In a "Viewpoint" published in The Lancet, Rainer Gross, PhD, UNICEF's chief of nutrition, and Patrick Webb, PhD, dean for academic affairs at the Friedman School of Nutrition Science and Policy at Tufts University, discuss five facts about world hunger, children and wasting, a condition that represents severe malnutrition.
Wasting is defined by a low weight-to-height ratio; it is visible in the form of skeletally thin children usually found in the middle of a famine. The authors note that a public health disaster is generally declared if more than 15% of the children in a country suffer from wasting. Gross and Webb analyzed countries with the highest child mortality rates and child wasting rates. Based on their assessment of the data, the authors present five surprising facts about severe children malnutrition and argue that such conditions must be resolved in non-emergency settings to prevent future public health crises.
First, contrary to popular belief, Africa does not have the most children suffering from wasting. "Although in the past 10 years, every subregion of Africa saw a rise in both the number of wasted children under the age of five and in the overall rate of wasting, about 78% of the world's 5.5 million wasted children live in India, Pakistan, and Bangladesh; nearly two thirds of those in India alone," says Webb.
Secondly, the absence of conflict, such as political instability, does not prevent or resolve wasting in children. When the authors compared countries without recent conflict to countries that have recently emerged from periods of conflict or remain continually unstable, they found that, "�stability, economic growth, and even political transparency are not in themselves sufficient factors to overcome the persistence of wasting in marginalized vulnerable groups." Wasting is a complex condition that is not simply caused by conflict or famine alone. Gross and Webb conclude that "effective, targeted actions are needed as part of the development agenda."
Third, HIV does not appear yet to contribute substantially and directly to severe wasting in children, although the authors state that "as the pandemic progresses, high HIV/AIDS rates will contribute to worsening nutrition, both from the direct effects of the disease and from an indirect impact on household food security and childcare. Without dual action against wasting and HIV/AIDS, the deadly synergy of these two factors is likely to grow in coming years."
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