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Mali: "European humanitarian aid treats 80 000 children each year whose lives are threatened by malnutrition."

expert Marion Saurel gives a presentation on malnutrition
European humanitarian expert Marion Saurel gives a presentation on malnutrition. © EU/ECHO/Isabel Coello.

Severe acute malnutrition causes five million child deaths each year worldwide. Most of these deaths are preventable, as over 90 percent of acute malnourished children who receive treatment are cured. In Mali, more than 120 000 severely malnourished children were admitted to health centres in 2017. This is one of the countries where the European Union's humanitarian aid has really invested in tackling malnutrition with tangible results: since 2011, it has devoted nearly €70 million to the fight against severe malnutrition and contributes to almost 80 percent of the treatment of sick children. Marion Saurel, an expert in Mali from the European Commission's Civil Protection and Humanitarian Aid Operations describes the situation and the progress made in dealing with it.

Isabel Coello

Interviewed by Isabel Coello, Regional Information Coordinator for north, west and central Africa

What are the different types of malnutrition?

Several forms of malnutrition exist between growth deficits and micronutrient deficiencies. But the two main forms are chronic malnutrition and acute malnutrition. Chronic malnutrition is stunted growth: for a given age, the child will not have grown enough, which has a significant impact on its development since its physical and cognitive abilities will be affected. For this type of malnutrition, there is no treatment per se, but rather prevention through good dietary practices and health. Acute malnutrition is a form of malnutrition directly related to mortality in children under five years of age. They undergo very rapid weight loss. In addition to preventive actions, a simple and effective treatment is available for acute malnutrition, both for its moderate and severe forms. Children with severe acute malnutrition are nine times more likely to die than well-nourished children. Those who have developed other health complications in parallel are at risk of imminent mortality and require treatment at the hospital.

What are the causes?

The causes are diverse. Malnutrition is the result of multiple factors, mainly illness - for example, diarrhoea or malaria, which causes the body to lose its nutrients - and inadequate dietary intake, but many other factors also come into play.

How serious is this problem in Mali?

In Mali, chronic malnutrition affects 28 percent of children under 5, while acute malnutrition affects about 800 000 children each year. There are roughly 650 000 moderate cases, nearly 150 000 severe cases, and of those severe cases 20 000 have complications.

What has been the response of European humanitarian aid?

The primary mission of European humanitarian aid is to save lives. Consequently, it has been very committed for years and is still very much present in Mali in order to deal with this problem. Over the period 2011 to 2017, nearly €70 million have been allocated to the fight against malnutrition, focusing on the most serious type of malnutrition, the one that threatens human life. These funds make it possible, on the one hand, to fund humanitarian organisations that support health centres and medical staff to treat nearly 80 000 children a year. On the other hand, we finance the supply of therapeutic foods that treat acute malnutrition. Not yet officially recognised as an essential drug, this therapeutic food is still not provided by individual countries as it would be for drugs against malaria. The Commission's Humanitarian Aid Operations finances this therapeutic food to the sum of €1.5 million per year, which corresponds to the treatment of about 40 000 children each year.

And on the prevention side?

Humanitarian aid finances food assistance provided to poor households to enable them to feed themselves and thus avoid deterioration in their nutritional status.

How has the fight against malnutrition evolved?

At the global level, over the past two decades, increased understanding of the problem, the development of specialised and nutritious food products, and the implementation of innovative health care delivery mechanisms have improved the quality and coverage of treatment, prospects for survival and reduced costs.

From 2012 to the present, progress has been notable in Mail since the disease is recognised and is the subject of a national policy. Effective treatments have become available in health centres which increased the number of children cared for from about 20 000 children in 2012 to more than 100 000 per year in the last 2 years. This is huge progress, but it is not enough. Making these new approaches and services widely available is a real challenge. Today, globally, less than 20 percent of children with acute malnutrition can access the treatment they need.

There is still a lot more to do then?

Indeed. We must continue working to increase the number of children treated each year, and also to improve early detection of the disease. When a child is identified as malnourished early enough, their chances of survival are much greater. In addition, the capacity of health systems in some of the world's poorest countries such as Mali will need to be improved so that doctors and nurses can treat the disease in a timely manner.

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