Malnutrition is a global crisis, and COVID-19 is making it worse

Open this photo in gallery:

The COVID-19 pandemic has disrupted nutrition programs and limited access to nutritious food around the world. Canada is well-positioned to help prevent a global health disaster, and be an example for other nations to follow

With some parts of the world slowly beginning to emerge from COVID-19, others are experiencing a rapidly worsening situation, and one of the reverberating and ongoing effects of the pandemic is a deepening global malnutrition crisis.

The pandemic has touched nearly every corner of the planet, resulting in vast economic disruption and limiting access to nutritious food for millions of people living in vulnerable situations.

“Even before COVID, malnutrition was a significant problem – with nearly 1 out of every 3 individuals suffering from some form of malnutrition, including close to one billion women in the world who were malnourished,” says Ann Witteveen, vice-president of program operations for Nutrition International, a global nutrition organization headquartered in Canada.

It’s a crisis for children as well. The 2021 global estimates indicate that nearly 149.2 million children were stunted in growth, up nearly five million since 2019; and 45 million were wasted (their weights significantly below what would be expected for a child of similar height).

According to UNICEF estimates, before the pandemic, 45 per cent of all child deaths were attributed to malnutrition, killing 3.1 million girls and boys under age five annually.

COVID-19 has exacerbated malnutrition in several ways, Witteveen explains. “It has not only curtailed access to food; has also curtailed access to services that people need for good nutrition at critical stages in their lives,” she says.

“For example, when a woman is pregnant, she has specific nutritional needs, and she needs to be able to see a health worker. This access to nutritious foods and care has really been disrupted during COVID.”

Filling bellies is not enough

Another way in which COVID has hampered nutrition is in the closing of schools, Witteveen says.

“In lots of developing countries, schools are not only important for learning; they’re also ways that we reach children with information about health and nutrition, and often a place where kids can access a healthy meal,” she says.

“Nutrition International, for example, works with adolescents in primary and high schools where we provide nutrition education as well as support the provision of weekly iron and folic acid supplements. Girls entering puberty are particularly at risk of anemia and these supplements contributes to anemia prevention, thereby increasing their ability to lead healthy lives and helping them be more productive in school, to learn better.”

The need for specific micronutrients such as iron and folic acid and vitamin A underscores the fact that a malnutrition crisis is not the same as a food crisis. While a food program will ensure that children and expectant mothers are not hungry, that’s not enough, Witteveen says. Proper nutrition through food fortification and supplementation programs is needed to ensure that brains, bodies and immune systems have what they need to grow and develop in a healthy way.

By disrupting supply chains, work patterns, productivity and daily routines, including school, as well as diverting resources away from the health system, the pandemic is eroding the slow but steady gains that were being made against malnutrition over the last several decades.

Research published in December 2020 predicts that pandemic-related malnutrition will affect pregnancies and children as soon as next year. COVID-19 could result in an additional 9.3 million wasted and 2.6 million stunted children, 2.1 million maternal anemia cases and 168,000 additional child deaths.

These negative outcomes may result in a cycle of further impoverishment, leading to US $29.7-billion in future productivity losses, according to the research. The danger is that the pandemic will end up reversing decades of progress on improved nutrition and health outcomes.

Open this photo in gallery:

Supplementation programs put on hold

Tomoko Nishimoto, Nutrition International’s regional director for Asia, says that women and children were already particularly vulnerable to malnutrition in many low-and-middle income countries even before the pandemic. During COVID-19, the nutrition security for women and girls in these regions has been further affected, she says.

“Distribution of vitamin A supplements and other low-cost, high-impact nutrition interventions in many countries has been disrupted,” says Nishimoto. “For example, Indonesia’s mandatory wheat and oil fortification program was put on hold last year due to import restrictions on the fortifying elements.”

Indonesia lifted the pause in January with revised fortification guidelines, but there’s still a danger of supply chain disruptions in hard-hit regions as long as the pandemic lingers and normal work, school and living patterns are disturbed. The link between disruptions and malnutrition can be direct, Nishimoto explains.

“When household income decreases, people can afford only cheaper, less nutritious food with higher calories. You can fill the stomach, but that doesn’t mean you are putting sufficient nutrients into your body,” she says.

“And it’s important to remember that those nutrients are needed especially at the right times: during pregnancy, infancy and adolescence.”

Canada’s leadership role

In this moment of crisis for women and children around the world, Canada can help, Witteveen says.

“Investing in nutrition is an opportunity for us [as Canadians] to ensure our response is high-impact. Canada has taken an engaged and compassionate global position in response to the COVID-19 crisis including on nutrition,” she says.

In December, Canada demonstrated global leadership by helping launch the N4G (Nutrition for Growth) Year of Action alongside Bangladesh, which ended up garnering more than US $3-billion in financing commitments.

But more still needs to be done, particularly as the COVID-19 pandemic continues to disrupt and devastate countries. Canada’s approach on prioritizing vaccine delivery is key in the battle against COVID-19, and when paired with nutrition interventions is the best way to build up long-term immunity while also mitigating the knock-on effects of a heightened malnutrition crisis. “Canada is well-positioned to be an example for other nations to follow,” Witteveen says.

She notes that one of Canada’s greatest strengths is the ability to rally like-minded donors and leverage the country’s political capital to bring others to the table.

“Canada is recognized globally as a leader in evidence-based nutrition programs and has been significantly investing in nutrition for over 30 years, “Witteveen says. “Nutrition can’t wait, nor can it be excluded from any phase of the COVID-19 response. Canada is well positioned to ensure nutrition is considered at every COVID-19 forum and influence global actors around the table, for example at the upcoming G7 Summit.”

Advertising feature produced by Globe Content Studio with Nutrition International. The Globe’s editorial department was not involved.