Severe acute malnutrition (SAM) is a common condition
that kills children and intellectually maims those
who survive. Close to 20 million children under the age
of 5 years suffer from SAM globally, and about 1 million
of them die each year. Much of this burden takes place
in Asia. Six countries in Asia together have more than
12 million children suffering from SAM: 0.6 million in
Afghanistan, 0.6 million in Bangladesh, 8.0 million in
India, 1.2 million in Indonesia, 1.4 million in Pakistan,
and 0.6 million in Yemen. This article is based on a
review of SAM burden and intervention programs in
Asian countries where, despite the huge numbers of
children suffering from the condition, the coverage of
interventions is either absent on a national scale or poor.
Countries in Asia have to recognize SAM as a major
problem and mobilize internal resources for its management.
Screening of children in the community for SAM
and appropriate referral and back referral require good
health systems. Improving grassroots services will not
only contribute to improving management of SAM, it
will also improve infant and young child feeding and
nutrition in general. Ready-to-use therapeutic food
(RUTF), the key to home management of SAM without
complications, is still not endorsed by many countries
because of its unavailability in the countries and its
cost. It should preferably be produced locally from locally
available food ingredients. Countries in Asia that do not
have the capacity to produce RUTF from locally available
food ingredients can benefit from other countries
in the region that can produce it. Health facilities in all
high-burden countries should be staffed and equipped to
treat children with SAM. A continuous cascade of training
of health staff on management of SAM can offset the
damage that results from staff attrition or transfers. The
basic nutrition interventions, which include breastfeeding,
appropriate complementary feeding, micronutrient
supplementation, and management of acute malnutrition,
should be scaled up in Asian countries that are
plagued with the burden of malnutrition.