The Silent Crisis: Funding Shortages Deepen Malnutrition Among Uganda’s Refugees

In the Nakivale Refugee Settlement in Uganda’s southwest, Fancine, 20, waits in line for her food ration, cradling her visibly undernourished, months-old baby Espoir, who winces and cries frequently. The wait is painful, but it’s just one chapter in her story of survival. Her journey, marked by violence and loss, began in Ruchuro, Democratic Republic of Congo (DRC), where she fled to escape escalating conflict.

“We were farming in my garden with my husband when we heard bullets,” Fancine recounts, her voice trembling. “We had to flee with my child to Uganda, searching for peace. My husband was killed as we fled, leaving me alone with my child.”

Upon arrival at Nyakabande Transit Centre in Kisoro District, Fancine and Espoir were immediately screened for malnutrition and other illnesses, part of a joint emergency response supported by UNHCR, WFP, UNICEF, the Ministry of Health, and partners. Espoir was diagnosed with acute malnutrition and quickly received treatment. 

Through consistent medical care and the provision of specialised nutritious foods supplied by WFP and distributed under UNHCR’s coordination, Espoir began visibly recovering. Regular nutrition education sessions delivered by Medical Teams International, a health partner in the response, helped Fancine learn how to prepare balanced meals using the limited food items available and prevent diseases.

Espoir’s early recovery was possible thanks to joint efforts by all partners working together to address urgent nutrition needs at transit and reception centres. In April 2025 alone, 8,885 children under five and 2,424 pregnant and breastfeeding women have been reached through these efforts across Nyakabande, Kabazana, and Matanda.

Due to severe funding constraints, WFP has had to prioritise nutrition support at transit and reception centres only, where malnutrition rates are critically high. Comprehensive services like the Maternal and Child Health Nutrition Programme and the broader Targeted Supplementary Feeding Programme have been suspended across most settlements, including in Nakivale, where Fancine has been relocated. This leaves over 51,000 children under two and 42,000 pregnant and breastfeeding women at risk of malnutrition. 

This comes at a time when food rations have been slashed, with monthly support to the equivalent of USD 4.9 per person per month for highly vulnerable refugees and USD 2.70 per person per month for moderately vulnerable refugees. These are the lowest ration sizes WFP is providing in East Africa. 

Meanwhile, UNHCR and UNICEF continue supporting treatment services for severe acute malnutrition across refugee settlements but face increasing challenges due to shortages of human resources, nutrition commodities, and medical supplies. Uganda’s national nutrition pipeline, managed by the National Medical Stores, is projected to break by June 2025, threatening the continuity of treatment for nearly 20,000 children.

Today, Espoir’s recovery from malnutrition is under threat due to the reduced food rations, which may cause him to fall back into malnutrition. “What I need most is help with medical care and food for my child,” Fancine says, determination in her eyes despite everything she’s endured. 

Global Appeal with Local Consequences

Despite significant successes, funding cuts have had far-reaching consequences beyond immediate hunger. The sharp increase in refugee arrivals - particularly from the DRC, South Sudan and Sudan – with over 90,000 refugees arriving in Uganda by April 2025 alone, has worsened malnutrition, with Global Acute Malnutrition (GAM) rates spiking as high as 21.5% among newly arriving refugees—a critical situation requiring urgent and continued nutrition support.

“The influx of refugees opens us up to diseases we’ve not dealt with before. Funding cuts have reduced support for maternal and child health programmes, leading to increased anaemia and malnutrition,” explained Dr. Alex Paul Tezita, the in-charge at the Panyadoli Health Centre in the Kiryandongo Refugee Settlement, home to over 144,000 refugees, mainly from Sudan, South Sudan and the DRC. “We’ve also seen a decline in antenatal and postnatal care attendance.”

The Human Cost of Funding Shortages

As of April 2025, Uganda hosts over 1.8 million refugees and asylum seekers, primarily from the DRC, Sudan, and South Sudan. Despite the increase in numbers, only 9% of the Uganda Country Refugee Response Plan (UCRRP) for Quarter 1 of 2025 has been funded — a 26% decrease compared to the same period in 2024. This severe underfunding has left critical gaps, particularly in Protection (68% decrease) and Health and Nutrition (61% decrease), impacting the ability of WFP, UNHCR, and UNICEF to meet urgent needs.

An emergency appeal of USD 44 million has been launched by Inter-Agency partners to support the response to 80,000 expected new arrivals from the DRC by September 2025. The response involves seven UN agencies, 15 international NGOs, and two national partners, and forms part of the Uganda Country Refugee Response Plan (UCRRP). The appeal focuses on addressing urgent, life-saving needs, including nutrition, as malnutrition remains a critical concern - especially among children, pregnant women, and other vulnerable groups. 

For Fancine and thousands like her, these funding shortages are not abstract figures—they represent a matter of survival. For now, her daily struggle continues, sustained only by hope—reflected in her child’s name, Espoir, the French word for “hope”—that help will soon arrive for both of them.

By Didas Kisembo, World Food Programme (WFP); Isaac Kabazzi, United Nations High Commissioner for Refugees (UNHCR); and Edmond Mwebembezi, United Nations Children’s (UNICEF)