1. Roush, Karen PhD, RN, FNP-BC


A result of war, COVID-19, and climate change.


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The world is currently experiencing a global food crisis of historic proportions, threatening the lives of millions of people and putting multiple countries on the verge of famine. According to the United Nations (UN), in 2021 more than 2 billion people faced food insecurity, an increase of 350 million from before the pandemic. People in Asia, Africa, and Latin America and the Caribbean are most effected by hunger. As usual, children face the gravest risk: in 2021, an estimated 45 million children under age five suffered from wasting. This most dangerous level of malnutrition can lead to a 12-fold higher risk of death.

Figure. Afra, held b... - Click to enlarge in new windowFigure. Afra, held by her mother Therese, is being checked for malnourishment at Al-Sabbah Children's hospital in Juba, South Sudan. Photo (C) UNICEF/UN0232174/Njiokiktjien VII Photo.

These developments have taken the world far off track in meeting the UN's Sustainable Development Goal 2-Zero Hunger-by 2030. At the current rate, the number of people suffering hunger in 2030 will be more than 840 million, a far cry from zero and nearly 10% of the world's population.


The global food crisis is a result of a confluence of events-the war in Ukraine disrupting the food and fertilizer supply chain, the COVID-19 pandemic leaving economic crises in its wake, and climate change causing natural disasters and weather extremes that have decimated crops and livestock.



As a top exporter of staple grains, Ukraine is known as the breadbasket of Europe. It also supplies 40% of the wheat used in the UN's World Food Programme, which provides food staples to the world's most vulnerable populations.


A Russian blockade of Ukrainian ports at the beginning of the war stopped the export of agricultural products, trapping about 20 million tons of grain, as well as supplies of maize and corn, inside Ukraine. Although the UN brokered an agreement between Ukraine and Russia to allow grain exports to resume in July, Russia backed out of the deal in late October. Though some ships were again allowed to leave Ukraine in early November, experts warned that a failure to remove the blockade and renew the export agreement would impact the global food crisis. As we went to press, Russia agreed to extend the export agreement for another 120 days.


The interruption of wheat and grain supplies isn't the only issue affecting food security. Russia is one of the world's largest exporters of fertilizer. According to the African Development Bank Group, fertilizer prices have risen a staggering 300% since the beginning of the war. That puts the purchase of fertilizer out of reach for many farmers in sub-Saharan Africa, a devastating blow to food security in a region where 90% of food is produced by small-scale farming. And it's not the only region suffering. Latin America, Eastern Europe, and Central Asia all rely on Russia for a large portion of their imported fertilizer, which has meant smaller harvests and higher food costs.


In her work in the community, both in Alabama and in her home country of Zambia, Mercy Mumba, PhD, RN, CMSRN, FAAN, an associate professor at the University of Alabama's Capstone College of Nursing and a UN liaison for Sigma Theta Tau International, has seen the effects firsthand. She notes that in Zambia, subsistence and small-scale farmers don't have the resources or capacity to endure economic downturns and weather extremes, relying on reserves of agricultural products from the government. "Now that reserve is depleted because of the war in Ukraine," she says, "which the farmer doesn't have anything to do with, but they're the ones feeling the effects. Politics has trickled down onto the backs of these day-to-day farmers."



Climate change is wreaking havoc on food supplies. Severe weather, including droughts and flooding, have brought catastrophic disruptions to agrarian and pastoral farming. On the Horn of Africa, 22 million people in Kenya, Ethiopia, and Somalia face starvation due to the worst drought in 40 years. For the fifth year in a row, the rainy season did not bring rain, resulting in fallow fields and dead livestock. Most of the population are pastoral and subsistence farmers, dependent on seasonal rainfall for their livelihood. In Somalia, the worst-hit country, almost half the population may be facing food insecurity, and experts warn of the impending onset of famine. According to the UN Children's Fund, every minute a child in Somalia is admitted to a health facility for the treatment of severe malnutrition.


On the other end of the climate spectrum, catastrophic floods in Pakistan have wiped out crops, livestock, and wheat and fertilizer stockpiles. According to the New York Times, experts have called the flooding "a climate disaster of epic proportions" and note the agricultural effects are likely to ripple across the globe, causing more shortages and price hikes.


Farmers in the United States have not been spared the effects of climate change. In June, an extreme heat wave, with temperatures reaching 108[degrees]F, killed at least 2,000 cattle in Kansas. In 2022, severe drought conditions affected more than 60% of the West, Southwest, and Central Plains, an area responsible for almost half of U.S. agricultural production (by value). In a survey of farmers in those regions, 74% reported a reduction in harvest yields as a result of the drought, and 66% reported selling off part of their herd or flock.



The COVID-19 pandemic was an economic and global health disaster, as cities and communities shut down, jobs and livelihoods were lost, and household incomes fell. The pandemic precipitated interruptions to the food supply chain and rising food prices that were later exacerbated by the war in Ukraine. The economic downturn was followed by sharply escalating global inflation, making the cost of food out of reach for many. In 2022, the UN's Food and Agriculture Organization (FAO) Food Price Index, which tracks the international costs of commonly traded food commodities, reached record levels.


The skyrocketing food-price inflation tipped many into food insecurity. In Haiti, which has an overwhelming 33% inflation rate, the rise in food prices, on top of political unrest, escalating violence, and natural disasters, has severely limited, and in some cases completely cut off, access to food. According to the FAO, 4.7 million people are facing acute hunger in the country, including 1.8 million people who are categorized as being at the "emergency" level of the Integrated Food Security Phase Classification and 19,000 who are at the highest level, "catastrophic."


The economic effects of the pandemic followed by the war in Ukraine and soaring national and international inflation has also led to rising rates of food insecurity in the United States. According to a Robert Wood Johnson Foundation policy brief, 21.6% of adults reported household food insecurity last summer, and that number rose to 30.8% among those who were unemployed. Black and Hispanic adults reported even higher rates of food insecurity-29.2% and 32.3%, respectively.


Mumba notes the impact of food insecurity in her state. "Food insecurity is a huge thing. Right here in Alabama, there are a lot of areas that are considered food deserts, where people don't have a grocery store available to them in 10, 15, or 20 miles. So how do you help people have nutritious meals?"



Mumba sees nurses as having two roles in addressing food insecurity and hunger-as professionals and as individuals. Along with educating people on the nutritional value of food, nurses can advocate for policies that support access to nutritious foods and health care. With inflation changing the equation between income and affording food, she encourages nurses to advocate for policies that address income shortfalls, including increasing the minimum wage and revising social support qualifications.


"We need better coverage for things like WIC," Mumba says, referring to the Special Supplemental Nutrition Program for Women, Infants, and Children. "Those programs can be further expanded to people who may not be categorized as low income, but they're really not meeting the demands of their family."


Improved access to health care is also important in a time of increasing food insecurity and hunger. "In terms of helping the most vulnerable to have the best chance at surviving and improving their health, [the social safety net] is important," Mumba says. "And this goes to the issue of health insurance coverage. Because if someone is coming from a lower socioeconomic status, they are less likely to have nutritious foods, they're more likely to have chronic diseases, but they're also less likely to be insured."-Karen Roush, PhD, RN, FNP-BC, news director