A discussion paper on the scope of the problem, its drivers, and strategies for moving forward for policy, practice, and research In many protracted emergencies, the prevalence rates of global acute malnutrition (GAM) regularly exceed the emergency threshold of > 15% of children with acute malnutrition (< -2 weight-for-height z-scores (WHZ) or with nutritional edema), despite ongoing humanitarian interventions. The widespread scale and long-lasting nature of “persistent GAM” means that it is a policy and programming priority.