COVID-19 pandemic fueling rise in child hunger: Malnutrition, wasting risks rise among youth around world
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* Kim Krisberg

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People line up for free food in Manila in December. Child hunger and malnutrition are soaring worldwide during the COVID-19 pandemic.

 Photo by Ted Aljibe, courtesy AFP/Getty Images

In 2019, U.S. child hunger hit its lowest point in more than two decades. Then the COVID-19 pandemic arrived, wiping out years of progress in a matter of months.

Similar trends are un-folding around the world, exposing the fragility of hard-fought food security gains and putting children’s short- and long-term health in serious jeopardy. Last summer, U.N. leaders warned in a commentary in *The Lancet* that the pandemic was critically exacerbating existing child malnutrition and hunger, putting kids at greater risk of death from COVID-19.

A July study estimated that an additional 6.7 million children younger than 5 went malnourished in low- and middle-income countries in the pandemic’s first 12 months, with most of those children in south Asia and sub-Saharan Africa. More than 10,000 additional child deaths per month also occurred in that same time period.

Before the pandemic, about 47 million children younger than 5 were moderately or severely wasted, defined as being too thin for their height. And 144 million were affected by stunting, defined as being too short for their age.

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Millions more children could become malnourished during the pandemic, experts warn.

Photo courtesy Mofles, iStockphoto

Lack of nutritious food can be especially harmful for very young children, who are going through critical physical and cognitive development stages, and is a key underlying cause of child deaths due to diseases such as diarrhea, malaria, pneumonia and measles.

In *The Lancet* commentary, leaders of the World Health Organization, World Food Program, UNICEF and Food and Agriculture Organization estimated a minimum of $2.4 billion was needed “immediately” to protect at-risk children, prevent and treat malnutrition, and avoid more child deaths. They called on governments and other stakeholders to take urgent steps, including safeguarding access to nutritious and affordable diets as central to COVID-19 response.

“The estimated increase in child wasting is only the tip of the iceberg,” cautioned the U.N. agencies. “The COVID-19 pandemic is also expected to increase other forms of child malnutrition, including stunting, micronutrient deficiencies and overweight. The global community’s failure to act now will have devastating long-term consequences for children, human capital and national economies.”

According to UNICEF, its country offices reported a 30% decline in overall coverage of nutrition services for women and children in low- and middle-income nations in the early months of the pandemic, and declines of 75% to 100% under certain stay-at-home conditions.

In January, UNICEF reported that 370 million children worldwide, many of whom depend on school meals as a key source of nutrition, have missed 40% of in-school meals, on average, since the start of the pandemic. Overall, more than 39 billion in-school meals have been missed.

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A child is screened for malnutrition in Yemen in 2020. Famine in the nation has worsened during the COVID-19 pandemic.

Photo courtesy UNICEF

Health advocates worry continued school closures and a lack of school meal programs — which often act as an incentive for keeping the most vulnerable children in the classroom — will also lead to millions more students dropping out of school.

“COVID-19 is a focusing event, with many more people now making the connection between food security and (food system) disruptions,” said Rebecca Heidkamp, PhD, an associate scientist at Johns Hopkins Bloomberg School of Public Health and an expert on nutrition programs in low-resource settings. “However, nutrition has not typically gotten the political traction we’d like to see.”

Even before the pandemic, she noted, only a small number of countries were on track to meet nutrition targets included in the global Sustainable Development Goals, which U.N. members adopted in 2015. Those targets include ending all forms of malnutrition by 2030 and meeting internationally agreed-upon objectives on stunting and wasting among kids younger than 5. COVID-19 has likely pushed those goals beyond their target dates.

In a December preprint study published in *Nature Food*, Heidkamp and co-authors estimated that by 2022, COVID-19 and its economic, food and health system disruptions could result in an additional 9.3 million wasted and 2.6 million stunted kids in low- and middle-income nations.

The pandemic could also cause 168,000 additional child deaths, 2.1 million maternal anemia cases and 2.1 million children born to women with low body mass index. They estimated potential future productivity losses of $29.7 billion due to excess child stunting and death during the pandemic. An additional $2.1 billion per year is needed to mitigate such impacts, the study found.

Heidkamp said there are effective interventions to address the problem in the short term, such as quickly scaling up nutritional supplementation for pregnant women and young children. For example, she pointed to small-quantity lipid-based nutrient supplements, which are typically added to home cooking and have been shown effective in improving child nutrition and development. However, she said longer-term investments to boost resiliency in food supply chains and strengthen social protection programs are also needed.

“It’s not just food — it’s really about nutritious food,” Heidkamp told *The Nation’s Health.* “It’s about healthy food security and affordability that also works with people’s lifestyles.”

In the U.S., the child nutrition crisis is not nearly as severe as it is in many nations. But child hunger in the U.S. is on an incline, with projections showing a rise from 5.3 million food-insecure children in 2019 to a high of 17 million in 2020, with disproportionate impacts on Black and Hispanic families.

Jason Gromley, director of advocacy and government relations at Share Our Strength, which runs the No Kid Hungry campaign, said the U.S. is now looking at a future in which 1 in 4 kids faces hunger.

“But we know how to fix this,” he told *The Nation’s Health.* “We know child nutrition programs like school meals and SNAP are key to meeting these basic needs. That’s the place where we as a society have a solution. It just takes political will.”

For more information, visit [www.unicef.org](http://www.unicef.org) and [www.nokidhungry.org](http://www.nokidhungry.org).

*   Copyright The Nation’s Health, American Public Health Association