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Hope for nutrition summit as global hunger spikes

2021; Elsevier BV; Volume: 398; Issue: 10316 Linguagem: Inglês

10.1016/s0140-6736(21)02743-4

1474-547X

John Zarocostas,

Food Security and Health in Diverse Populations

As COVID-19, climate change, and conflict drive hunger and malnutrition, the health community looks towards the Nutrition For Growth Summit. John Zarocostas reports. Global food insecurity is on the rise. Hundreds of millions of people are facing acute food crises or famine-like catastrophes aggravated by the COVID-19 pandemic and its crippling economic effects, climate extremes, and conflict. UN officials say the crises will deepen and might also put at risk decades of development gains and efforts to reach the 2030 Sustainable Development Goals, including ending hunger and malnutrition. The latest update of the 2021 Global Report on Food Crises says an estimated 161 million people were in crisis or worse (Integrated Food Security Phase Classification [IPC] Phase 3 or above) in 43 countries—up from 135 million in 2020—and in need of action to save lives. The surge is largely driven by deepening humanitarian emergencies in DR Congo (27·0 million), Afghanistan (22·8 million), Ethiopia (16·8 million), Yemen (16·1 million), Nigeria (12·8 million), Sudan (9·8 million), and South Sudan (7·2 million). The report also documents that about 584 000 people (more than four times higher than the estimates for 2020) are in Catastrophe (IPC Phase 5) situations—meaning they face starvation and death—in Ethiopia's Tigray region (401 000), in southern Madagascar (28 000), South Sudan (108 000), and Yemen (47 000). According to UN officials, the increase in food prices is another driver of the burden. A new report by the Food and Agriculture Organization (FAO) projects the global food import bill is to hit a record high in 2021, surpassing US$1·75 trillion (an increase of 14% compared with 2020), with developing regions accounting for 40% of the outlays. Josef Schmidhuber, FAO deputy director for trade and markets, said that the higher bills are mainly due to higher costs, rather than higher import volumes, and noted that of the additional imports of $25 billion by Low-Income Food Deficit Countries, more than $14 billion are due to higher prices and freights, whereas only $11 billion reflect higher volumes. The rise in food crises “will translate immediately into child malnutrition”, Francesco Branca, WHO director for Nutrition and Food Safety, told The Lancet. In 2020, the UN estimated that 149·2 million children (22%) younger than age 5 years were stunted, 45·4 million (6·7%) wasted, and 38·9 million (5·7%) overweight, and between 720 million and 811 million people globally faced hunger. Branca noted that the COVID-19 pandemic has disrupted nutrition services for children. For example, UNICEF, is facing difficulties in efforts to deliver life-saving treatment to children suffering from severe and acute malnutrition. Saul Guerrero Oteyza, senior adviser on emergency nutrition at UNICEF, described the challenges humanitarians are facing. “What we have now is a combination of crises. We have to juggle and respond to multiple crises simultaneously all with a fair amount of unpredictability and a heightened level of need”, he told The Lancet. Experts anticipate that the COVID-19 pandemic will have longer-lasting effects, and adversely affect health and nutrition services for children. Callum Northcote, senior nutrition policy and advocacy advisor at Save the Children UK, told The Lancet that the charity is anticipating that the worst-case scenario predictions will materialise. “The consensus now is that it will play out because the pandemic has carried on longer than people anticipated and the economic impact is worse than initially anticipated in some countries, and because of the correlation between the economic stagnation and malnutrition. So you can see everything falling together to create essentially a perfect storm for malnutrition.” “Without fast and decisive action from the global community, an additional 3·6 million children will become stunted by 2022 and an additional 13·6 million children wasted. And as a result, 283 000 more children under five will die”, the charity warned in a policy brief. “Humanitarian assistance for the food sector is unable to keep pace with the increasing number of people in need”, Luca Russo, senior food crises analyst at FAO's Office for Emergencies and Resilience, told The Lancet. “We don’t expect donor assistance to increase in the coming years. Most probably we will need to have closer collaboration between development and humanitarian donors which is not happening at the moment”. Until late November, funding appeals for food security had received only $5·2 billion of $14·1 requested, and nutrition had received only $1 billion of $2·5 billion requested, according to UNOCHA. Similarly, the World Food Programme—which is aiming to provide food for 139 million people in 2021 and seeking $15·7 billion (including $7 billion for 45 million people in food emergencies [IPC Phase 4])—has so far been able to mobilise nearly $7 billion from donors. The global health and nutrition community is hopeful that the Tokyo Nutrition for Growth Summit, to be held on Dec 7–8, could be a turning point for new nutrition-related commitments. The UN Secretary-General and heads of major UN agencies are due to address attendees along with representatives of governments, civil society, and business, and new policy commitments and financial pledges will be made in an attempt to strengthen global efforts to tackle malnutrition. The government of the host nation Japan has identified five main areas for the summit to address: making nutrition integral in universal health coverage; building food systems to promote safe, healthy diets and nutrition; addressing malnutrition effectively in fragile and conflict-affected setting contexts; promoting data-driven accountability; and securing new investments to tackle malnutrition. Gerda Verburg, coordinator of the Scaling up Nutrition Movement, and assistant UN secretary-general, told The Lancet, “We should be ambitious because nutrition is one of the most important topics to build back better from COVID-19, and COVID has taught us hard lessons about focusing only on health and forgetting about food and nutrition issues, creating more poverty, but also because nutrition is the game-changer.” At the initial Nutrition For Growth Summit hosted by the UK in 2013, stakeholders committed more than $4 billion to tackle undernutrition and $19 billion in nutrition-sensitive investments to prevent at least 20 million children from being stunted and save at least 1·7 million lives by 2020. Timothy Wise, a senior adviser at the Institute for Agriculture and Trade Policy, told The Lancet that an accountability mechanism—especially for national commitments—is crucial. He also pointed out the need to ensure that “the most obvious solutions are not effectively vetoed by powerful interests in the food and beverage industry”. Nancy Aburto, FAO deputy director for food and nutrition, told The Lancet that there was a real opportunity to see unprecedented commitments at the Summit. “We need to address these drivers and not merely to address the final problems once we have seen a manifestation of children that are stunted, of children that are wasted, and then try to address these problems. We need to recognise that trying to prevent those problems is the only way that we will be able to reach our goal for 2030 to reach zero hunger.” Branca hopes the summit will see high-level commitments by member states in the provision of nutrition services in primary health care both in terms of what is provided and in terms of coverage of these services. “It's about finances, it's about the capacity of the health workers, it's about the supplies, it's about making sure these services are part of the basic packages of primary health care. It's so simple.” Oteyza says that UNICEF is focused on prevention and treatment of child wasting. “For a long time we have put most of our energy on trying to offer treatment, but we will have to start paying greater attention to what can be done to reduce the number of children affected. It requires first, and foremost, a shift, from seeing it as something to be treated into something to be prevented.” Jan Egeland, secretary-general of the Norwegian Refugee Council, told The Lancet, building the resilience of communities hit hardest (most of whom are on the verge of starvation and live in fragile and conflict hotspots) “is a crucial way to reversing this deadly trend. This means investing in livelihoods so that families can feed and fend for themselves.” For the new Food and Agriculture Organization report see https://www.fao.org/3/cb7491en/cb7491en.pdfFor the predictions of how COVID-19 will affect child nutrition see Nat Food 2021; 2: 476–84 For the new Food and Agriculture Organization report see https://www.fao.org/3/cb7491en/cb7491en.pdf For the predictions of how COVID-19 will affect child nutrition see Nat Food 2021; 2: 476–84 Tokyo Nutrition for Growth Summit 2021: an opportunity to accelerate the efforts towards achieving the SDGsNutrition is fundamental for the health and wellbeing of individuals and a basis for sustainable development and economic growth. Investing in good nutrition is an opportunity to positively impact health, increase individual potential and productivity, and support the economic development of nations. The Government of Japan will host the Tokyo Nutrition for Growth Summit 2021 on Dec 7–8. This is the third Nutrition for Growth Summit following London in 2013 and Rio de Janeiro in 2016. The Tokyo Summit aims to review the current status and challenges in nutrition improvement worldwide and to promote global efforts towards better nutrition. Full-Text PDF