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Undernutrition and Malaria: A Vicious Circle

A blog from Steven Lewis, Global Health Advocacy Manager at RESULTS UK. Follow Steven on Twitter @owstonlewis

Malaria and malnutrition are closely related, as malaria usually affect families that are both poor and malnourished.  The months of the ‘hunger gap’, when malnutrition is at its peak, often coincides with the rainy season, when mosquitoes breed and the number of malaria cases shoots up. The diseases combine in a vicious circle: malnourished children have weak immune systems, so their bodies are less able to fight diseases such as malaria, while children sick with malaria are more likely to become dangerously malnourished.

Evidence shows that investing in nutrition is tremendous value for money in the fight against child mortality.  The example of malaria prevention shows that integrating nutrition programs into other development initiatives delivers even greater benefits. 

The most underweight children have the highest risk of dying from malaria but if children are deficient in essential micronutrients, such as zinc, Vitamin A, iron and folate, they face dying from malaria even if they are not underweight. Large numbers of children less than five years old suffer and die from malaria due to lack of protein energy, zinc, vitamin A and other micronutrients. 

Unlike many causes of death and disability, with appropriate nutritional support these deaths are entirely preventable. With the advances in nets and other simple malaria technologies there is massive potential to bring down child deaths through increased investment in these simple solutions.  

Studies have demonstrated that malaria-control programs will have limited success if they do not also address undernutrition.[1]  Nutritional counseling and education of mothers followed by feeding programs have to specifically focus on improving the health of the malnourished. This, alongside malaria-control measures, could reduce deaths from malaria on a large scale if built into a long term programme.

Medicins San Frontiers (MSF) is one of the organisations in the field that is addressing both malnutrition and malaria as public health problems and integrating their prevention and treatment into the set of basic health measures aimed at all young children.  They are currently employing this approach in Niger[2]

 “The effort being made to treat malnutrition in Niger is tremendous, and this needs to be supported,” says José Antonio Bastos, president of MSF in Spain. “The problem in 2012 was that a massive plan for treating malnutrition was prepared and implemented, but it excluded other health needs, in particular malaria prevention and immunisations. It failed to take account of the fact that even if you provide children with appropriate nutrition, you can still lose them to malaria or a respiratory infection. There is a need for an integrated response, rather than for pushing one response to the exclusion of others.”

So measures to improve nutrition, if sustained over a number of years, increase the success of other development interventions.  In the UK there is an opportunity to promote this lesson on 8th June, when the Prime Minister is hosting a second ‘Hunger Summit’, co-hosted by the Childrens Investment Fund Foundation (CIFF).  The UK government can take the lead by giving a significant pledge, of £150 million per year, for the next five years. This has been calculated as the UKs ‘fair share’ of the funding gap, according to World Bank figures, and will encourage other donor countries and leverage major contributions from private foundations.


[1] “Malaria, Anemia, and Malnutrition in African Children—Defining Intervention Priorities” Erdhart, et. al. July 2006. http://jid.oxfordjournals.org/content/194/1/108.full.pdf

[2] http://www.doctorswithoutborders.org/press/release.cfm?id=6739&cat=press-release