Undernutrition, acute or chronic, is a medical condition that mostly affects women and children under 5 years of age. Wasting, stunting and micronutrient deficiency are features of undernutrition, which lead to weight loss. Poor access to nutritious food, water or sanitation facilities, diseases, lack of basic health and social services are underlying factors that lead to suboptimal nutritional status. Poor nutrition outcomes are the result of multiple factors, which require interventions from different sectors. Factors are often structural and linked to poverty, but they can be exacerbated by natural or human-made crises such as disasters, conflicts, outbreaks, and forced displacement.
Undernutrition may have devastating consequences on the physical and mental survival and development of children. Every year, nearly half of all deaths in children under 5 years are due to undernutrition. Health problems, such as diarrhoea or respiratory disease, can be a major cause of malnutrition, which in turn increases the risk of illness. Malnourished children are more likely to fall ill because their immune systems do not develop properly and therefore cannot protect them from illnesses and infectious diseases. Failure to treat undernutrition undermines the effectiveness of efforts to tackle other diseases such as malaria, diarrhoea, and pneumonia. If untreated, it also causes irreversible impairment of growth and cognitive development for hundreds of millions more children.
Worldwide, in 2019, 50.5 million children under the age of 5 suffered from acute malnutrition, also known as wasting (Global Nutrition Report 2020). Wasting refers to a child who has a weight deficiency resulting from recent rapid weight loss or the failure to gain weight. This can result in an increased risk of death. Stunting refers to a child who has an impaired growth and development due to poor nutrition, repeated infection and inadequate psychosocial stimulation. Analysis shows that more than 15 million of children under 5 years of age globally are both stunted and wasted.
Malnutrition remains a major concern in humanitarian emergencies, but also in protracted crises. In fragile countries, the prevalence of wasting escalates dramatically when people face food shortages, disease outbreaks, displacement, and a breakdown of essential services. Children affected by wasting are 9 times more likely to die prematurely than those who are not.
The European Union addresses acute malnutrition through an integrated multi-sectoral approach, which combines the assessment of nutritional status of children, the treatment of acute malnutrition, and the prevention of all forms of malnutrition.
Severe acute under-nutrition results in high risk of death, but it is preventable and curable. Since the adoption of the community-based management of malnutrition by UNICEF, the World Health Organization and the World Food Programme in 2007, national protocols have been adopted in many developing countries. However, their implementation remains suboptimal due to limited resources, recurrent crises in fragile contexts and the complexity of emergencies, demanding tailored interventions to meet specific needs.
When a crisis hits and when the prevalence of acute undernutrition is above the emergency threshold, the European Union and its humanitarian partners intervene and support the implementation of nutrition programmes. Treatment of acute malnutrition is increasingly being delivered as part of a package of integrated health and nutrition services. In high-risk areas, the EU also supports a disaster preparedness approach in strengthening response capacities and shock responsivity of existing community and health systems.
Funding from the EU allocated to nutrition programming has increased in the past decade, reaching over €100 million in 2019. This money provides specialised therapeutic and nutritious products for the treatment of severe acute malnutrition. In-house nutrition experts in regional support offices assist partners in the field to ensure the relevance and quality of the nutrition programming supported by the EU.
Through its resilience approach, the European Union also aims to apply a nutrition angle to its programming in order to mainstream the nutrition impact of humanitarian interventions, and to reinforce the link between humanitarian and development programming.
Collaboration and exchange of expertise ensures the treatment is available beyond humanitarian crises to address the underlying causes of undernutrition. Examples of prevention strategies include the provision of access to safe drinking water and sanitation facilities for affected communities, free access to healthcare for children and pregnant and lactating mothers, and support to households in restoring their livelihoods after a disaster.
The humanitarian and development aid services of the EU work closely together to ensure coherence and complementarity in the field of nutrition.
Innovative and simplified approaches together with operational research aim to optimise performance, coverage, and cost efficiency of treatment protocols, and identify effective prevention strategies. During the coronavirus pandemic, innovative ways of delivering nutrition assistance have been developed to ensure continuation of services, while respecting preventive measures.