A May 2025 survey in Nepal identified a 12.3% wasting rate among children in Madhesh province. This data emerged more than a year after the United States Agency for International Development (USAID) discontinued funding for child nutrition initiatives in the region.

The survey, conducted over three weeks, included more than one million children aged six months to five years. Overall, 7.8% of children surveyed suffered from wasting, while 1.6% experienced severe wasting. Additionally, 17.4% of children were classified as underweight across the survey, with 24.2% of children in Madhesh province specifically classified as underweight.

Pooja Pandey Rana, the country director for Nepal at Helen Keller Intl, stated that current malnutrition figures are higher than they were 14 months prior. She described the situation as "What we're seeing is [an] alarming rate of acute malnutrition in Nepal." Rana added that the screening program reached approximately half of the children in the relevant age groups.

Community outreach programs, including door-to-door identification of malnourished children, were previously funded by aid but ceased following U.S. aid cuts. "In the last 14 months, we have seen this breakdown of systems where you have RUTF, but we don't have families coming in," Rana said, referring to Ready-to-Use Therapeutic Food.

Helen Keller Intl secured just under $5 million from donors other than USAID to provide nutrition programs to 223,000 people across nine districts. This contrasts with planned USAID funding of $72 million over five years, beginning in 2025, which aimed to cover nearly 9 million people in 48 districts.

A Unicef spokesperson in Nepal stated that current supplies are insufficient to meet the overall demand for treatment. The spokesperson added that only about 35% of children under five affected by wasting currently receive treatment. Rana expressed concern, stating, "The worry we have is we are now backsliding."

Why It Matters

The survey results indicate a challenge in addressing child malnutrition in Nepal, particularly following the cessation of U.S.-funded nutrition programs. The 12.3% wasting rate in Madhesh province exceeds the World Health Organization's threshold of 10% for high wasting rates, which typically prompts recommendations for immediate intervention. Unicef's statement regarding insufficient supplies and treatment coverage for children affected by wasting demonstrates the scale of the current need.

This situation contrasts with a documented decline of 72% in death rates among children under five in Nepal between 1996 and 2022. The 2025 national wasting rate of 6.6% indicates that the issue is not uniform across the country. The Nepalese government procures its own stocks of Ready-to-Use Therapeutic Food (RUTF), but the disruption of community outreach programs has affected the delivery of services. Rana emphasized the severity of malnutrition, stating, "If you are malnourished, your risk of dying, compared to a child who is not malnourished, is 12 times higher."