governments, donors, the United Nations, and political support from G7 and G20 global fora.

It is not too late to rescue a generation of children from the devastating impacts of malnutrition. However, every day of delay means countless more mothers and children will face diminished futures.