Menaka Bhusal/Bonita Sharma

Over the past couple of months, the world has witnessed the emergence of the novel coronavirus (SARS‐CoV‐2) disease. In December last year, the Chinese city of Wuhan first reported the outbreak of COVID-19. The lethal virus spread progressively to other countries with the World Health Organisation (WHO) declaring it a global public health emergency. The pandemic has now become a global threat to humanity, with over 1,067,983 fatalities and millions of infected cases worldwide.

Nutritional status
The COVID-19 pandemic has been affecting the overall health and wellbeing of people in an unprecedented manner. It also has also caused a devastating impact on global malnutrition as the virus is no longer just a public health emergency, but a serious socio-economic crisis. The alarming global social and economic impact triggered by the contagion poses a grave risk to the nutritional status and survival of young children.
Several studies predict that an increase in the cases of malnutrition is highly likely in the coming months due to unemployment, loss of income, financial distress, food insecurity, unaffordability of nutritious foods and interruptions to health, nutrition and social protection services. Some of the strategies being adopted to respond to the COVID-19, including physical distancing, school closures, trade restrictions and nationwide lockdowns, are also affecting the food systems as it has disrupted the production, transportation and sale of nutritious, fresh, and affordable foods, forcing millions of families to rely on nutrient-poor alternatives.

The current crisis has threatened the nutritional status of vulnerable groups through multiple mechanisms. The vulnerable group that we must be particularly concerned about is the children under five years, as almost 90 per cent of the brain development takes place by the age of five. An alarming decline in dietary quality among the children is expected due to income losses. Such a difficult situation results from government-mandated shutdowns and prohibitory orders, freezing of food transfer schemes such as school feeding programmes (mid-day-meal) and the breakdown of food markets due to both demand shocks and supply constraints.
The impact is not just limited to this, as malnutrition could also increase because of the failure of the entire healthcare system. The basic health services such as antenatal, postnatal care, institutional delivery, immunisation, micronutrient supplementation, prevention and treatment of childhood diarrhea, infections, and acute malnutrition, among others, are being underutilised or interrupted. This could further contribute to reduced immunity and increased susceptibility to infectious diseases, including COVID-19.

A study conducted by Derek Headey and colleagues published in Lancet in July 2020 suggests that without timely action, the global prevalence of child wasting (low weight-for-height, an acute and life threatening form of malnutrition) could rise by a shocking 14·3 per cent. Globally, almost 47 million children younger than five years had already been affected by wasting before the outbreak of the pandemic. UNICEF has expected that an additional 6·7 million children could be wasted during the first 12 months of the pandemic and over half (58 per cent or 3.9 million) would be from South Asia alone.
In Nepal, around 52,000 children under five might suffer from wasting due to the pandemic as per the analysis of the Global Acute Malnutrition (GAM) prevalence of 12 per cent, revealed by the 2019 Nepal Multiple Indicator Cluster Survey (NMICS). These numbers depict an alarming situation for the entire country. However, the numbers are just the tip of the iceberg as the COVID-19 pandemic is also expected to increase other forms of child malnutrition, including stunting, micronutrient deficiencies and overweight.

To timely address these looming challenges for health, social, economic status of the entire world, four UN agencies (WHO, UNICEF, WFP and FAO) have suggested five urgent actions to protect children’s right to nutrition during the ongoing pandemic. They include safeguarding and promoting access to nutritious, safe and affordable diets, investing in improving maternal and child nutrition through pregnancy, infancy, and early childhood, re-activating and scaling up services for the early detection and treatment of child wasting, maintaining the provision of nutritious and safe school meals for vulnerable children and expanding social protection to safeguard access to nutritious diets and essential services.

Collective intervention
The existing inequities in our system are widening in the shadow of COVID-19, and the children are the ones bearing its devastating long-term consequences. If we do not immediately intervene at individual, community, national and global levels, an entire generation of children is going to be left behind from reaching their full potential in life. So, it is high time that the government, the UN agencies, private sector, businesses, civil societies and youth came together and acted collectively for the prevention and treatment of malnutrition amid the COVID-19.

(Bhusal is a public health professional and Sharma is a youth activist and Cofounder of Social Changemakers and Innovators (SOCHAI). bonitasharma15@gmail.com)