Opinion: $950 million — the price to end child starvation deaths

I recently took a trip to Kenya with a delegation of 19 members of the United States Congress. For the first day and a half, a central discussion point from both sides of the aisle was current budget constraints — and even how tempting it can be to consider cutting humanitarian aid at a time when other competing interests feel too pressing to ignore.

But then we visited a severe acute malnutrition, or “SAM,” clinic in the Kakuma refugee camp. We met children there who were being treated for wasting, the deadliest form of malnutrition. If children don’t receive treatment for wasting, their muscles break down and their bodies become skeletal. They suffer multiple organ failure and loss of brain mass. Eventually, they become so weak they cannot move. Each year, about a million of these wasted children will die. That’s 1 in 5 child deaths globally.

A familiar silence fell on our group as we took a bus back to Nairobi. I have experienced this same tomb-like quiet after other visits to SAM clinics. How do you go back to your daily worries and preoccupations after you’ve heard the cry of a child dying from starvation? How does life resume normalcy when you’ve seen hunger and poverty in a refugee camp such as Kakuma with almost 200,000 displaced people living on less than $2 per day?

The conversations about budget constraints were set aside for the rest of the trip. That feeling — that we have to do something — took over.

Solutions are within reach

Fortunately, there is a simple way that we could save nearly every one of the lives of the one million children who die from wasting each year.

Ready-to-use therapeutic food, or RUTF, is a peanut-based medical food that can bring a severely malnourished child back from the brink of death in a matter of weeks. There are no silver bullets in global health, but when it comes to preventing children dying from starvation, RUTF is as close as one comes.  It has a cure rate of up to 90%, and costs less than $1 per day.

RUTF not only revives children who face death from malnutrition — it also widely prevents child stunting and long-term chronic malnutrition. And yet only one in four children who need RUTF have had access to it.

But last year, there was a breakthrough. The U.S. Agency for International Development Administrator Samantha Power leveraged supplemental food security funds from the U.S. Congress to announce an unprecedented investment in child wasting treatment. In total, USAID — alongside our foundation and other donor partners — pledged an historic $577 million to combat child wasting. When announcing this additional funding at the United Nations General Assembly last year, Power said, “We have the chance together to turn what has been for so long a story of despair into one of hope, because the truth is … wasting is treatable.”

The committed funds have not yet been entirely allocated, and already we have seen a significant increase in treatment coverage for children suffering from malnutrition. In 2022, under the leadership of Executive Director Cathy Russell, UNICEF delivered the largest malnutrition response on record — reaching 35% more wasted children than the previous year, for a total of 7.3 million children.

This success story is also an easy sell to the American people, because RUTF represents a cost-effective, home-grown way to send U.S. assistance abroad. Its ingredients — including peanuts, dairy, vegetable oil, and sugar — come from farms across at least 28 states. The production of RUTF therefore supports American farmers and manufacturers, such as MANA Nutrition in Georgia and Edesia in Rhode Island, and shows how U.S. agriculture can make a difference in millions of vulnerable lives.

The need is greater than ever

Once on the decline, child wasting is experiencing a startling uptick as a result of conflicts, COVID-19, and climate change.

We know that the global need for RUTF and other malnutrition interventions is growing. The war in Ukraine and Russia’s halt of the Black Sea Grain Initiative have added increased urgency to the global food insecurity crisis — and if we don’t act now, more children will die.

But continued funding for RUTF is at risk at precisely the moment we need to sustain and scale up our support for this lifesaving treatment. We need to secure multiyear, predictable, and reliable investment in wasting treatment.

The Eleanor Crook Foundation estimates that it would only cost an additional $950 million annually to scale up RUTF treatment to reach nearly all severely wasted children in the world with treatment that will save their lives. $950 million a year is what it would cost to live in a world where children no longer die of starvation. To offer a sobering comparison, this cost is substantially less than a single day’s revenue at Amazon. As one member of the Kenya congressional delegation put it, “A billion dollars to live in a world where no kids die from hunger — that’s peanuts.”

The systems to deliver this product are largely in place. If we deployed that $950 million tomorrow, we could see an end to mass deaths from child wasting in a mere matter of months.

Where we go next

The U.S. should be the country that ushers in this new chapter of human history. We will never live in a stable, peaceful world so long as millions of parents watch their children starve to death each year. The cost is nearly infinitesimal — 0.004% of our GDP.

With USAID’s historic commitment last year, we are already halfway there. Other public and private donors will almost certainly meet the moment if USAID continues its historic leadership on RUTF this year and beyond. And the U.S. government could leverage other existing resources to achieve global coverage for wasting treatment — such as exercising the Department of Agriculture’s Commodity Credit Corporation authority to procure and donate RUTF and other lifesaving nutrition products.

This week we’ve joined together at UNGA to confront many complex global problems, some of which will take decades to solve. But ending child deaths from wasting is something we can do right now. Each of the one million children dying from starvation deserves our urgent attention. Every day we delay, thousands of lives go to waste. Let’s maintain the incredible momentum that ignited in 2022. Let’s make sure every wasted child gets access to treatment with RUTF. Next year, let’s usher in a new chapter where children no longer die of starvation. $950 million a year is all that it would take.

To end global malnutrition, ECF invests in research, policy, and advocacy to scale up high-impact, cost-effective interventions, like the Power 4. To learn more, visit www.eleanorcrookfoundation.org.