Malnutrition in the Sahel requires long-term solutions

The annual peak of malnutrition in the Sahel region has begun, exacerbated in parts of the region by higher market prices, epidemics and political instability. One million severely malnourished children* are expected to receive treatment – by far the largest number in the history of humanitarian aid. The medical humanitarian organisation Médecins Sans Frontières (MSF) is scaling up its emergency response, but warns that malnutrition in the Sahel is a public health problem that demands long-term solutions. In the past 6 months, some 56,000 severely malnourished children have been admitted to MSF’s nutrition programmes in seven countries in the region, a higher albeit similar figure to the same period last year.A recurrent problem “Nutritional crises are recurrent and cyclical in this region,” says Michel-Olivier Lacharité, MSF’s programme manager for Mali, Niger and Chad. “But this year, additional factors have created pockets where malnutrition is even higher than usual. These include higher market prices, instability in northern Mali and Nigeria, and a measles outbreak in eastern Chad." On top of this, a particularly heavy rainy season in southern Niger and parts of eastern Chad has brought forward the expected seasonal increase in malaria cases. For children, malaria and malnutrition are a lethal combination. MSF is deploying additional emergency resources to treat as many children as possible before the rains make the roads impassable. Early warnings and response plan This year, and for the first time, all those countries in the Sahel most affected by malnutrition launched early warnings and, along with international aid organisations, developed an ambitious response plan in late 2011. This included treating an estimated one million severely malnourished children and distributing food to young children to prevent them from becoming malnourished, with milk-based products specifically designed to meet their nutritional requirements. Implementing this response plan will be a challenge, and demand considerable efforts from governments, aid organisations and donors. However, MSF warns that an emergency response cannot be the only option. Long-term solutions needed “Malnutrition is a public health problem in this region, and it should be addressed as such,” says Dr Susan Shepherd, MSF paediatrician and nutrition expert. “The prevention and treatment of malnutrition allow many lives to be saved. They should become part of the set of basic health measures aimed at young children, like immunisation. Countries that have succeeded in containing malnutrition have all set up access to free healthcare and to adequate nutrition for children. It is vitally important to get out of the emergency mode and begin the transition to long-term solutions.” While MSF continues to expand its intervention in the Sahel every year during nutritional emergencies, it is also looking to develop simpler and more affordable methods of fighting malnutrition in the long term. Promising strategies are emerging, including delegating some activities to non-medical staff, making available locally manufactured nutritional products, and developing systems that will make it simpler and less costly for children to access the food they need.