Bold reality checks: nearly one million young lives are lost each year because of growth failure, a toll that highlights a preventable and increasingly urgent global health crisis. New findings from the Global Burden of Disease 2023 study, published in The Lancet Child & Adolescent Health, reveal that while deaths linked to child growth failure (CGF) declined—from about 2.75 million in 2000 to around 880,000 in 2023—the burden remains heavy and geographically concentrated. Sub-Saharan Africa accounted for 618,000 CGF-associated deaths, and South Asia for 165,000, underscoring persistent regional disparities.
Among CGF indicators, underweight carries the largest burden, responsible for roughly 12% of all deaths in children under five, followed by wasting at 9% and stunting at 8%. Importantly, researchers found that stunting affects a larger share of children than previously estimated.
CGF heightens the risk of death and disability from a range of illnesses. Nearly 800,000 under-five deaths were due to lower respiratory infections, diarrheal diseases, malaria, and measles in the CGF group. In 2023, CGF accounted for 77% of diarrheal deaths and 65% of lower respiratory infection deaths in sub-Saharan Africa. In South Asia, CGF contributed to 79% of diarrheal deaths and 53% of lower respiratory infection deaths. The high-income regions, while having the fewest CGF-related deaths, still showed substantial shares: about 33% for diarrheal deaths and 35% for lower respiratory infections.
Dr. Bobby Reiner, co-author and professor at the Institute for Health Metrics and Evaluation, University of Washington School of Medicine, emphasizes the complexity of CGF.
'The drivers behind child growth failure are multifaceted and cumulative, including feeding issues, food insecurity, climate change, sanitation gaps, and conflict,’ he notes. ‘No single strategy will boost health across all regions.’’
Related Stories
- Clinical trial confirms ivermectin safety in very young children down to 5 kg
- Study: Biological underpinnings of autism and ADHD may transcend traditional diagnostic boundaries
- Alzheimer’s drugs improve key cognitive skills in children with autism and low IQ
A key insight from the research is that most stunted infants show signs of growth failure within the first three months of life, highlighting the critical importance of interventions before conception, during pregnancy, and in early infancy. The cycle between wasting and stunting forms a detrimental loop: stunting raises the risk of future wasting, and wasting can worsen stunting, a pattern that intensifies as children age. Early growth failure in infancy often points to babies who were small at birth or born prematurely, whereas growth issues later in infancy and early childhood may reflect ongoing nutrition gaps, repeated infections, or other contributing factors.
Dr. Reiner stresses the practical takeaway: with reversal of stunting being notably challenging, current estimates should help pinpoint areas with high CGF prevalence. Early detection and timely intervention are essential to improving outcomes for the most vulnerable children.
