Hunger crisis deepens in global hotspots as famine risk rises: UN
Extreme hunger is intensifying in 13 global hot spots, with Gaza, Sudan, South Sudan, Haiti and Mali at immediate risk of famine without urgent humanitarian intervention, a joint UN report warned on Monday.
The 'Hunger Hotspots' report by the UN Food and Agriculture Organisation (FAO) and World Food Programme (WFP) blames conflict, economic shocks and climate-related hazards for conditions in the worst-hit areas.
The report predicts food crises in the next five months. It called for investment and help to ensure aid delivery, which it said was being undermined by insecurity and funding gaps.
'This report is a red alert. We know where hunger is rising and we know who is at risk,' said WFP executive director Cindy McCain. 'Without funding and access, we cannot save lives.'
For famine to be declared, at least 20% of the population in an area must be suffering extreme food shortages, with 30% of children acutely malnourished and two people out of every 10,000 dying daily from starvation or malnutrition and disease.
In Sudan, where famine was confirmed in 2024, the crisis is expected to persist due to conflict and displacement, with almost 25-million people at risk.
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More than half a million people previously diagnosed with HIV have started on HIV treatment since the end of February, the health minister says. But can a big jump in 10 weeks really be? We look at the numbers At a glance Last month, the health minister said that more than half a million previously diagnosed people with HIV have been started on treatment since the end of February. But can it really be, especially since the gap to getting 95% of people diagnosed with HIV on medication has been hovering around 1 million for the past five years? Critics say they're sceptical about the minister's figures, and that the country will close the gap by December. We dive into the numbers to see what the picture looks like. Numbers are powerful. They can also be dangerous — if not used correctly. When the health minister said last month that 520,700 more people previously diagnosed with HIV have started on treatment since the end of February, the number sounded astounding. The health department's goal before the end of the year is to find 1.1 million people who know they have HIV but have either never started treatment or fell out of treatment. In his words, the department has reached 'more than 50% of the target' it set out to achieve by the end of the year. If that gap is closed, South Africa would have met two of the three so-called 95-95-95 goals the country signed up for as part of the United Nations plan to end HIV/Aids as a public health threat by 2030. However, knowing exactly how much the gap is closing is tricky, because people who know they have HIV may start and stop and then restart treatment again later – sometimes several times – during the course of their care. In fact, a study from the Western Cape shows that close to half of people on medication stop at least once, and that some even pause and then restart up to three times. So, many of the 520,700 previously diagnosed people Motsoaledi says are now on medication could, at least in theory, very well be people who are counted repeatedly as they cycle in and out of treatment. But because the patient information system isn't digitally centralised – most clinics still keep track of their clients on paper, which means different facilities can't easily access one another's records – someone who stops treatment at one clinic can easily be counted as a new start at another, rather than a restart. The set of UN targets aim for 95% of people in a country with HIV to know their diagnosis, 95% of those being on treatment and 95% of those taking medication having such low levels of virus in their bodies that they can't infect someone through sex. 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Part of the reason for this, she says, is that a large proportion of the group needed to close the gap are people who have in fact been on antiretrovirals before, but have since stopped. Sometimes people miss an appointment to get a refill of their medicine because they can't afford to take time off work to go to the clinic ,or they might have moved to another province or district and so they don't go back to the facility where they first got their prescription, she explains. The longer the interruption lasts, the more hesitant people are to go back, she says, because they dread being treated poorly or getting 'kicked to the back of the queue' for having missed an appointment, with people such as sex workers, trans folk or men who have sex with men especially facing judgement. 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But that's based on programmes running as they have up to now — and with recent upsets because of US funding cuts, it may be an unreasonable assumption, Johnson says. Part of the reason for the small net gain every year is that although many people sign up for medication in a year, many also stop coming back to get their scripts refilled. Of those who drop out of treatment, some might choose to restart within a couple of months again, while others may pause their treatment for more than a year. In 2023, for example, roughly 793,500 people who had been on treatment before weren't any longer, but about 728,000 who received medication were restarters, Thembisa numbers show. So even though some people who stop taking their medication might not restart – or restart quickly –the total number who are on treatment still grows; it's just slow-going. This means getting a handle on how close to – or far from – the 95% treatment mark South Africa is, is more dynamic than simple addition. Stops, starts and restarts 'There will always be people who interrupt their treatment,' says Rees. 'It's not possible to keep everyone perfectly in the system all the time — that's life.' But what's important, she says, is to make those pauses as short as possible by helping people to get back on medication quickly and easily – without judgement. Gesine Meyer-Rath agrees. She's a health economist at HE2RO, a health economics research group at the University of the Witwatersrand, and focuses on how the government can get the most bang for its buck in its HIV programme. Data in the Thembisa model shows that over the years, the number of people starting medication for the first time – in other words, those who have never been on treatment before – has shrunk, but at the same time counts of restarters have grown. 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