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The State of Food Security and Nutrition in the World 2023

Chapter 2 FOOD SECURITY AND NUTRITION AROUND THE WORLD

2.2 Cost and affordability of a healthy diet

KEY MESSAGES
  • The cost of a healthy diet rose globally by 4.3 percent in comparison to 2020, and by 6.7 percent compared to the pre-COVID-19-pandemic levels, in 2019. This increase is due to the overall rise in inflation in 2020 and 2021, driven in part by the persisting effects of the pandemic.
  • Worldwide in 2021, the average cost of a healthy diet was 3.66 PPP dollars per person per day. The cost was higher in Latin America and the Caribbean (4.08 PPP dollars) compared to Asia (3.90 PPP dollars), Africa (3.57 PPP dollars), Northern America and Europe (3.22 PPP dollars), and Oceania (3.20 PPP dollars).
  • In Africa, Asia, and Latin America and the Caribbean, the cost of a healthy diet increased by more than 5 percent from 2020 to 2021, negatively affecting all subregions except for Northern Africa, where the cost fell by 2.8 percent. In the same period, the cost of a healthy diet rose in Oceania (5.2 percent) and in Northern America and Europe (marginally, by 0.6 percent). The surge hit lower-middle-income countries more than high-income countries.
  • More than 3.1 billion people in the world – or 42 percent – were unable to afford a healthy diet in 2021, representing an increase of 134 million people compared to 2019, before the pandemic. This reflects the increase in the cost of a healthy diet that, in many countries, occurred in combination with a decline in disposable income.
  • While Asia had the largest number of people who were unable to afford a healthy diet (1.9 billion) in 2021, Africa reported the highest proportion of the population unable to afford it (78 percent) compared to Asia (44 percent), Latin America and the Caribbean (23 percent), Oceania (3 percent), and Northern America and Europe (1 percent).
  • Southern Asia shows the highest number (1.4 billion) and proportion (72 percent) of the population unable to afford a healthy diet in Asia, with the prevalence almost twice the regional average. Eastern and Western Africa report the highest proportion (85 percent) in the Africa region, as well as the highest number (712 million), when considered together.

Healthy diets are essential for achieving food security goals and improving nutritional outcomes. A healthy diet is composed of a variety of nutritious and safe foods that provide dietary energy and nutrients in the amounts needed for a healthy and active life. A healthy diet is based on a wide range of unprocessed or minimally processed foods, balanced across food groups, while it restricts the consumption of highly processed foods and drink products; it includes wholegrains, legumes, nuts, an abundance and variety of fruits and vegetables, and can include moderate amounts of eggs, dairy, poultry and fish, and small amounts of red meat.22, 23 Eating a healthy diet throughout the life cycle is critical for preventing all forms of malnutrition, including child stunting and wasting, micronutrient deficiencies and overweight or obesity. It also helps reduce the risk of non-communicable diseases (NCDs) such as cardiovascular diseases, diabetes and certain types of cancer.24

FAO, with support from the World Bank Data Group, systematically monitors the cost and affordability of a healthy diet (CoAHD) indicators and recently began to disseminate the updated series on the FAOSTAT database.25 These indicators provide evidence regarding people’s economic access to the lowest-cost healthy diet in a given country, using locally available foods to meet nutritional requirements. In this year’s report, the CoAHD indicators are updated to 2021. Lack of updated income distribution at the country level and of detailed food prices and purchasing power parity (PPP) conversion factors makes it impossible to update these estimates for 2022. See Annex 2, Section D for details on the methodology and important updates.

This year, affordability indicators reflect not only price shocks but also income shocks induced by the pandemic, better capturing the global situation in 2020 and 2021. This was possible because income distributions – derived from the Poverty and Inequality Platform to estimate affordability – have now been updated to include the years 2020 and 2021 for all countries (see Annex 2, Section D).i Following the recent release of new PPPs for 2017, the World Bank adopted the latest conversion factors to present its monetary indicators in 2017 PPP terms, including income distributions.26 Consequently, the indicators of affordability are expressed in 2017 PPP rather than 2011 PPP, as in previous years (see Annex 2, Section D).

The cost and affordability of a healthy diet in 2021

The revised analysis presented in this year’s report – which accounts for updated income distributions in 2020 and 2021 – shows that almost 3.2 billion people worldwide could not afford a healthy diet in 2020, with a slight improvement in 2021 (a decrease of 52 million people). Food prices continued to climb throughout 2021, pushing up the average cost of a healthy diet globally. However, a rebound in economic growth in many countries, particularly in Asia, may have translated into larger fiscal space for stimulus packages, social transfers and improved labour markets.27, 28 These efforts helped to counter the effects of high food inflation, thereby reducing the number of people unable to afford a healthy diet at the global level, largely driven by Asia.

Table 5 presents the CoAHD indicators at the global and regional levels, and by country income group, for 2019, 2020 and 2021. Estimated ranges of affordability indicators are presented in Table A3.2 for 2021, where lower and upper bounds reflect different assumptions about the share of income reserved for food. Country-level estimates for the entire 2017–2021 series can be found in Table A3.1.

TABLE 5More than 3.1 billion people could not afford a healthy diet in 2021, although there was some improvement from 2020 to 2021

SOURCE: FAO. 2023. FAOSTAT: Cost and Affordability of a Healthy Diet (CoAHD). In: FAO. [Cited 12 July 2023]. www.fao.org/faostat/en/#data/CAHD
NOTES: The cost of a healthy diet is expressed in purchasing power parity (PPP) dollars per person per day. The share of people unable to afford a healthy diet is a weighted average (%) estimated using population data. The 2022 World Bank’s income classification is used to identify country income groups. The calculation of the annual change (%) in the cost of a healthy diet is based on the cost rounded to three decimal places.
SOURCE: FAO. 2023. FAOSTAT: Cost and Affordability of a Healthy Diet (CoAHD). In: FAO. [Cited 12 July 2023]. www.fao.org/faostat/en/#data/CAHD

In 2021, the average cost of a healthy diet globally was 3.66 PPP dollars per person per day (Table 5). The cost was higher in Latin America and the Caribbean (4.08 PPP dollars) compared to Asia (3.90 PPP dollars), Africa (3.57 PPP dollars), Northern America and Europe (3.22 PPP dollars), and Oceania (3.20 PPP dollars).

The cost of a healthy diet has been on the rise since 2019. It increased globally by 6.7 percent between 2019 and 2021, with a notable single-year increase of 4.3 percent in 2021 (Table 5 and Figure 10A). The surge in the cost of a healthy diet reflects an overall rise in food inflation that hit every region following the outbreak of the pandemic. Soaring prices were mostly driven by lockdowns and by disruptions in the global supply chain and transportation systems, as well as labour shortages hitting especially the agriculture sector.8

FIGURE 10 Globally in 2021, the cost of a healthy diet increased and more people were unable to afford the diet compared to 2019 in all regions except Northern America and Europe, despite a small decline in unaffordability from 2020 to 2021

SOURCE: FAO. 2023. FAOSTAT: Cost and Affordability of a Healthy Diet (CoAHD). In: FAO. [Cited 12 July 2023]. www.fao.org/faostat/en/#data/CAHD
SOURCE: FAO. 2023. FAOSTAT: Cost and Affordability of a Healthy Diet (CoAHD). In: FAO. [Cited 12 July 2023]. www.fao.org/faostat/en/#data/CAHD

The cost of a healthy diet increased by more than 5 percent between 2020 and 2021 in Africa, Asia, Latin America and the Caribbean, and Oceania, but only marginally in Northern America and Europe (0.6 percent). The increase in cost in Africa, Latin America and the Caribbean, and Oceania was nearly double that which occurred between 2019 and 2020, while the cost rose to a lesser extent in Asia and in Northern America and Europe (Table 5 and Figure 10A).

Between 2020 and 2021, soaring costs affected all subregions in Africa, Asia, and Latin America and the Caribbean, except for Northern Africa, where the cost declined by 2.8 percent. The cost of a healthy diet climbed by 7.6 percent in Western Africa, a threefold increase compared to the period between 2019 and 2020 (Table 5). Eastern Africa also experienced a 6.7 percent rise in the cost of a healthy diet, followed by Southern Africa (5.8 percent) and Middle Africa (5.3 percent). In Asia, the highest surge was seen in Central Asia and Southern Asia (7.2 percent and 6.9 percent, respectively). Eastern Asia reported the smallest increase in the cost between 2020 and 2021 (4.1 percent) and showed a slowdown in cost inflation compared to the previous period. In Latin America and the Caribbean, the cost increase ranged from 6.4 percent in South America to 4.1 percent in Central America.

The COVID-19 pandemic has exacerbated existing inequalities across all regions in the world. Low- and middle-income countries have faced greater challenges related to increases in food prices and food insecurity compared to high-income countries.29 This is also reflected in the increased cost of a healthy diet from 2020 to 2021, which was much larger in LMICs (6.2 percent increase), UMICs (5.1 percent) and LICs (4.7 percent), compared to HICs (2.1 percent) (Table 5).

About 3.14 billion people in the world – or 42 percent – were unable to afford a healthy diet in 2021; this figure is down somewhat from 3.19 billion people – or 43 percent – in 2020 (Table 5 and Figure 10B). In many countries, the increase in the cost of a healthy diet occurred in combination with a decline in disposable income following the persisting effects of the pandemic. Lockdowns, economic downturns, and other pandemic-related disruptions in 2020 led to job losses and reduced incomes for many people, affecting low-income households the most as they spend a higher share of income on food.30 The impact of escalating prices, coupled with a reduction in disposable income in many countries, resulted in an additional 186 million people unable to afford a healthy diet in 2020 compared to 2019.

A slight turnaround occurred in 2021, when the number of people unable to afford a healthy diet declined by 52 million compared to 2020 (Table 5 and Figure 10B), but this is still 134 million more people compared to pre-pandemic levels in 2019. A rebound in global GDP growth to 6 percent in 2021, following the pandemic that plunged most countries into recession in 2020,3 likely alleviated the burden of unaffordability, owing to several factors, including government stimulus programmes, social protection measures, and employment recovery, in some instances.31 However, the unequal pattern of economic recovery across and within countries, coupled with increasing prices and inequalities, has made a healthy diet less affordable especially in some regions, placing an additional burden on the most vulnerable households.

Compared to 2019, the number of people unable to afford a healthy diet was higher in 2021 in all regions except Northern America and Europe, where the number of people unable to afford the diet decreased by 2.3 million despite the price and income shocks induced by the pandemic (Figure 10B). In Asia, the number of people who could not afford a healthy diet increased by 154 million from 2019 to 2020, but then decreased by 81.5 million from 2020 to 2021 (Figure 10B). A notable improvement occurred from 2020 to 2021 in Eastern Asia, where a healthy diet was out of reach for fewer people (71.5 million fewer people could not afford it), and in Southern Asia (17.4 million fewer people), following sharp increases the previous year in the number of people unable to afford this diet. Eastern Asia is the only subregion in Asia reporting an overall improvement in 2021 compared to 2019, as the number of people unable to afford a healthy diet decreased by 18.4 million. In Africa, unaffordability continued to worsen: 51.1 million more people could not afford a healthy diet in 2021 compared to 2019, with the highest increase occurring from 2019 to 2020 (31 million). Sub-Saharan Africa reported the largest increase in the number of people unable to afford a healthy diet from 2019 to 2021 (54 million more people), while the situation improved in Northern Africa, where the diet was out of reach for almost 3 million fewer people (Table 5). Finally, in Latin America and the Caribbean, 13.4 million more people could not afford a healthy diet in 2021 compared to 2019, with the largest increase in South America (13.3 million people) due to a sharp jump from 2020 to 2021 (Table 5 and Figure 10B).

Of the people in the world who were unable to afford a healthy diet in 2021, 1.9 billion, or 62 percent, were found in Asia (Figure 11). In terms of proportion, however, Africa was the region with the highest proportion of the population that could not afford a healthy diet in 2021 (78 percent) compared to Asia (44 percent), Latin America and the Caribbean (23 percent), Oceania (3 percent), and Northern America and Europe (1 percent) (Table 5).

FIGURE 11 Most of the people unable to afford a healthy diet in 2021 lived in Southern Asia, and in Eastern and Western Africa

SOURCE: FAO. 2023. FAOSTAT: Cost and Affordability of a Healthy Diet (CoAHD). In: FAO. [Cited 12 July 2023]. www.fao.org/faostat/en/#data/CAHD
SOURCE: FAO. 2023. FAOSTAT: Cost and Affordability of a Healthy Diet (CoAHD). In: FAO. [Cited 12 July 2023]. www.fao.org/faostat/en/#data/CAHD

Almost 70 percent of the people in Africa who were unable to afford a healthy diet lived in Eastern and Western Africa. Considered together, the two subregions reported the highest number (712 million) and proportion (85 percent) of people who were unable to afford a healthy diet in Africa in 2021 (Table 5 and Figure 11). A high proportion was also found in Middle Africa (82 percent) in 2021, followed by Southern Africa (67 percent) and Northern Africa (52 percent), whose percentage was lower than the regional average (78 percent).

In Asia, Southern Asia showed the highest number (1.4 billion) and proportion (72 percent) of people unable to afford a healthy diet in 2021, far above the regional average of 44 percent. In South-eastern Asia, around 55 percent of people could not afford this diet, and the number has been increasing since 2019.

Finally, in Latin America and the Caribbean, 63 percent of the people unable to afford a healthy diet lived in South America, and only 12 percent lived in the Caribbean (Figure 11). The Caribbean was the subregion with the lowest absolute number of people (15 million) but the highest proportion of the population (57 percent) unable to afford a healthy diet – more than twice the regional average.

The indicators described in this section and in Annex 2 and Annex 3 provide a snapshot of the “average” cost and affordability situation at the global, regional and country levels. However, they do not fully capture the heterogeneous characteristics of a population that determine the ability to afford a healthy diet within a country or a region. Affordability is affected not only by the average cost of a healthy diet and people’s incomes, but also by factors such as place of residence, proximity to food markets, or food production for own consumption. Due to data limitations, affordability estimates cannot control for these factors and may overestimate, in some instances, the cost of a healthy diet for specific population subgroups, and hence the number of people whose income falls below the cost threshold for a healthy diet.

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