A Simple Solution to Save Millions of Children From Wasting Away


The alarm has sounded: Famine is stalking the Central Sahel and the Horn of Africa. Across both regions, UNICEF projects that some 6.4 million children will experience severe wasting, the painfully accurate term for what happens to children experiencing severe acute malnutrition. Overall, severe wasting is responsible for one in five deaths among children under age 5, making it one of the most serious threats to children in the world today.

But unlike many global problems, the solution to child wasting is staring us in the face.

A daily dose of low-cost, ready-to-use therapeutic food – RUTF – will save the vast majority of children suffering from wasting, if we reach them in time.

But at least two out of three children suffering from wasting don’t have access to this cost-effective, lifesaving treatment. We need to remove the obstacles that are standing in their way.

Global and national leaders in the nutrition sector should start by simplifying treatment protocols and putting children and families at the center of care. In many places, nutrition programs still treat children with moderate and severe wasting with different products, through different supply chains, at different delivery points, with complex admissions criteria.

Trials show that using a single product, RUTF, and simplified approaches for children with both moderate and severe wasting, is just as effective as standard, more complex protocols – and costs less to deliver. Experience from high-burden countries shows that simplified treatment can achieve recovery rates over 95 per cent. And ample evidence shows that centering prevention and treatment in the community can increase access and impact.

Hunger Grows in Somalia
A mother holds her malnourished baby in Banadir Maternity and Children Hospital in Mogadishu, Somalia, on June 1, 2022. Four consecutive seasons of poor rains have left millions of people in Kenya, Somalia and Ethiopia facing starvation.
ED RAM/AFP via Getty Images

As a sector, we also need to get serious about scale by supporting country-owned, community-led efforts to reach every child at risk. International organizations like ours already work closely with governments and partners in high-burden countries – as we are urgently working right now in the Sahel and Horn of Africa regions. But with the threat level growing, we must fully align our technical assistance, operational support and resources behind comprehensive nationally led strategies for scale. We call on our partners to join us in this approach.

The Global Action Plan on Child Wasting was developed to spur and support country action, using costed, operational roadmaps to drive progress in more than 20 high-burden countries. National programs are already using these maps to meet rapidly escalating needs in the Central Sahel and the Horn of Africa – our top priority. But organizations like ours must help to accelerate their implementation so we can reach every child with lifesaving treatment.

Finally, donors and country governments need to pile in the financing. Since July, led by an initial $200 million investment by the United States, governments, philanthropies, and private donors have committed $377 million to respond to this mounting crisis.

This urgently needed support will go a long way to help – but it still falls far short of the $1.2 billion we need to reach the most vulnerable children.


At the recent G7 and Nutrition for Growth summits, government and private donors pledged billions for nutrition and food security – a welcome development.

But wheat and soy won’t cure wasted children. They need RUTF and they need it now. Nutrition programs can quickly close the gap if those donors allocate a fraction of their pledged funds to address wasting in Central Sahel and the Horn of Africa.

Children are suffering now – and it is inexcusable to let proven solutions sit on the shelf, especially when the funding is on the table.

Of course, the best solution to child wasting is to prevent it in the first place. The 1,000 days from conception through the second year are a window of opportunity. Making sure pregnant women have access to good nutrition and care, encouraging exclusive breastfeeding for the first six months, and supporting better foods and feeding practices for young children are mission critical.

But when prevention fails, proper treatment is the only way to save children’s lives. We may not have averted famine in Africa, but we can prevent children from painful deaths by delivering proven solutions now.

David Miliband is president and CEO of the International Rescue Committee. From 2007 to 2010, Miliband was the 74th Secretary of State for Foreign Affairs of the United Kingdom.

Catherine Russell serves as UNICEF’s 8th executive director, overseeing the organization’s work for children in over 190 countries and territories. Prior to joining UNICEF, Ms. Russell served in the US government as assistant to President Joe Biden and director of the White House Office of Presidential Personnel.

The views expressed in this article are the writers’ own.


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