Foreword

Global acute malnutrition remains a persistent and unacceptable scourge among children under 5 years of age, affecting an estimated 50 million children around the world. ¹ As global attention is directed to multiple, overlapping food crises and climate change impacts that are pushing increasing numbers of people into poverty and hunger, it is essential that we maintain a strong spotlight on the needs of children, the risks associated with acute malnutrition, and workable, lasting solutions.

The Food and Agriculture Organization of the United Nations, the Bureau for Humanitarian Assistance at USAID, and the Feinstein International Center at the Friedman School of Nutrition at Tufts University have been working together to improve the way we address child acute malnutrition in Africa’s drylands. A 2018 USAID-funded study highlighted the widespread scale and frequent recurrence of emergency levels of Global Acute Malnutrition in dryland areas. ² A follow-up study revealed the seasonality of acute malnutrition, linked to livelihoods, conflict, climate, and environmental factors. ³ Building on this research, an adapted conceptual framework for analyzing and addressing acute malnutrition in drylands was developed and refined as part of a 2020 technical series and roundtable meeting with UN agencies and their resource partners. ⁴

This supplement takes this work forward with the goal of supporting country- and local-level understanding of the role of systems and institutions in addressing acute malnutrition. Providing papers from a wide range of perspectives, it draws out 3 critical points.

Evidence: Evidence and understanding must be the basis for policies and programs. However, relevant evidence on acute malnutrition and the role of systems and institutions in addressing it are lacking. We must jointly agree on an agenda for research and learning on the basic drivers of acute malnutrition and also the systemic and institutional factors that mitigate it in order to overcome this paucity of evidence and drive forward action on the ground.

Concepts and tools: Young’s (2020) adapted framework for addressing acute malnutrition in Africa’s drylands highlights the importance of analyzing and operationalizing evidence-based “systems approaches.” These approaches address the basic drivers of acute malnutrition to bring about transformative and sustainable change and complement the nutrition-sensitive and nutrition-specific program approaches that focus on the immediate and underlying causes.

Collective efforts: Taking this work forward requires mobilizing cross-cutting networks and partnerships that effectively engage at all levels, from the community upward. We need to look beyond multisectoral approaches to the role of governance and institutions and the way they impact basic drivers of malnutrition. No single organization, institution, or sector can do this alone.

Our organizations are pleased to be a part of this ongoing work and remain committed to finding and implementing systems approaches to addressing acute malnutrition in Africa’s drylands.

Paul Howe Feinstein International Center, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA Lynnette Neufeld Food and Nutrition Division, Food and Agriculture Organization of the United Nations, Rome, Italy Rein Paulsen Office of Emergencies and Resilience, Food and Agriculture Organization of the United Nations, Rome, Italy Shanda Steimer Office of Technical and Program Quality, Bureau for Humanitarian Assistance, United States Agency for International Development, WA, USA