Now updated with key developments in mitigation and adaptation from the last decade, Climate Change and Public Health, Second Edition offers an engaging overview of climate change and its health consequences alongside evolving methods for climate resilience.

New evidence this year corroborates the rise in world hunger observed in this report last year, sending a warning that more action is needed if we aspire to end world hunger and malnutrition in all its forms by 2030. Updated estimates show the number of people who suffer from hunger has been growing over the past three years, returning to prevailing levels from almost a decade ago. Although progress continues to be made in reducing child stunting, over 22 percent of children under five years of age are still affected. Other forms of malnutrition are also growing: adult obesity continues to increase in countries irrespective of their income levels, and many countries are coping with multiple forms of malnutrition at the same time – overweight and obesity, as well as anaemia in women, and child stunting and wasting. Last year’s report showed that the failure to reduce world hunger is closely associated with the increase in conflict and violence in several parts of the world. In some countries, initial evidence showed climate-related events were also undermining food security and nutrition. This year’s report goes further to show that climate variability and extremes – even without conflict – are key drivers behind the recent rise in global hunger and one of the leading causes of severe food crises and their impact on people’s nutrition and health. Climate variability and exposure to more complex, frequent and intense climate extremes are threatening to erode and reverse gains in ending hunger and malnutrition. Furthermore, hunger is significantly worse in countries where agriculture systems are highly sensitive to rainfall, temperature and severe drought, and where the livelihood of a high proportion of the population depends on agriculture. The findings of this report reveal new challenges to ending hunger, food insecurity and all forms of malnutrition. There is an urgent need to accelerate and scale up actions that strengthen resilience and adaptive capacity of people and their livelihoods to climate variability and extremes. These and other findings are detailed in the 2018 edition of The State of Food Security and Nutrition in the World.

Food insecurity at the national and household level not only is a consequence of conflict but can also cause and drive conflicts. This paper makes the case for an even higher priority for food security–related policies and programs in conflict-prone countries. Such policies and programs have the potential to build resilience to conflict by not only helping countries and people cope with and recover from conflict, but also contributing to preventing conflicts and supporting economic development more broadly—that is, helping countries and people become even better off. Based on this definition and a new conceptual framework, the paper offers several insights from four case studies on Egypt, Somalia, Sudan, and Yemen. First, conflicts are often related to other shocks such as economic crises, price shocks, and natural disasters. Second, increasing subsidies is a favored policy measure in times of crisis; however, such measures do not qualify as resilience building. Third, climate change adaptation should be an integral part of conflict prevention in part because climate change is expected to significantly increase the likelihood of conflict in the future. Fourth, building price information systems, introducing and expanding credit and insurance markets, geographic targeting of social safety nets, and building functioning and effective institutions are key measures for building resilience to conflict. Finally, the paper points to several important knowledge gaps.

Hunger and acute child malnutrition are increasingly concentrated in fragile countries and civil conflict zones. According to the United Nations, Yemen’s civil war has caused the world’s worst humanitarian crisis in recent history. We use high-frequency panel data and district fixed-effects and household fixed-effects models to estimate the impact of civil conflict on child nutrition. Our results indicate that an increase by one standard deviation in civil conflict intensity translates into an increase in the prevalence of acute child malnutrition by at least 0.7 percentage points if measured by weight-for-height z-scores and by at least 1.7 percentage points if measured by mid-upper arm circumference z-scores. In mid-December 2018, Yemen’s main warring parties agreed to a ceasefire for the contested port city of Hodeida and to allow humanitarian aid to be shipped in and distributed through protected corridors. While the recent agreements are an important, first step to tackle the humanitarian crisis, the road to a sustainable peace agreement will certainly be long and bumpy. Relative stability could soon open a window of opportunity for targeted interventions to support recovery in Yemen. Against this background, our analysis suggests that unconditional cash transfers can be an effective tool in situations of complex emergencies. Our estimation results show that cash transfers can mitigate the detrimental impact of lingering civil conflict on child nutritional status in Yemen on a large scale. Our results also reveal that the regularity of transfer payments influence the magnitude of the mitigation effect, as regular assistance allows beneficiary households to smoothen their food consumption and other demands influencing child nutrition outcomes.

Ethiopia is currently embroiled in a large-scale civil war that has continued for more than a year. Using unique High-Frequency Phone Survey (HFPS) data, which spans several months before and after the outbreak of the war, this paper provides fresh evidence on the ex durante impacts of the conflict on the food security and livelihood activities of affected households. We use difference-in-differences estimation to compare trends in the outcomes of interest across affected and unaffected regions (households) and before and after the outbreak of the civil war. Seven months into the conflict, we find that the outbreak of the civil war increased the probability of moderate to severe food insecurity by 38 percentage points. Using the Armed Conflict Location and Event Data (ACLED) on households’ exposure to violent conflict, we show that exposure to one additional battle leads to 1 percentage point increase in the probability of moderate to severe food insecurity. The conflict has reduced households’ access to food through supply chain disruptions while also curtailing non-farm livelihood activities. Non-farm and wage related activities were the most affected by the conflict while farming activities were relatively more resilient. Similarly, economic activities in urban areas were much more affected than those in rural areas. These substantial impact estimates, which are likely to be underestimates of the true average effects on the population, constitute novel evidence on the near-real-time impacts of an on-going civil conflict, providing direct evidence on how violent conflict disrupts the functioning of market supply chains and livelihoods activities. Our work highlights the potential of HFPS to monitor active and large-scale conflicts, especially in contexts where conventional data sources are not immediately available.