Recent global crises have exposed the limits of a universal mortality threshold for declaring famine—an approach that can obscure how famine actually plays out in different populations. In a paper published in the Lancetresearchers at Columbia University’s Mailman School of Public Health and colleagues are calling for a fundamental rethinking of how famine thresholds are defined.
The mortality thresholds used by the Integrated Food Security Phase Classification (IPC) were developed for rural African areas, not middle-income urban populations. There are marked differences in how famine mortality is assessed in different contexts.’
LH Lumey, MD, PhD, Professor of Epidemiology at the Columbia Mailman School
Lumey and his co-authors argue that widespread hunger can remain officially unclassified for extended periods because it does not meet the IPC Phase 5 benchmark of two deaths per 10,000 people per day. As a result, mass starvation can go unnoticed until it is far advanced.
The authors also note that the IPC is based on absolute mortality rates, while ignoring steep relative increases in specific age groups. Evidence from the Dutch Hunger Winter—an event studied extensively by Lumey—demonstrates this point. The crisis was characterized by a decline in birth weight and fewer births in the population, followed by a dramatic increase in child mortality. In the major cities, infant mortality in March 1945 rose to four times its pre-war level, while mortality among children aged one to four increased sevenfold. However, as Lumey noted, “these dramatic increases would not meet the current IPC starvation threshold for children under five.”
Furthermore, mortality is inherently a lagged indicator. By the time we reach the bottom lines, preventable starvation deaths have already occurred. The classification process can also be politicized, as access to reliable mortality data is often restricted or falsified.
“Identifying earlier indicators of famine stress could shorten the time between acute food insecurity and increased mortality,” Lumey said. “A more sensitive and specific approach would support faster humanitarian action.”
Co-authors are Ingrid de Zwarte, Wageningen University. and Alex de Waal, Tufts University.
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