A set of 10 nutrition interventions can save nearly a million children's lives

Nearly 15 percent of all deaths in children under five can be prevented, and at least a fifth of all stunting averted, if 10 key nutrition interventions are scaled up to 90 percent coverage in the 34 countries most affected by malnutrition, according to the second paper in The Lancet Series on maternal and childhood malnutrition.

Scaling up these interventions would save 900 000 children's lives per year, at an estimated cost of US$9.6 billion. More than half of this cost is accounted for by India and Indonesia, both countries with sufficient financial resources to make a substantial contribution to the cost of stepping up the fight against malnutrition. The authors estimate that once plausible contributions by affected countries are taken into account, the remaining cost to external donors would be around $3–4 billion – somewhat less than Coca-Cola and McDonalds' combined annual spend on advertising.

The result would not only be nearly a million lives saved; the authors estimate that the prevalence of stunting in children under 5 years of age would be reduced by 20%, with a resulting improvement in the survival and development prospects of 33 million children worldwide.

The ten interventions identified include providing folic acid, calcium, and balanced energy protein and micronutrient supplements to pregnant women; promoting breastfeeding and delivering appropriate complementary feeding to infants; providing vitamin A and zinc supplements to children up to the age of five; and using proven treatment strategies to manage moderate and severe malnutrition in children. The authors also evaluated delivery strategies and concluded that community based delivery strategies had much potential to improve nutrition and reduce deaths among the poorest sections of the population.

While these interventions were chosen for their proven ability to reduce illness and deaths in women and children in a cost-effective way, the authors also examined a much wider range of nutritional interventions, many of which have the potential to make a substantial difference in the fight against malnutrition. The authors found that, despite growing global awareness of malnutrition in recent years, coverage rates for many of the interventions studied remain poor – and, in some cases, non-existent. Moreover, not all potential interventions have been evaluated at scale and rigorous evidence for the effectiveness of many of the interventions is scarce, meaning that the costs and potential effects of scaling up simply cannot be estimated in many cases.

According to Professor Zulfiqar Bhutta, the lead author of the study, "Our conservative estimates show that with enhanced investment in a small number of proven interventions, we could save the lives of 900 000 children, and improve the life prospects for millions more. The potential benefits to the affected countries in terms of improved productivity and reduced healthcare costs are substantial, and the investment required should be entirely within the means of countries and donors who wish to save children's lives and improve their future."