06 Dec Wasting and Child Pneumonia Scorecard
Reducing wasting will deliver many benefits to child health including significant declines in deaths from pneumonia – the leading killer of children under five. Wasting is the leading risk factor for child pneumonia death, contributing to 367,800 (55%) deaths in 2019. No other risk factor contributes to this many child pneumonia deaths, according to the Global Burden of Disease (GBD).
A child is wasted when they have extremely low weight-for-height. Wasting often indicates recent and severe weight loss, although it can also persist for a long time. It usually occurs when a child has not had food of adequate quality and quantity and/or they have had frequent or prolonged illnesses. There are an estimated 45 million wasted children in the world.
Wasting is a much greater risk factor for child pneumonia death than stunting (81,000 deaths) and underweight (70,000 deaths). Since 2010, wasting-related child pneumonia deaths have declined by just 38 per cent, slower than stunting-related pneumonia deaths (-43%) and underweight-related pneumonia deaths (-46%).
Wasting-related child pneumonia deaths are concentrated among very young children. Two-thirds (244,300) are among children aged 28 days to one year and one third (123,500) are among children aged one to four years. Evidence suggests wasting often begins much earlier in the womb and that children who are born with low birth weight are more likely to become wasted.
Some populations of children are extremely vulnerable to wasting-related pneumonia deaths. Ninety per cent of these deaths are in 40 low- and middle-income countries – 28 in Africa, 10 in Asia, one in the Middle East and one in Latin America. In a subset of 14 countries wasting contributes to more than 60 per cent of child pneumonia deaths, including 10 in Africa, three in Asia and one in the Middle East.
The Every Breath Counts Wasting and Child Pneumonia Scorecard ranks the 20 countries with the largest numbers of wasting-related child pneumonia deaths and includes Nigeria, India, Pakistan, Niger, Burkina Faso, Ethiopia, Somalia, Tanzania, Chad, Mali, Afghanistan, Democratic Republic of Congo, China, Philippines, Indonesia, Bangladesh, Guinea, Côte d’Ivoire, Cameroon and Mozambique.
It is critical that governments, from the countries where most wasted children live, introduce policies and programs to identify and reduce the numbers of wasted children and related deaths, and integrate wasting prevention, diagnosis and treatment within broader child health services, especially vaccination.
Specifically, the Every Breath Counts Coalition is calling on governments to set a national target to reduce the percentage of children under five who are wasted to less than three per cent by 2030, publish progress to the target, and introduce new measures to achieve the target including by:
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- Assessing all pregnant women at risk of low birth weight (LBW) and supplementing pregnancy diets and diets of low birth weight babies in the first months of life (if necessary)
- Integrating the provision of wasting prevention, diagnosis, treatment and referral (if necessary) at the point of vaccination, including by testing all children with the mid-upper arm circumference (MUAC) prior to vaccination
- Increasing local manufacturing and availability of quality and affordable therapeutic foods to treat child wasting
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Investments to reduce wasting and the risk of pneumonia death will help countries accelerate progress to several of the Sustainable Development Goals for health, including:
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- 2.2 End all forms of malnutrition, including by achieving the internationally agreed target on wasting in children (0-4 years)
- 3.2.1 Reduce neonatal (0-28 days) deaths to at least 12 per 1,000 births and child (0-4 years) deaths to at least 25 per 1,000 births
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In these critical times, when the pandemic is contributing to food shortages that will increase the number of wasted children in the world, and as leaders meet at the Tokyo Nutrition for Growth Summit, it is vital that the nutrition, health and environment sectors are working together to put wasting reduction at the centre of national and global development agendas.
Released for the Tokyo Nutrition for Growth Summit
December 2021