Abuja - A recent survey done by Médecins Sans Frontières (MSF) concluded that there are critical levels of malnutrition in parts of northwest Nigeria. The survey was conducted on 2,066 children of three local government areas of Katsina state, in collaboration with Epicentre (MSF’s epidemiology arm) and the Katsina State Ministry of Health.

It shows that in some areas, levels of global acute malnutrition have doubled since last year, when the situation was already considered dire. Aid in this region has never been enough to meet people’s needs and is now decreasing even further. Immediate additional support is needed to avoid an even deadlier catastrophe in 2025.

The survey, which was done in July 2024 in the local government areas of Katsina, Jibia and Mashi, shows a major nutritional crisis underway with over 30% of children suffering from global acute malnutrition in some areas and severe acute malnutrition rates — the most dangerous form of malnutrition — of between 6.8% and 14.4%.

Children in these areas are suffering under an "extremely critical level of malnutrition", which is level five -the worst possible designation - of the Integrated Food Security Phase Classification system for evaluating malnutrition. MSF has continued to see an increase in malnutrition admissions since the survey was conducted.

This survey has been carried out yearly since 2022 at the same period in the same areas and with the same methodology to estimate the prevalence of acute malnutrition in children aged six months to almost five years of age. The global acute malnutrition levels in the first survey were 22 per cent. The survey assessed the nutritional status of children six to 59 months by using a combination of three methodologies: mid-upper arm circumference, bilateral pitting oedema¹, and weight-for-height z-score.

“These survey results are, quite frankly, terrifying,” says Dr Raphael Kananga, MSF medical coordinator. “We have seen figures rising steadily for the past couple of years and now we are moving from critical to extremely critical levels. In one area of the state, Mashi local government area, we found 14 per cent of children we surveyed were severely malnourished, prevalence this high is catastrophic. We really need to see more, not less action from organisations, otherwise we are going to see children dying in record numbers.”

As a result of this situation, MSF, which runs four therapeutic treatment centres for malnourished children in Katsina state, has provided care to more children this year, in more severe states of malnutrition, of which more had to be hospitalised. In total, our medical teams have attended to more than 100,000 malnourished children from January until now.

This represents a 20 per cent increase compared to the same period last year. Admissions for hospitalisation have increased by more than 50 per cent compared to 2022 and 2023, and more than 800 children with severe conditions of malnutrition died in our facilities in Katsina state between January and September 2024. 

The projections of a further deterioration in food insecurity for the near future are also worrying. Inflation is high in Nigeria, the devaluation of the local currency is continuing, and agricultural yields have strongly decreased again this year. This is while the cost of living is increasing, insecurity remains a concern in several parts of the region, and climate events are expected to continue – impacting livestock and crops.

All of these factors mean that if no additional support is set in place, we fear a deadlier catastrophe in 2025. However, despite the huge increases in prevalence of global acute malnutrition, which is over 75 per cent in Jibia local government area, the northwest region is still not included in the UN’s humanitarian response plan for Nigeria.

Earlier this year, MSF conducted a mass screening in several areas of Zamfara state and found 27 per cent of children suffering from global acute malnutrition. This is a trend we are seeing across all our nutrition facilities in northern Nigeria. Overall, MSF medical teams responding in seven states across northern Nigeria have treated 294,000 children for malnutrition between January and September this year. This is 43 per cent higher than the number of children treated in that same period in 2023.

Despite this, global funding cuts are reducing the ability of organisations to respond and treat children with malnutrition. Insufficient amounts of therapeutic food globally have been a challenge over the last year, and this is still worsening. In some areas, such as Zamfara, there have only been limited supplies available since March. UNICEF has recently launched a global appeal with fears that nearly two million children across 12 countries are at risk of death due to these shortages.²

“We have consistently raised the alarm about the escalating malnutrition crisis in northern Nigeria, and the findings of recent surveys confirm our worst fears—conditions have not improved; they have significantly deteriorated,” says Dr Simba Tirima, country representative for MSF in Nigeria. “This year, our teams across locations such as Kebbi, Zamfara, Katsina, and Maiduguri have been overwhelmed by an unprecedented number of malnourished children requiring urgent care. We have utilised every available resource, from overflow tents to spare mattresses, to manage the influx of patients arriving at our hospitals.”

“Without meaningful and immediate action, I fear the situation could worsen dramatically in the coming year,” he says. “We recognise the Federal Ministry of Health and Social Welfare's recent and ongoing efforts towards tackling malnutrition. If all stakeholders increase funding and ensure a reliable supply of therapeutic food, there is hope that we can save the lives of many children next year.”

MSF runs nutrition projects in seven states in Nigeria: Borno, Bauchi, Katsina, Kano, Sokoto, Zamfara and Kebbi. We have 10 inpatient facilities, including facilities in Maiduguri and Katsina city, as well as over 30 outpatient feeding centres to treat children with moderate and severe malnutrition who do not need to be admitted to hospital.