Babies are weighed and checked for signs of malnutrition at a government health center in the Damot district, Wolayita Zone in Ethiopia. Photo by: © Ashley Gilbertson / CC BY-NC-ND

According to a recently released U.N. report, more than 820 million people worldwide are hungry, and for three consecutive years, the number of people without enough to eat has grown. The failure to reduce hunger is closely associated with the increase in conflict and violence in several parts of the world and with increasingly extreme weather.

The numbers paint a bleak picture, but there is new hope for the 50 million children suffering from acute malnutrition, which increases the risk of death up to tenfold.

Perhaps not since the invention of Ready-to-Use-Therapeutic Foods, namely Plumpy’Nut in 1996, has there been hope like there is today for children with acute malnutrition. This highly nutritious peanut-based supplement transformed care for children with acute malnutrition.  Prior treatments relied on hospitalizing children and providing them with specially formulated milk to only limited success.

Despite steady progress to expand the number of children accessing treatment, coverage rates have tragically only reached 20%, which means tens of millions of children with acute malnutrition do not have access to the care they need. Although it is an extremely effective treatment, the lack of coverage means the promise of RUTF has not come to fruition. And while incremental improvements in food aid have certainly been realized since then, no major breakthroughs have transpired. That is, until now.

The alarming coverage rates, while deeply disturbing, have catalyzed much-needed action from those with the power to help. We are enjoying a pivotal global moment, marked by greater political will among U.N. actors, the development of new treatment approaches such as those the International Rescue Committee and other NGOs are currently testing, and an imminent opportunity for expanded global financing at the Nutrition and Growth conference in July 2020. It is this confluence of events that could finally unlock the barriers stopping children from getting the help they need and deserve.

In part, the existing barriers to treatment are structural. Under the current system, children with severe and moderate acute malnutrition are enrolled into separate treatment programs and treated with different products procured by way of two different supply chains. This fragmented approach means many children do not get the full benefit of treatment because severe and moderate acute malnutrition therapies are rarely both available in the same place at the same time. Treatment is clinic-based, rather than at the community level. This forces mother to trek hours or days in dangerous conditions to seek help for their sick children. Some do not survive the trek, and those that do often deteriorate along the way. Mothers are forced to contend with the perilous journey and leave other children at home.

This approach clearly has room for improvement, and the U.N. seems to agree. Last month, the World Health Organization, the U.N. High Commission for Refugees, the U.N. International Children’s Emergency Fund, the World Food Programme, the U.N. Food and Agriculture Organization, and U.N. Office for the Coordination of Humanitarian Affairs released a joint statement on steps they will take to improve the system for treating acute malnutrition.

This represents great progress for system reform at the highest levels of the U.N. The promise of a new global action plan and new treatment guidelines have the potential to transform access and modes of operation. This potential can be realized by committing to a single system that treats all children with acute malnutrition together in one treatment program. The plans offer renewed promise for upgrading the system and reaching millions of children currently without access to the treatment they need.

Simultaneously, IRC and other NGOs are testing alternative ways of improving the efficiency of treatment of acute malnutrition in children. We’re focused on simplifying treatment protocol and tools, taking treatment out of hard-to-reach clinics and putting it in the hands of community health workers. They can deliver care where it’s needed most: in homes.

Via our research studies and pilots, we have already proven that low-literate community health workers can diagnose and treat severe acute malnutrition effectively, and we’re generating evidence to prove the viability and cost-effectiveness of treating children with moderate and severe acute malnutrition together in one program. These exciting efficiency developments are critical for informing the U.N.’s global action plan that will be published at the end of this year.

These developments couldn’t be more timely. U.N. member states are set to meet at the Nutrition and Growth Summit in July 2020, where they will have an opportunity to make ambitious funding pledges for nutrition. They should offer renewed commitments to solving this crisis that lets too many children suffer, and in the worst cases, die largely preventable deaths. The world will not meet the Sustainable Development Goals if the status quo persists.

All of this progress represents a new dawn in the fight against hunger and malnutrition. But it will only matter if the commitments made translate to tangible change on the ground. As the number of global conflicts continues to rise, and as climate shocks exacerbate already fragile states, the momentum must continue.

Otherwise, we risk another quarter century of stagnation.

About the author

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    Mesfin Teklu Tessema

    Mesfin Teklu Tessema is the senior director of health at the International Rescue Committee. He has more than 24 years of experience in public health, nutrition, international development, and humanitarian affairs.