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Millions of people in East Africa are experiencing chronic hunger and the threat of famine. Conflict, recurring severe drought, and high food prices are to blame. In addition, more than 800,000 people fled their homes due to violence in south Ethiopia in the first half of 2018.

Much of the region experienced some respite near the end of 2018 and has a somewhat positive early-2019 outlook, thanks in part to humanitarian aid efforts. But South Sudan is facing high levels of food insecurity in various parts of the country over the next few months. More than 22 million people in East Africa need help to secure their livelihoods and acquire adequate food.

The Famine Early Warning Systems Network predicts that below-average seasonal rainfall will cause an increase in food insecurity again in early 2019. Recurring East Africa droughts make it difficult for farmers and herders to produce crops and feed livestock. Children are the worst affected, with their health and development drastically impacted. World Vision staff in the region say about 14 million children in Ethiopia, Kenya, South Sudan, and Somalia are struggling to get enough to eat.

Brief history of hunger and famine in Africa

A look back at some of Africa's major food crises shows conditions still faced by many Africans today: poverty, drought, conflict, and environmental degradation due to overgrazing, deforestation, and other types of environmental damages.

1968 to 1980s - A drought in the Sahel region led to 1 million deaths in Mali, Chad, Niger, Mauritania, and Burkina Faso.

1980 to 1981 - Drought and conflict led to widespread hunger in Uganda.

1984 to 1985 - Famine in Ethiopia. Drought in the northern highlands and problems delivering aid led to approximately 1 million deaths and massive displacements.

1991 to 1992 - The Somalia famine was caused by drought and civil war.

1998 to 2004 - During the Second Congo War, more than 3 million people died in the Democratic Republic of the Congo, mainly from starvation and disease.

2011 to 2012 - The Horn of Africa hunger crisis was responsible for 285,000 deaths in East Africa.

2015 to 2016 - A strong El Niño affected almost all of East and Southern Africa, causing food insecurity for more than 50 million people.

2017 - 25 million people, including 15 million children, need humanitarian assistance in East Africa. In September, inter-communal conflict in Ethiopia leads to more than 800,000 people being displaced internally.

2018 - From February to May, torrential rains in East Africa caused floods that killed people, livestock, and crops, and washed away roads and bridges making it hard to deliver aid. In June, rain brought some relief to dry pastures and cropland. But the height of the lean season brought severe food shortages for many.

2019 - The regional outlook through May is positive, overall. But forecasts for war-rattled South Sudan show easing food insecurity in some areas and increased needs in others.

FAQs: What you need to know about the East Africa hunger crisis

Explore frequently asked questions about the East Africa hunger crisis, and learn how you can help hungry children and families:

Fast facts: East Africa hunger crisis

Recurring failed rainy seasons have made it impossible for many East African farmers and herders to keep up their livelihoods. Flash floods during the 2018 rainy season are increasing humanitarian needs in South Sudan, Ethiopia, Somalia, and Kenya.

6 million people in the East African region are displaced due to conflict and drought, making them dependent on aid to meet their needs.

Communicable diseases threaten the lives of children. More than 131,000 cases of acute watery diarrhea or cholera were reported in Ethiopia, Somalia, and Kenya during 2017, according to the World Health Organization. Measles outbreaks in Ethiopia and Somalia affected more than 24,000 children.

Conflict, hunger, poverty, and displacement create a climate in which children are at risk of violence and exploitation.

Help is necessary to keep the Africa hunger and food crises from worsening. Children, especially those younger than 5, are the most vulnerable because they need critical nutrients to build strength and immunity against disease.

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East Africa food insecurity map

While decreasing in some areas, serious food insecurity will be a concern in East Africa in early 2019, according to the Famine Early Warning Systems Network (FEWS NET).
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Why are people in Africa facing chronic hunger?

Recurring drought, conflict, and instability have led to severe food shortages. Many countries have struggled with extreme poverty for decades, so they lack government and community support systems to help their struggling families.

A compressed cycle of recurring drought is plunging the same communities into drought again before they have a chance to recover sufficiently from the last one.

In South Sudan, where people fled their homes because of violence, few farmers have been able to harvest a crop. This limits what is available at community markets and raises food prices. In addition, during the rainy season, 60 percent of the country is inaccessible by roads, which limits transportation of food aid as well as goods sent to market.

From March through May 2018, long rains were 150 to 200 percent above normal in some East Africa locations. This brought some relief to herders as livestock benefit from renewed grasslands. However, in many places flash floods and overflowing rivers wiped out crops, roads, and bridges, thwarting both cultivation and relief activities.

In such conditions, poor families can't afford enough food to keep their children healthy, and eventually, they need emergency help from government agencies or aid groups when they run out of money and food. We're not talking low funds or food that's been in our pantry that's well past its expiration. We're talking about not having any money or any food at all - nothing.

The longer these factors persist, the harder it is for families to stave off the effects of lost livelihoods and homes.
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I hear the word famine a lot, but how do you define famine?

The word famine means an extreme scarcity of food. But it's more than that - it's the absolute worst-case scenario for a food crisis and has a technical definition used by the humanitarian community.

Keep in mind that not all food crises become famines. A food crisis becomes a famine when there's so little food in the region that it causes large-scale starvation, malnutrition, and death.

South Sudan declared famine in February 2017 in two counties in Unity state with a population of about 100,000. By July, enough aid had reached the area so that famine conditions had ended.

To declare a famine, the following three things must all happen:

At least 20 percent of households in a given area face extreme food shortages with limited ability to cope.

More than 30 percent of children suffer from acute malnutrition.

Hunger causes more than two deaths each day for every 10,000 people.

When a food crisis no longer meets these technical criteria, a famine is no longer in effect.
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Why does it seem like there's always a hunger crisis in Africa?

Drought, poor harvests, and instability create a cycle that's extremely difficult to break. And this happens in other regions of the world too.

When instability persists because of conflict or political problems, people flee their homes or are unable to plant their crops. Then less food gets harvested. Prices go up. Families' livelihood prospects dwindle as markets close. Violent conflict makes situations worse because humanitarian groups often cannot access affected communities to bring emergency relief.

Droughts have become more frequent and intense in recent years in western, eastern, and southern Africa. These droughts affect food-production systems in fragile contexts in similar ways that conflict does. Less food and water also means vast numbers of dead livestock in affected areas. This devastates families' source of income and food.

And when nearly 40 percent of children in sub-Saharan Africa grow up stunted due to chronic malnutrition, they lack the capacity to learn and contribute to society. It's because their little bodies don't get enough of the right nutrients at the right times to support physical and intellectual growth. Thus, their countries lose out on significant leadership and innovative potential, which perpetuates the cycle of poverty and deprivation.
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What is malnutrition?

Malnutrition refers to an unhealthy condition that develops when your body does not get enough of the vitamins, minerals, and other nutrients it needs to function properly. It can occur when you don't eat enough food or you aren't eating enough healthy food.

When food crises happen, some children are malnourished for long periods. This leads to stunting (being underweight for their age). Children who were already growing poorly when the food crisis began now risk becoming permanently stunted (being short for their age).

Those who are most at risk experience severe acute malnutrition, known as severe wasting. This means their bodies are beginning to lose the ability to absorb vital nutrients. So they're literally starving to death. And they're nine times more likely to die than a well-nourished child.

Malnourished children don't just need more food. They need nutrient-rich food treatment, called ready-to-use therapeutic food (RUTF).

Medical workers often measure a child's mid-upper arm circumference to gauge the level of malnutrition the child is experiencing. That's why you may see photos of people wrapping a band with green, yellow, and red sections around a malnourished child's tiny upper arm. Green indicates the child is not malnourished. Yellow indicates malnourishment. Red indicates severe malnourishment and risk of death.

Malnutrition is the cause or a contributing factor to 45 percent of deaths among children younger than 5 globally, according to the World Health Organization.
Read more on the BACK TO QUESTIONS tragic, long-term effects of malnutrition.
How is World Vision responding to the East Africa hunger and food crisis?

For more than 40 years, World Vision has brought emergency aid and long-term assistance to families and communities in East Africa. Here are some of the ways we help to overcome the root causes of hunger and malnutrition in Africa:

Food assistance, including emergency feeding and cash

Diagnosis and treatment of childhood malnutrition

Water and sanitation to prevent water-related diseases and provide water for irrigation

Support for improved, more efficient agriculture and for farmers to diversify livelihoods

Land rehabilitation to improve harvests

Between October 2017 and September 2018, World Vision staff in the region were able to reach more than 2.7 million people in Ethiopia, Kenya, Somalia, and South Sudan. Interventions include life-saving food, clean water and sanitation services, medical assistance, livelihood skills training, educational programs, other essential relief supplies, and child-protection activities and programs.
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Funding provided through child sponsorship programs in Kenya and Ethiopia enabled our local staff to intervene to assist communities in 2016 before the crisis intensified. They provided drought-resistant seeds and training for farmers, cash-for-work programs, and other interventions that help families avert crisis or weather it more confidently.

By the time the food crisis became full-fledged, staff in South Sudan and Somalia were already helping communities struggling with food insecurity and malnutrition due to conflict and years of persistent drought.

How can people become resilient so they don't need aid?

There's no substitute for life-saving aid in an emergency. But World Vision also focuses on long-term solutions that build resilience, which allows families and communities to bounce back when crops fail or streams dry up. Livelihood skills training is one aspect of World Vision's current responses that help families find their own way out of a food crisis.
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With long-term development programs in place, hunger crises can often be avoided and families can maintain independence. Here's how World Vision is working today to prevent future food and hunger crises:

Farmers and pastoralists benefit from market development, immunizations for livestock, and training and seeds to grow drought-resistant crops.

Cash aid gives impoverished families the ability to take care of themselves and stimulates local markets.

Saving groups and community banks make loans that help members recover from emergencies.

Building and repairing water and sanitation facilities contribute to healthy living.

New business training, equipment, and materials can help families diversify their income so their assets are not wiped out by drought or adverse weather.

Developing resilience is a generational process. Children who stay in school are better prepared for the challenges and opportunities in their future.

BACK TO QUESTIONS Chris Huber and Kathryn Reid of World Vision's staff in the U.S. contributed to this article.
How can I help hungry children and families in East Africa?

1. Pray for children and families affected by famine and hunger crises in East Africa.

2. Give to our East Africa hunger crisis fund. Your gift will help provide emergency food aid, agricultural support, clean water, medicine, and other essential care to hungry children and families.

3. Sponsor a child. World Vision's sponsorship program is the most powerful way you can help fight poverty at the family and community level. When you sponsor a child, you provide access to life-saving basics like nutritious food, healthcare, clean water, education, and more. You will help change a child's life story and the life of their family and community.

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East Africa hunger, famine: Facts, FAQs, and how to help | World Vision

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Millions of people in East Africa are experiencing chronic hunger and the threat of famine. Conflict, recurring severe drought, and high food prices are to blame. In addition, more than 800,000 people fled their homes due to violence in south Ethiopia in the first half of 2018.

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Not all countries support the fight against hunger because of the cost, but there is ban effort to lower costs by getting rid of unnecessary foods that are provided in the food packages.

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The design of the previous system was flawed in the way that people weren’t always able to reach help due to the distance and dangerous conditions that they might traverse when they embark on a trip.

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A couple of organizations have come together to develop a solution. Their new methods are working and the simplicity is the main reason. Health workers can diagnose issues and problems even if they aren’t able to read. The materials that are used can be interpreted using colors and

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“The way we save hungry children needs an efficiency overhaul.”

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Natural disasters like El Niño cause famine and makes it hard for crops to grow with high temperatures and torrential downpours of rain. Since natural disasters are getting more common the food supply is affected even more. Natural weather events also increase the disease rates causing them to spread faster.

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In underdeveloped countries it’s harder for them to produce the same amounts of food as technologically advanced countries. The methods that can be used to aid crop growth cause unintended damage to the land.

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Over half the hungry people in the world live in conflicted countries. Countries that go through conflict also have a higher chance of becoming undernourished as well. The conflict also prevents some transportation of foods and even destroys resources.

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There are many causes of famine but these four stand out the most

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98-04: The 2nd Congo War caused over 3 million people to die in the Democratic Republic of the Congo from disease and starvation.
11-12:The Horn of Africa hunger crisis killed 285,00 people in East Africa
15-16:El Niño affected a lot of the eastern and southern parts of Africa which caused food insecurity for 50 million plus people.
2017:25 million people, 15 million of them being children, need humanitarian help in Eastern Africa. In that September, inter-communal conflict in Ethiopia leads to over 800,000 people being displaced

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Conflict and drought led to widespread hunger in Uganda. In the years 84-85 a drought in the northern highlands and complications delivering help caused about 1 million deaths. 1991 and 1992 there was famine in Somalia as a result of civil war and drought.

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In 1968 into the 1980s a drought in the region of Sahel caused millions to die in the countries of Mali, Niger, Chad, Mauritania, and Burkina Faso.

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“
A look back at some of Africa’s major food crises shows conditions still faced by many Africans today: poverty, drought, conflict, and environmental degradation due to overgrazing, deforestation, and other types of environmental damages.”
(worldvision.org)

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Due to extreme proverty there are over 226.7 million people starving in Africa most of theses countries are south of the Sahara.

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In addition to the lasting affects of past wars countries are having to deal with the weather occurence known as El Niño. Which causes torrential rains droughts that destroy crops kill livestock and leads to starvation.

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The four crisis areas all are results of armed conflict. In Nigeria it was the war between Boko Haram and the Nigerian army, and in South Sudan, Yemen, and Somalia suffering was caused by their long civil wars.

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“Hunger crises are escalating at several hot spots: in four countries – three in Africa and one in the Middle East – a total of 20 million people, including countless children, are at risk of starvation.”
(sos-usa.org)

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The challenge challenges businesses to start implementing sustainable food systems

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The UN will also be working to minimize the amount of wasted food therefore giving some of the hungry the food that would normally be wasted

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The zero hunger challenge is a plan to hopefully be in full effect by the year 2030.

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United Nations' fight against world hunger

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United Nations' fight against world hunger

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“The United Nations Secretary-General launched the Zero Hunger Challenge in 2012 during the Rio+20 World Conference on Sustainable Development. The Zero Hunger Challenge was launched to inspire a global movement towards a world free from hunger within a generation.”

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The number of undernourished people in the world has been on the rise since 2014, reaching an estimated 821 million in 2017. (The State of Food Security and Nutrition in the World 2018)

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Fixes

Malnutrition kills a million of the world's children a year. To stem that, United Nations agencies and charities are testing a new system for distributing high-nutrition foods more efficiently.

Image

A severely malnourished 11-month-old, whose mother was also malnourished and could not produce breast milk, arrived at a clinic in Aslam, Yemen, and died eight hours later. Credit Credit Tyler Hicks/The New York Times

As Americans gather for our most food-centric holiday, there's some potentially great news about food - especially for people who have very little to eat. It's a new strategy that could save the lives of hundreds of thousands of hungry children every year.

Fifty million children under 5 suffer from acute malnutrition. It's one of the biggest contributors to the nearly one million deaths each year of children under 5. Malnutrition wears down the immune system, so a child can die from a cold. It also can cause permanent physical and cognitive damage to children who survive.

Acute malnutrition is easy to treat with therapeutic food. The best-known of these is Plumpy'Nut, a packet of peanut butter, dried milk, oil and sugar fortified with extra vitamins and calories introduced in 1996. It's very effective for children who get it; one or two packets a day can restore a child to health in a few months. But most children don't get it. "At best, we are providing treatment for 20 percent of children with severe malnutrition," said Victor Aguayo, chief of Unicef's global nutrition program.

Why do we fail children so badly? One reason is we aren't willing to spend the money. Voluntary donations from governments finance the United Nations' food programs. The World Food Program is frequently forced to cut food rations and turn people away. Right now, severe child malnutrition in Africa's Sahel countries is the highest in a decade, but Unicef has only 35 percent of the funds it needs to treat children.

Hunger is rising again after declining for many years. One major cause is climate variability and extremes. The Sahel crisis is due primarily to drought.

But another factor is war. It's especially hard to work in those war and chaos zones where malnutrition is common. Today the most severely malnourished places are Yemen and South Sudan - both entirely man-made crises. The disruption of war means families can't work, can't reach crops and livestock or bring them to market. Health and sanitation systems shut down and workers flee.

But there's a third reason so many children don't get help - really bad design. The World Food Program and Unicef share responsibility for feeding children. "There are two protocols, two institutions, two delivery mechanisms, for one group of children," said David Miliband, the head of the International Rescue Committee, a New York-based agency commonly known as the I.R.C. that works in humanitarian emergencies. "It doesn't make any sense at all." (He lays out the case for change here.)

And the system requires desperate mothers to come to the food every week - which can mean walking for miles through perilous terrain, and then waiting for hours - rather than getting the food to them.

The way we save hungry children needs an efficiency overhaul.

Now it may have one. A group of organizations that feed children, including the I.R.C., Action Against Hunger and the Alliance for International Medical Action, have worked in several countries to test a new system that eliminates the duplication. So far, it works. One reason for success is its simplicity; community health workers can diagnose problems and treat children at home very successfully. Even illiterate health workers can do this, employing materials that use drawings and colors.

O.K., successful pilot experiments happen all the time in the social sector. They almost never lead to widespread change. Even when bureaucracies endorse a new idea, officials often fear change and jealously guard their turf. Many a good idea has been studied to death.

But this time might be different. The World Food Program and Unicef are enthusiastic, to the point of running joint pilot programs to test the idea in West Africa. "We are tremendously supportive," said Lauren Landis, the director of nutrition of the World Food Program. "We believe it's time for a revolution in the way we address acute malnutrition."

Here's how malnourished children have been treated until now: If the child has a complication, such as pneumonia or fever, he or she goes to the hospital. Uncomplicated cases are separated into two categories, severe or moderate. (The test can be a weight/height ratio, the presence of marked water retention in the feet or the circumference of the mid upper arm.)

Unicef treats severe cases, usually giving children Plumpy'Nut packets to take home. The child must come back every week for a checkup and more packets. Children with moderate malnutrition go to a World Food Program feeding center, where they can get food on site and take-home food, often a corn-soy blend, to supplement the family diet.

What could possibly go wrong? You name it.

A large majority of malnourished children can't reach either program. "Mothers have to walk for hours, and even if they get there, the service might not be available," said Mesfin Teklu Tessema, senior director of health for the I.R.C.

When programs do exist, a mother has no idea which one to go to. "The referral between programs doesn't always work," Ms. Landis said. And it's hard to make a weekly trip. "It's common to relapse if the mother is not able to bring the child every week to get the Plumpy'Nut," said Grace Funnell, associate director of nutrition and health at Action Against Hunger.

Since money is short, it is focused on treating severe cases. That means many children get no treatment for malnutrition until they deteriorate to the point where it is severe. This endangers children and creates extra costs, because they might need hospitalization. It also leads to a lot of relapses, because children can, in effect, be cut off treatment once they are only moderately malnourished.

Even this flawed system, though, is far better than what came before, when hospitalization was the only treatment for severe malnutrition. In the past decade or so, the number of children treated each year has more than tripled.

Much of the increase can be attributed to Plumpy'Nut. The product was developed by the French company Nutriset 22 years ago but took about 10 years to reach widespread use. (It must get each government's approval, because technically it's a medicine.)

With Plumpy'Nut, or other similar high-nutrition blends developed since it emerged, a parent can easily treat a child at home. There's nothing to measure or prepare, and it doesn't have to be mixed with water, which is often unsafe to drink.

The other factor is the growing numbers of community health workers, who fight diseases like malaria and tuberculosis effectively and cheaply. But they are still not widespread in every country, and few of them deal with malnutrition - in part because the system is so complex.

The Food Program and Unicef have long been aware of the system's flaws. In 2011, they signed an agreement laying out a division of their labor. "We thought at that time we were clarifying roles and responsibilities," Ms. Landis said. "But as we've gone on, we felt it wasn't a problem of clarifying. It was more a need to combine more closely, so children don't fall through the cracks."

The dual system arose because the Food Program historically has run feeding centers for people of all ages, and one of Unicef's missions is to train health care workers. So hospitalized children fell under Unicef's umbrella.

But severe and moderate acute malnutrition aren't two different illnesses, like colds and pneumonia. The line between them is arbitrary. So why not treat them the same way?

The I.R.C. and Action Against Hunger are now analyzing the results of a randomized control trial in Kenya and South Sudan that employed a new strategy. It simplifies the diagnosis and treats both degrees of malnutrition with Plumpy'Nut at home. The study also looks at the longer-term effects of the treatment and at cost savings.

Ms. Landis said the cost savings would come largely from switching to a single therapeutic food. "Since that's the largest component of the cost of treatment, we could really save money," she said. "If we have one pipeline to buy everything, we can optimize the supply chain. And if there's one thing we know, it's a supply chain."

A single, simplified protocol would enable a child to be treated wherever a mother brought him or her. The program becomes easier to manage and can cover more children. And if it's simple enough for community health workers to use, they can find many more children, catch malnutrition earlier and reduce missed doses.

Mr. Miliband said that the Food Program, Unicefand the World Health Organization should endorse further pilot programs, support shifting as much nutrition work as possible to community health workers,and then, presuming all goes well, make this the new global system.

"In principle, they are broadly sympathetic," he said.

Only that?

"That might be typical British understatement," he said. "Now it's a matter of turning good will into action."

"Everything we see is promising," Unicef's Dr. Aguayo said. "But we're trying to go as fast as possible, but not faster, in the greatest interest of children's rights."

One reason for further testing, Dr. Aguayo said, was to find out how best to ensure that the most severely ill children get help in a system that treats severe and moderate alike. "We will still have limited resources," he said. "We need to prioritize the children with the greatest risk. I'm sure that we can."

Jeanette Bailey, the International Rescue Committee's senior technical adviser for nutrition and the leader of the just-concluded study, agreed that more pilots can test different ways to solve operational problems. But don't take too long, she cautioned. "If millions of adults were dying of Ebola, there would be outrage," she said. "Malnutrition kills the youngest among us in a very slow way. It's been about a decade that we're not getting past 20 percent coverage. We can't keep letting generations of children slip through our fingers."

Tina Rosenberg won a Pulitzer Prize for her book "The Haunted Land: Facing Europe's Ghosts After Communism." She is a former editorial writer for The Times and the author, most recently, of " Join the Club: How Peer Pressure Can Transform the World" and the World War II spy story e-book" D for Deception."
To receive email alerts for Fixes columns, sign up Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram. here.

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Opinion | For Starving Children, a Bite of Hope

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Fixes Malnutrition kills a million of the world's children a year. To stem that, United Nations agencies and charities are testing a new system for distributing high-nutrition foods more efficiently. As Americans gather for our most food-centric holiday, there's some potentially great news about food - especially for people who have very little to eat.

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Children are the most visible victims of undernutrition. It is estimated that undernutrition-including stunting, wasting, deficiencies of vitamin A and zinc, and fetal growth restriction (when a baby does not grow to its normal weight before birth)-is a cause of 3·1 million child deaths annually or 45 percent of all child deaths in 2011 (UNICEF, World Health Organization [WHO], & The World Bank, 2018). Undernutrition magnifies the effect of every disease, including measles and malaria. The estimated proportions of deaths in which undernutrition is an underlying cause are roughly similar for diarrhea (61%), malaria (57%), pneumonia (52%), and measles (45%) (Black 2003, Bryce 2005). Undernutrition can also be caused by diseases, such as those that cause diarrhea, by reducing the body's ability to convert food into usable nutrients.

From GAIN. https://www.gainhealth.org
Stunting

Globally 150 million under-five-year olds were estimated to be stunted in 2017. (UNICEF, WHO, & The World Bank, 2018).

The global trend in stunting prevalence and numbers affected is decreasing. Between 2000 and 2017 stunting prevalence declined from 33 percent to 22 percent and numbers declined from 198 million to 150 million (UNICEF, WHO, & The World Bank, 2018).

In 2017, about half of all stunted children under five years of age lived in Asia and over one-third in Africa (UNICEF, WHO, & The World Bank, 2018).

Wasting and severe wasting

Globally, 50.5 million under-five-year olds were wasted (or low weight for height) in 2017 (UNICEF, WHO, & The World Bank, 2018).

Globally, wasting prevalence in 2017 was estimated at almost 8 percent (UNICEF, WHO, & The World Bank, 2018).

Approximately two-thirds of all wasted children under five years old lived in Asia and over one-quarter in Africa, with similar proportions for severely wasted children (UNICEF, WHO, & The World Bank, 2018).

Take a three-question hunger quiz on this section
Quite a few trace elements or micronutrients-vitamins and minerals-are important for health. Three very important micronutrient deficiencies in terms of health consequences for people in lower-middle-income countries are:
Iron

In many lower-middle-income countries, iron deficiency anemia is aggravated by worm infections, malaria and other infectious diseases such as HIV and tuberculosis.

The major health consequences include poor pregnancy outcome, impaired physical and cognitive development, increased risk of morbidity (illness) in children and reduced work productivity in adults. Anemia contributes to 20 percent of all maternal deaths (FAO, 2017).

Vitamin A

Vitamin A deficiency can cause night blindness and reduce the body's resistance to disease. In children, vitamin A deficiency can also impair growth.

An estimated 250 million preschool children are vitamin A deficient. An estimated 250,000 to 500,000 vitamin A-deficient children become blind every year, half of them dying within 12 months of losing their sight (FAO, 2017).

Iodine

Iodine deficiency is one of the main cause of impaired cognitive development in children, especially in iodine-deficient areas of Africa and Asia. About 38 million babies are born with iodine deficiency (FAO, 2017).

Iodine deficiency has a simple solution: iodized salt. Thanks to this intervention, the number of countries where iodine deficiency is a public health problem has been halved over the past decade. However, 54 countries still have a serious iodine deficiency problem. (WHO)

The world produces enough food to feed everyone. For the world as a whole, per capita caloric availability and food diversity (the variety of food groups in a diet) have increased between the 1960s and 2011 (FAO, 2017). This growth in food availability, along with improved access to food, helped reduce the percentage of chronically undernourished people in lower-middle-income countries from about 30 percent in the 1990-92 to about 13 percent two decades later (FAO, 2017). A principal problem is that many people in the world still do not have sufficient income to purchase (or land to grow) enough food or access nutritious food. This is an element of "food security". The FAO defines four dimensions of food security, all of which must be fulfilled simultaneously, for food security to exist. The four dimensions are: 1) physical availability of food, 2) economic and physical access to food, 3) food utilization, and 4) the stability of those other dimensions over time.

Poverty is the principal cause of hunger. The causes of poverty include lack of resources, unequal income distribution in the world and within specific countries, conflict and hunger itself. As of 2013, when the most recent comprehensive data on global poverty was collected, about 767 million people are living below the international poverty line of less than $1.90 per person per day (The World Bank, 2016). This was a decrease of about 1 billion people below the poverty line from 1990 (The World Bank, 2016). However, although the number of people living in extreme poverty globally has been declining, in lower-middle-income regions, such as sub-Saharan Africa, the number is actually growing (FAO, 2017).

Hunger is also a cause of poverty, and thus of hunger, in a cyclical relationship. By causing poor health, small body size, low levels of energy and reductions in mental functioning, hunger can lead to even greater poverty by reducing people's ability to work and learn, thus leading to even greater hunger. See Victoria et al. 2008.

Conflict. More than half (489 million) of the 815 million hungry people in the world live in countries affected by conflict (FAO et al., 2017). Ranging from non-state and state-based violence to one-sided violence, some of the conflicts that result in internal or international displacement have occurred in Syria, Yemen, Somalia, the Democratic Republic of the Congo and Myanmar, among many other countries throughout the world. In addition, most of the 19 countries listed by FAO as countries in complex, prolonged conflict are located in Africa (FAO et al., 2017).

In 2016, the average prevalence of undernourishment in countries undergoing conflict was about four percentage points greater than the prevalence in non-conflict countries (FAO et al., 2017). About 75 percent of children in the world who are stunted live in conflict areas (FAO et al., 2017).

Conflict in rural areas interferes with food and agriculture production, when transportation or market infrastructure are affected, land is seized or resources are destroyed, or the violence forces displacement from home (FAO, 2017). In addition to impacting food systems, conflict can also impact the economy, driving up food prices and making it difficult to buy necessary foods (FAO et al., 2017). In areas of severe violence, it may be difficult to deliver humanitarian assistance to address undernutrition (FAO, World Food Programme [WFP], & European Union [EU], 2018).

Source: FAO, WFP, & EU, 2018

Political instability. In countries facing political instability, the resulting decline of the economy reduces the value of the country's currency, leading to higher food prices and less nutritious food available for purchase (FAO, WFP, & EU, 2018). The loss of jobs in a declining economy also impacts people's ability to afford food, as income declines as well (FAO, WFP, & EU, 2018). Countries like the Democratic Republic of Congo, South Sudan, Yemen and Venezuela are examples of countries in which political instability is currently affecting food security (FAO, WFP, & EU, 2018).

Food and agricultural policy. A lack of adoption of more productive technologies for agriculture in lower-middle-income countries contributes to large differences in amount of crops produced when compared with upper income countries (FAO, 2017). Within regions, the gap between potential crop yield and actual crop yield can be as large as 76 percent, as seen in Sub-Saharan Africa (FAO, 2017).

Also, past agricultural practices implemented to increase crop yield have unintended consequences in the form of land and soil degradation, and using up or polluting the available groundwater (FAO, 2017). This then affects future capacity for food production, as these resources have been permanently depleted (FAO, 2017). However, more countries are beginning to adopt "conservation agriculture," where various strategies are used to prevent the rapid depletion of scarce natural resources (FAO, 2017).

Climate change. Throughout the previous 30 years, natural disasters have become increasingly common (FAO, 2017). Unstable weather patterns can lead to drought - in 2016, El Niño was responsible for conditions of severe food insecurity for 20 million people (FAO, WFP, & EU, 2018). On the other extreme, hurricane and cyclone seasons have produced more powerful storms, causing damage to livelihoods, agricultural production and local market prices, in countries in the Caribbean and Asia (FAO, 2017). In agricultural-driven areas, especially in parts of Africa (Somalia, southeastern Ethiopia, and countries in West Africa), drought has driven economic, food production and political stability crises (FAO, WFP, & EU, 2018). For countries facing prolonged conditions or yearly disasters, undernutrition worsens, as there is little time for recovery (FAO, 2017).

The ecological impacts of climate change can affect the emergence or re-emergence of diseases on a larger scale, especially those with vectors (like mosquitoes and fleas) that thrive in warm humid environments (FAO, 2017). Disease caused by these vectors can prolong the cycle of malnutrition (FAO, 2017).

Source: FAO, WFP, & EU, 2018
Revised May 25, 2018, with the assistance of Crystal Lam, George Washington University, MPH candidate
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World Hunger, Poverty Facts, Statistics 2018 - World Hunger News

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Children are the most visible victims of undernutrition. It is estimated that undernutrition-including stunting, wasting, deficiencies of vitamin A and zinc, and fetal growth restriction (when a baby does not grow to its normal weight before birth)-is a cause of 3·1 million child deaths annually or 45 percent of all child deaths in 2011 (UNICEF, World Health Organization [WHO], & The World Bank, 2018).

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In addition, people in many African countries have recently been suffering from the effects of the weather phenomenon El Niño: droughts or torrential rains destroy crops, kill cattle and lead to starvation. In 2017, 37 countries, including 28 in Africa, depended on food aid, according to the Food and Agriculture Organization of the United Nations (FAO).

These countries are: Afghanistan, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Djibouti, DR Congo [or Democratic Republic of the Congo], Eritrea, Ethiopia, Guinea, Haiti, Iraq, Kenya, Lesotho, Liberia, Libya, Madagascar, Malawi, Mali, Mauritania, Mozambique, Myanmar, Niger, Nigeria, North Korea, Pakistan, Sierra Leone, Somalia, South Sudan, Sudan, Swaziland, Syria, Uganda, Yemen and Zimbabwe.

But the United Nations lacks the money to provide much-needed aid to millions of hungry people: donations promised by the international community have not yet been made.

FAMINE AND CHRONIC HUNGER

Famines are acute food crises, usually after drought or due to armed conflict. Famine is the worst form of food shortage. In addition to old people, babies and small children are especially threatened by starvation. According to the United Nations definition (Integrated Food Security Phase Classification), there is a famine if at least:

One of the worst hunger crises of the past 25 years was the famine in East Africa in 2011/12. In war-torn Somalia, 260,000 people starved to death, including 133,000 children under the age of five.

Sub-Saharan Africa is also a hotbed of chronic hunger due to extreme poverty. According to the FAO definition, people suffer from chronic hunger if their daily energy intake for an extended period of time is below what they would need for a healthy and active life. The lower limit is an average of 1,800 calories per day. According to this measure, 226.7 million people are starving in Africa. The countries most affected by extreme

poverty and hunger in Africa are mainly those located south of the Sahara. One in four people suffers from hunger there - which means that the share of the world's hungry is highest in sub-Saharan Africa.

In the sub-Saharan region, 40% to 50% of people live below the poverty line, meaning they have a daily income that is on average below $1.25. This means that sub-Saharan Africa, along with southern Asia, is one of the poorest regions in the world.

MALNUTRITION AND HIGH INFANT MORTALITY

Children are particularly affected by the hunger crisis in Africa. There are far too many starving kids in Africa, every single affected kid is one too much. Malnutrition leads to physical and mental development delays and disorders and is a major cause of high infant mortality rates in sub-Saharan Africa.

According to UN data, 165 million children worldwide are too small for their age, or stunted, due to chronic malnutrition. Three quarters of these children live in sub-Saharan Africa and South Asia. In sub-Saharan Africa, 40% of children are affected; in South Asia, 39%.

Worldwide, nearly every second death in children under the age of five is due to malnutrition. As this weakens the immune system, diseases such as pneumonia, malaria or diarrhea often lead to death.

The sub-Saharan child mortality rate is one of the highest in the world, with one in nine children dying before the age of 5. In Sierra Leone, one in every six children dies before the age of 5. Especially young children die in Nigeria and the Democratic Republic of the Congo.

HUNGER AND FOOD SCARCENESS IN AFRICA HAS MANY CAUSES

The reasons for the widespread hunger and food scarceness in Africa are complex and are not, as often assumed, a lack of agricultural productivity or difficult climatic conditions. Sub-Saharan Africa has millions of hectares of fertile soil. The African continent could feed itself. However, several factors prevent self-sufficiency and a victory in the fight against hunger in Africa:

Debt trap and mismanagement: The high level of indebtedness of many African countries as well as poor governance and corruption is blocking economic development. Mass poverty and hunger are the consequences.

Armed conflicts: Africa has more than its share of trouble spots. Most wars in the world rage south of the Sahara. Refugee misery and hunger are the companions.

FIGHT AGAINST HUNGER AND FOOD SCARCENESS IN AFRICA - UN MILLENNIUM GOAL NARROWLY MISSED

In 2000, the 55th UN General Assembly, the Millennium Summit, took place in New York. On September 9, 2000, the 189 UN member states adopted a declaration with the UN Millennium Development Goals that the proportion of malnourished people should be halved by 2015. T his goal was narrowly missed. One in eight people in developing regions is starving today (12.9% in 2014-2016). This is due in particular to the fact that the population is growing strongly in sub-Saharan African countries.

The fight against hunger and famine remains one of the biggest challenges facing the world community. By 2030, the United Nations wants to end hunger. This was enshrined in the Sustainable Development Goals (SDGs), which the UN adopted in 2015 as a follow-up to the Millennium Development Goals.

SUCCESSES AND REGRESSION IN THE FIGHT AGAINST HUNGER AND FAMINE IN AFRICA

Efforts to counteract hunger and food scarceness in Africa have been marked by significant successes, but also by devastating setbacks. The most important achievements include:

Greater political stability in countries formerly experiencing civil war

Economic growth of the sub-Saharan region

Progress in the fight against HIV/AIDS and malaria

Reduction in the infant mortality rate

Decreases in the fight against hunger and famine in Africa include:

Crop failure due to climate change and environmental degradation

Rising food prices and food speculation worldwide

Humanitarian crises due to armed conflicts in northern Mali, northern Nigeria and South Sudan

SOS CHILDREN'S VILLAGES HELPS THE HUNGRY IN AFRICA

SOS Children's Villages is active in 46 African countries. A total of 147 SOS villages in Africa prived homes for orphaned and abandoned children who would otherwise be in acute danger of starvation and malnutrition. In the fight against hunger in Africa, SOS is also involved in long-term development projects and humanitarian aid:

Family strengthening programs: SOS Children's Villages helps starving and food-insecure families by pairing short-term aid (food, access to medical care, school supplies for children) with long-term support and guidance on income generation, childrearing, and financial and household management.

Emergency aid: SOS Children's Villages currently provides emergency relief for hunger crises and famine in Somalia, Nigeria, South Sudan, Ethiopia and Malawi. Other examples of recent SOS emergency actions are 2005 and 2010 in Niger, 2011-2012 in East Africa and 2012 in the Sahel region.

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Hunger in Africa: facts, causes, consequences

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Hunger, famine, disease, wars: children in Africa suffer especially. SOS Children's Villages USA provides orphans and abandoned children in Africa with a family environment, quality education and healthcare - sponsor a child today!