Feeding hunger and insecurity

6. what more is needed?Table 6.4: Costs of a pilot investment for the treatment of one million severely acutely malnourishedchildrenApproximate numberof children under age5 who are severelyPercentage of childrenunder age 5 who areseverely acutelyApproximate costof treatment,LOW estimateApproximate costof treatment,HIGH estimatemalnourished malnourishedEthiopia 656,171 4.7% $44,619,644 $88,346,895Kenya 130,259 2.4% $8,857,607 $17,538,061Malawi 74,153 3.2% $5,042,390 $9,983,933Niger 104,753 4.3% $7,123,215 $14,103,966Zambia 43,718 2.3% $2,972,847 $5,886,291Total 1,009,054 3.9% $68,615,703 $135,859,1456.3.2 Scaling-up the Treatment ofMalnutritionA particular priority of Action Against Hungeris the scale-up of treatment of severe acutemalnutrition. Despite improved coverage throughthe community-based management approach,Doctors Without Borders (MSF) estimated thatonly 9 percent of severely malnourished childrenhad access to treatment with ready-to-usetherapeutic foods (RUTFs) in 2007 (ACF andMSF 2009). Successful scale-up will requireintegrating treatment of SAM into primary healthcare, strengthening health systems, increasingavailability of RUTFs, possibly through localproduction and commitment of donors for moreand predictable funding.Action Against Hunger proposes a pilot investmentof about $68-$140 million which would allowfor the treatment of one million children infive priority countries (Ethiopia, Kenya, Malawi,Niger and Zambia). Although this is only a smallproportion of malnourished children worldwide, ifsuccessful, scale up in these countries could beused as an example for scaling up treatment inother countries.About three quarters of the funding would beused to operate community-based managementprogrammes, including the cost of producingand purchasing all therapeutic foods, with therest going to establish nutritional treatment inpatientfacilities. With this funding, the lives ofone million children could be saved and severeillness and permanent stunting among hundredsof thousands prevented – at a cost of only US$70to US$140 per life.Greater effort is needed to establish quality,year-round health services in many developingcountries, and is the only permanent solution tosevere acute malnutrition. However, these systemsand institutions cannot be built overnightand external aid often provides the only viableshort and medium-term response to combatinghunger. Counter-seasonal interventions providea number of proven tools which can help to curbmalnutrition and food insecurity, but seasonalityalso provides a way to adapt budgeting processesand project design. Pre-positioning resourcesbefore the annual hunger season is but one exampleof how a seasonally-sensitive approachcan save lives that our current strategies will not.The Food Crisis has shown that organisationsand governments must be more aware of the impactsof globalisation and the link between globalACF International Network Feeding Hunger and Insecurity 61