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The global ravages of NOFUD-28


Our blogger, Nicholas Freeland, is an independent consultant in social protection and a Senior Associate of Development Pathways. Nicholas is a frequent contributor of blogs and papers for Development Pathways. 

COVID-19 is dangerous. But it is nowhere near as dangerous as having No Food to Eat (NOFUD-28). In the five months since the COVID-19 outbreak started, we have watched the number of worldwide deaths caused by it rise inexorably past 200,000, representing a tragic loss to the families and friends of those afflicted. But NOFUD-28 is the root cause of the death of more than 200,000 children under the age of 5 years every single fortnight (in other words, NOFUD-28 causes double the total number of COVID-19 deaths to date, every month of every year), most of them from easily preventable causes. Yet the global reaction to these two crises is observably, and shamefully, different.

First, the arrival of COVID-19 has sparked extraordinary measures in developed countries:

  • Schools are closed – yet almost none of the under-5s who die each year will even have visited a school, let alone received any education from one (and many of their parents, especially their mothers, will not have done either).
  • International travel is effectively banned – yet most of those who die from NOFUD-28 will not have ventured beyond the boundaries of their village, or perhaps, if they have been very fortunate, the nearest health post.
  • Employees are being asked to work remotely from home – yet most of those whose children die young have no work at all, or have only work that is seasonal, poorly-paid, irregular, exploitative or remote (but a different kind of remote!).
  • Scientists are working round the clock to find a cure to COVID-19 – yet most of the NOFUD-28 deaths are caused by easily curable diseases: a third of them from simple pneumonia or diarrhoea; and many of the rest from malaria, polio, even the plague, diseases which no longer even exist in high-income countries.
  • Hospitals with intensive care units and over 1,000 beds are being built, equipped and staffed in the space of 10 days – imagine how welcome one or two of those would be in countries which currently have less than 1 hospital bed per 1,000 citizens!
  • Information systems are in overdrive – we are now kept informed on an hourly basis about how many cases and how many deaths there have been from COVID-19. People can quote these statistics from countries that they would be hard pushed to identify on a map. Yet we are only able to estimate to the nearest few hundred thousand how many under-5s die each year.

Second, COVID-19 has caused a rash of panic-buying.

The shelves of supermarkets in rich countries have been stripped of a variety of what are seen to be basic necessities, yet would be totally alien to those facing NOFUD-28:

  • Loo-rolls – most of the households whose infants die young would not know what to do with a loo-roll if you gave them one. Many would not even recognise a loo: more than 20 per cent of the population of low-income countries still defecate in the open (the figure is more than 25 per cent in India and over 50 per cent in Niger, Solomon Islands and Eritrea, for example).
  • Sanitiser gel – again these would be unrecognisable objects to poor households, where even soap is a rare luxury: in fact, soap is often one of the first non-food items a household will buy if it is given a gift or a social transfer. Most young NOFUD-28 victims would be taught to wash their hands with ash or mud.
  • Bottled water – empty plastic bottles are a treasured storage item for many of the poorest households, but the household members would never get to drink the water that originally came in those bottles: their water more often comes from stagnant ponds, polluted rivers, saline boreholes, or arsenic-laden wells.
  • Packets of flour – for most NOFUD-28 victims, flour doesn’t come in packets: rather it has to be pounded from grains (of maize, rice, sorghum, etc.) in a tedious, energy-sapping daily grind, usually by women and girls.
  • Toothbrushes – most of our NOFUD-28 infants would love a toothbrush as a toy; but, globally, more people now own a cell-phone than a toothbrush. Those whose children are most likely to die young would use coal or twigs (typically of oak, neem or arak) to brush their teeth…or just their finger smeared with mud from the wall of their hut.
  • Guns (yes, there was a run on gunshops in America!) – whilst the efficacy of guns against COVID-19 is still unproven (clinical trials are ongoing), it is unlikely that they will be an effective response to NOFUD-28.

Finally, there are outpourings of global sympathy for every fatality of COVID-19.

This is right, and as it should be: every life lost is a tragedy. We watch with horror as the number of deaths rises daily. But it should be the same with NOFUD-28. We should be given a constant reminder that we are losing, every single day of every single year, nearly 15,000 children under the age of 5, with their entire lives ahead of them. Who knows how many of them would have gone on to make a genuine contribution to society as medics, pioneers, researchers, artists, sportspersons, scientists, rappers, entrepreneurs? Cutting so many young lives short represents an appalling and unforgivable waste to our world.

So, yes, let’s pull together to defeat COVID-19, and minimise the depredations that it is causing. But let’s remember – as it recedes, and as loo-rolls, sanitiser gel, bottled water and toothbrushes reappear on our civilised supermarket shelves – that there is a much more terrible tragedy unfolding out there, killing more than five million infants and babies each year, that could be resolved with a smaller effort, and at a much lower cost, than that currently being mobilised against COVID-19. Let’s take seriously the pledge of the Sustainable Development Goals (specifically SDG2) that by 2030 the phenomenon of NOFUD-28 will have been eradicated from our world.

Let’s also recognise now that we will not achieve this by a return to “normal”: “normal” is why we are in this mess in the first place. What we should be looking for is something much better, and it will require substantial changes from the “normal”. At global level, we clearly need global solutions to what are now undeniably global problems: we have pretended for too long that we can cosset our pampered selves in comfortable isolation from the faraway problems of poverty, deprivation and climate change. At national level, we need far more enlightened and compassionate leadership than that offered by most of the current crop of posturing popinjays pandering to populist prejudice. We need progressive systems of wages and taxation which reward handsomely those on the front-line who really make a difference to our lives, and much less those whose contribution to society is notional, superficial or ephemeral. And finally, at personal level, we all need to recognise we have a very comfortable life in developed countries (even when deprived of loo-rolls, sanitiser gel, bottled water and flour!). We must snap out of our current insularity, complacency and egotism before we go the way of previous “civilisations” that have succumbed to these same vicissitudes.

If we can make all these changes, we will have no difficulty overcoming COVID-19, then NOFUD-28. Then that can become our new normal.

Read more like this:

Pathways’ Perspectives: What has the Covid-19 crisis taught us about social protection?

Blog: Now more than ever, human rights considerations are vital for social protection responses to COVID-19

News: ILO urges countries to realise the right to social security to respond to the global COVID-19 crisis 

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