A/HRC/19/73 those countries that have high rates of stunting in children who, without early intervention, may be unable to reach their full potential as productive members of society. 11. At the global level, 20 million children are estimated to be severely wasted19 and thus suffer from severe acute malnutrition.20 The (preventable) tragic thing about these children has been described by Nicholas Kristof as their equanimity: “They don‟t smile. They don‟t move. They don‟t show a flicker of fear, pain or interest. Tiny, wizened zombies, they shut down all nonessential operations to employ every last calorie to stay alive”.21 The human dignity of these children is being compromised and ultimately their right to life, since about 1 million children die every year from severe acute malnutrition. 22 12. As is evident from the above, malnutrition in itself is a serious medical condition that affects children. In addition, there is a two-way relationship between malnutrition and childhood diseases. As medical studies show: “Infection adversely affects nutritional status through reductions in dietary intake and intestinal absorption, increased catabolism and sequestration of nutrients that are required for tissue synthesis and growth. On the other hand, malnutrition can predispose to infection because of its negative impact on the barrier protection afforded by the skin and mucous membranes and by inducing alterations in host immune function.”23 13. Thus, children become severely malnourished because of acute paediatric diseases, such as pneumonia, diarrhoea, malaria and measles, which are not treated or are inadequately treated owing to poor access to health care in terms of both timing and quality.24 Often a deadly circle ensues. For example, in recent decades, applied research has confirmed the deleterious effect of diarrhoeal illness on the nutritional status of children. 25 Diarrhoea seriously exacerbates malnutrition in children, while at the same malnourished children are more vulnerable to acute diarrhoea and suffer multiple episodes every year. 26 It is important to note in this context that diarrhoea is the second leading cause of death among children under 5 at the global level, killing about 1.5 million each year.27 14. Equally, chronic diseases in children, such as HIV, cancer, tuberculosis and sicklecell anaemia, that are not treated or are inadequately treated may be a reason for severe malnutrition in children.28 In the context of HIV/AIDS, WHO flags the need for a massive effort “to alleviate the overall burden of malnutrition and to reduce the severity and 19 20 21 22 23 24 25 26 27 28 6 For definition, see UNICEF, Tracking Progress on Maternal and Child Nutrition, p. 4. “Community-Based Management of Severe Acute Malnutrition”, A Joint Statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children‟s Fund, May 2007, p. 2. N. D. Kristof, “The Hidden Hunger”, The New York Times, 23 May 2009, Available from www.nytimes.com/2009/05/24/opinion/24kristof.html. “Community-Based Management of Severe Acute Malnutrition”. K.H. Brown, “Diarrhea and Malnutrition”, Journal of Nutrition, vol. 133, No. 1, Supplement (2003), pp. 328–332; N.S. Scrimshaw, C.E. Taylor and A.J.E. Gordon, “Interactions of Nutrition and Infection”, WHO Monograph Series No. 57 (Geneva, 1968). Communication with Dr. M-C. Bottineau, MSF Paediatrics Working Group Acting Team Leader, 29 June 2011. Brown, “Diarrhea and Malnutrition”. UNICEF and WHO, Diarrhoea: Why children are still dying and what can be done (2009), pp. V and 1. Ibid., p. 1. Communication with Dr. M-C. Bottineau.