Afghanistan is facing a major crisis now and it is not just economic. A raging measles outbreak has sickened thousands and killed nearly 100 in the crisis-ravaged country this year, the World Health Organisation said, warning that many more would die without urgent action.

The UN health agency said the outbreak was particularly concerning since Afghanistan is facing surging food insecurity and malnutrition.

“For malnourished children, measles is a death sentence,” WHO spokeswoman Margaret Harris told journalists in Geneva via video-link from Kabul.

She emphasised the need to urgently scale up disease surveillance and testing in the country, but said that even without sufficient monitoring, it was clear that “a measles outbreak is raging.”

New cases are cropping up every day.

Since the start of the year, more than 24,000 cases of the highly contagious disease have been diagnosed clinically in Afghanistan, including 2,397 laboratory-confirmed cases.

Nasty food shortages stare Afghanistan in the eye, and unless the authorities, including members of the world community, act, it could worsen considerably.

The United Nations has repeatedly warned that Afghanistan is on the brink of the world’s worst humanitarian crisis, with more than half the country facing an “acute” food scarcity and the winter forcing millions to choose between migration and starvation.

Harris said over three million children under the age of five in the country are expected to suffer from acute malnutrition by the end of this year. More than one million of them could suffer from the most severe form of malnutrition and risk dying. Harris said the WHO did not have specific numbers for how many children have already died from malnutrition in the country.

But she said the agency staff was hearing anecdotally of a number of cases and seeing devastating scenes in health centres treating severally malnourished children.

“It is happening and it is happening now,” she said.

World hunger and malnutrition levels worsened dramatically last year, with most of the increase likely due to the COVID-19 pandemic.

According to a World Health Organisation report, malnutrition, in all its forms, includes undernutrition (wasting, stunting, underweight), inadequate vitamins or minerals, overweight, obesity, and resulting in diet-related non-communicable diseases.

It said that 1.9 billion adults are overweight or obese, while 462 million are underweight.

Globally in 2020, 149 million children under 5 were estimated to be stunted (too short for age), 45 million were estimated to be wasted (too thin for height), and 38.9 million were overweight or obese.

Around 45% of deaths among children under 5 years of age are linked to undernutrition. These mostly occur in low- and middle-income countries. At the same time, in these same countries, rates of childhood overweight and obesity are rising.

The developmental, economic, social, and medical impacts of the global burden of malnutrition are serious and lasting, for individuals and their families, for communities and for countries.

Another report, published last year, quotes the director general of the World Health Organisation  saying that an additional 10,000 children a month could die in 2020 from malnutrition as a result of the impact of the COVID-19 pandemic. Dr Tedros Adhanom Ghebreyesus said he expected a 14% increase in children suffering from malnutrition as a result of the pandemic.

This equates to 6.7 million more malnourished children, mostly in sub-Saharan Africa and south Asia. “We cannot accept a world where the rich have access to healthy diet while the poor are left behind,” he added.

Changing rain patterns caused by the El Nino warming phenomenon leads millions of children to malnutrition, according to a recent report.

Crucially, while the children’s weight appeared to rebound following an El Nino, the shock to their nutrition caused by the phenomenon led to stunted growth for years.