Photo by: Christine Nesbitt (UNICEF 2010)
In June 2019, the UN Secretary General commissioned UN agencies working on nutrition (FAO, UNHCR, UNICEF, WFP and WHO) with preparing the first-ever Global Action Plan (GAP) on Child Wasting. The plan aimed to respond to the slow progress towards achieving the Sustainable Development Goal on reducing childhood wasting, and to growing calls for a more coordinated and streamlined UN approach to addressing this challenge.
The newly released GAP Framework identifies four critical outcomes to achieving the SDG target on child wasting and to improving early detection and treatment for those who need it:
Reduced incidence of low birthweight
Improved infant and young child feeding
Improved child health
Improved early detection and treatment of child wasting
Under each outcome, the Framework identifies pathways to accelerate the delivery of essential actions and to create an enabling environment for their success. UNICEF will lead the development of the GAP Country Operational Roadmaps, supporting countries to implement context-specific commitments to reach the global SDG target on child wasting.
WHAT IS CHILD WASTING?
Wasting is a form of acute malnutrition characterized by a loss of body weight in relation to height, which increases a child’s risk of infection and death and decreases their ability to learn.
As estimated 50 million children, or 7.3% of the total under-five population around the world suffer from wasting, a form of undernutrition that can be lethal. In 2015, as part of the Sustainable Development Goals (SDGs), governments around the world committed to reducing this number to <5% by 2025 and to <3% by 2030.
Yet, since these targets were adopted, the proportion of wasted children has remained largely unchanged. Wasting affects children in virtually every continent on the planet, with the largest number of children suffering from wasting today being found in South Asia.
For much of the past two decades, global efforts to address wasting have primarily focused on providing treatment for wasted children, especially in humanitarian crises. In 2019, an estimated 11 million children received treatment for wasting. Although the coverage of treatment services has steadily increased since 2010, the proportion of wasted children who can access treatment remains unacceptably low with just one in three severely wasted children receiving treatment.
The GAP Framework recognizes that effective responses to address child wasting must be defined on the basis of stronger evidence of how specific drivers manifest and interplay to increase vulnerability to child wasting across different contexts, populations and seasons, and how national governments and their partners can mobilize to address these.
In most contexts, this can be achieved by strengthening national health, food and social protection systems. The Framework aims to shift collective focus towards ensuring that these systems are responsive and aligned to deliver healthy diets and sufficient mother and child care, including nutrition interventions.
The goal of the GAP is to accelerate the delivery of essential actions to address the immediate determinants of child wasting, while aligning actions across multiple systems to simultaneously address underlying drivers that continue to limit our collective ability to protect communities, households and children from wasting.
THE FRAMEWORK FOR ACTION
To achieve the goal of reducing wasting prevalence to less than 5% by 2025 and 3% by 2030, the GAP Framework will accelerate action towards four key outcomes that will directly contribute to the achievement of the SDG targets on wasting:
Finally, the development and implementation of the GAP on Child Wasting will be driven by seven common principles:
Promote government leadership and ownership of prevention and treatment of wasting in all contexts and at all levels.
Re-position prevention at the center of our collective efforts to reduce the number of children suffering from wasting and increase the efficiency of our collective efforts.
Prioritize scalable responses that are cost-effective, efficient and designed to be practical and feasible at scale, increasing access to hard-to-reach populations.
Enhance the life cycle approach to ensure inclusion of adolescents, pregnant women, breastfeeding women, infants 0-5 months and children 6-59 months in prevention, protection and treatment.
Ground the design of wasting interventions on key present and future factors that impact on wasting, including urbanization, climate change, demographics shifts and increasing inequalities.
Commit to gender, equality, women’s empowerment, community participation and ownership and inclusion of excluded groups and responsiveness to special needs, including populations on the move.
Encourage iterative action and learning, acting on what we already know and gradually adapting on the basis of emerging evidence and data to ensure maximum effectiveness.
THE RESEARCH AGENDA
To support the delivery of impactful actions for the prevention and treatment of child wasting, policy and practice will need to be reviewed and updated to reflect the latest evidence. The World Health Organization (WHO) and its partners have identified evidence gaps which will require additional operational and scientific research. This Agenda will be further detailed in consultation with key stakeholders at global, regional and country level to identify specific evidence needs to support operational delivery at scale and global normative guidance.
Over the next five years, WHO, with the support of other UN agencies, will coordinate and oversee the generation of new evidence to address these gaps and accelerate the process to update global normative guidance for the prevention and treatment of child wasting. In doing so, WHO will collaborate with national governments, academics, donors and other stakeholders to regularly update the global community on key emerging evidence and their wider implication for policy and practice.