Closing the knowledge gap: Research priorities for preventing child wasting

Preventing child wasting is more urgent than ever before. Nearly 43 million children worldwide suffer from wasting at any given time, and severe wasting accounts for 20% of deaths among children under 5 years of age. This situation will likely worsen as conflicts and crises intensify poverty and food insecurity around the world.

Research on how to address child wasting has historically focused on treatment of severe wasting. While treatment remains critical, there is growing recognition that prevention is equally vital to reduce the high global burden and recurrent nature of wasting. For the first time, the 2023 WHO Guideline on wasting acknowledged the critical importance of preventing wasting, in addition to accelerating efforts to treat children suffering from wasting. Prevention is critically important if the world is to meet the global development goal of reducing wasting prevalence from 6.3% to less than 3% of children by 2030.

Two recent commentaries in BMJ Global Health by experts involved in formulating the 2023 WHO Guideline shed light on the critical evidence gaps that must be addressed to prevent wasting and to save lives. We were among the authors of these commentaries. The first commentary highlights three critical research gaps related to wasting prevention: 1) the lack of evidence on what works to prevent wasting; 2) a poor understanding of operational challenges related to implementing complex wasting prevention programs; and 3) the absence of simple, yet effective mechanisms to target prevention efforts. The second commentary highlights the absence of data on resource use and cost-effectiveness for preventive interventions, providing recommendations on how to fill this knowledge gap.