An interesting editorial in The Lancet Global Health discusses the situation in poorer countries following COVID-19 infection.
UNICEF published a discussion documented on April 29 comparing the possible downstream effects of COVID-19 in developed and developing countries.
High income and upper-middle income countries have borne the brunt of deaths associated with COVID-19 so far and this fortunately is now diminishing. Countries across the world are easing lockdown restrictions. But, as the UNICEF paper discusses, populations which are least affected by the disease itself at present but for whom food insecurity, hunger and malnutrition are prevalent fear the worst is still yet to come.
The Global Nutrition Report, which is launched this month, reveals the bleak headline that one in nine people throughout the world are hungry or malnourished. In 2018, almost 25% of the world’s children under the age of 5 years, that is 149 million children, were stunted and 7.3%, that is 49.5 million children were wasted. It seems that progress over the past few years has been minimal and this remains far from the 2025 global nutrition targets which were to reduce childhood stunting to fewer than 100 million children and childhood wasting to 5% or less.
Unfortunately, though, in light of the current pandemic, tackling this malnutrition is expected to become much harder.
The 2020 Global Report published on April 20 discussed factors that may lead to a perfect storm for a food crisis in sub-Saharan Africa.
The report discussed the fact that armed conflict still remains a key driver of food insecurity in the region. This leads to the disruption of agriculture and trade, blocking supply chains and prompting mass population displacement.
Unusual heavy rains since last June have facilitated the development of locust swarms, devastating crops across east Africa. Now with movement restrictions in response to the COVID-19 crisis, there is a delay in delivery of pesticides and the stationing of staff to address this problem.
At the same time, reports suggest that where farmers can grow crops, lockdown restrictions are regularly preventing them from transporting the produce and livestock to markets and that rice imports, which were intended to compensate for the shortfall, have been disrupted or stopped to sub-Saharan Africa. This has driven up the price of staple food.
Finally, financial loss in the form of loss of wages resulting from government-imposed lockdowns further restricts the purchasing power of many families who were already on the borderline of poverty. A study by the African Union has projected that up to 20 million jobs could be lost in the region due to the COVID-19 crisis.
Unfortunately, the Global Report on food crisis estimated that 135 million people were food insecure in 2019 but now with the economic and supply chain disruptions associated with COVID-19, this number could double to 265 million people.
David Beasley, Executive Director of the World Food Programme warned: “if we don’t prepare and act now – to secure access, avoid funding shortfalls and disruptions to trade – we could be facing multiple famines of biblical proportions within a short few months.”
It is felt that women and particularly children will bear the brunt of the effects of this food insecurity and Timothy Roberton in his article in The Lancet Global Health estimates the effects of these disruptions on maternal and under-5 child deaths in 118 low-income and middle-income countries. He feels that there could be an additional 42,240 child deaths and 2,030 additional maternal deaths per month. The worst-case scenario resulting in an excess 1,157,000 child deaths and 56,700 maternal deaths over 6 months.
These indirect effects will obviously reach far beyond the disease itself with many long-term social and economic consequences for individuals and society.
So how can we prepare for this impending humanitarian disaster?
In March, the United Nations set up the US $2 billion COVID-19 Global Humanitarian Response Plan, to enable agencies such as the WHO, UNICEF, and the WFP to provide food, water, sanitation and vaccinations, as well as the COVID-19 testing materials and medical equipment to the most vulnerable communities.
Unfortunately, the authors say that at the time of writing this global response plan had only received 46% of its required funding. It is clear that this appeal requires full funding and is an urgent priority for donors, even when they are struggling with economic shocks of their own.
Additionally, restrictions on transport and trade should be considered in the wider context of their potentially devastating effects on the food supply chains.
It is clear that the leaders of our world need to be acutely aware of the potential for this infectious disease pandemic to be compounded by a pandemic of malnutrition of biblical proportions.
The London General Practice
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