UNICEF: An additional 6.7 million children under 5 could suffer from wasting this year due to COVID-19

An additional 6.7 million children under the age of five could suffer from wasting – and therefore become dangerously undernourished – in 2020 as a result of the socio-economic impact of the COVID-19 pandemic, UNICEF warned today.

According to an analysis published in The Lancet, 80 per cent of these children would be from sub-Saharan Africa and South Asia. Over half would be from South Asia alone.

“It’s been seven months since the first COVID-19 cases were reported and it is increasingly clear that the repercussions of the pandemic are causing more harm to children than the disease itself,” said UNICEF Executive Director Henrietta Fore. “Household poverty and food insecurity rates have increased. Essential nutrition services and supply chains have been disrupted. Food prices have soared. As a result, the quality of children’s diets has gone down and malnutrition rates will go up.”

Wasting is a life-threatening form of malnutrition, which makes children too thin and weak, and puts them at greater risk of dying, poor growth, development and learning. According to UNICEF, even before the COVID-19 pandemic, 47 million children were already wasted in 2019. Without urgent action, the global number of children suffering from wasting could reach almost 54 million over the course of the year. This would bring global wasting to levels not seen this millennium.  

The Lancet analysis finds that the prevalence of wasting among children under the age of five could increase by 14.3 per cent in low- and middle-income countries this year, due to the socio-economic impacts of COVID-19. Such an increase in child malnutrition would translate into over 10,000 additional child deaths per month with over 50 per cent of these deaths in sub-Saharan Africa.

The estimated increase in child wasting is only the tip of the iceberg, UN agencies warn.  COVID-19 will also increase other forms of malnutrition in children and women, including stunting, micronutrient deficiencies and overweight and obesity as a result of poorer diets and the disruption of nutrition services. UNICEF reports from the early months of the pandemic suggest a 30 per cent overall reduction in the coverage of essential – and often life-saving – nutrition services. In some countries, these disruptions have reached 75 per cent to 100 per cent under lockdown measures. For example, in Afghanistan and Haiti, fear of infection and lack of protective equipment for health workers has led to an estimated 40 per cent and 73 per cent decline, respectively, in admissions to treat severe wasting in children. In Kenya, admissions dropped by 40 per cent. Over 250 million children globally are missing the full benefits of vitamin A supplementation due to COVID-19.

When the projected increase in wasting in each country is combined with a projected year average of 25 per cent reduction in nutrition services, there could be 128,605 additional deaths in children under the age of five over the year, according to the analysis. The range reflects scenarios using a low of 15 per cent and a high of 50 per cent disruption in vitamin A supplementation, the treatment of severe wasting, the promotion of improved young child feeding, and the provision of micronutrient supplements to pregnant women.

In a commentary to The Lancet report, also released today, the heads of UNICEF, the Food and Agriculture Organization, the World Food Programme and the World Health Organization warned that the COVID-19 pandemic is undermining nutrition across the world particularly in low- and middle-income countries, with the worst consequences being borne by young children. More children and women are becoming malnourished due to the deteriorating quality of their diets, the interruption of nutrition services, and the shocks created by the pandemic.

Humanitarian agencies immediately need USD $2.4 billion to protect maternal and child nutrition in the most vulnerable countries from now until the end of the year. The heads of the four United Nations agencies appeal to governments, the public, donors and the private sector to protect children’s right to nutrition by:

• Safeguarding access to nutritious, safe and affordable diets as a cornerstone of the response to COVID-19 by protecting food producers, processors and retailers; discouraging trade bans; and designating food markets as essential services;  

• Investing decisively in support for maternal and child nutrition by protecting breastfeeding, preventing the inappropriate marketing of infant formula, and securing children and women’s access to nutritious and diverse foods;

• Re-activating and scaling up services for the early detection and treatment of child wasting while expanding other life-protecting nutrition services;

• Maintaining the provision of nutritious and safe school meals by reaching vulnerable children through home delivery, take-home rations, cash or vouchers when schools are closed; and

• Expanding social protection to safeguard access to nutritious diets and essential services among the poorest and most affected households, including access to fortified foods.

UNICEF’s Reimagine campaign aims to prevent the COVID-19 pandemic from becoming a lasting crisis for children, especially the most vulnerable children. Through the campaign, UNICEF is issuing an urgent appeal to parents, governments, the public, donors and the private sector to join UNICEF as we seek to respond, recover and reimagine a world currently besieged by the coronavirus:

• Respond. We must act now to stop the disease from spreading, help the sick, and protect first responders on the frontlines risking their own lives to save others.
• Recover. Even when the pandemic slows, each country will have to continue to work to mitigate the knock-on effects on children, and address the damage inflicted. Communities will also have to work together, and across borders to rebuild and prevent a return of the disease.
• Reimagine. If we have learned anything from COVID-19, it’s that our systems and policies must protect people, all the time, not just in the event of a crisis. As the world recovers from the pandemic, now is the time to lay the groundwork for building back better.

“We cannot allow children to be the overlooked victims of the COVID-19 pandemic,” said Fore. “We must simultaneously think both short and long term, so that we not only address the challenges posed by the pandemic and its secondary impacts on children, but also chart a brighter future for children and young people.”

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Comment pieces in The Lancet are written by experts in the field, and represent their own views, rather than necessarily the views of The Lancet or any Lancet specialty journal. Comment was externally peer-reviewed.

About the Analysis

The analysis is based on research efforts by the Standing Together for Nutrition consortium. They link three approaches to model the combined economic and health systems impacts from COVID19 on malnutrition and mortality: MIRAGRODEP’s macroeconomic projections of impacts on per capita gross national income (GNI)8; microeconomic estimates of how predicted GNI shocks impact child wasting using data on 1.26 million children from 177 Demographic Health Surveys (DHS) conducted in 52 LMICs between 1990-2018; and the Lives Saved Tool (LIST) which links country-specific health service disruptions and predicted increases in wasting to child mortality.

About the Reimagine Campaign

In response to the COVID-19 pandemic, UNICEF has launched Reimagine — an urgent appeal to governments, the public, donors and the private sector to support UNICEF’s efforts to respond, recover and reimagine a world currently besieged by COVID-19. Together, we can prevent this pandemic from becoming a lasting crisis for children—especially the most vulnerable—and Reimagine a fairer world for every child.

Learn about the #Reimagine campaign here: www.unicef.org/reimagine