Child alert: Severe wasting
Also known as severe acute malnutrition, severe wasting is an overlooked but devastating child survival emergency.
Severe wasting is the most lethal form of undernutrition, and one of the top threats to child survival. Around 1 in 5 deaths among children under 5 are attributed to severe wasting, which is caused by a lack of nutritious food and repeated bouts of diseases such as diarrhoea, measles and malaria, which in turn compromise a child’s immunity.
Unlike famine or starvation, relatively few people have heard of severe wasting – also known as severe acute malnutrition – even though it affects around 13.6 million children globally under the age of 5. Ongoing conflicts and climate-related emergencies meant that this number was already likely to grow. But with so many countries heavily reliant on exports from Ukraine and Russia, the war in Ukraine is threatening to plunge the world even deeper into a food crisis. Meanwhile, the price of life-saving ready-to-use therapeutic food (RUTF) is projected to soar in the coming months, placing even more children’s lives at risk.
Wasting isn’t only rising in countries facing humanitarian crises – countries across a variety of regions, including some relatively stable, have seen an increase in child wasting by more than 40 per cent. For example, in Uganda, child wasting has increased by around 60 per cent since 2016. Yet despite the scale of the problem, relatively small additional investments in treatment for severe wasting could lead to an exponential reduction in child deaths.
The reality is that we already have the knowledge and tools to save hundreds of thousands of lives each year from this excruciatingly painful condition. Ending global hunger and malnutrition won’t happen overnight. But there is plenty we can do right now to stop children dying from severe wasting.
Crisis at a glance
What is severe wasting?
Wasting, defined as low weight-for-height, is the most visible and lethal type of malnutrition. Severe wasting, also known as severe acute malnutrition, is its most deadly form. It is caused by a lack of nutritious food and repeated bouts of diseases such as diarrhoea, measles and malaria, which compromise a child’s immunity.
How is it impacting children?
Severe wasting turns common childhood illnesses into killer diseases. Children who are severely wasted succumb to those diseases because their bodies provide virtually no protection against the bacteria, virus or fungi that infect them. They die because their digestive systems can no longer absorb nutrients. A severely wasted child is reduced to the most basic bodily functions. It takes all their energy just to keep breathing.
How many children are affected?
Globally, at least 13.6 million children under the age of 5 suffer from severe wasting, which is responsible for 1 in 5 deaths among children under age 5, making it one of the top threats to child survival. A severely wasted child is up to 11 times more likely than a healthy child to die of common childhood illnesses such as pneumonia, the single largest infectious cause of death in children worldwide.
An escalating problem…
Countries across a variety of regions have seen a rise in wasting levels since 2016. There’s no single reason for this alarming rise. But cases are rapidly increasing in areas affected by conflict and climate shocks, precisely where the risk of child mortality is already highest.
If we fail to significantly reduce the number of affected children, severe wasting will continue to limit the extent to which we can reduce child deaths from all causes.
…and a largely invisible one
About a quarter of children suffering from severe wasting live in emergency contexts that generate news headlines, often with images of excruciatingly emaciated children. But severe wasting is most concentrated among the youngest children in the most underserved areas, both rural and urban, far from the news cameras.
Nine out of 10 of those who receive treatment are caught in emergencies, even though three-quarters of children suffering from severe wasting live in non-emergency contexts. This is primarily because the children in complex emergencies face the highest risk of death – especially displaced, destitute children who are exposed to disease.
But it’s preventable and treatable
A relatively small additional investment – by donors, governments and other financial instruments – would dramatically reduce child death rates. And it would bring irrevocable socio-economic benefits to children who need help desperately. Reaching virtually every child in need can be achieved with just $300 million in additional funding – 0.1 per cent of total overseas development assistance spent in a year.
In 2020, about 5 million children were treated with cost-effective, ready-to-use therapeutic food (RUTF) that is proven to save lives. But the COVID-19 pandemic and armed conflicts are driving up the price of RUTF, which will likely halt the scale-up of treatment of wasting. More funding is essential to maintain the supply of RUTF.
How is UNICEF responding?
In southern Madagascar, UNICEF provided life-saving treatment to more than 60,000 severely wasted children in 2021 – four times the number reached in 2020. Over 800,000 were reached with safe water, sanitation and hygiene support. And 5,000 of the most vulnerable households were provided with humanitarian cash transfers to help meet their most urgent needs.
In the Horn of Africa, UNICEF and partners are supporting an integrated response encompassing nutrition, safe water, sanitation and hygiene, disease prevention, and food security.
In Afghanistan, UNICEF has launched its largest ever single-country appeal for the country – $2 billion – to reach more than 15 million people, including 8 million children, with humanitarian assistance in 2022.
In South Sudan in 2021, UNICEF and partners treated more than 240,000 severely wasted children – 80 per cent of all children in need. Together with partners, UNICEF is also reaching record numbers of families with prevention support.
What is UNICEF calling for?
- Donors and governments to fully fund the Global Action Plan to scale up treatment on a massive scale, provide multi-year funding that will enable continuous services, and cover treatment for child wasting under health and long-term development funding.
- Donors to ensure that budget allocations to address the global hunger crisis include specific allocations for therapeutic food interventions to address the immediate needs of children suffering from severe wasting.
- Governments to integrate wasting programmes as a central priority in national health systems and services and protect nutrition from budget cuts.
- All stakeholders to prioritize treatment of child wasting as an essential child survival intervention and prioritize resources where they will save the most lives – severely wasted children under age 2.
Most people have never heard of wasting, also known as ‘severe acute malnutrition.’ But it is one of the leading underlying causes of preventable deaths in young children. Conflicts, and climate crises that destroy access to healthy diets, are causing that number to rise. But even in fairly stable countries, child wasting has been on the rise.
‘Severe wasting: An overlooked child survival emergency’ looks at some of the causes behind this rise, the rising cost of ready-to-use therapeutic food (RUTF), and the need to massively scale up the early prevention and treatment of child wasting.