“I had to do it for the sake of my children. I didn’t have any other option.” says Nooruddin, an Afghan father who sold his kidney on the black market to be able to feed his family. 

It’s a practice that has become so widespread in the western Afghan city of Herat that a nearby settlement is bleakly referred to as “one-kidney village.”

Sacrificing organs is just one of the desperate measures those at risk of starvation are being forced to take in the face of a global food crisis. 

A devastating convergence of conflict, climate change, and COVID-19 had already put enormous strain on many of the world’s poorest countries. But the ongoing conflict in Ukraine, and the soaring prices of grain and cooking oil that have resulted, now risks the onset of what the UN has called a “hurricane of hunger,” tipping millions of the world’s poorest people into the most acute classification of hunger: famine. 

Here’s everything you need to know about famine, its causes, who is most at risk, and how you can help. 

4 Things to Know About Famine

• Famine is a situation in which a substantial number of people in a region are unable to access adequate food and is only declared when specific conditions are met, such as 20% of a population receiving less than 2,100 calories per day. 
• The last time a famine was declared — in parts of South Sudan in 2017 — it left some 100,000 people facing starvation. 
• There are times famine has almost been declared such as in Nigeria and Somalia in 2017, and in Madagascar in 2021.
• Although there is currently no place in the world that is officially classified as experiencing a famine, at least 50 million people across 45 countries — including Somalia, Yemen, and Afghanistan — are teetering on the edge.

Hunger, Acute Malnutrition, Starvation, Famine — What’s the Difference?

Acute malnutrition, hunger, starvation, food insecure, famine. These words might all seem to connote the same thing but in the world of humanitarian aid and international development, they have specific definitions, markers, and criteria. 

In 2004, the UN’s Food and Agriculture Organization (FAO) developed the Integrated Food Security Phase Classification (IPC), as a tracking tool for global hunger that would provide a "common currency for classifying the severity and magnitude of food insecurity.”  

This tool has become the main way for a famine to be identified, and it works with a sliding scale from phase 1 (no or minimal food insecurity) to phase 5 (catastrophe or famine). 

Here’s a crash course to a few of its key terms. 

Food Insecurity

Food insecurity occurs when a person lacks regular access to enough food for normal growth and development. This may be due to unavailability of food and/or lack of resources to obtain food. 

Hunger

According to the UN's Hunger Report, the term “hunger” is used to define periods when populations are experiencing severe food insecurity — meaning that they go for entire days without eating due to lack of money, lack of access to food, or other resources.

Acute Malnutrition

Global anti-hunger charity Action Against Hunger defines acute malnutrition as “a form of under-nutrition caused by a decrease in food consumption and/or illness that results in sudden weight loss or oedema (fluid retention).” If it is not treated immediately, there is a very high risk of death. 

Starvation 

In humanitarian law, starvation can relate to “any objects essential to the survival of civilians.” So that’s food, water, and other types of necessity. 

The deliberate use of starvation of the civilian population as a method of combat was made a war crime by the UN in 2018. 

Famine

While many countries worldwide face food insecurity, famine — a situation in which a substantial number of people in a country or region are unable to access adequate food — is only declared when certain conditions are met. 

Famine is the end of the road and the complete exhaustion or inaccessibility of food in a region.

The result? Widespread acute malnutrition and death by starvation and disease. 

Famine is the most serious of the food security phases of the IPC and its main criteria is that at least 20% of a population receives less than 2,100 calories per day. 

The last time a famine was declared — in parts of South Sudan in 2017 — it left some 100,000 people facing starvation. 

What Are the Main Causes?

Famine can occur because of several different factors, such as conflict, displacement, extreme poverty, food insecurity, and climate change, but when more than one of these crises converge is when famine becomes a likely outcome. 

Wars and conflicts are usually the primary drivers of famine as they force people to flee their homes, disrupt the way people would normally access food and income, obstruct humanitarian aid, and crater economies. 

The effects of climate change — such as droughts, flooding, and cyclones — can also increase the risk of famine in regions where most of the people living there rely on the land’s agriculture to survive. Such was the case in parts of southern Madagascar, where famine was almost declared in 2021. 

Which Countries Are Most at Risk?

According to the IPC, no area currently meets the criteria to be classified a famine. 

However, a report by the FAO and the World Food Programme (WFP) has categorized Nigeria, Ethopia, South Sudan, Yemen, Afghanistan, and Somalia as hunger hotspots on the brink. Here they are in ascending order of the number of people affected. 

In north-west Nigeria, a growing malnutrition crisis is unfolding, which the humanitarian organization Médecins Sans Frontières (MSF) has warned is threatening the lives of up to 100,000 children.

In Ethiopia, violent clashes in the northern Tigray region have left tens of thousands of people dead and an estimated 4 million people are in urgent need of food assistance. Although a humanitarian truce was agreed upon in April 2022, the hunger crisis is predicted to get worse in coming months.

In Somalia, the worst drought in decades means 7 million people (out of a total population of 16 million) could be at risk of famine in the next two months if aid is not scaled up to meet skyrocketing needs.

South Sudan is bracing for the “worst hunger crisis ever” in which about 8.3 million people — over 70% of the population — are predicted to face extreme hunger over the next few months.

For six years, Yemen has been locked in a bloody civil war between the Saudi-supported government forces and the Houthi fighters backed by Iran. Nearly a quarter of a million Yemenis have been killed and up to 17.4 million have become food insecure, according to the World Food Programme. 

The recent takeover of Afghanistan by the Taliban after 20 years of US-led conflict has hit the country’s economy hard and led to almost universal poverty and an unprecedented hunger crisis. Over 20 million people (half of the 40 million population) face “extreme levels of hunger, and nearly 9 million of them are at risk of famine,” according to the UN refugee agency, UNHCR.

How Many People Are at Risk of Famine?

A total of 50 million people are teetering on the edge of famine, across 45 countries.

But there are a further 828 million people who are not classified as facing famine but still go to bed hungry every night, and the number of those facing acute food insecurity has soared — from 135 million in 2019 to 345 million in 2022. 

Who Is Most Vulnerable When Famine Strikes?

Children (especially infants under three years old), and pregnant and nursing people are particularly vulnerable to the effects of severe malnutrition. 

However, more generally, women and girls are disproportionately impacted during famines as they face existing barriers such as fewer work opportunities, a heightened risk of gender-based violence, forced labor, and child marriage.

How Can You Help?

A crisis is looming but the cataclysmic wave of famine is not inevitable. As a new report argues, if world leaders implement policies and take action now to stabilize the global food supply, it’s still possible we can prevent a steep rise in poverty, and ensure global food security. 

Join Global Citizens around the world in taking action against the food and hunger crisis, calling on world leaders to work toward an end to the conflict in Ukraine, while also stabilizing the global food system, and supporting the world’s most vulnerable communities.

Take the quiz — Understand how climate change is affecting Africa with droughts that directly impact the growth of crops which can have devastating consequences.
Sign the open letter — Urge world leaders to take immediate and decisive action to avert a worldwide food crisis by signing our open letter.
Take this quiz — Find out why women farmers are the future by testing your knowledge.
Leave a message (if you’re based in the US) — Tell the White House how the food crisis is affecting you.
Take a quiz — Find out how food insecurity is affecting Africa by taking this quiz.
Tweet Congress (if you’re based in the US) — Send an urgent tweet to Congress to support emergency funding for COVID-19 and hunger relief.
Take a quiz — Find out how hunger is forcing many Nigerian kids out of school by taking a quiz.