Current data and trends in morbidity and mortality for the sub-Saharan Region as presented in this new edition reflect the heavy toll that HIV/AIDS has had on health indicators, leading to either a stalling or reversal of the gains made, not just for communicable disorders, but for cancers, as well as mental and neurological disorders.

According to research, almost one billion people suffer from undernutrition in developing countries. This book provides a detailed study of undernutrition in Sub-Saharan Africa, one of the worst affected areas.

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.

Africa is not on track to meeting the Sustainable Development Goal (SDG) 2 targets to end hunger and ensure access by all people to safe, nutritious and sufficient food all year round and to end all forms of malnutrition. The number of hungry people on the continent has risen by 47.9 million since 2014 and now stands at 250.3 million, or nearly one-fifth of the population. The 2017, 2018 and 2019 editions of this report explain that this gradual deterioration of food security was due to conflict, weather extremes, and economic slowdowns and downturns, often overlapping. A continued worsening of food security is expected also for 2020 as a result of the COVID-19 pandemic. In addition to hunger, across all countries in Africa millions of people suffer from widespread micronutrient deficiencies, and overweight and obesity are emerging as significant health concerns in many countries. This report shows that the food system in Africa does not provide food at a cost that makes nutritious food affordable to a majority of the population, and this is reflected in the high disease burden associated with maternal and child malnutrition, high body-mass, micronutrient deficiencies and dietary risk factors. The report also shows that current food consumption patterns impose high health and environmental costs, which are not reflected in food prices. The findings presented in this report highlight the importance of prioritizing the transformation of food systems to ensure access to affordable and healthy diets for all, produced in a sustainable manner.

One in three preschool children in developing countries is undernourished. Consequently, they are likely to have impaired immune systems, poor cognitive development, low productivity as adults, and susceptibility to diet-related chronic diseases such as hypertension and coronary heart disease later in life. Undernourished female preschoolers are likely to grow into undernourished young women who are more likely to give birth to babies who are undernourished even before they are born, thus perpetuating the intergenerational transmission of deprivation. This report sheds light on some of the main causes of child malnutrition, projects how many children are likely to be malnourished in the year 2020 given current trends, and identifies priority actions for reducing malnutrition most quickly in the coming decades.

Most contributions reflect an evolution of thinking during the 1990s.