Opinion: Revealing the costs of 'hidden hunger' and combating anemia

Students at a primary and secondary school gather to learn about how to tackle iron deficiency by eating the right foods. Photo by: Melkit Mersha / UNICEF Ethiopia / CC BY-NC-ND

A hidden emergency is unfolding. Globally, 40% of pregnant women and 42% of children under 5 are anemic. Hidden hunger stems from a lack of critical vitamins and minerals.

Part of our The Future of Food Systems series

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In the majority of anemia cases, lack of iron puts mothers at double risk of dying during or shortly after childbirth. Often the effects are invisible, characterized by lethargy and fatigue, but its consequences loom large — with anemia linked to about 20% of all maternal deaths.

Children born to anemic mothers are more likely to be born too early or too small, and face an increased risk of death. Anemia during pregnancy and during the early years of life can negatively impact a child’s cognitive, motor, and social development, preventing children from reaching their potential.

In 2012, the World Health Assembly, or WHA, committed to cutting rates of anemia in half by 2025 among women of reproductive age. Currently, no country is on track to meet this target.

Mothers play a central role in nourishing their children. Anemia stands in the way of survival, growth and development throughout their life-course. Urgent and renewed emphasis must be placed on cost-effective and proven nutrition interventions and actions during the first 1,000-day window, the critical period between a woman’s pregnancy and the baby’s second birthday.

Progress is stagnant 

In 2012, the World Health Assembly committed to cutting rates of anemia in half by 2025 among women of reproductive age. Currently, no country is on track to meet this target — the prevalence of anemia in women remains high and unabated in many countries.

The COVID-19 pandemic continues to make matters worse.

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The economic repercussions of COVID-19, disruptions to food and health systems, and environmental conditions, such as a lack of access to clean water and proper sanitation, are making it more difficult for people to access the nutritious foods and health services they need to stave off micronutrient deficiencies such as anemia.

Researchers estimate that the COVID-19 crisis could result in an additional 2.1 million maternal anemia cases by 2022.

Take a systems approach and focus on root causes

We must use both food and health systems to bring down rates of anemia.

Policies and programs that improve diet quality and diversity, infant feeding practices, and intake of micronutrients through food fortification or supplementation, will be key.

For example, supplying all pregnant women with a full dose of prenatal vitamins will reduce the rate of maternal anemia, thus supporting healthy pregnancies, promoting optimal fetal growth, and helping ensure babies are born at healthy birth weight.

Antenatal care, through the health system, is a key entry point for the delivery of prenatal vitamins and other services to prevent, detect, and treat anemia and ensure healthy pregnancies.

While poor diets are the most common cause of anemia, tackling the causes of anemia will also require interventions to control disease; strengthen health systems; improve water, sanitation, and hygiene; and promote reproductive health. With these measures in place, we will be able to lift future generations of children out of poverty and build gender equity.

A window of opportunity

Later this year, two landmark opportunities aim to transform the ways in which food and health systems tackle all forms of global malnutrition, including anemia.

The UN Food Systems Summit and the Nutrition for Growth Summit aim to transform the way we tackle malnutrition through both food and health systems. They will bring together country governments, donors and philanthropies, businesses, NGOs, and beyond to drive progress toward the 2030 Sustainable Development Goals.

The U.N. Food Systems Summit and the Nutrition for Growth Summit will bring together global leaders and provide opportunities to make financial and policy commitments to tackle the challenge of malnutrition and launch game-changing solutions to help us meet the 2025 WHA Nutrition Targets.

As global actors come together to reenvision our food and health systems, we must advance and commit to multisectoral solutions to prevent anemia by addressing its underlying causes. This requires stronger political commitment; new evidence and lessons from implementation research; and expedited funding to increase coverage and improve quality of service delivery.

In doing so, we will simultaneously improve the opportunities for women and girls and march closer to a world in which all mothers and their children have a healthy first 1,000 days and beyond.  

Visit the Future of Food Systems series for more coverage on food and nutrition — and importantly, how we can make food fair and healthy for all. You can join the conversation using the hashtag #FoodSystems.

About the author

  • Nadra Franklin

    Nadra Franklin serves as the Managing Director of FHI Solutions, FHI 360’s nonprofit subsidiary that promotes healthy growth and development through nutrition.