Worldwide famine

The world is facing one of the worst humanitarian crises since World War II. As the looming threat and tragic reality of famine spread across South Sudan, northern Nigeria, Somalia and Yemen, 20 million people are at immediate risk of starvation and in urgent need of food and other assistance. But even with grim reports from the United Nations' relief agencies and images of starving children, there is widespread confusion about what famine is and what we can do to help.

• Myth No. 1: Famine is caused by drought or overpopulation.

These explanations are common. For instance, CNN accounted for Somalia's situation by noting, "The country has been hit by a severe drought that has affected more than 6.2 million people who are currently facing food insecurity and lack of clean water because of rivers that are drying up and recent years with little rain." Others see famine as vindication for 18th-century British philosopher Thomas Malthus, who predicted that population growth would outstrip the food supply.

But the Horn of Africa has seen many droughts, and not all have resulted in famine. And the countries at greatest risk of famine today are hardly the most densely populated.

Famine strikes countries and regions when poverty and vulnerability go untended because of government neglect, under-investment in development and, sometimes, willful obstruction.

The United Nations and famine experts agree that the four crises we are witnessing now, for example, are man-made and made worse by chronic conflicts. Poor communities in northern Nigeria are the playing fields of terrorist group Boko Haram. The presence of al-Shabab in Somalia constrains commerce and the operations of a new and still weak government. The government and opposition in South Sudan continue to wage a bloody war not over any principle but out of rivalry, showing absolutely no regard for the rapid descent of the majority of the population into a hell on earth. And in Yemen, a devastating war between coalition forces and Houthi rebels has pounded that country's economy into the Stone Age and impeded international relief efforts.

What the U.N. humanitarian chief told the Security Council in May about Yemen could be said of all of these countries: "If there was no conflict in Yemen, there would be no descent into famine."

• Myth No. 2: During a famine, the greatest risk is starving to death.

That's a phrase often associated with famine, as in the recent Vox headline "20 million starving to death."

People experiencing famine conditions do starve, but starvation is typically not the primary cause of death. The process of starving weakens the immune system, leaving people susceptible to diseases such as malaria or cholera that are not always killers in other contexts but can be fatal to people whose bodies are compromised by starvation. In Somalia, for example, prevailing pre-famine conditions and under-nutrition have accelerated a measles outbreak. Famine emergencies can also aggravate noncommunicable diseases such as heart disease, high blood pressure, diabetes and cancer. Diarrhea, too, is extremely common. Because of the lack of healthy food, clean water and medical care, treatable diseases and conditions rapidly turn into deadly ones.

Moreover, famine can inflict irreparable harm on those who survive. Children are most vulnerable in these settings. Those under 5 who

survive measles commonly suffer from blindness, brain swelling and severe respiratory infections that can permanently impair a child before he or she starves. Inadequate nutrition and repeated infections during the first 1,000 days of a child's life can also cause stunting, which has irreversible longterm effects on the physical and mental development of children. In 2015, according to the World Health Organization, there were 156 million stunted children under 5.

• Myth No. 3: To prevent famine, we need better ways to predict it.

You may have read about how new apps or satellites or social networks finally will allow us to predict famine and prevent it once and for all.

But we already have reliable early warning systems that can provide a trigger for global action. Lack

of information is not the problem. The Famine Early Warning Systems Network (FEWS NET), created by the U.S. Agency for International Development, analyzes weather conditions, food prices, nutrition data, population displacement and other indicators, pooling information and comparing assessments with other countries and the United Nations to collectively determine the level of risk. FEWS NET and most aid agencies rank situations on a five-point scale, going from "minimal" food insecurity to "stressed," "crisis," "emergency" and finally "famine."

When this information is acted upon by governments and international partners, particularly in the early stages, famine can be and often is prevented.

The real problem is governments that refuse to act or combatants that prevent anyone from acting.

• Myth No. 4: A country

on the brink of famine is on the verge of a crisis.

"African crisis looming over threat of famine," a typical headline declares. And yet a crisis is well underway by the time conditions merit the "famine" label. At Level 5 there are two deaths per 10,000 people, or four child deaths per 10,000 children, happening every day from a lack of food; at least 1 in 5 households is experiencing an extreme lack of food; and acute malnutrition exceeds 30 percent in a given area. As Arif Husain, chief economist for the World Food Program, put it: "When you declare a famine, bad things have already happened. People have already died."

So far this year, only parts of South Sudan have qualified as experiencing active famine. But, no question, the other at-risk countries are in crisis or emergency conditions. In Yemen, 60 percent of the population is food insecure

while a quarter is on the brink of famine; according to the World Health Organization, there have been more than 100,000 cases of cholera and nearly 800 deaths from that disease. Similarly, a substantial share of the people in northeast Nigeria and in Somalia are nearing Level 5, or famine.

• Myth No. 5: Famine relief and other aid enables corrupt officials and doesn't help people in need.

This is a common criticism of U.S. aid in general. "With so much corruption in Africa, how much of our funding is stolen?" the incoming Trump administration asked the State Department.

True, some self-described "leaders" care so little for their people that they loot international relief aid or abandon their citizens to the international community, as the government in South Sudan has done. But local and international humanitarian workers have proved that they can reach people in need, often at great personal risk.

The sweeping assertion that we are wasting our money also discounts potential and positive trends that could prove far more potent over time. A growing number of developing countries are investing in the agricultural sector, upon which millions depend, and generating real and lasting results by combining policy reforms, money from their own budgets and donor assistance. Through Feed the Future, an initiative launched by President Barack Obama, investments in this progress have paid off.

According to Feed the Future's 2016 progress report, poverty has fallen between 7 and 36 percent in 11 focus countries since the program began collecting data in 2011. Child stunting has been reduced by more than 20 percent among 604,000 participating households. In areas of Ethiopia where Feed the Future works, poverty is down 12 percent. And support for countries' own policy reforms has helped open up opportunities on the ground, as in Senegal, where the government passed a law requiring that local seed certification standards be in line with regional standards, thereby providing breeders with access to regional markets and reducing transaction costs.

President Donald Trump, when meeting with the pope in May, promised $300 million in famine relief for Yemen, South Sudan, Somalia and Nigeria. That was a good gesture, but the real statement is in his budget proposal, which slashes disaster relief, zeroes out funding for FEWS NET and doesn't even reference Feed the Future. Without these tools, we risk losing our ability to prevent a scourge that can kill millions.