Women feeding child Ready-to-use Supplementary Food (RUSF), a food supplement for the dietary management of children 6. Photo by Abel Gichuru for Action Against Hunger, used with permission.

By Dr. Charles E. Owubah, CEO of Action Against Hunger

Recent cuts to US government budgets for international aid threaten essential programs worldwide. How should nonprofit leaders respond? With advocacy and enhanced innovation.

Issue advocacy has long been a priority for many nonprofit leaders, and now is the time to draw on that capacity. We need to respond with a sense of urgency while taking a long-term view. 

In the immediate term, many groups are seeking US government waivers for lifesaving programs, yet even in the limited cases where waivers have been granted, funds are not yet flowing in many cases. We also are concerned about what might happen after the US government’s grant review, which is supposed to take place within 90 days. Action Against Hunger, a global nonprofit fighting hunger, faces up to USD 120 million in lost funding in countries like Haiti, Ethiopia, and Afghanistan, meaning hundreds of thousands could be affected and innumerable lives could be lost. Across our sector, the impact could be even greater. 

Leaders should address this challenge individually and through collective action, such as groups like InterAction, a leading alliance of NGOs in the United States. It is worth repeating that these cuts come despite broad bipartisan support for the US government taking a stand to end global hunger, including nearly 60 percent of Republicans who support the issue. 

We also must continue to look beyond the US alone. For example, Action Against Hunger advocacy results in dozens of governmental policy improvements each year, many well outside the US. Collectively, we would do well to expand those efforts. Funds are essential to deliver impact, but we also can take this as an opportunity to revisit how funds are spent.

While continuing to advocate for increased funding, nonprofits also must redouble efforts to maximize impact and stretch every dollar. Innovation has never been more important. The area of hunger prevention and treatment is a prime example and one that might benefit other sectors as well. Here are three steps we can take now.

Streamline processes and programs

My colleagues and I have long championed efforts to simplify the processes and protocols required to provide care for vulnerable populations, particularly children. For example, current policies separate treatment protocols for different severities of acute malnutrition, requiring disjointed services and inefficient support systems. This division makes it harder for families to access care, as severely and moderately malnourished children often need to visit different clinics and use different therapeutic food products.

As a result, every 15 seconds, a child dies from hunger-related causes.

This is an urgent issue. Today, only one in five malnourished children lack access to lifesaving treatment. However, malnutrition is a medical issue, and it is risky to change treatment protocols without solid evidence. To address this, Action Against Hunger, alongside the International Rescue Committee and the London School of Hygiene and Tropical Medicine, conducted the Combined Protocol for Acute Malnutrition Study (ComPAS). This study tested a unified approach using a simplified diagnostic tool and a single treatment product, all within one combined protocol for both severe and moderate malnutrition.

By treating severe and moderate malnutrition as a single condition rather than two separate ones, the ComPAS approach removes unnecessary complexity, which can reduce costs and expand access to treatment. When tested in South Sudan and Kenya, this approach was found to be just as safe and effective as current treatment methods while lowering costs by about 12 percent per child. By improving efficiency without compromising care, implementing a ComPAS approach for treating malnourished children could enable countless more children to receive treatment each year.

Research the root cause

Prevention is equally crucial to saving lives and lowering costs. For example, research shows that children who have been treated for Severe Acute Malnutrition (SAM) are incredibly vulnerable to relapse. Sometimes as many as 30 percent to 50 percent of recovered malnourished children backslide, especially in rural and resource-constrained areas. Given these risks, preventing malnutrition in the first place not only prevents suffering but also reduces the need for repeated services over the long term.

We are looking into new and potentially more effective ways to help ensure and sustain recovery from malnutrition. On the horizon is an improved version of Ready-to-Use Therapeutic Food (RUTF), a nutrient-dense paste that can be eaten directly from the packet without the need for clean water and without a trip to the hospital. Now, more than two decades after its development, scientists are exploring ways to make RUTF more affordable using local ingredients.

Researchers are also studying the gut microbiome, which is crucial to overall health but can be deteriorated by SAM, potentially increasing a child’s risk of future malnutrition. By modifying the bacteria in the gut microbiome, scientists hope to reduce relapse rates and improve long-term recovery in SAM-affected children. 

Prioritize data-based prevention

If prevention is critical at the individual or community level, it is perhaps even more essential at scale. In fact, using proactive measures to prevent humanitarian crises can reduce response costs by as much as 30 percent. The good news is that the global community has developed tools to monitor and provide an early warning about rising hunger levels, so we can save more lives with less funding. For example, the Famine Early Warning Systems Network (FEWS NET) and the Integrated Food Security Phase Classification (IPC) provide critical insight into food insecurity. Yet, it would be better to detect potentially dangerous hunger conditions even earlier. 

With this in mind, the Modeling Early Risk Indicators to Anticipate Malnutrition (MERIAM) focuses on malnutrition among children under five, zoning in on malnutrition outcomes and then forecasting malnutrition prevalence up to 12 months in advance, longer than what other systems allow. Together, MERIAM, FEWS NET, and IPC can help identify malnutrition risks and inform a coordinated response before a potential crisis escalates. 

By equipping us with insights and options, these approaches enhance efficiency and impact. They can help us predict and prevent famine, streamline operations to reach more children, and one day prevent relapse in the children we treat. Investing in research and innovation enables us to maximize impact within limited budgets. But, we need the funds to invest.

Now is the time for global leaders to commit to both increased funding and smarter, more effective solutions — because when it comes to hunger, aid is not just a financial matter — it’s a life-or-death imperative.