There is more than enough food produced in the world to feed everyone, yet 815 million people go hungry. As reflected in Sustainable Development Goal 2 (SDG 2), one of the greatest challenges the world faces is how to ensure that a growing global population - projected to rise to around 10 billion by 2050 – has enough food to meet their nutritional needs.
To feed another two billion people in 2050, food production will need to increase by 50 percent globally. Food security is a complex condition requiring a holistic approach to all forms of malnutrition, the productivity and incomes of small-scale food producers, resilience of food production systems and the sustainable use of biodiversity and genetic resources.
World hunger on the rise
After steadily declining for over a decade, global hunger appears to be on the rise, affecting 11 percent of the global population.
In addition to an increase in the proportion of the world’s population that suffers from chronic hunger (prevalence of undernourishment), the number of undernourished people on the planet has also increased to 815 million, up from 777 million in 2015.
This sobering news comes in a year in which famine struck in parts of South Sudan for several months in 2017 and food insecurity situations at risk of turning into famines were identified in other conflict-affected countries, namely Nigeria, Somalia and Yemen.
The food security situation visibly worsened in parts of sub-Saharan Africa, South Eastern and Western Asia. This was most notable in situations of conflict, in particular where the food security impacts of conflict were compounded by droughts of floods, linked in part to El Niño phenomenon and climate-related shocks.
Over the past ten years, the number of violent conflicts around the world has increased significantly, in particular in countries already facing food insecurity, hitting rural communities the hardest and having a negative impact on food production and availability.
The situation has also deteriorated in some peaceful settings, particularly those affected by economic slowdowns. A number of countries heavily dependent on commodity exports have experienced dramatically reduced export and fiscal revenues in recent years. Thus food availability has been affected through reduced import capacity while access to food has deteriorated in part due to reduced fiscal potential to protect poor households against rising domestic food prices.
The multiple burden of malnutrition
The worrisome trend in undernourishment is, however, not yet reflected in nutritional outcomes. Evidence on various forms of malnutrition points to continuous decreases in the prevalence of stunting among children, as reflected in global and regional averages.
Nevertheless, stunting still affects almost one in four children under the age of five years, increasing their risk of impaired cognitive ability, weakened performance at school, and dying from infections.
At the same time, various forms of malnutrition are still cause for concern worldwide.
Overweight among children under five is becoming more of a problem in most regions, while adult obesity continues to rise in all regions. Multiple forms of malnutrition therefore coexist, with countries experiencing simultaneously high rates of child undernutrition and adult obesity.
Undernutrition, overweight and their associated non-communicable diseases now coexist in many regions, countries and even households. Six nutrition indicators – three that form part of the SDGs (Sustainable Development Goals) monitoring framework, and three that refer to global nutrition targets agreed by the World Health Assembly, are described below to better understand the multiple burden of malnutrition, which affects all regions in the world.
Stunting among children under the age of five
While the prevalence of child stunting seems to be decreasing for both global and regional averages, in 2018 155 million children under five years of age across the world suffered from stunted growth, increasing their risk of suffering impaired cognitive ability, weakened performance at school and work, and dying from infections. Globally, the prevalence of stunting fell from 29.5 percent to 22.9 percent between 2005 and 2018.
Wasting among children under the age of five
In 2018 wasting affected 7.7 percent of children under five years of age worldwide. About 17 million children suffered from severe wasting. Southern Asia stands out with a high prevalence of 15.4 percent. At almost 9 percent, South-Eastern Asia is also far off the targets set by the internationally agreed global nutrition target. While the prevalence is somewhat lower in Africa, it still stands above the global nutrition target
Obesity among adults
Adult obesity continues to rise everywhere, representing a major risk factor for non-communicable diseases including cardiovascular diseases, diabetes and some forms of cancer.
The global prevalence of obesity more than doubled between 1980 and 2016. In 2016, more than 600 million adults were obese, equal to about 13 percent of the world’s adult population.
While it varies across regions, the problem is most severe in Northern America, Europe and Oceania, where 28 percent of adults are classified as obese, compared with 7 percent in Asia and 11 percent in Africa. In Latin America and the Caribbean roughly one quarter of the adult population is currently considered as obese. Historically the prevalence of adult obesity has been much lower in Africa and Asia. However, more recently it has spread rapidly among larger parts of the population in these regions as well. Hence, while many low- and middle-income countries still face high levels of undernutrition and prevalence of infectious, communicable diseases, they are now also experiencing an increasing burden of people suffering from overweight and obesity and an associated rise in certain non-communicable diseases such as diabetes.
Anaemia in women of reproductive age
The most recent estimates for 2018 indicate that anaemia affects 33 percent of women of reproductive age globally (about 613 million women between 15 and 49 years of age). In Africa and Asia, the prevalence is highest at over 35 percent. It is lowest in Northern America, Europe and Oceania (below 20 percent).
Progress to halve the prevalence of anaemia in women of reproductive age by 2025 has so far been off track.
Levels of exclusive breastfeeding
More women are feeding their infants solely with breastmilk than ever before, providing a critical cornerstone for children’s survival and development. Globally, 43 percent of infants younger than six months were exclusively breastfed in 2016, up from 36 percent in 2005.
Estimated to have the single largest preventative impact on child mortality, improving rates of breastfeeding could prevent 820 000 child deaths each year and an additional 20 000 maternal cancer related deaths each year. Breastfeeding also decreases the prevalence of overweight or obesity later in life by 26 percent.
Towards an integrated understanding of food security and nutrition
As difficult as it might be to make sense of a situation in which food security is under threat globally but child undernutrition (stunting) is falling and adult obesity is rising, there are a number of possible explanations.
Food security is only one determinant of nutritional outcomes, especially for children. Other factors include: women’s educational level; resources allocated to national policies and programmes for maternal, infant and young child nutrition; access to clean water, basic sanitation and quality health services; lifestyle; food environment; and culture.
Particularly in high- and upper-middle income countries, food insecurity and obesity often co-exist - even in the same household. When resources for food become scarce, and people’s means to access nutritious food diminish, they often rely on less-healthy, more energy-dense food choices that can lead to overweight and obesity.
Additionally, food insecurity and poor nutrition during pregnancy and childhood are associated with metabolic adaptations that increase the risk of obesity and associated non-communicable chronic diseases in adulthood.
Last but not least, changes in dietary patterns and food systems have led to increasing consumption of highly processed foods in many countries. Readily available and accessible, these products are often high in fat, sugar and salt and signal a shift away from traditional diets, further explaining the coexistence of multiple forms of malnutrition within the same communities and even households.
More context-specific assessments are needed to identify the links between household food security and nutrition and the causes underlying the apparent divergence in the most recent food security and nutritional trends.
However, overall, these recent estimates are a warning signal that the aim of a world without hunger and malnutrition by 2030 will be challenging, and that accomplishing it will require sustained commitment and efforts to promote the adequate availability of and access to nutritious food.
Hunger, malnutrition and conflict: a complex relationship
Of the 815 million chronically food-insecure and malnourished people in the world, the vast majority – 489 million –live in countries affected by conflict.
The proportion is even more pronounced for undernourished children. Almost 122 million, or 75 percent, of stunted children under age five live in countries affected by conflict, with the difference in average prevalence between conflict and non-conflict affected countries at nine percentage points.
Simple correlations show higher levels of chronic and acute food insecurity and undernutrition in countries affected by conflict. In 2018, the unweighted average of the prevalence of undernourishment in countries affected by conflict was almost eight percentage points higher than countries not affected by conflict.
Although the frequency of wars had been decreasing in recent decades to reach an all-time low in 2005, there has recently been a surge in the number of violent conflicts and conflict-related deaths. Violent conflicts have increased dramatically since 2010 and are currently at an all-time high, a worrying sign that current trends are likely to continue over the coming years.
Of these, non-state conflicts – between two organized armed groups of which neither is the government or a state – have increased by 125 percent since 2010, surpassing all other types of conflict. State-based conflict also rose by over 60 percent in the same period. Moreover, civil wars or internal conflicts have now surpassed the number of interstate or external conflicts between states. In other words, there has been a shift away from conflict between nations to conflicts within nations. As internal conflicts become more prominent, external parties are increasingly likely to become involved or to suffer the consequences of violence; thus, local conflicts evolve into regional or even continental crises.
Violence and conflict are unevenly distributed across continents, with most concentrated in four regions: the Near East and North Africa, northern sub-Saharan Africa, Central America and Eastern Europe, particularly Ukraine. Many of the most protracted conflicts currently flow across borders and are regional in nature, including in the Horn of Africa, the Great Lakes region of Africa, between Afghanistan, India and Pakistan and from Cameroon, Chad and northern Nigeria across the Sahel.
Conflict is a main driver of population displacement, and displaced populations are among the most vulnerable in the world, experiencing high levels of food insecurity and undernutrition. The number of refugees and internally displaced persons (IDPs) has increased significantly with the greater number of conflicts, doubling from 2007 to 2016 to total about 64 million people. One in every 113 people is now either refugee, internally displaced or seeking asylum. Conflict and violence are causing and protracting food insecurity in host communities as well. For example, the civil war in the Syrian Arab Republic has driven more than 6 million people to flee their homes to other locations within the country and another 5 million to neighbouring countries. Displaced people today spend an average of more than 17 years in camps or with host communities. (see the case of Lebanon).
When the state, socio-economic systems and/or local communities do not have the capacities to prevent, cope with or manage situations of conflict, the worst affected are generally the poorest and most vulnerable sectors of society.
On average, 56 percent of the population in countries affected by conflict live in rural areas, where livelihoods largely depend on agriculture. Conflict negatively affects almost every aspect of agriculture and food systems, from production, harvesting, processing and transport to input supply, financing and marketing. In many countries affected by conflict, subsistence agriculture is still central to food security for much of the population. In Iraq, for instance, before the conflict, the Ninewa and Salah al-Din districts produced almost one-third of the country’s wheat and nearly 40 percent of its barley. An assessment in February 2016 found that 70-80 percent of corn, wheat and barley cultivations were damaged or destroyed in Salah al-Din, while in Ninewa 32-68 percent of land normally used for wheat cultivation was either compromised or destroyed, as was 43-57 percent of the barley cultivation.
South Sudan provides an illustrative example of conflict’s destructive impact on agriculture and food systems and how this can combine with other factors, including public health, to undermine livelihoods and create a downward spiral of increased food insecurity and malnutrition as conflict intensifies.
Problems of acute food insecurity and malnutrition tend to be magnified where natural hazards such as droughts and floods compound the consequence of conflicts. The concurrence of conflict and climate-related natural disasters is likely to increase with climate change, as climate change not only threatens food insecurity and malnutrition, but can also contribute to further downward deterioration into conflict, protracted crisis and continued fragility.
In some cases the root cause of the conflict is competition over natural resources.
In fact, competition over productive land and water has been identified as a potential trigger for conflict, as loss of land and livelihood resources, worsening labour conditions and environmental degradation negatively affect and threaten household and community livelihoods. Sources estimate that over the past 60 years, 40 percent of civil wars have been associated with natural resources. Since 2000, some 48 percent of civil conflicts have taken place in Africa, in contexts where access to rural land is essential to the livelihoods of many and where land issues have played a significant role in 27 out of 30 conflicts.
Conflict, especially when compounded by climate change, is therefore a key factor explaining the apparent reversal in the long-term declining trend in global hunger, thereby posing a major challenge to ending hunger and malnutrition by 2030. Hunger and all forms of malnutrition will not end by 2030 unless all the factors that undermine food security and nutrition are addressed.
The impact of conflict on food systems can be severe, particularly if the economy and people’s livelihoods rely significantly on agriculture. It undermines resilience and can force individuals and households to engage in increasingly destructive and irreversible coping strategies that threaten their future livelihoods, food security and nutrition. Food insecurity itself can become a trigger for violence and instability, particularly in contexts marked by pervasive inequalities and fragile institutions. Therefore, conflict-sensitive and timely interventions aimed at improving food security and nutrition can contribute to sustaining peace. FAO
