As aid groups scramble to contain COVID-19, malnutrition set to increase

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Staff members of the Social Association, a partner of Catholic Relief Services, with food and hygiene items for needy families in Lebanon. Photo by: @CatholicRelief via Twitter

BERLIN — In the rush to stall the spread of COVID-19, experts are warning of disastrous increases in malnutrition in both the immediate and long terms as key programs to deliver food and micronutrients to vulnerable populations are interrupted.

“We’re focusing on the survival of people, but nutrition is a part of this.”

— Gerda Verburg, global coordinator, Scaling Up Nutrition Movement

Communities dealing with malnutrition are doubly vulnerable because of the pandemic. Since malnutrition can weaken the immune system, these populations may be more vulnerable to acquiring COVID-19. Government policies aimed at containing the virus’s spread, such as banning large gatherings, may cost them access to key sources of nutrition or micronutrients. Alternatively, the pandemic could force people to take on additional transmission risks by continuing to seek out those resources.

Focus on: Improving Nutrition

This focus area, powered by DSM, is exploring innovative solutions to improve nutrition, tackle malnutrition, and influence policies and funding.

Humanitarian groups are scrambling to maintain food distribution and create other systems for delivering food and other supplies. Members of the nutrition community are also taking steps to warn of and mitigate some short- and long-term impacts on food security and nutrition that may result from countries’ radical actions to slow coronavirus transmission.

“We’re focusing on the survival of people, but nutrition is a part of this,” Gerda Verburg, global coordinator for the Scaling Up Nutrition Movement, told Devex. “There is a need to open up more to paying attention to the role that good nutrition can play toward resilience building and further prevention.”

At the moment, though, they just want to make sure people are getting the basic nutrition they need.

The dilemma for nutrition

The pandemic is creating an impossible dilemma for the nutrition sector. Food distribution programs are often lifesaving, especially in low-income communities and among refugee populations, but the traditional process of gathering people to pass out food and supplies risks spreading the novel coronavirus among particularly vulnerable populations.

“We don’t want our food provision to become problematic for those communities,” said Bill O’Keefe, executive vice president for mission, mobilization, and advocacy at Catholic Relief Services. Protecting food security is a central part of the organization’s emergency response work. “We’re working very hard to strike that balance,” he said.

Recognizing the importance of nutrition programs, some national governments are allowing them to continue operations even as they shut down other kinds of relief work and are putting trust in agencies’ strategies for minimizing coronavirus transmission.

Of course, this is not the first time that international organizations have been called on to distribute food in the midst of an outbreak. Experts said they have learned from previous epidemics, including the West Africa Ebola outbreak years ago.

The World Food Programme has issued food distribution recommendations, including blueprints for setting up sites that minimize contact and integrate health checks and sanitation stations. CRS is staggering distributions and adding more locations to keep down the number of people at a site at any given time. It is also explaining the pandemic to recipients and offering recommendations on how they can protect themselves from infection.

At the same time, aid workers face their own challenges, including the risk of transmission. They are impacted by the same movement restrictions as the rest of the population, which can slow or halt their ability to run nutrition programs. And even though some nutrition programs are exempted, bans on gatherings are having an effect.

The global NGO Nutrition International has seen its community health days — large gatherings that bundle key health interventions and distribute vitamin A supplements — shuttered across the 10 African and Asian countries where it works.

Vitamin A helps shore up children’s immune systems and ward off diarrheal disease, measles, and other illnesses. Some countries have routinized other ways to deliver the vitamin, Joel Spicer, Nutrition International’s president and CEO, told Devex. But he added that “others will stop, miss a round, and children will die. We are working with partners to reduce the damage.”

Long-term implications

Some short-term measures to stem the virus’s spread could have long-term implications for nutrition. Of particular concern are the moves by leaders in Africa and elsewhere to close their borders, echoing similar responses during the height of the 2008 financial crisis.

“This was exactly the wrong answer, the wrong reaction,” Verburg said of the 2008 response. “It deepened the crisis,” she said, leading to food shortages and spiking food prices. And she is worried the same thing could happen again.

There are already warning signs, including price increases in places as disparate as China and Sudan. Rwanda, Uganda, and other East African governments are taking preventive steps, such as arresting people for price gouging and capping the cost of essential items.

Verburg said she also worries that, in the rush to respond to the pandemic, countries will pull funding from nutrition programs and attention from hard-won, multisectoral efforts to curb malnutrition. And, she said, people will almost certainly emerge from the crisis poorer, with a diminished ability to access nutritious foods.

“The systems and resilience in many countries is not ready for coping with these kinds of crisis situations,” she said.

Acknowledging that leaders are still in the midst of an immediate response to mitigate danger, Spicer called for a quick pivot “from the reactive to a proactive, resilience-building phase” that pays special attention to the most vulnerable and considers nutritional needs.

This would include thinking about alternative ways of delivering food and micronutrients, such as by increasing food fortification, while leveraging technology to better inform people.

The World Health Organization has been encouraging countries to at least maintain humanitarian corridors so that the trade of essential goods can continue, even as they close their borders. Verburg has also urged participating governments to consult the Agricultural Market Information System, which was created in the wake of the food crises resulting from the 2008 financial collapse. It forecasts the demands on agricultural markets and helps identify global food shortages early so that policymakers can take action.

“We need to make sure that governments are taking decisions that are helpful to stop the virus and not taking wrong decisions and making the impact of the virus worse,” Verburg said.

As the response eventually shifts to recovering from the impact of the pandemic, Spicer called for leaders and donors to position nutrition — an essential component of any multisectoral health strategy that could mitigate future outbreaks by building up people’s immune systems — at the center of those efforts.

“Governments and donors that are supporting nutrition are actually investing in resilience,” he said. “Nutrition is prevention and treatment. Investments like nutrition are going to seem very cheap in retrospect.”

This focus area, powered by DSM, is exploring innovative solutions to improve nutrition, tackle malnutrition, and influence policies and funding. Visit the Focus on: Improving Nutrition page for more.

About the author

  • Andrew Green

    Andrew Green is a Devex Contributing Reporter based in Berlin. His coverage focuses primarily on health and human rights and he has previously worked as Voice of America's South Sudan bureau chief and the Center for Public Integrity's web editor.