# data[].attributes.body
Kellogg’s has donated $1 million to the No Kid Hungry program to help improve and expand school breakfast programs across the country.

# data[].attributes.body
Feed the Future is a government organization that feeds people in other countries. Some countries it helps are Bangladesh, Guatemala, Ethiopia, and Ghana.

# data[].attributes.attachment_link.description
Feed the Future is the U.S. Government's global hunger and food security initiative. It addresses the root causes of hunger and poverty in the developing world to improve global food security and nutrition.

# data[].attributes.body
According to the Global Hunger Index, the five countries with the most hungry people in 2018 were the Central African Republic, Chad, Yemen, Madagascar, and Zambia. The five countries with the least amount of hungry people were Belarus, Bosnia and Herzegovina, Chile, and Costa Rica.

# data[].attributes.attachment_link.provider_name
Global Hunger Index - A Peer-Reviewed Publication

# data[].attributes.attachment_link.readable_text
Global, Regional, and National Trends

About image

Photo: Welthungerhilfe/ Stefanie Glinski 2018; People queuing at a food distribution point in Bentiu refugee camp, South Sudan. Eighty percent of all refugees worldwide are displaced for more than 10 years. Hide

Explore Country-Level Data (2018)

Note: Rankings cannot be accurately compared with rankings and index scores from previous reports.
Countries that have identical 2018 scores are given the same ranking (for example, Bulgaria and the Slovak Republic are both ranked 16th). The following countries could not be included because of lack of data: Bahrain, Bhutan, Burundi, the Democratic Republic of the Congo, Equatorial Guinea, Eritrea, Libya, Moldova, Qatar, Somalia, South Sudan, the Syrian Arab Republic, and Tajikistan. The 15 countries with 2018 GHI scores of less than 5 are not assigned individual ranks, but rather are collectively ranked 1-15. Differences between their scores are minimal.

Order Alphabetically Order by 2018 GHI Score

The 2018 Global Hunger Index (GHI) indicates that the level of hunger and undernutrition worldwide falls into the serious category, at a value of 20.9, down from 29.2 in 2000 (Figure 2.1). Underlying this improvement are reductions since 2000 in each of the four GHI indicators - the prevalence of undernourishment, child stunting, child wasting, and child mortality.

In the countries included in the GHI, the share of the population that is undernourished stands at 12.3 percent as of 2015-2017, down from 17.6 percent in 1999-2001. Of children under five, 27.9 percent are stunted based on data from 2013-2017, down from 37.1 percent in 1998-2002, and 9.3 percent are wasted, down slightly from 9.7 percent in 1998-2002. Finally, the under-five mortality rate was 4.2 percent as of 2016, down from 8.1 percent in 2000.

Despite these improvements, the question remains whether the world will achieve Sustainable Development Goal (SDG) 2, which aims to end hunger, ensure food security and improved nutrition, and promote sustainable agriculture, by 2030. For each of the indicators used in the GHI, the UN agencies tasked with monitoring progress toward the SDGs have offered some sobering assessments:

We are still far from a world without malnutrition. The joint estimates... cover indicators of stunting, wasting, severe wasting and overweight among children under 5, and reveal insufficient progress to reach the World Health Assembly targets set for 2025 and the Sustainable Development Goals set for 2030 (UNICEF/WHO/World Bank 2018b).

The ambition of a world without hunger and malnutrition by 2030 will be challenging - achieving it will require renewed efforts through new ways of working... Achieving zero hunger and ending undernutrition could be out of reach for many countries affected by conflict (FAO/IFAD/UNICEF/WFP/WHO 2017).

Accelerated progress will be needed in more than a quarter of all countries to achieve SDG targets in child survival (UN IGME 2017b).

Taken together, these statements show that the goal of achieving zero hunger will not be reached without increased efforts and new approaches to that end. GHI projections show that at the pace of hunger reduction observed since 2000, approximately 50 countries will fail to reach low hunger levels as defined by the GHI Severity Scale by 2030; at present, 79 countries have failed to reach that designation according to the 2018 GHI. Yet given the gains that have already been made, we know progress is possible. To better understand which parts of the world face the most daunting challenges in achieving SDG2, the following sections report on hunger and undernutrition - expressed in terms of the GHI and its underlying indicator values - at regional, national, and subnational levels and provide insight into how and why these values have changed over time.

United Nations - "Ending Poverty and Hunger" is part of a UN short film series "The Story You are Shaping" which premiered at the UN Sustainable Development Summit 2015.

The Regions About image

Photo: Welthungerhilfe/Thomas Rommel 2018; Faysal Hassan Ismail, 36 years old, harvests tomatoes in Baki district in Somaliland. Many people in Somaliland have been displaced because of drought, yet with sufficient planning and investment in rural areas and agricultural training the effects of drought on farmers can be significantly reduced. Hide

Figure 2.1

GLOBAL AND REGIONAL 2000, 2005, 2010, AND 2018 GLOBAL HUNGER INDEX SCORES, WITH CONTRIBUTION OF COMPONENTS
Source: Authors.
Note: See Appendix B for data sources. The regional and global GHI scores are calculated using regional and global aggregates for each indicator and the formula described in Appendix A. The regional and global aggregates for each indicator are calculated as population-weighted averages, using the indicator values reported in Appendix C. For countries lacking undernourishment data, provisional estimates provided by the Food and Agriculture Organization of the United Nations (FAO) were used in the calculation of aggregates only, but are not reported in Appendix C.

At the regional level, the 2018 GHI scores for South Asia and Africa south of the Sahara, at 30.5 and 29.4, respectively, are dramatically higher than those of other regions of the world (Figure 2.1 above). These scores, indicating serious levels of hunger, stand in stark contrast to those of East and Southeast Asia, the Near East and North Africa, Latin America and the Caribbean, and Eastern Europe and the Commonwealth of Independent States, which range from 7.3 to 13.2 and indicate low or moderate hunger levels.

Even those regions with low or moderate GHI scores include countries where hunger and undernutrition are problematically high. For example, in Latin America and the Caribbean, which has a GHI score of just 9.0, the Caribbean island nation of Haiti is one of just seven countries in this year's report with GHI scores that are considered alarming or extremely alarming. Another of these seven is Yemen, located in the Near East and North Africa region. This region has a GHI score of 13.2, indicating moderate hunger and undernutrition, yet Yemen's score of 39.7 is the third-highest score in this report (see the " The Countries " section below).

The GHI scores for South Asia and Africa south of the Sahara merit special consideration. In both of these regions, the rates of undernourishment, child stunting, child wasting, and child mortality are unacceptably high. In particular, South Asia has the highest child stunting and child wasting rates of any region, followed by Africa south of the Sahara. In terms of undernourishment and child mortality, Africa south of the Sahara has the highest rates, followed by South Asia.

South Asia's child wasting rate constitutes a critical public health emergency (UNICEF/WHO/World Bank 2018b). This is made all the more concerning because it has not decreased but rather has slightly increased since 2000. The child wasting rate for the region is amplified in part by that of India, which has the region's largest population and highest level of child wasting, at 21 percent according to the latest data. Yet even without India, South Asia's child wasting rate would top the rates of the other regions of the world. Several factors characterize child wasting throughout South Asia. Wasting rates are highest for infants aged 0 to 5 months, indicating that the youngest children are most vulnerable to wasting and suggesting that attention to birth outcomes and breastfeeding is important. Furthermore, a low maternal body mass index (BMI) is associated with child wasting throughout the region, suggesting that the nutritional status of the mother during pregnancy influences the nutritional status of the child at birth and beyond. Interestingly, in South Asia maternal BMI and access to improved water and sanitation are more closely associated with rates of child wasting than household wealth, suggesting that a reduction in poverty alone may not be sufficient to correct the problem (Harding, Aguayo, and Webb 2018).

Child stunting in South Asia is also very high. Since 2000, the rate of stunting in the region has fallen from approximately half of all children to over a third, but this still constitutes the highest regional child stunting rate worldwide. Factors that could reduce child stunting in South Asia include increased consumption of non-staple foods, access to sanitation, women's education, access to safe water, gender equality, and national food availability (Smith and Haddad 2015). These factors must be addressed.

In Africa south of the Sahara, the 2015-2017 undernourishment rate, at 22 percent, has increased marginally since 2009-2011 (FAO 2018d) and is the highest regional rate of all regions in the report. Conflict plays a devastating role in this region: countries engaged in protracted crises have undernourishment rates that are approximately twice as high as those of countries not affected by conflict (FAO 2017c). Other factors driving undernourishment are poor climatic conditions, exacerbated in 2015 and 2016 by the El Niño phenomenon, which led to prolonged droughts, reduced harvests, and loss of livestock in many parts of Africa. In some cases, the effects of climate change and conflict combine to further increase undernourishment rates (FAO 2017c).

Africa south of the Sahara's high under-five mortality rate is also due in part to conflict, with rates in fragile countries about twice those of non-fragile countries. The 10 countries with the world's highest under-five mortality rates are all located in Africa south of the Sahara, and seven of these are considered fragile states (UN IGME 2017b). The instability generated by conflict contributes to childhood undernutrition, which then increases children's vulnerability to disease and can lead to premature death (Tamashiro 2010). While there are some similarities, the nature and causes of hunger and undernutrition in South Asia and Africa south of the Sahara vary substantially, and the situation in each region requires distinct solutions. Food insecurity in Africa south of the Sahara may be more visible-major crises and the threat of famine in that region have garnered international headlines in recent years-yet the crisis in child nutrition in South Asia makes it clear that the situation there, too, is far from where it needs to be. In Africa south of the Sahara, much work remains to ensure adequate calories are accessible to all, particularly in contexts of conflict; at the same time, it is critical to promote proper nutrition and ensure a sufficient supply of diverse foods without overreliance on staples.

The Countries About image

Photo: Welthungerhilfe/Stefanie Glinski 2018; A woman prepares tea and coffee in Bentiu-South Sudan's largest IDP camp, with more than 112,000 people. The country is in its fifth year of conflict, which has caused large-scale displacement, led to high levels of food and nutrition insecurity, and left 7.1 million people dependent on humanitarian assistance. Hide

Table 2.1
GLOBAL HUNGER INDEX SCORES BY RANK, 2000 GHI, 2005 GHI, 2010 GHI, AND 2018 GHI

Rank

Country

2000

2005

2010

2018

2018 GHI scores less than 5,
collectively ranked 1-15

Belarus

5

<5

<5

<5

Montenegro
-
-

<5

<5

Note: Rankings and index scores from this table cannot be accurately compared with rankings and index scores from previous GHI reports (see About section).

Table 2.1 shows the numerical ranking, from lowest to highest hunger levels, for each country included in the GHI, as well as each country's 2000, 2005, 2010, and 2018 GHI scores. Appendix C shows the values of the GHI indicators-the prevalence of undernourishment, child wasting, child stunting, and child mortality-for each country, including their historic values. An examination of the individual indicators provides a useful glimpse into the nature of hunger and undernutrition in each country and how these have changed over time. Appendix D shows the 2000, 2005, 2010, and 2018 GHI scores for each country, alphabetized by country. For 16 countries with GHI scores in the moderate, serious, alarming, or extremely alarming categories, their 2018 GHI scores are the same as or higher than their scores for 2010 (the most recent historical reference period in this year's report). The stagnation or worsening of hunger and undernutrition in these countries is a troubling trend.

According to the 2018 GHI, six countries suffer from levels of hunger that are alarming, while one country, the Central African Republic (CAR), suffers from a level that is extremely alarming.

The six countries with alarming levels of hunger are Chad, Haiti, Madagascar, Sierra Leone, Yemen, and Zambia.

Forty-five countries out of 119 countries that were ranked have serious levels of hunger. GHI scores for several countries could not be calculated because data were not available for all four GHI indicators. Yet the hunger and undernutrition situations in seven of these countries are identified as cause for significant concern ( Box 2.1). In each of these seven countries - Burundi, Democratic Republic of Congo, Eritrea, Libya, Somalia, South Sudan, and Syria - violent conflict, political unrest, and/or extreme poverty have precipitated substantial flows of forced migration, which is closely associated with food insecurity as described in the 2018 Issue in Focus.

The Central African Republic (CAR), which has the highest 2018 GHI score - 53.7 - has suffered from instability, sectarian violence, and civil war since 2012. Livelihoods have been lost, markets have been disrupted, and food security has been weakened (USAID 2017a). As of December 2017, more than 1 million people had been displaced, internally or internationally, out of a population of just 5 million (IDMC 2018a). The inability of displaced people to engage in typical agricultural activities further disrupts food supplies and contributes to food insecurity (FAO 2018a). Underlying CAR's high GHI score are its extremely high undernourishment value of 61.8 percent, the highest in this year's report, and its child mortality rate of 12.4 percent, the third highest in the report. The country's child stunting and child wasting estimates are also high and cause for great concern. The situation in CAR shows clearly the role that conflict and forced migration play in deepening hunger and undernutrition.

Chad, which neighbors CAR to the north, has the second-worst GHI score according to this year's ranking, at 45.4 (considered alarming). According to FAO, the primary factors behind Chad's worsening food security situation are the following: " conflict and instability in neighboring countries and related population movements, poor terms of trade for pastoralists, the ongoing agricultural lean season, exacerbated by chronic poverty, low economic development and climate variability " (FAO 2018c).

Figure 2.2
2018 GHI SCORES AND PROGRESS SINCE 2000

Click to enlarge:

Source: Authors. Note: This figure illustrates the change in GHI scores since 2000 in absolute values. The results cannot be compared to results from similar figures in previous GHI reports because of data revisions (see About section) and because previous figures featured the percentage change since 2000. This figure features countries where data were available to calculate 2000 and 2018 GHI scores and where 2018 GHI scores show moderate, serious, alarming, or extremely alarming hunger levels. Some likely poor performers may not appear due to missing data.

At 39.7, Yemen's GHI score is the third highest in this year's report and falls into the alarming category. With Yemen mired in conflict, segments of the population were at high risk of famine in 2017 and could still experience famine in 2018 if the worst-case situation comes to pass (FEWS NET 2018d). Yemen is heavily dependent on imported goods, including food and fuel, and a conflict-induced blockade that started in late 2017 has severely restricted the flow of critical goods into the country. Since then, imports have resumed to some extent, but the threat of future restrictions poses major risks to the population's food security and well-being (FEWS NET 2018d). In 2013, 46.5 percent-nearly half-of Yemen's children were stunted and 16.3 percent were wasted, constituting a critical public health emergency.

Haiti, with a GHI score of 35.4 and thus in the alarming category, has the highest hunger level in the Western Hemisphere and the seventh-highest GHI score in this report. Its undernourishment rate, at 45.8 percent in 2015-2017, is the fourth-highest rate in this year's report, after only Central African Republic, Zimbabwe, and Somalia. Low agricultural productivity in Haiti-owing in part to severe environmental degradation-places strain on national food supplies. Haiti has a long history of political instability, which has hampered its development (CFR 2018). Poverty is widespread, with more than half of the population living on less than $2 a day, and this limits people's ability to gain access to much-needed food supplies (USAID 2017b). The situation was worsened first by the earthquake that struck Haiti in 2010, killing up to 300,000 people and displacing more than 1 million (DesRoches et al. 2011), and then by Hurricane Matthew, which struck in 2016, resulting in further destruction and destitution (World Bank 2017b). In addition to considering countries' GHI rankings, it is informative to compare them with one another in terms of the individual GHI component indicators:

Zimbabwe, Somalia, and CAR have the highest rates of undernourishment, ranging between 46.6 and 61.8 percent.

Stunting rates are highest in Timor-Leste, Eritrea, and Burundi with at least half of the children suffering from stunting in each country.

Wasting is most prevalent in Djibouti, India, and South Sudan, but even among these three countries the rates and estimates vary widely, at 16.7 percent, 21.0 percent, and 28.6 percent, respectively.

Finally, the highest under-five mortality rates are in Somalia (13.3 percent), Chad (12.7 percent), and CAR (12.4 percent).

Despite these sobering statistics, there is cause for optimism. This year's GHI includes 27 countries with moderate levels of hunger and 40 countries with low levels of hunger. Even some countries in South Asia and Africa south of the Sahara-the regions with the highest hunger and undernutrition levels-have achieved moderate scores, including Gabon, Ghana, Mauritius, Senegal, South Africa, and Sri Lanka.

Within Country Borders About image

Photo: Welthungerhilfe/Daniel Pilar 2017; A Rohingya refugee from Myanmar with her child in Nayapara Registration Camp, Bangladesh. Hide

Figure 2.3
SUBNATIONAL INEQUALITY OF CHILD STUNTING

Click to enlarge:

Source: Authors. Based on surveys listed in UNICEF/WHO/World Bank (2018a) and WHO (2018), from 2013-2017. Countries included are those with subnational stunting data available for 2013-2017.
Note: The number in parentheses following each country name indicates the number of subnational units into which the country was divided for the sake of the survey. All stunting values in this figure are taken directly from original survey reports. The national averages may vary slightly from those used for GHI calculations, which in some cases underwent additional analysis before inclusion in UNICEF/WHO/World Bank (2018a).

While it is valuable to understand hunger and undernutrition rates at the country level, national scores can mask substantial variation within country borders, raising the risk that serious problems at the subnational level may go unnoticed and unaddressed. Furthermore, recognizing the nature of the hunger and undernutrition challenges facing individual areas within a country can help to better tailor interventions and policies to meet those areas' needs.

Figure 2.3 illustrates the subnational disparities in child stunting rates for children under the age of five in 65 countries. Childhood stunting is a key indicator because it can be caused by a wide range of factors-not just inadequate consumption of calories, but insufficient intake and absorption of micronutrients related to broader physical health and recurrent diseases that affect child growth. For each country with available data, this figure shows the stunting rates for the states or areas with the highest and lowest stunting levels, as well as the national average. In addition to inequality in nutrition and health, several other factors influence the size of the within-country gap in stunting levels, such as the number of subnational units into which a country is split for the sake of the survey, national population size and land area, and the average national stunting level.

Countries in all regions of the world exhibit wide variations in stunting levels. Latin America, for example, has one of the lowest regional hunger levels, yet stunting levels in Guatemala's departments range from 25 percent to a staggering 70 percent. The highest stunting levels are found in the western highlands, where the population consists mainly of indigenous groups and where the country's civil war (1960-1996) took a heavy toll (IFAD 2012). Peru's indigenous population is more likely than the non-indigenous population to live in poverty and to experience the double burden of malnutrition as measured by child stunting along with overweight or obesity among women (Ramirez-Zea et al. 2014).

In Peru, stunting levels range from 2.3 percent in the coastal region of Tacna to 33.4 percent in the mountainous and highly indigenous region of Huancavelica. Peru's average child stunting rate has fallen dramatically in recent years, from nearly 30 percent in 2004-2006 to 13.1 percent in 2016. The largest declines have been in the mountainous areas, falling from 43.2 percent to 21.2 in this period (INEI et al. 2007; INEI 2017). Peru's reduction in stunting has been influenced by social factors such as the percentage of families with at least one unmet basic need, the percentage of families living below the poverty line, urbanization, and women's schooling (Huicho et al. 2017). Even so, the continued challenges in regions such as Huancavelica and for indigenous groups must not be overlooked.

In many cases, the areas with the lowest stunting levels are predominantly urban areas, such as national capitals, that are outliers relative to other parts of the country. An example of this is Burundi, where the national average is 55.9 percent, and the stunting level in the lowest province-Bujumbura Mairie, home to the capital city-is just 23.7 percent. In fact, other than Bujumbura Mairie, all 17 other provinces have stunting levels between 49 and 66 percent, indicating that extremely high stunting levels are widespread throughout the country with the exception of the capital (MPBGP et al. 2017). In other cases, there are areas where stunting is exceptionally high relative to the country as a whole. For example, in the case of the Republic of Congo, the national average for stunting is 21.2 percent, whereas 36.9 percent of children in the department of Sangha are stunted. Sangha is in the northern part of the country, situated between Likouala and Cuvette-Ouest departments, which also have stunting levels above 30 percent. The Republic of Congo is highly urbanized (World Bank 2018d), yet its northern departments are sparsely populated and heavily forested (Statoids 2015).

Infant and young child feeding practices, children's health, and treatment practices for childhood illnesses are not extraordinarily poor in these departments, although Sangha and Cuvette-Ouest do have the lowest percentages of infants who are predominantly breastfed. Moreover, consumption of iodized salt, the absence of which is associated with child stunting (Krämer et al. 2016; Semba et al. 2008), is substantially lower in Sangha and Cuvette-Ouest than in other departments (INS and UNICEF 2015).

In large and highly populous Nigeria, stunting levels are dichotomous, with a stark difference between rates of stunting in the north and the south of the country. In the south, near the Atlantic coast and Nigeria's largest city, Lagos, stunting levels are consistently between 10 and 20 percent, whereas in the north they rise to 50 percent or higher (NBS and UNICEF 2017). Households in the north tend to be poorer on average and depend heavily on agricultural activities, which in some northern states have been disrupted by terrorist activity; these disruptions increase food insecurity and may contribute to child stunting (Akombi et al. 2017). In northern Nigeria, stunting starts at an earlier age than in the rest of the country, suggesting that the poor nutritional status of the mother during pregnancy is a greater problem there. Efforts to address child stunting in Nigeria must take into account these and other differences (Amare et al. 2018).

In addition to geographic inequalities, there are other important dimensions of inequality, such as gender-based inequality, racial and ethnic inequality, and inequality based on educational status. Disaggregated hunger and nutrition indicators other than child stunting should also be considered. In the formulation of policies and interventions to address undernutrition, the key is to consider these and other factors as a means of both diagnosing the problem and devising solutions to meet the challenges at hand.

Box 2.1

COUNTRIES WITH INSUFFICIENT DATA, YET SIGNIFICANT CONCERNS

In the case of 13 countries assessed for the GHI, data were unavailable for one or more indicators used in the GHI formula, preventing the calculation of their 2018 GHI scores. In some cases, data are unavailable as a result of violent conflict or political unrest, which are also strong predictors of hunger and undernutrition, so the countries with missing data may be the ones suffering most. Based on the data that are available and information from international organizations that specialize in combating hunger and undernutrition, we have determined that 7 of the countries with missing data are cause for significant concern. The following is a brief explanation of what is known about the hunger and nutrition situation in each of the 7 countries; the table below shows the existing GHI indicator values for these countries.

BURUNDI: Approximately 1.67 million Burundians out of a population of 11 million are estimated to be severely food insecure (FAO GIEWS 2018). Chronic malnutrition, as measured by child stunting (the prevalence of low height-for-age), is rampant in Burundi. At 55.9 percent, Burundi's child stunting level is the highest of all countries covered in this report. More than a decade of violent conflict from 1993 to 2005 contributed to Burundi's poor food and nutrition security situation (Verwimp 2012; WFPUSA 2015). Since the onset of political unrest in 2015, roughly 420,000 Burundian refugees have fled to neighboring countries, where budget shortfalls for humanitarian efforts present a challenge in terms of ensuring adequate food and health services for the refugee population (UNHCR 2018c).

DEMOCRATIC REPUBLIC OF CONGO (DRC): The DRC has been beset by ongoing conflict and far-reaching poverty in recent decades. Since 2016, increasing levels of violence have precipitated a crisis; as of December 2017, about 4.5 million people were internally displaced and more than 700,000 refugees had fled to neighboring countries (UNHCR 2018d; USAID 2018c). In 2017, 7.7 million Congolese in rural areas faced acute food insecurity, a 30 percent rise from the previous year, precipitated largely by violence and displacement (IPC 2017). Roughly 43 percent of children under the age of five are stunted, 8 percent are wasted, and the child mortality rate is 9 percent. According to the World Food Programme, " The combination of persistent violent armed conflicts, massive population displacements, poor or inexistent infrastructures, and widespread deterioration of productive assets have significantly affected food security in the DRC over the past two decades " (WFP 2015).

ERITREA: According to the World Health Organization (WHO), malnutrition is one of the greatest public health problems facing Eritrea (WHO and MOH 2014; WHO 2014). Eritrea's child stunting rate is estimated to be 52.8 percent and its child wasting rate 14.5 percent, although updated data on these indicators are badly needed. The country's child mortality rate has declined in recent years, from 8.9 percent in 2000 to 4.5 percent in 2016. Undernutrition in Eritrea is related to the challenges of food production that result from limited arable land, water shortages, and frequent droughts. Severe poverty also limits people's ability to buy food (UNICEF 2015). Eritrea ranks 179th out of 188 countries in the UN Human Development Index (UNDP 2016). According to the UN Human Rights Council, human rights abuses, indefinite conscription, and a faltering economy have helped make Eritrea one of the largest refugee-producing countries in the world (UNHRC 2015). A peace agreement signed between Eritrea and Ethiopia in July 2018 officially ended hostilities that have been ongoing between the two countries since 1998. The signing of the accord has the potential to ease Eritrea's conscription policy, enabling its population to engage in more productive livelihoods and redirect resources from security operations to development purposes, which may improve food and nutrition security.nges of food production due to limited arable land, water shortages, and frequent droughts. Severe poverty also limits people's ability to buy food (UNICEF 2015).

LIBYA: Since the Arab Spring protests in 2011 and the capture and death of longtime authoritarian ruler Muammar Gaddafi, Libya has faced ongoing conflict between rival groups over control of the country. Conflict and instability have disrupted agricultural production and diminished the supply of food available for sale in markets. Refugees, asylum seekers, and internally displaced people are particularly vulnerable to food insecurity (FAO GIEWS 2017a). Libya's child stunting rate is estimated at 25.3 percent, child wasting at 3.9 percent, and child mortality at 1.3 percent. Although these values are not extremely high, updated data are urgently needed to shed light on how Libya's conflict has affected food security and undernutrition.

SOMALIA: In 2011, Somalia experienced a famine that took the lives of more than 250,000 people (Seal and Bailey 2013), and in 2017 a severe drought again brought the country to the brink of famine (FEWS NET 2017). While the situation has improved in 2018, many still face food insecurity, particularly in the northern and central parts of the country. Herd sizes are smaller than normal owing to last year's drought and will likely take several years to recover, leaving households with insufficient assets for food purchases (FEWS NET 2018b). The prevalence of undernourishment in Somalia for 2015- 2017 is estimated to be 50.6 percent-in other words, half of the population has insufficient access to calories. This is the second-highest undernourishment rate in this report, after that of the Central African Republic. Somalia's child mortality rate, at 13.3 percent, is the highest rate of child mortality among all the countries included in this report.

SOUTH SUDAN: A civil war that began in 2013 has plunged South Sudan into crisis. Large segments of the population have been displaced. Engagement in typical economic activities including food production is severely limited (FEWS NET 2018c). In February 2017, the UN declared that the counties of Leer and Mayendit in Unity State were in the midst of famine (FAO 2017a). As of February 2018, nearly half of the country's population faced crisis-level food insecurity or worse, with the possibility of famine unless humanitarian assistance is forthcoming (FEWS NET 2018c). Nearly 1 in 10 children does not survive to his or her fifth birthday. Child stunting and child wasting are estimated to be 37.6 percent and 28.6 percent, respectively, though updated child nutrition data are necessary.

SYRIAN ARAB REPUBLIC: Since the onset of the Syrian civil war in 2011, food insecurity has been a serious and ongoing concern. As of June 2018, 10.5 million people out of a population of 18 million were considered unable to meet their basic food needs owing to soaring food prices, widespread displacement, disrupted markets and transport systems, damaged agricultural systems, and loss of jobs and livelihoods (USAID 2018b). Furthermore, the Syrian government has been accused of using food blockades as a weapon of war, deliberately exacerbating the situation (Human Appeal 2018). Up-to-date figures on the prevalence of undernourishment, child stunting, and child wasting were not available for this year's GHI.

EXISTING GHI INDICATOR VALUES

Country

Undernourishment
Prevalence of undernourishment
2015-2017 (%)

Child Stunting
Stunting in children under five
2013-2017 (%)

Child Wasting
Wasting in children under five
2013-2017 (%)

Child Mortality
Under-five mortality
2016 (%)

Global Average

12.3

27.9

9.3

4.2

Source: Authors. See Appendix B for a list of data sources. Note: - = not available. *indicates authors' estimates. **The global averages for each indicator are population-weighted averages based on the countries included in this report and differ from the global averages reported elsewhere owing to the inclusion of different countries.

Conclusion About image

Photo: Welthungerhilfe/Imke Lass, 2015; A Yazidi refugee family in Essyan Camp near Dohuk having lunch. Hide

The 2018 GHI reveals that broadly speaking, hunger and undernutrition have fallen since 2000, but progress in many areas has stagnated or even reversed in recent times. At the regional level, this stagnation manifests itself in stalled progress on certain indicators-since 2010 the rate of child wasting in South Asia has increased, and the prevalence of undernourishment in Africa south of the Sahara has increased marginally. Of the countries with moderate, serious, alarming, or extremely alarming hunger levels, 16 have seen no improvement or even experienced a deterioration in hunger levels since 2010.

Countries facing conflict fare particularly poorly owing to disruptions to food and clean water supplies, livelihoods, and health care services, which combine to jeopardize food and nutrition security. In many cases, the conditions precipitate crises of forced migration, and those who are displaced both within and beyond their home countries struggle to properly feed themselves and their families. This is the case in many of the countries that rank the worst according to the GHI, as well as the countries for which there are inadequate data to calculate scores.

Yet there is still hope. Countries that experienced brutal civil wars and extremely alarming hunger levels in the past have seen remarkable reductions in hunger once their situations stabilized. Although there are exceptions, the overall trends in hunger and undernutrition are promising and show improvements over time. The international community is committed to achieving the SDGs, including SDG2, known in short as Zero Hunger. This report highlights the parts of the world where achieving this goal will be most challenging and where acceleration in the reduction of hunger is most critical. For these areas, this much-needed acceleration will require not just diligence in implementing the plans and policies that are currently in place, but increased efforts, innovative thinking, and a commitment to working more deeply and broadly to address the root causes of hunger.

1. The worldwide estimates in this paragraph refer to the 132 countries in this report for which GHI data were available. The indicator estimates may vary from those published by other organizations for the same indicators owing to the inclusion of different countries.

2. Black et al. (2013) estimate that undernutrition causes almost half of all child deaths globally.

3. The 2030 projections are linear projections based on the existing 2000, 2005, 2010, and 2018 GHI scores for each country.

4. The designation of fragile states is based on the World Bank's annual list of fragile situations.

5. Ranked according to 2018 GHI scores. Countries that have identical 2018 scores are given the same ranking (for example, Bulgaria and the Slovak Republic are both ranked 16th). The following countries could not be included because of lack of data: Bahrain, Bhutan, Burundi, Democratic Republic of Congo, Equatorial Guinea, Eritrea, Libya, Moldova, Qatar, Somalia, South Sudan, the Syrian Arab Republic, and Tajikistan.

6. The 15 countries with 2018 GHI scores of less than 5 are not assigned individual ranks, but rather are collectively ranked 1-15. Differences between their scores are minimal.

7. - = Data are not available or not presented. Some countries did not exist in their present borders in the given year or reference period.

8. These 16 countries are the Central African Republic, Comoros, Gambia, Jordan, Lebanon, Madagascar, Malaysia, Mali, Mauritania, Morocco, Nigeria, North Korea, Oman, Sri Lanka, Venezuela, and Yemen. Countries are not included in this trend analysis if their hunger level is still considered low even with an increase since 2010.

9. Child stunting is highlighted here because subnational data for this indicator are available for a wide range of countries and because, unlike child wasting, child stunting is not significantly subject to seasonal variation.

# data[].attributes.attachment_link.title
2018 Global Hunger Index Results - Global, Regional, and National Trends

# data[].attributes.attachment_link.description
About image Photo: Welthungerhilfe/ Stefanie Glinski 2018; People queuing at a food distribution point in Bentiu refugee camp, South Sudan. Eighty percent of all refugees worldwide are displaced for more than 10 years. Hide Note: Rankings cannot be accurately compared with rankings and index scores from previous reports.

# data[].attributes.body
Charity: Water is an organization that provides clean drinking water to people in rural areas who cannot get it easily. It has helped over 8 million people around the world. Charity: Water builds wells, piped systems, and rainwater harvesters, and filters unclean water with biosand filters,

# data[].attributes.body
The World Food Programmer pledge to end food hunger, achieve food security, improve nutrition, and promote sustainable agriculture. They help by providing food and humanitarian assistance to those who urgently need it. They also build the resilience of communities, so they don’t have to help every year.

# data[].attributes.attachment_link.description
The world has made great progress in reducing hunger: There are 216 million fewer hungry people than in 1990-92, despite a 1.9 billion increase in the world's population. But there is still a long way to go, and no one organization can achieve Zero Hunger if it works alone.

# data[].attributes.body
Loaves and Fishes is a soup kitchen in San José that serves over half a million people in the Bay Area each year. It partners with nonprofits to provide food to places such as low-income senior centers, community centers, schools, and afterschool programs. Loaves and Fishes also provides grocery bags filled with nutritious items to over 100 families each month.

# data[].attributes.attachment_link.provider_name
Loaves & Fishes Family Kitchen | San Jose Soup Kitchen | Free Meals to Anyone in Need

# data[].attributes.attachment_link.title
Loaves & Fishes Family Kitchen | San Jose Soup Kitchen | Free Meals to Anyone in Need

# data[].attributes.attachment_link.description
Soup kitchen located in San Jose, California providing free, hot, nutritious meals across Santa Clara County along with grocery bags and food assistance programs.

# data[].attributes.body
According to the University of Arizona, the five countries that have the least amount of water are Yemen, Libya, Jordan, The Western Sahara, and Dijibouti.

# data[].attributes.attachment_link.title
Five Countries with the Greatest Water Scarcity Issues | UA

# data[].attributes.attachment_link.description
In the U.S., people are lucky enough to consider water as an amenity. It comes out of faucets without a second thought.

# data[].attributes.body
The Thirst Project educates young students about the global water crisis. They tell people about how providing a community with clean water drops disease and child mortality rates by up to 90%, makes it easier to manage and treat HIV/AIDS, and makes it easier for children to go to school.

# data[].attributes.attachment_link.readable_text
Our mission is simple: Build a socially-conscious generation of young people who END the global water crisis. We do this by educating students about it and activating them to rock the clean water cause & build real water projects all over the world. Why Water? Health and Sanitation: Waterborne diseases kill more children every single year than AIDS, Malaria, and all world violence combined. Small children typically do not have strong enough immune systems to fight diseases like cholera, dysentery, or schistosomiasis.

By providing a community with safe drinking water, disease rates can drop by up to 88% virtually overnight! Child mortality rates can drop up to 90%- overnight! Clean water also plays an incredibly critical role in effectively treating and managing HIV/AIDS in rural communities. Swaziland, for example, has the single-highest-density population of HIV/AIDS in the world. For a person with HIV/AIDS, even if you have access to medical treatment or antiretroviral medication, but are still forced to drink dirty water from contaminated sources, the diseases in the water you drink will actually kill you faster than AIDS itself.

Women and children spend on average six to eight hours each day walking to fetch water. The average distance that women and children in developing communities walk to fetch water is 3.75 miles. The time children spend collecting water keeps them from going to school and getting an education.

The amount that disease rates can drop virtually overnight by providing safe drinking water.

Agriculture accounts for 70% of all water consumption worldwide.

Women, young and old, spend hours every day collecting water from sources that are typically polluted. Carrying a jerry can that weighs 44 pounds 3.75 miles is incredibly physically demanding. We've documented countless womens' health issues as a result of hauling water. Women experience chronic fatigue and dehydration while walking for water. Pregnant women can suffer spontaneous miscarriages because of the physical demand of collecting water. The time spent and the physical toll it takes on women to collect water keeps women from better employment opportunities to provide for their families. With close, safe drinking water, women can provide a second income for their families, and contribute to economic development in their community.

Worldwide, agriculture accounts for 70% of all water consumption. Crops and livestock must have water to grow. When a community has a close, safe water source, locally-grown food provides for a sustainable food source.

Why Students? We believe that students are THE most powerful agents for social change in the world! No other group activates like students do. Since we began educating our peers about the global water crisis in 2008, the response and initiative of students to take action on this issue has been AMAZING! We know that STUDENTS will change the world! Students are not afraid to dream, and we are only limited by what society tells us. Over half of the United States is enrolled in some type of schooling. Imagine if every single student responded and activated around the global water crisis.

When a student gains perspective on an issue as big as the global water crisis, amazing things happen! In just six years we have spoken to over 300,000 students, and STUDENTS have been the driving force in helping us raise over 8 million dollars, giving clean water to 13 different countries and over 280,000 people!

Together, this generation, everyone alive today WILL be the ones to end this. WE will be the ones to push the water crisis into the history books. We invite you to learn more here and join us.

Carrying a jerry can that weighs 44 pounds over 3.75 miles is incredibly physically demanding.

# data[].attributes.attachment_link.description
Our mission is simple: Build a socially-conscious generation of young people who END the global water crisis. We do this by educating students about it and activating them to rock the clean water cause & build real water projects all over the world. Why Water?

# data[].attributes.body
Tintoretto, Jacopo. The Miracle of the Loaves and Fishes. 1545-1550, oil on canvas, Metropolitan Mueseum of Art, New York, United States