Nepal's child malnutrition crisis deepens after US aid cuts

In May, government health workers in Nepal weighed and measured more than a million children between six months and five years old. What they found alarmed the people who have spent two decades trying to keep Nepal's youngest alive. The malnutrition they documented was not a marginal problem or a seasonal dip. It was, by every measure that matters, a crisis.

The timing was not coincidental. Just over a year earlier, in 2025, the Trump administration had closed USAID—the American government's principal development agency—and with it, the funding that had sustained Nepal's nutrition programs. The $72 million that Helen Keller International had been promised over five years, money meant to reach nearly 9 million people across 48 districts, simply stopped. The organization has since scraped together just under $5 million from other sources, enough to serve 223,000 people in nine districts. The gap is not a shortfall. It is a collapse.

Pooja Pandey Rana, who directed Helen Keller International's work in Nepal, has watched what two decades of progress looks like in reverse. Between 1996 and 2022, Nepal had reduced deaths among children under five by 72 percent—a genuine achievement, the kind that changes the trajectory of a nation. Now, she said, the country is backsliding. The numbers from the May survey make the danger concrete. The World Health Organization considers wasting rates—the measure of children dangerously underweight for their height—of 10 percent or higher to be critically high and demanding of immediate action. In Madhesh province, near the Indian border, the rate reached 12.3 percent. Nationally, 7.8 percent of children suffered from wasting, 1.6 percent from severe wasting. Nearly a fifth of all children surveyed were underweight for their age. And the survey had only reached about half the country's children in that age group. In remote areas, the actual numbers are likely worse.

The human stakes are not abstract. A malnourished child faces a mortality risk twelve times higher than a well-nourished one. Malnutrition does more than threaten immediate survival—it damages the immune system, compromises cognitive development, and leaves scars that persist into adulthood in the form of poor school performance and reduced productivity. Nepal's government still purchases Ready-to-Use Therapeutic Food, a nutrient-dense paste designed to treat malnourished children. But the infrastructure that made treatment possible has fractured. Health workers who once went door to door identifying children in need, referring families to clinics, and following up on treatment—that work was funded by American aid. When the money stopped, the workers stopped. "We saw this sudden, abrupt halt," Pandey Rana said. "In the last 14 months, we have seen this breakdown of systems where you have RUTF, but we don't have families coming in. You have services, but there's no one to refer or follow up."

The problem extends beyond the loss of outreach workers. Food prices have climbed sharply. Two eggs now cost as much as a kilogram of rice—a calculation that forces families choosing between nutrition and calories to choose calories. Women's economic empowerment, access to clean water, and gender equality all feed into whether children are nourished or not, and all require sustained, integrated work. Malnutrition is also competing for scarce government resources against other health priorities like immunization. Unicef reported that only about 35 percent of children under five who suffer from wasting currently receive any treatment at all. Supplies remain insufficient to meet demand.

A 2025 survey had measured wasting at 6.6 percent nationally. The new figures, while difficult to compare directly due to methodological differences, are unambiguously higher. Pandey Rana was certain of that much. What happens next depends on whether the international community can rebuild what American aid once supported, and whether Nepal's government can absorb the cost. The window for preventing permanent damage to an entire generation of children is closing.