Undernutrition is a medical condition that affects mostly young children and women. It can be found under chronic and an acute form, or both forms combined in the same individuals. Undernutrition can be caused by a variety of factors (i.e. access to nutritious food and water/sanitation facilities, adequate care practices, and health services). These factors are often structural and linked to high poverty levels. They are exacerbated when a crisis (natural or man-made) hits.
Under-nutrition has devastating consequences on the survival and development of children: nearly half of all deaths in children under five are due to under-nutrition. Malnourished children are more likely to fall ill because their immune systems do not develop properly and therefore cannot defend against illnesses and infectious diseases. Failure to treat under-nutrition undermines the effectiveness of efforts to tackle other diseases such as malaria, diarrhoea, and pneumonia. It also causes irreversible impairment of growth and cognitive development for hundreds of millions more children.
Globally, it is estimated that 51 million children under five suffer from acute under-nutrition, also known as “wasting”. Wasting refers to a child who is too thin for his or her height. Wasting is the result of recent rapid weight loss or the failure to gain weight. A child who is moderately or severely wasted has an increased risk of death, but treatment is possible.
There are several possible factors leading to wasting, often present at the same time: poor food intake, poor care practices and inadequate sanitation, and access to health care. Although they can be found in all contexts and are often linked to high poverty levels, these factors are exacerbated in humanitarian crises where access to existing services and markets are disrupted.
Severe acute under-nutrition is deadly but curable. Since the adoption of the community-based management of malnutrition (CMAM) by UNICEF, WHO and WFP in 2006, national protocols have been adopted in many developing countries. However, their implementation remains patchy due to limited resources.
When a crisis hits and when the prevalence of acute under-nutrition is above emergency threshold, the European Commission and its humanitarian partners intervene and support the implementation of nutrition programmes, either through direct implementation in complex emergencies, or through a resilience approach and a reinforcement of existing systems.
Funding from the EU allocated to nutrition programming has increased significantly in the past decade, reaching nearly €130 million in 2017. This money provides most of the specialised food product (Ready to Used Therapeutic Food) used for the treatment of severe acute malnutrition. In-house nutrition expertise has also been reinforced in the past years: regional thematic experts in six regional support offices, a dedicated global expert, a nutrition working group. All make sure that under-nutrition remains high on the European Commission agenda and means are devoted to qualitative nutrition programming.
Through its resilience approach, the Commission also aims to apply a nutrition lens to its programming in order to maximise the nutrition impact of humanitarian interventions, and to reinforce the link between humanitarian and development programming.
The ultimate goal is to sustainably address the factors of under-nutrition. Examples of prevention strategies include the provision of access to safe drinking water and sanitation facilities for affected communities; free access to health care 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 European Commission work closely together to ensure coherence in the field of nutrition.
In 2017, 20% of the children affected by severe acute malnutrition received adequate care. Alongside advocacy efforts toward more resources and for an increased awareness of the scope and consequences of under-nutrition, a technical agenda has been developed and undertaken by the European Commission and it partners.
Innovative approaches and operational research are looking at how to optimise performance and the cost efficiency of treatment protocols, and how to identify strategies that demonstrate significant impact on prevention.