Undernourishment around the world

Depth of hunger: how hungry are the hungry?

Meaningful action to end hunger requires knowledge of not just the number of hungry people around the world but also of the depth of their hunger.

Average food deficit of the undernourished

Knowing the number of kilocalories missing from the diets of undernourished people helps round out the picture of food deprivation in a country. Where the undernourished lack 400 kilocalories a day, the situation is more dire than in a country where the average shortage is 100 kilocalories. The greater the deficit, the greater the susceptibility to nutrition-related health risks. A weak, sickly person cannot fulfil his or her individual potential. A nation of weak, sickly people cannot advance.

The state of food insecurity in the world regularly reports on the latest estimates of the number and prevalence of chronically hungry people (see pages 8-9). This year the report goes one step further, calculating the food deficit of hungry people. This measurement indicates how deeply the dietary energy intake of undernourished people falls short of their minimum needs.

Improving the quantity and quality of diets: an example from China

When dietary intake is adequate, the variety of foods is generally greater, providing more energy and better nutrition.

Source: National Survey of Income and Expenditure of Urban Households, Government of China, 1990

The depth of hunger, or food deficit, is measured by comparing the average amount of dietary energy that undernourished people get from the foods they eat with the minimum amount of dietary energy they need to maintain body weight and undertake light activity. (See box on page11 for more details.)

The diets of most of the 800 million chronically hungry people lack 100-400 kilocalories per day. Most of these people are not dying of starvation. Often they are thin but not emaciated. The presence of chronic hunger is not always apparent because the body compensates for an inadequate diet by slowing down physical activity and, in the case of children, growth. In addition to increasing susceptibility to disease, chronic hunger means that children may be listless and unable to concentrate in school, mothers may give birth to underweight babies and adults may lack the energy to fulfil their potential.

In terms of sheer numbers, there are more chronically hungry people in Asia and the Pacific, but the depth of hunger is clearly the greatest in sub-Saharan Africa. There, in 46 percent of the countries, the undernourished have an average deficit of more than 300 kilocalories per person per day. By contrast, in only 16 percent of the countries in Asia and the Pacific do the undernourished suffer from average food deficits this high.

Where the average kilocalorie deficit is very high, many people's diets are deficient in everything, including the starchy staple foods (carbohydrate-rich maize, potatoes, rice, wheat and cassava) that provide mostly energy. But where the deficit is more moderate, people generally get enough of the staple foods. What they often lack is a variety of other foods that make up a nutrititious diet: legumes, meat, fish, oils, dairy products, vegetables and fruit that provide protein, fat and micronutrients as well as energy. Rounding out their diets is crucial to food security.

Lack of cash income is one of the most important factors hindering both urban and rural people from obtaining the diverse foods needed for an adequate diet. Even when poor rural families are helped to produce a greater variety of foods on their household plots, they will often sell these items rather than consume them because of their high market value. Thus, their food security improves only when overall household income rises to a level that permits them to afford the other foods they need.

Falling short
The depth of hunger is measured by the average dietary energy deficit of undernourished people - not of the population as a whole - expressed in kilocalories per person per day. The higher the number, the deeper the hunger.		Near East and North Africa	kcal
		Afghanistan	480	Countries in transition	kcal
		Yemen	290	Tajikistan	250
		Iraq	210	Azerbaijan	240
		Morocco	210	Kyrgyzstan	230
		Algeria	190	Bulgaria	220
		Egypt	190	Armenia	210
		Iran	190	Georgia	210
		Kuwait	180	Moldova Rep	210
		Jordan	170	Bosnia and Herzegovina	190
		Turkey	170	Turkmenistan	190
Asia and Pacific	kcal	Lebanon	160	Croatia	180
Bangladesh	340	Syria	160	Estonia	180
Korea DPR	340	Saudi Arabia	150	Uzbekistan	180
Mongolia	310	United Arab Emirates	140	FYR Macedonia	170
India	290	Libya	130	Russian Fed	170
Lao PDR	280	Tunisia	130	Kazakhstan	160
Viet Nam	280			Slovakia	160
Cambodia	270	Sub-Saharan Africa	kcal	Ukraine	160
Pakistan	270	Somalia	490	Albania	150
Philippines	270	Mozambique	420	Latvia	150
Nepal	260	Burundi	410	Slovenia	150
Papua New Guinea	260	Liberia	390	Yugoslavia**	150
Sri Lanka	260	Congo, Dem Rep	380	Hungary	140
Thailand	260	Sierra Leone	380	Lithuania	140
China*	250	Eritrea	370	Belarus	130
Indonesia	200	Niger	350	Czech Rep	130
Myanmar	200	Ethiopia	340	Poland	130
China, Hong Kong SAR	140	Zambia	340	Romania	130
Malaysia	140	Zimbabwe	340
Korea, Rep	130	Chad	330	Developed countries	kcal
		Rwanda	330	South Africa	160
Latin America and Caribbean	kcal	Angola	320	Sweden	150
Haiti	460	Guinea	320	Finland	140
Nicaragua	300	Central African Rep	310	Greece	140
Honduras	270	Madagascar	310	Italy	140
Brazil	250	Malawi	310	Netherlands	140
Dominican Rep	250	Tanzania	300	Switzerland	140
Guatemala	250	Burkina Faso	290	United States	140
Peru	240	Congo, Rep	290	Australia	130
Bolivia	230	Kenya	290	Austria	130
Guyana	230	Mali	290	Belgium	130
Panama	230	Lesotho	280	Canada	130
Trinidad and Tobago	230	Uganda	280	Denmark	130
Colombia	220	Cameroon	260	France	130
Paraguay	220	Namibia	260	Germany	130
Cuba	210	Togo	260	Iceland	130
Mexico	210	Botswana	240	Ireland	130
Venezuela	210	Gambia	240	Japan	130
El Salvador	200	Mauritania	240	Luxembourg	130
Jamaica	200	Senegal	240	New Zealand	130
Suriname	190	Sudan	240	Norway	130
Costa Rica	160	Côte d'Ivoire	230	Spain	130
Ecuador	160	Benin	220	United Kingdom	130
Chile	150	Ghana	210	Israel	120
Uruguay	150	Nigeria	210	Malta	120
Argentina	140	Swaziland	210	Portugal	110
		Mauritius	180	* Includes Taiwan Province of China ** Serbia and Montenegro
		Gabon	160

Estimates and projections of hunger

Latest estimates indicate that 826 million people remained undernourished in 1996-98: 792 million people in the developing world and 34 million in the developed world. These figures represent no change from 1995-97, the previous reporting period. Information shown in the charts and figures reveals that the overall picture at regional level has also altered little.

Projected trends in undernourishment
	1996-98	2015	2030	1996-98	2015	2030
	percent of population			millions of people
Sub-Saharan Africa	34	22	15	186	184	165
Near East / North Africa	10	8	6	36	38	35
Latin America and the Caribbean	11	7	5	55	45	32
China* and India	16	7	3	348	195	98
Other Asia	19	10	5	166	114	70
Developing countries	18	10	6	791	576	400
Source: Agriculture: Towards 2015/30, Technical Interim Report, FAO, April 200

But short-term events are not necessarily indicative of long-term trends, and new projections for 2015 and 2030 show an improving course. The number of undernourished people in the developing world is expected to fall to around 580 million by 2015 - an improvement, but still far short of the World Food Summit goal of a reduction by half, to about 400 million people. Projections indicate that the 400 million figure will not be reached until 2030.

Number and proportion of undernourished, by region and subregion, 1996-98

The figures for 2015 indicate that the overall proportion of the developing countries' population that is undernourished will be half what it was in 1990-92, the base period for the World Food Summit target. But the number of undernourished people will still be around 70 percent of what it was in 1990-92.

If the goal were applied regionally, South and East Asia would be on track to approach it by 2015. Sub-Saharan Africa and the Near East would remain far from the target, and Latin America would be in between.

Total population and number of under-nourished, by region, 1996-98 (millions)

Overall, these outcomes would reflect the continuation of long-term declines in the prevalence of undernourishment in Asia, which began in 1969-71 in East Asia and a decade later in South Asia. In the world's two largest countries - China and India - slowing population growth and strong economic growth would bring significant increases in per capita food availability between 1996-98 and 2015.

For these two countries combined, the prevalence of undernourishment is projected to decline from 16 percent in 1996-98 to 7 percent in 2015. Together they represent more than one third of the world's population, so any change in their levels of undernourishment has a large effect on world averages.

Sub-Saharan Africa faces greater challenges. This region is home to most of the world's poorest countries, where prevalence of undernourishment is high and prospects for immediate and rapid economic growth limited. The central, southern and eastern parts of the continent are especially hard hit.

Number of undernourished, by region, 1996-98 (millions)	Proportion of population undernourished by prevalence category and region, 1996-98

Although the prevalence of undernourishment in sub-Saharan Africa is projected to decline from 34 percent of the population in 1996-98 to 22 percent in 2015, high population growth rates mean that the actual number of undernourished people could increase slightly between now and 2015 before beginning to decline. Some very poor countries in East Asia, the Caribbean and the Near East have similar characteristics and also have poor prospects for achieving the Summit target.

As explained further throughout this report, the countries and regions where progress is slow are caught in a trap of poverty and hunger that requires particular attention. But, as the successes achieved in other parts of the world demonstrate, a concerted, focused effort can make a difference and prove the projections wrong.

Food deprivation: prevalence and depth of hunger

To get the most accurate picture possible of how hungry people are, FAO has combined the estimates of both prevalence and depth of hunger (presented on pages 6-9) into five food deprivation groups. Shown by country on the map, the groups range from the least deprived (Group 1 - low prevalence of undernourishment in the population and low dietary energy deficit among the undernourished) to the most deprived (Group 5 - high prevalence of undernourishment and high energy deficit).

The 23 countries in Group 5 face the most pressing and difficult problems in feeding their people. Chronic instability and conflict, poor governance, erratic weather, endemic poverty, agricultural failure, population pressure and fragile ecosystems go hand in hand with deep, widespread and persistent hunger.

Eighteen countries in sub-Saharan Africa, nearly half the African nations covered in this report, are in this group. So are Afghanistan, Bangladesh, Haiti, Mongolia and the Democratic People's Republic of Korea.

At the other extreme are the 52 countries in Group 1 - all of the industrialized countries, 11 countries in transition (see pages 12-13 for details) and 15 relatively high-income developing countries. Peace and economic prosperity characterize all these countries.

Extent of food deprivation, 1996-98 Combining prevalence and depth of hunger results in five food deprivation groups

The World Food Summit target is to reduce the overall number of undernourished people around the world. However, significant improvement could also be achieved by concentrating first on lessening the depth of hunger.

In this scenario, a country with higher prevalence of undernourishment and a daily dietary energy deficit of over 300 kilocalories per person would strive to reduce the depth of hunger as a top priority. This strategy might not permit a country to report an immediate decrease in the number of undernourished people, but it would mean the undernourished were not as hungry as they had been. Their susceptibility to nutrition-related health risks would therefore decline, and the country would be on the path to a sustainable reduction in hunger prevalence.

Estimating prevalence and depth of hunger

Here is a brief description of the method FAO uses to estimate the prevalence and depth of undernourishment:

Calculating food energy requirements How much people need to eat each day - their daily dietary energy requirement - depends on their weight, height, age, sex and activity level. The table gives examples of light, moderate and heavy activity levels and the amount of food energy required for such activities by men and women of differing body weight. The energy requirements for elderly people are somewhat less, and those for children are much less. The prevalence and depth of hunger are calculated using the minimum daily energy requirements of the different sex and age groups in a population. The minimum requirement for each group is based on the lowest acceptable weight for the typical height of the group in a country and the light activity norm.	Physical activity norms for adults Light activity: -Activity associated with sitting at a desk or behind a counter with reliance on automated appliances. Moderate activity: -Continual light physical activity such as in light industry or during off-season farm work. Heavy activity: -Heavy and occasionally strenuous work (e.g. agricultural production, mining or steel work).
	Approximate daily energy requirement for adults
		Light activity (kcal)	Moderate activity (kcal)	Heavy activity (kcal)
	Men (height 1.71 m)*
	lowest acceptable body weight (54 kg)	2335	2682	3164
	highest acceptable body weight (73 kg)	2786	3199	3775
	Women (height 1.59m)*
	lowest acceptable body weight (47 kg)	1846	1941	2154
	highest acceptable body weight (63 kg)	2223	2337	2594
* Requirements would be higher for taller people and lower for shorter people. Norms based on Report of the Joint FAO/WHO/UNU Expert Consultation on Energy and Protein Requirements , 1985

Locating the hungry in countries in transition

Note on the estimates

The FAO estimate of the number of undernourished people is derived from available data on population, food production, trade and distribution of food or income within the population. For many countries these data are weak. In the CIS the problem is further complicated by the difficulties associated with ongoing changes in data collection systems. In the centrally planned system, data were obtained mainly from administrative records. To replace them, sample surveys must be implemented, but this work is still at an early stage. Therefore the estimates of the number and proportion of undernourished people in the CIS should be read with particular caution. As the reliability of current data in many CIS countries is uncertain, experts working in the field supplement quantitative data with qualitative assessments. Field evidence supports the data, finding that a substantial number of people are living in hardship as a result of low purchasing power, lack of employment, dietary inadequacies and insufficent fuel, shelter, transport and health facilities.

Less than ten years after the break-up of the Soviet Union in 1991, undernourishment remains a persistent challenge in many of the successor countries now part of the Commonwealth of Independent States (CIS). By contrast, the Eastern European and Baltic countries have largely managed to escape this problem.

These findings emerged from FAO's first estimates of the number and proportion of undernourished people in countries in transition. In nine of the 12 CIS countries, at least 5 percent of the population is undernourished. In four countries - Armenia, Azerbaijan, Georgia and Tajikistan - at least 20 percent of the population suffers from undernourishment. Only one country, Belarus, has a level of undernourishment comparable to levels found in the industrialized world (less than 2.5 percent of the population).

Commonwealth of Independent States

Seven CIS states - Armenia, Azerbaijan, Georgia, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan - with a combined population of 53 million, are now classified by the United Nations as low- income food-deficit countries, with an annual gross national product of less than US$1 505 per capita.

A number of reasons are commonly cited to explain this difficult situation. Economic transition in the CIS countries has been accompanied by far-reaching political and administrative changes that have disrupted previous trade and exchange relations and led to serious foreign exchange shortages. In addition there has been a breakdown of agricultural production and marketing systems, spiralling inflation, temporary bread shortages and, in several instances, outright conflict. The gross domestic product has plummeted along with the purchasing power of large numbers of ordinary citizens. In most CIS countries, levels of production are now only a fraction of what they were in 1991, and levels of unemployment and underemployment are quite high, although often disguised because of work in the informal sector.

Vulnerability to food insecurity in CIS countries
Very high vulnerability Azerbaijan Tajikistan Relatively high vulnerability Armenia Georgia Kyrgyzstan	Intermediate vulnerability Moldova, Rep Turkmenistan Uzbekistan	Relatively low vulnerability Kazakhstan Russian Federation Ukraine Very low vulnerability Belarus

But the data for Eastern Europe and the Baltic countries, where similar disruptions have occurred, illustrate that economic transition need not diminish food security. As of 1996-98, only five of the 12 Eastern European and three Baltic countries were experiencing undernourishment levels of more than 5 percent of the population, and in none were more than 20 percent undernourished.

The risk of undernourishment in the CIS countries has also fallen since 1995, although not as far as in Eastern Europe and the Baltic states. Agricultural market liberalization and privatization of agricultural production have led to improved food distribution in most of the countries. Control of grain and bread prices has largely been lifted, the role of private trade has increased and shortages have mostly disappeared. As a result, emergency food aid programmes have been terminated in most CIS countries. By 1997, the majority of farm commodities in most CIS countries were produced in the private sector. Private producers were marketing as much as 30-40 percent of their production, usually directly to consumers for cash payment.

Focus: Azerbaijan

Focus: Georgia

Although food is available in both urban and rural markets, the purchasing power of the bulk of the country's 7.6 million inhabitants remains low. Costing on average US$68 per month for a family of five, food continues to account for around 70 percent of total expenditures among the most economically vulnerable. Humanitarian assistance has been provided since the early 1990s. Nearly 500000 people (half of whom have fled the areas affected by political conflict with Armenia) still need this help. By now, most have sold any valuable possessions and have little margin of security left. A survey of internally displaced families conducted in 1998 found that 30 percent showed some signs of malnutrition. Source: Special Report: FAO/World Food Programme Crop and Food Supply Assessment Mission to Azerbaijan, December 1999

Rural incomes have remained practically stagnant despite rapid growth in the agriculture sector since 1995. Income disparity has increased greatly, and a large proportion of the country's population of 5.1 million remains poor. Expenditures on food absorb 60-70 percent of the average family budget. The social safety net system remains relatively ineffective, with very low pensions and benefits and long arrears in payments. The elderly, disabled, unemployed and geographically isolated remain highly vulnerable to food insecurity. Although there is no officially recognized acute malnutrition, a slow but clear increase of malnutrition among children is being observed, despite targeted distribution of supplementary food aid. Source: Crop and Food Supply Situation in Georgia, FAO Global Information and Early Warning System on Food and Agriculture, December 1999