Food aid must change to suit children

The response to global food price rises is failing small children, which could have a long-term impact on the economic growth of poor countries, according to Médecins Sans Frontières (MSF).



International food aid for young children, who are most affected by the crisis, largely consists of cereal-based porridges made of corn-soya blend containing no animal-source food, which is not ideal for children aged below two years and moderately malnourished children, said Stéphane Doyon, leader of MSF's nutrition team. 



MSF has lobbied the UN Secretary-General's High-Level Task Force (HLTF) on Global Food Security to take action."Food aid must change," Doyon told delegates at the recent two-day UN meeting to review global plans to deal with the food price crisis, in Madrid, Spain.



The current food price crisis could exacerbate pervasive malnutrition in the Sahel, the Horn of Africa and parts of Asia, aid agencies said.



Nutritionists have been advocating that the provision of ready-to-eat blended food such as Plumpy'nut - a paste of milk powder, sugar, peanut paste, oil, minerals and vitamins - be scaled up.



Although the UN Standing Committee on Nutrition endorsed the use of read-to-use therapeutic food (RUTF) in 2007, change will only come when the World Health Organisation (WHO) amends the minimum standard for children aged under two for donors, and the World Food Programme switches to the new generation of foods, in turn boosting production.



Stephen Jarrett, Principal Adviser to the UN Children's Fund, UNICEF said the UN agencies "were working on it" and changes would be announced soon.



The new foodstuff has revolutionised the treatment of acutely malnourished children: over 25 countries have adopted this approach, widely acknowledged as effective in treating severe malnutrition, but only nine percent of the 20 million children needing it get this treatment, said MSF.



At the end of the Madrid meeting, nutritionists had reason to feel somewhat elated when the final communiqué urged countries to make their "best efforts" to ensure that children aged under five had permanent access to adequate food.



"It was good news for us that the need for adequate nutrition was acknowledged," said Doyon. Undernutrition contributes to between 10,000 and 15,000 child deaths every day, and to one-third of all child deaths before age five worldwide, according to MSF, which called for changes to the minimum standards for food aid in a letter to the HLTF in 2008.









''The option before countries is to provide the cheapest solution or the effective one''

"The fact that milk was removed from donated enriched flours targeted at young children in the late 1980s, solely due to economic reasons, indicates a deadly double standard in which nutritional science is ignored," MSF wrote in their letter. 



UNICEF's Jarrett said their organisation was also pleased with the recognition given to the importance of nutrition at the Madrid meeting. 



The UN agency runs the world's biggest  RUTF programme in Ethiopia. It dispensing a record 10,000 tonnes in 2008, most of it in Ethiopia, which was struggling with high food inflation and a lack of relief food.



The children's agency has initiated a pilot project providing ready-to-use supplementary food (RUSF) to prevent malnutrition in conflict-ridden Somalia, where drought is also persisting.



MSF recently published a study in the Journal of the American Medical Association, showing that children in a region in rural Niger, who had received RUSF, had a 58 percent lower chance of suffering from severe malnutrition.



"Window of opportunity "



A series of studies published in The Lancet in 2008 confirmed that the first two years of life were a "window of opportunity", when nutrition programmes had enormous impact on a child's development, with life-long benefits.



Improved nutrition in early childhood leads to better adult human capital, including larger body size, greater physical work capacity, more schooling, and better cognitive skills, according to John Hoddinott, a senior research fellow at the International Food Policy Research Institute, who led one of the studies.



Young Lives, a 15-year study of childhood poverty in Ethiopia, India, Vietnam and Peru, funded by the UK Department for International Development (DFID), found that the impact of high food prices on young children was already unfolding, and underlined the need for adequate nutrition, including breastfeeding and supplementary feeding programmes.



The study collected data in 2006, when food prices were already higher than in 2000, and noted that stunting had increased in all four countries, affecting one-third of children as well as lowering their cognitive abilities. Stunting also had a psycho-social impact on the children in terms of their self-esteem, sense of shame, respect, and being included.



Costs



There are also costs. According to MSF, treating 19 million children with severe acute malnutrition and 36 million with moderate acute malnutrition would cost about US$3.6 billion.



"The option before countries is to provide the cheapest solution or the effective one. Either we continue with today's sub-standard approaches, which are driven by an impulse of compassionate aid at cheap cost, and which sacrifice current scientific knowledge and innovations to short-sighted economical considerations," said Doyon.



"Or we apply nutritional science based on our current knowledge, and reform food aid and help countries setting up effective nutritional support programmes."



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