How close are we
to #ZeroHunger?

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.

PART 1

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.

World hunger is on the rise: the estimated number of undernourished people increased from 777 million in 2015 to 815 million in 2016

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.

PART 2

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.

Stunting still affects 155 million of children under the age of five years

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 2016 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 2016 (figure 2).

From 2005 to 2016 most regions achieved reductions in stunting, with the rate of improvement fastest in Asia and Latin America and the Caribbean. The prevalence of stunting also declined in all sub-regions in Africa, but at a much slower rate. In fact the rate of decline has not kept pace with population increases, resulting in a high number of stunted children overall.

Wasting among children under the age of five

In 2016 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 (figure 3).

The number of children overweight under the age of five

Childhood overweight is a growing problem in most regions. Worldwide, an estimated 41 million children under five were overweight in 2016, up from 5 percent in 2005 (figure 4).

With the exception of Western Africa, South America, and Eastern Asia, where slight declines were recorded between 2005 and 2016, and Eastern Africa where the prevalence remained constant, all other regions registered increases in the prevalence of children overweight, the fastest rising being South-Eastern Asia and Oceania.

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 2014. In 2014, 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 2016 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.

PART 3

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.

A world without hunger and malnutrition by 2030 will be challenging

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.

PART 4

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.

"Peace is of course the key to ending these crises, but we cannot wait for peace to take action. It is extremely important to ensure that these people have the conditions to continue producing their own food. Vulnerable rural people cannot be left behind, especially youth and women"
José Graziano da Silva, FAO Director-General

Simple correlations show higher levels of chronic and acute food insecurity and undernutrition in countries affected by conflict. In 2016, 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.

While most countries have achieved significant 25-year gains in reducing hunger and undernutrition, progress in the majority of countries affected by conflict has stagnated or deteriorated

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.

Assistance to countries affected by conflict should focus on support for investments in building resilience and preparedness

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.

PART 5

Food security, malnutrition and conflicts: country case studies

A humanitarian catastrophe on a massive scale: the case of South Sudan

The conflict in South Sudan has resulted in a humanitarian catastrophe on a massive scale: famine was declared in parts of Greater Upper Unity State in February 2017, more than 4.9 million people (over 42 percent of the population) were severely food insecure.

Food access has been hampered by sharp increases in prices, with inflation driven by shortages, currency devaluation and high transport costs owing to insecurity along major trading routes. The year-on-year inflation rate peaked at 836 percent in October 2016. A lack of financial and physical access to food is limiting individual and household consumption, with real labour incomes and the relative price of livestock falling dramatically. Meanwhile, violence and insecurity have led to the depletion and loss of assets such as livestock and key household food sources such as standing crops and grain stocks.

In the worst-affected areas, food is being used as a weapon of war, with trade blockades and security threats leaving people marooned in swamps with no access to food or health care. Humanitarian access to these areas is limited, as warring factions are intentionally blocking emergency food, hijacking aid trucks and killing relief workers. A lack of protection of civilians against the violence has led to 1.9 million internally displaced persons and more than 1.26 million refugees, who have lost their livelihoods and are dependent on support for their survival.

Yemen: a protracted crisis threatens nutrition and health

As of March 2017, an estimated 17 million people are experiencing severe food insecurity and require urgent humanitarian assistance. This represents 60 percent of the entire population – a 20 percent increase from June 2016 and a 47 percent increase from June 2015. Chronic child undernutrition (stunting) has been a serious problem for a long time, but acute undernutrition (wasting) has peaked in the last three years. One of the main channels of impact on livelihoods and nutrition has been the conflict-induced, economy-wide crisis that is affecting the entire population.

The nutrition situation has been aggravated by the dramatic breakdown of the health care system and its infrastructure, combined with an outbreak of cholera and other epidemics that affected several governorates in 2016 and that is continuing into 2017.

A protracted crisis stretches across borders: the Syrian war

Formerly a vibrant middle-income economy, 85 percent of the population of the Syrian Arab Republic now live in poverty. In 2016, an estimated 6.7 million people were acutely food insecure and in need of urgent humanitarian assistance, while the prevalence of acute malnutrition was at increased levels in most areas. Anaemia affects about one-quarter of adult women and children under the age of five.

Six years of civil war have led to massive losses in the agriculture sector, including destroyed assets and infrastructure. Today agriculture production is at a record low in the country, with about half the population unable to meet their daily food needs.

Years of conflict have not only had a cumulative destructive effect on the economy, infrastructure, agricultural production, food systems and social institutions, but also more generally on people’s ability to cope. Since 2011, there has been a continuous exodus of Syrians seeking to escape the conflict, mostly into neighbouring countries. By 2016, an estimated 4.8 million refugees had fled to Turkey, Lebanon, Jordan, Iraq, and Egypt.

Lebanon: spillover from a protracted crisis

The crisis in the Syrian Arab Republic has had an immense impact on Lebanon, which has experienced an economic slowdown and is having to absorb more than 1.5 million refugees – a quarter of its native population. The economic slowdown is a result of increased insecurity, disrupted trade routes, and declining confidence among investors and consumers. Exports and foreign direct investments fell by 25 percent between 2013 and 2014, and tourism has dropped by 60 percent since the start of the crisis.

The crisis is having a disproportionate impact on already vulnerable households, not only because of increased competition among unskilled workers and overloaded public services, but also because half of the refugees live in the poorest one-third of districts. Those who were already poor will become poorer and adverse impacts on food security and nutrition are to be expected.

East Africa: conflict breaks down traditional systems

Long-lasting and recurrent conflicts have altered the grazing patterns of pastoralists in Ethiopia, Kenya and Uganda, forcing communities to concentrate livestock on reduced territory due to limited mobility. Traditional systems have been affected as a result.

FAO has documented the breakdown of traditional systems and how this has affected environmental degradation, undermining the long-term viability of pastoral livelihoods.

In Kenya, concentrating livestock in limited areas has resulted in overgrazing and the general degradation of the environment. Pastoralists have nonetheless been forced to settle in these areas, which has led to overgrazing and ecological degradation. This undermines their livelihoods and communities’ ability to cope with droughts and other climate-related disasters, while the congested settlements are causing loss of soil cover due to erosion. Communities also suffer from water scarcity from the larger numbers of people and livestock, while environmental degradation is exacerbated by the cutting down of trees and grass for construction, fuelwood, and sale for income generation.

Meanwhile, across the border in Ethiopia, on-and-off violent conflicts between the Borana, Garre, Guji and Konso have become commonplace. Though occurring at local levels, complex legal, political and economic dynamics are involved that have leant a national and even regional dimension to the violence, encompassing communities and allies elsewhere in Ethiopia and in Kenya.

Colombia: displacement, dispossession and unequal access to natural resources

Colombia witnessed over 50 years of conflict that left up to six million people internally displaced – equivalent to 14 percent of the total population. This was the result of systematic strategies of eviction and dispossession by armed groups in their quest to seize rural territories, control valuable natural resources and land, and appropriate the rents associated with these resources. Strategies of forced displacement have also been associated with drug trafficking, as the growth of this sector requires control over routes and land to cultivate illegal crops. The scale and magnitude of forced displacement is not only the main effect of armed conflict, but also the main source of food insecurity. The impact has been most keenly felt by the poorest and most vulnerable populations, including ethnic communities.

The economic and social repercussions of Colombia’s conflict were both short- and long-term. Rebel strategies led to the concentration of land ownership in fewer hands and lasting changes in land-use and agricultural production – from staple food crops to those for industrial use, including palm oil and coca leaves. This affected poverty and inequality as well as food production and access. From 1980 to 2010 it is estimated that 6.6 million hectares of land were abandoned as a result of displacement, a figure that would be even higher if the territories of ethnic communities were included. Dispossession particularly affected the poorest and most vulnerable rural families. It became critical for Colombia to make up for the material losses experienced by displaced and rural populations as a result of conflict, including by instigating land and housing restitution and programmes to improve access to working capital and capital goods.

Investing in peace and food security: the case of northern Uganda

The post-conflict recovery of northern Uganda shows how investments in peace and recovery can contribute to dramatic improvements in food security and nutrition in a former conflict zone. Two decades of conflict between government forces and the Lord’s Resistance Army (LRA) in northern Uganda led to mass displacements coupled with a surge in poverty and food insecurity and malnutrition, particularly in the formerly agricultural Acholi region. Forced to live in camps, the Acholi population – who had previously been largely food secure – became almost entirely reliant on international food assistance.

However, since the end of the conflict food security and nutrition in northern Uganda have improved substantially, and by 2011 no further food assistance was required for the Acholi population (having previously been provided to a peak of 1.9 million people in 2007). Across the whole of Uganda, childhood wasting declined by almost one-third and the percentage of the country’s population living below the poverty line declined by over 10 percent between 2005 and 2012.

The Government of Uganda had identified agriculture as a priority for post-conflict recovery. Multiple organizations supported IDPs and ex-combatants in repairing their livelihoods by providing seeds, tools, livestock, cash and food-for-work programmes, and national policies were implemented to enhance food security and nutrition.