To understand how COVID-19 is affecting nutrition and what the UK Government can do to mitigate the effects, the APPG held a one off evidence session with experts from the nutrition sector. The expert witnesses were:
- Danny Harvey, Executive Director, Concern Worldwide
- Lawrence Haddad, Executive Director, GAIN
- Dr Francesco Branca, Director of Nutrition, WHO
The witnesses told us that up to 487 more children per day could die of undernutrition in 2020 than was predicted before the pandemic and 135 million additional people will suffer from acute hunger. Modelling by GAIN predicts that the number of children suffering from wasting is likely to increase from 47 million to 53 million and irreversible stunting is due to rise by 2.5 million. There are expected to be 2 million more pregnant women with anaemia and 160 million more people unable to afford a healthy diet.
The rise in malnutrition is due to a number of intersecting factors. Firstly, as health systems have redeployed resources to address COVID-19, other areas of health – such as nutrition – have been under-resourced. Secondly, people have been pushed into poverty as jobs and livelihoods have been lost, while restrictions on the movement of goods have pushed food prices up and reduced availability. There is also on average a 30% reduction in the coverage of nutrition programmes – in some countries, coverage has reduced by as much as 75%.
The impact of COVID-19 on nutrition will not only be felt in the short term. Following the Ebola outbreak in West Africa, health systems took at least a year to recover – and that outbreak was far less widespread than COVID-19. Some of the effects of COVID-19 on nutrition are yet to be felt. For example, harvests are predicted to be more severely impacted in 2021 than they have been this year. Many of the health effects of malnutrition are not felt for many years. For example, a child who faces stunted growth due to a restricted diet this year may appear healthy in the short term but will be more susceptible to disease throughout their life.
All the witnesses emphasised the following recommendations that were made in the Lancet earlier this year:
- Safeguard and promote access to nutritious, safe, and affordable diets
- Invest in improving maternal and child nutrition through pregnancy, infancy, and early childhood
- Re-activate and scale up services for the early detection and treatment of child wasting
- Maintain the provision of nutritious and safe school meals for vulnerable children
- Expand social protection to safeguard access to nutritious diets and essential services
The witnesses made the following recommendations specifically for the FCDO to contribute to the Lancet goals:
- By the end of this year, the FCDO should make a multi-year funding commitment to nutrition. Predictable, reliable multi-year funding is critical to ensure that governments and aid agencies can plan ahead and get maximum impact from nutrition programmes. The level of funding pledged should at the very least be equal to existing funding levels and, if possible, an increase. The UK Aid budget for nutrition has remained at roughly the same level since 2013 despite the aid budget increasing from £10bn to £15bn. There is therefore no argument for reducing aid for nutrition as the UK Aid budget contracts this year, particularly when there is such a heightened level of need. The commitment must be made before the end of this year in order to avoid a cliff edge in commitments at the start of 2021.
- The FCDO should provide support to make nutrition programmes as COVID-19 friendly as possible. For example, steps should be taken to enable families to screen their own children for malnutrition and community health workers must be provided with essential PPE.
- Addressing the secondary impacts of COVID-19 on nutrition must be built into the global COVID-19 response in order to prevent the virus undoing years of progress on global health and human development. This can be done by, for example, integrating services to treat and screen for COVID-19 with services that treat and screen for malnutrition. Integrating services as much as possible is not only more impactful but also more cost-effective than dealing with the two issues separately.
- The FCDO must ensure data on nutrition is still being collected as best as possible. While normal surveys are disrupted it is possible to continue to collect data by, for example, maintaining surveillance and monitoring when safe to do so and training community health workers to collect nutrition data using no-touch assessments, mobile data collection or web-based surveys. Sufficient investment must be made in the technologies to carry this out and maintain the quality of data.
- Lastly, none of the above recommendations can be effectively implemented unless the FCDO maintains its in-house expertise on nutrition both in Whitehall and in country offices.
Following the evidence session, the group wrote to the Secretary of State to share the witnesses recommendations and to request a meeting.