17 October 2014

Ebola means there should be a greater focus on nutrition, not less

The Second International Conference on Nutrition (ICN2) is scheduled for Nov 19-21.

I have heard some people talk about how Ebola may take the focus away from nutrition, but I think it strengthens (unfortunately) the case for more attention to nutrition.

First, people with poor malnutrition will have weaker immune systems and so--all other things being equal--it is plausible that they will be more likely to contract the disease given the same exposures (note, as a number of you have pointed out since I originally published this, it is hard to find any actual evidence to support this statement, it just seems plausible--but if you have seen any evidence supporting or refuting this, please let me know and I will edit the blog).

Second, health systems are going to be decimated because health workers are most at risk and the health system will be working overtime to deal with Ebola in countries with high levels of infection (see this harrowing account in the New England Journal of Medicine from an MSF staff member).  This means fewer resources to prevent malnutrition to stifle infection.

Third, because the infection is spread through touching, it becomes more difficult to give very young children the care they need for healthy growth, even without the virus.

Fourth, agriculture is going to suffer, just as it did with HIV/AIDS.  There will be a labour shortage effect, but perhaps the bigger effect will be an inability to transport food due to curfews and lockdowns -- hence the very real risk of food price spikes.

Of course, much more investment is needed NOW to deal with the infection.  But once the case loads have peaked, more attention is needed to building resilience to future outbreaks-and that means better nutrition and stronger health systems.


Desmond Whyms said...

Thanks for this Lawrence, I think we can take some solace from the fact that the UN lead on Ebola, David Nabarro, is also the SUN / Nutrition lead.

Do we have any strong evidence to demonstrate that better nourished individuals are 1) less likely to contract Ebola or 2) more likely to survive?

Having strong data here would help advocacy around nutrition as part of the response now, and that well nourished populations are a global public good.

It makes sense, and undoubtedly true for other diseases and infections, but I think we need specific evidence to strengthen our argument.

Lawrence Haddad said...

Desmond, a couple of you have pointed this out and I have amended the blog to make it clear that there is no evidence on susceptibility (at least that I can find--in either direction). Apologies for being sloppy on this. The main points, 2-4, hold though. Thanks for pointing out. L