Part I: A Visionary Beginning
In 1979, a small group of visionary academics, doctors, philanthropists, and scientists came together around a simple but powerful idea: since food is a basic human right, we need to end hunger for everyone, for good. It was a bold notion in a world that largely saw hunger as inevitable.
At the time, acute malnutrition – particularly in vulnerable young children – was almost certainly a death sentence. Hunger wasn’t getting the attention it deserved. Unwilling to accept the status quo, the group formed Action Against Hunger. Since our founding, research and innovation have been a core part of our DNA.
To meet the needs of people in these countries and elsewhere, we grew: from our founding in 1979 to 1989, we expanded to more than 20 countries.
A crisis we can solve (the 1980s)
Beginning in Afghanistan, we worked to prevent hunger by helping farmers access better seeds and tools; teaching more effective agricultural techniques; and providing access to clean water to prevent diarrhea and other life-threatening illnesses. But conflict and natural disasters left others in Afghanistan chronically malnourished, along with hundreds of millions of others around the world.
Famines of a magnitude rarely seen today impacted countries including Ethiopia, Sudan, and Somalia. We expanded across 20 countries in just ten years, tackling malnutrition as a massive global health crisis.
Malnutrition weakens adults and interrupts the development of young children’s bodies and brains. Studies show that people who went hungry as kids earn 10% less over their lifetimes and are 33% less likely to escape poverty. To recover from severe malnutrition, food alone is not enough since the body loses the ability to absorb nutrients. At the time, there was no standardized, effective, and accessible treatment.
Action Against Hunger first responded in Afghanistan, and we still work there today.
Innovating to treat malnutrition (1990s)
In 1993, we helped develop F100, the first therapeutic milk formula to treat malnourished children. It became the global standard. The next challenge was getting this effective new formula to the people who needed it most.
For many – then and now – the nearest hospital could be hundreds of miles away. Health care can be nearly impossible to reach, and the care is often unaffordable. For the few who could make the journey, spending weeks in the hospital meant leaving other children, farm animals, and crops largely unattended back home, which could jeopardize a year’s worth of food and income. There was a need for an effective treatment that was safe, portable, and available anywhere.
A few years later, scientists adapted the original treatment formula, creating Ready-To-Use Therapeutic Food (RUTF), a medicinal paste that doesn’t need to be mixed or refrigerated and can be eaten directly from the packet. These special foods can restore a malnourished child’s health in as little as 45 days. It was a game changer, particularly in places that don’t have electricity or clean water.
We were the first organization to test RUTF in our programs. With data from our field research, we helped to develop the international standard for treatment protocols. The evidence showed that 90% of children could be treated effectively without hospitalization. More than 70 national governments adopted this cost-effective model. But, access to treatment remained a challenge, just as it does today.
RUTFs like peanut-butter-like paste Plumpy’Nut saves the lives of millions of children every year.
There was another problem, too: in communities without access to a scale or thermometer – let alone a doctor – it can be surprisingly hard to tell if a child is malnourished. Even comparing a child to peers isn’t helpful if a large percentage of other children could be malnourished, too. Experts use complex data tables that rely on precise height and weight measurements that are slow, cumbersome, and largely out of reach for most children.
In fact, only one in four malnourished children can hope to receive the care they need. And it all starts with screening and diagnosis.
Community-based approaches (early 2000s)
At the turn of the century, we again challenged conventional thinking and conducted rigorous research to prove that children could be screened for malnutrition and treated effectively right in their own communities. We helped popularize the use of the Mid-Upper Arm Circumference (MUAC) band, which is a critical tool for assessing malnutrition for children under five years of age. This “band of hope” is basically a malnutrition thermometer. Here’s how it works: simply wrap the band around a child’s arm and use the color code to determine the arm’s size. It’s one of the simplest ways of identifying malnutrition.
We came together with a small group of NGOs and pioneering governments to upend decades of development practices by advocating for localized approaches. By training community health workers and other caregivers to monitor children’s nutritional health with MUAC bands, we placed the power of early detection directly in the hands of communities and parents themselves. Many parents don’t know their child is sick until it’s too late. Diagnosis is the first step, and with MUAC bands, children can be screened within seconds without traveling at all.
A Band of Hope
It’s a feeling nearly every parent on the planet has experienced: the fear of realizing your child is sick, but not knowing why or how to make them feel better. In some areas of the world, panicked parents reach first for a thermometer, a tool in their medicine cabinet that helps them begin to figure out what’s wrong. Elsewhere, mothers and fathers turn to a simple, color-coded “MUAC” band – a band that acts as a thermometer for malnutrition.
In what amounted to a quiet revolution, we helped mobilize millions of community health workers and well-trained volunteers in an unprecedented effort to save the lives of millions of children who die from hunger each year.
Screening also can help advance another big idea that grew out of global experience in the 1980s: an early warning system to predict potential famine and enable local governments and the global community to prevent the worst impacts of hunger.
We have helped develop new prediction models and played a key role in collecting and analyzing data on levels of food insecurity down to a postcode level. These efforts helped usher in the first global standard to assess food insecurity, from minimal to stressed, then to crisis, emergency, and famine.
This progress nearly made famine a thing of the past. But, that’s not the end of the story.
Stay tuned for Part II of this story!
