CARE's Response to the COVID-19 Crisis

The COVID-19 pandemic and the War in Ukraine have exposed the fragilities and inequalities in food systems, stressing the urgent need to ensure that food systems are more sustainable, inclusive, and resilient.

The makings of a global hunger crisis

In February 2022, war broke out between Russia and Ukraine. As the world bears witness to its atrocities, a global hunger crisis looms for an estimated 863 million people in 91 countries facing hunger and insufficient food consumption.

When crisis happens in one part of the world, it can send shock waves across the globe. For decades, Ukraine has been the breadbasket to the Global South. Ukrainian and Russian grains provide more than one-third of the wheat imported by 45 African and least-developed countries.[1] Shortages of food, fuel and fertilizers from Ukraine and Russia is having a compounding effect—the resulting rise in fuel and fertilizer costs are hampering the ability of smallholder farmers (roughly half of them women) to produce and store enough food in the coming seasons. In the last five months alone, prices of major food crops have risen by 40%, accounting for 400 million of the people who are now food insecure.[2] The war in Ukraine could be the tipping point that plunges already fragile families into deeper states of malnutrition.

CARE’s full-scale strategy for response

Women and children facing hunger and severe malnutrition need more than food aid.Since 1945,CARE has proven time and again that the best safety net, particularly for women and children, combines both emergency response and building resilience long before needs are life-threatening. 

That’s why CARE has launched a $250 million comprehensive response to the global hunger crisis—so that families now on the brink of famine avoid the direst of consequences and smallholder farmer communities on the cusp of malnutrition ramp up production and tip the balance of nutrition in their favor.Our response bridges the full spectrum of food and nutrition insecurity—from emergency response and treatment for severe malnutrition, to the transition to short-term recovery and longer-term resilience building that prepares families to weather future shocks. We also seek to ensure that governments and communities in less-developed nations build strength and policies that help these interventions stick.

IPC is the gold standard for measuring food insecurity by country. Classifications range from 1 to 5 with:

1-     Minimal

2-     Stressed

3-     Crisis

4-     Emergency

5-     Famine

Country

% Population IPC Level ≥ 3% (CRISIS)

Afghanistan 45%

Ethiopia 37%

Guatemala 25%

Haiti 45%

Honduras 28%

Kenya 27%

Madagascar 32%

Malawi 9%

Mozambique 10%

Somalia 45%

South Sudan 63%

Sudan 13%

Syria* 60%

Tanzania 17%

Yemen 60%

Zambia 13%

Zimbabwe 35%

*WFP # (Syria does not participate in IPC)

CARE’s two-year response includes a three-pronged approach: 1) immediate food and nutritional assistance for families most at risk of hunger and severe malnutrition; 2) accelerated training and inputs for smallholder farmers—especially women farmers—who are most susceptible to fertilizer and fuel shortages and thus, reduced harvests and deeper malnutrition this year; and 3) rallying key stakeholders in the food security and nutrition arena—from engaging private sector partners to advocating with developing country governments, donor country governments like the U.S., and global actors like international donors, to prevent repeat crises.

To save lives now and sow resilience for tomorrow, we must look beyond food aid to address food and nutrition security andlet women lead the way. CARE’s strength as a global organization allows us to lean into broad expertise and simultaneously fortify three components of food security—increasing the supply of food, improving effective demand by increasing access and a person’s ability to pay, and addressing the true impacts of food scarcity on nutrition.

Given the unfolding nature of the hunger crisis, CARE’simmediate humanitarian assistance will prevent women, children and families in countries where severe malnutrition rates are highest from reaching possible famine levels. Simultaneously, we will address fuel and fertilizer shortages and rising costs in as many as 540 communities in countries where farming is becoming cost prohibitive, and families are on the cusp of deeper malnutrition. Countries like Afghanistan, Ethiopia, Guatemala, Haiti, Honduras, Kenya, Madagascar, Malawi, Mozambique, Somalia, South Sudan, Sudan, Syria, Tanzania, Yemen, Zambia and Zimbabwe are showing alarming declines in access to nutritious foodand alarming malnutrition levels. To create a safety net for the future and strengthen less-developed nations’ ability to mitigate crises of this magnitude, CARE will work with the private sector, governments and bilateral donors to access alternate food, fuel and fertilizer supplies, and change the policies and systems that create unstable environments and unfavorable conditions at local, country and international levels. Our comprehensive approach will be adapted to the specific needs and contexts of each country or region and scale up as need and resources warrant. These initial focus countries and communities are ones CARE knows well, where our presence will allow us to act quickly—with a core focus on women, children and vulnerable groups.

Beyond food aid

CARE’s humanitarian assistance goes far beyond handing out meals. Beginning with a critical needs assessment and rapid gender analysis, we identify those most in need of nutritional support, drivers of malnutrition, and the power dynamics of household food security and nutrition.

In the Horn of Africa, we are seeing challenging situations like drought, political turmoil, violent civil unrest and COVID-19 deteriorate social support systems and thwart access to nutritious food. In the Middle East, sub-optimal feeding practices, high prevalence of disease, inadequate sanitation conditions and hygiene practices, limited access to health and nutrition services are reversing health gains of the past and leading to acute malnutrition and severe acute food insecurity. And in the Central American Dry Corridor and Haiti, drought, migration, COVID-19, poor infant feeding practices and little to no access to sanitation services are escalating malnutrition rates.

These compounding situations have a multiplier effect on annual cereal shortages now exacerbated by reduced wheat and grain imports from Ukraine and embargoes on Russian fuel and fertilizers. In Afghanistan, for example, the U.N. reports that 95% of Afghans are not getting enough to eat.[1] In Somalia, the number of people facing extreme levels of acute food insecurity has nearly doubled since the beginning of 2022. Millions of women and children across the Horn of Africa, Middle East, Central America and Haiti are reaching their breaking points and we must act now so that families can move out of this critical phase into a place of stability and hope. To do that, we must partner with women to empower them with information and resources that will break malnutrition cycles now and for future generations.

CARE listens to women because they are integral to their families’ and communities’ health, particularly when it comes to food security and nutrition. They also have specific needs including those related to reproductive and maternal health, caregiving, hygiene, and access to education and livelihoods. CARE leverages women’s insight and partners with them to identify and reach the most vulnerable groups, households, and individuals: children under 5; pregnant and lactating women; the elderly and/or disabled; orphaned children; women and girls at risk of gender-based violence (GBV); and minority groups. We also work with respective authorities, other humanitarian stakeholders and local partners, especially women-led organizations, to ensure that more people can be reached faster and in ways specific to their needs.

At the outset of every intervention, CARE conducts detailed a Response Analysis Consideration. This analysis assesses available contextual information and applies strategic thinking to facilitate decision-making on the most appropriate level in each scenario. Factors we consider are:

1. Timeliness: Can one intervention be implemented faster than others?
2. Feasibility/Scale: Is one intervention more practical and convenient than others given the emergency context? Is the target population easier to reach physically with one intervention compared to others?
3. Suitability to project objectives: Does one intervention better meet the program objectives (e.g., improve dietary diversity, reduce malnutrition, mitigate family asset depletion) than others?

©CARE/ Saddam Mohamed 

In Somalia, the number of acutely malnourished children admitted to CARE-supported health facilities increased by 60% during the first four months of 2022 compared to the same period in 2021. A mother holds her 7-month-old daughter as a health officer measures her Mid-Upper Arm Circumference (MUAC) at Kismayo Health Centre. MUAC is used for the assessment of nutritional status. Red indicates severe acute malnutrition (SAM) - the child should be immediately referred for treatment. Yellow indicates that the child is at risk for acute malnutrition and should be counselled and followed-up for growth promotion and monitoring. 

1. Value for money/cost-effectiveness and cost-efficiency: Can significantly more community members be served with one intervention compared to others?
2. Local market readiness: Do markets have adequate supplies of food and will increased purchases disrupt the markets?
3. Community preferences, priorities and capacity: Do project participants prefer one intervention over another?
4. Security: Does the proposed intervention pose a significantly increased security risk to project participants and/or aid workers?

With thorough assessments complete, CARE and our partners provide a suite of interventions to treat life-threatening malnutrition, increase self-reliance, safety nets, and community representation, and establish market linkages through:

• Provision of dry ration foods;
• Cash assistance, including cash for work (CFW), food vouchers and multipurpose cash grants where markets allow;
• Prevention and treatment of acute malnutrition, coupled with social and behavior change communication to support learning and set families up for future health;
• Protection of remaining productive assets by providing seeds and vaccinations for livestock; and
• Integration of a new model of Village Savings and Loan Associations in Emergencies (VSLAiE) contexts that combines advocacy, support for broad adoption of best practices in cash and voucher assistance, and innovations that strengthen women’s ability to respond to crises.

An impactful and sustainable food security and nutrition response that boosts local production requires an integrated approach with protection considerations (especially gender-based violence, common in food-scarce situations) mainstreamed. The full scope should support food consumption, health, increased household income, nutrition, water, sanitation and hygiene. CARE works closely with affected communities to ensure a holistic strategy in combatting hunger and malnutrition while reducing negative coping mechanisms and building resilience. Once the nutrition situation is stabilized, CARE teams work with families to regain longer-term strength through agricultural and livelihood support, including supply of fertilizer, seeds and tools, and market- and value chain-based longer-term interventions. 

A primary cause of intergenerational cycles of poverty is the recurrence of shocks – both manmade and natural – that entrench people in poverty. CARE has adapted our proven Village Savings and Loan Association (VSLA) model to emergency settings (VSLAiE), providing a stable pathway for women and girls to access crucial services that meet their immediate needs, while also building the assets, networks and skills that will enable them to achieve their long-term goals. Applying this model to people in crisis helps to bridge the divide between short-term humanitarian aid and longer-term recovery, a conundrum that has created disjointed and ultimately ineffective programs without a sustainable future for people displaced by conflict, climate change or other crises. VSLAiE, like more traditional VSLAs, are simple, highly replicable and scalable. And as with VSLAs, they are the first step in creating a pathway out of crisis and into recovery.

Our comprehensive approach goes beyond food aid to remove barriers that hinder a person’s ability to achieve improved nutrition. CARE seeks to understand the complexities of situations faced by individuals—especially women and girls—and to involve them from the outset of our response.

Read CARE's report: The Crisis We Can Still Avert: Agriculture losses in 2022 could tip 4x more people into extreme vulnerability over next 6 months. Partner with CARE to stop it.

[1] https://news.un.org/en/story/2022/03/1113982

[1]https://news.un.org/en/story/2022/04/1116152?msclkid=a6509192cf9d11ec8a46224fc042ff3a

[2]https://www.un.org/press/en/2022/sc14894.doc.htm

Links:

• Conflict, climate change, and COVID-19

More than two years into the COVID-19 pandemic, infection rates are dropping dramatically in much of the U.S., but the challenge is far from over. No one is safe while much of the world remains unvaccinated - leaving the potential for additional troubling variants to emerge. At present 66.3% of people worldwide –but only 17.8% of people in low-income countries –have received at least one dose.1The World Health Organization has renewed its urgent call for 70% of the world’s population to be fully vaccinated.

CARE is supporting efforts to improve desperately low vaccination rates in places like remote, hard-to-access villages, refugee and internally displaced people’s camps, and densely populated urban areas. Some countries continue to fall far short of goals. Only about half of all countries track vaccination rates by gender.

 Read the full report for more information.

1 https://ourworldindata.org/covid-vaccinations, accessed June 14, 2022

Links:

• Additional CARE COVID Reports

• COVID_Vaccine_Crisis_Response_Campaign_report_62022_1.pdf (PDF)