IN BRIEF

THE STATE OF

FOOD SECURITY
AND NUTRITION
IN THE WORLDTRANSFORMING FOOD SYSTEMSFOR AFFORDABLE HEALTHY DIETSThis booklet contains the key messages and content from the publication The State of Food Security andNutrition in the World 2020. The numbering of the table and figures corresponds to that publication.
https://doi.org/10.4060/ca9699en
COVER PHOTOGRAPH ©Mint Images
THAILAND. Floating market on a canal in Bangkok, where local boats are laden with fresh food.

| 2 |CONTENTS
KEY MESSAGES

4FOREWORD

7

PART 1
FOOD SECURITY AND NUTRITIONAROUND THE WORLD IN 202011

1.1 Progress towards hunger
and food insecurity targets

11} FIGURE 1 The number of undernourished people
in the world continued to increase in 2019. If recent
trends are not reversed, the SDG 2.1 Zero Hunger
target will not be met} FIGURE 5 If recent trends persist, the distributionof hunger in the world will change substantially,making Africa the region with the highest numberof undernourished in 2030
} FIGURE 7 Moderate or severe food insecurity
affects one quarter of the world population, and it
has been increasing over the past six years. Over halfof the population in Africa, almost one-third in
Latin America and the Caribbean and more than
one-fifth in Asia are food insecure

1.2 Progress towards global nutrition targets} FIGURE 10 Despite some progress for most indicators,
only the 2025 target for exclusive breastfeeding is
on track to be achieved. Childhood overweight andadult obesity trends need to be reversed

1.3 The critical link between food security andnutrition outcomes: food consumption
and diet quality} FIGURE 20 The proportions of different foodgroups available for human consumption differ
across country income groups: a snapshot of 2017

1.4 Conclusions

PART 2
TRANSFORMING FOOD SYSTEMSTO DELIVER AFFORDABLEHEALTHY DIETS FOR ALL

23

2.1 The cost and affordability of healthy
diets around the world

23} TABLE 7 The cost of a healthy diet is 60 percent
higher than the cost of the nutrient adequate diet,and almost 5 times the cost of the energy sufficient
diet in 2017
} FIGURE 28 A healthy diet is unaffordable for thepoor in every region of the world in 201712

2.2 The hidden health and environmental
costs of what we eat} FIGURE 34 Adoption of any of the four alternative
healthy diet patterns would dramatically decreasediet-related health costs by 2030
} FIGURE 37 Adoption of plant-based dietary patterns
would reduce the social cost of GHG emissions by
41–74 percent in 2030

14

27
28

29
31
32

2.3 What is driving the cost of nutritious food?

34} FIGURE 39 Protectionary trade policies protect
and incentivize domestic production of staple foods,
such as rice, but often to the detriment of nutritious
foods in low-income countries

37

17

2.4 Policies to reduce the cost of nutritious
foods and ensure affordability of healthy diets

38

19} FIGURE 41 Policy options to reduce the costof nutritious foods and enhance affordability ofhealthy diets with complementary policies
to promote healthy diets

40

15

16

21

22

| 3 |

KEY MESSAGESè Updates for many countries have made itè The world is not on track to achieve Zero Hunger

possible to estimate hunger in the world withgreater accuracy this year. In particular, newly
accessible data enabled the revision of the entire
series of annual undernourishment estimates for
China back to 2000, resulting in a substantial
downward shift of the series of the number ofundernourished in the world. Nevertheless, therevision confirms the trend reported in past editions:the number of people affected by hunger globallyhas been slowly on the rise since 2014.

by 2030. If recent trends continue, the number ofpeople affected by hunger would surpass
840 million by 2030.
è A preliminary assessment suggests that the

COVID-19 pandemic may add between 83 and132 million people to the total number ofundernourished in the world in 2020 depending on
the economic growth scenario.
è Globally, the burden of malnutrition in all its

forms remains a challenge. According to current
estimates, in 2019, 21.3 percent (144.0 million) of
children under 5 years of age were stunted,
6.9 percent (47.0 million) wasted and 5.6 percent(38.3 million) overweight.

è Current estimates are that nearly 690 million

people are hungry, or 8.9 percent of the world
population – up by 10 million people in one year
and by nearly 60 million in five years. The numberof people affected by severe food insecurity, which isanother measure that approximates hunger, shows asimilar upward trend. In 2019, close to 750 million– or nearly one in ten people in the world – were
exposed to severe levels of food insecurity.

è The world is making progress but is not on

track to achieve the 2025 and 2030 targets forchild stunting and low birthweight, and for
exclusive breastfeeding, is on track only for the2025 target. The prevalence of wasting is notably
above the targets. Most regions are not on track toachieve the targets for child overweight. Adult
obesity is on the rise in all regions. Urgent action
is needed to reverse these upward trends.

è Considering the total affected by moderate orsevere food insecurity, an estimated 2 billion people
in the world did not have regular access to safe,
nutritious and sufficient food in 2019.

| 4 |è The nutritional status of the most vulnerable

five times more expensive than diets that meet only
dietary energy needs through a starchy staple.

population groups is likely to deteriorate further
due to the health and socio-economic impacts of
COVID-19.

è The cost of a healthy diet exceeds theinternational poverty line (established at USD 1.90
purchasing power parity (PPP) per person per day),making it unaffordable for the poor. The cost also
exceeds average food expenditures in mostcountries in the Global South: around 57 percent ormore of the population cannot afford a healthy dietthroughout sub-Saharan Africa and Southern Asia.

è Food insecurity can worsen diet quality andconsequently increase the risk of various forms of
malnutrition, potentially leading to undernutrition
as well as overweight and obesity.
è Low-income countries rely more on staple

foods and less on fruits and vegetables and animal
source foods than high-income countries. Only in
Asia, and globally in upper-middle-income
countries, are there enough fruits and vegetables
available for human consumption to be able tomeet the FAO/WHO recommendation of
consuming a minimum of 400 g/person/day.

è All diets have hidden costs, which must be

understood to identify trade-offs and synergies
in relation to other SDGs. Two hidden costs thatare most critical relate to the health (SDG 3) andclimate-related (SDG 13) consequences of our
dietary choices and the food systems that
support these.

è While we still face significant challenges in just

è Under current food consumption patterns,

accessing food, challenges are even more importantin terms of accessing healthy diets.

diet-related health costs linked to mortality andnon-communicable diseases are projected to exceed
USD 1.3 trillion per year by 2030. On the other
hand, the diet-related social cost of greenhouse gas
emissions associated with current dietary patterns
is estimated to be more than USD 1.7 trillion peryear by 2030.

è Healthy diets are unaffordable to many people,

especially the poor, in every region of the world. The
most conservative estimate shows they areunaffordable for more than 3 billion people in theworld. Healthy diets are estimated to be, on average,| 5 |KEY MESSAGESè Shifting to healthy diets can contribute tofood supply chain, within the food environment,
and in the political economy that shapes trade,public expenditure and investment policies.
Tackling these cost drivers will require largetransformations in food systems with noone-size-fits-all solution and different trade-offs
and synergies for countries.

reducing health and climate-change costs by 2030,
because the hidden costs of these healthy diets arelower compared to those of current consumption
patterns. The adoption of healthy diets is projected
to lead to a reduction of up to 97 percent in direct
and indirect health costs and 41–74 percent in thesocial cost of GHG emissions in 2030.

è Countries will need a rebalancing ofagricultural policies and incentives towards more
nutrition-sensitive investment and policy actions
all along the food supply chain to reduce foodlosses and enhance efficiencies at all stages.
Nutrition-sensitive social protection policies will
also be central for them to increase the purchasing
power and affordability of healthy diets of themost vulnerable populations. Policies that moregenerally foster behavioural change towards
healthy diets will also be needed.

è However, not all healthy diets are sustainable

and not all diets designed for sustainability arealways healthy. This important nuance is not wellunderstood and is missing from ongoing discussions
and debates on the potential contribution ofhealthy diets to environmental sustainability.
è To increase the affordability of healthy diets,the cost of nutritious foods must come down. The
cost drivers of these diets are seen throughout the| 6 |FOREWORDF

ive years after the world committed to end hunger, food insecurity and all formsof malnutrition, we are still off track to achieve this objective by 2030. Data tellus that the world is progressing neither towards SDG target 2.1, of ensuring
access to safe, nutritious and sufficient food for all people all year round, nor towards
target 2.2, of eradicating all forms of malnutrition.
There are many threats to progress. The 2017 and 2018 editions of this report showedthat conf lict and climate variability and extremes undermine efforts to end hunger,
food insecurity and malnutrition. In 2019, the report showed that economic slowdowns
and downturns also undercut these efforts. In 2020, the COVID-19 pandemic, as well as
unprecedented desert locust outbreaks in Eastern Africa, are obscuring global
economic prospects in ways no one could have anticipated, and the situation may only
get worse if we do not act urgently and take unprecedented action.
The most recent estimate for 2019 shows that prior to the COVID-19 pandemic, almost
690 million people, or 8.9 percent of the global population, were undernourished. Thisestimate is based on new data on population, food supply and more importantly, newhousehold survey data that enabled the revision of the inequality of food consumption
for 13 countries, including China. Revising the undernourishment estimate for China
going back to the year 2000 resulted in a significantly lower number of undernourishedpeople worldwide. This is because China has one-fifth of the global population. Despite
this, the trend reported in past editions of this report still stands: since 2014, thenumber of hungry people worldwide has been slowly rising. The new estimate for 2019has revealed that an additional 60 million people have become affected by hunger since2014. If this trend continues, the number of undernourished people will exceed
840 million by 2030. Hence, the world is not on track to achieve Zero Hunger, even
without the negative effects that COVID-19 will likely have on hunger. Preliminary
projections based on the latest available global economic outlooks, also presented inthis report, suggest that the COVID-19 pandemic may add an additional 83 to
132 million people to the ranks of the undernourished in 2020.

| 7 |FOREWORD

Beyond hunger, a growing number of people have had to reduce the quantity and qualityof the food they consume. Two billion people, or 25.9 percent of the global population,
experienced hunger or did not have regular access to nutritious and sufficient food in
2019. This situation could deteriorate if we do not act immediately and boldly.
These trends in food insecurity contribute to increasing the risk of child malnutrition,
as food insecurity affects diet quality, including the quality of children’s and women’s
diets, and people’s health in different ways. Hence, as painful as it is to accept, it isunsurprising that the burden of child malnutrition remains a threat around the world:in 2019, 21.3 percent (144.0 million) of children under 5 years of age were estimated to
be stunted, 6.9 percent (47.0 million) wasted and 5.6 percent (38.3 million) overweight,
while at least 340 million children suffered from micronutrient deficiencies. The goodnews is that between 2000 and 2019, the global prevalence of child stunting declined by
one-third. However, the world is not on track to achieve the global nutrition targets,
including those on child stunting, wasting and overweight by 2030. Furthermore, adultobesity is on the rise in all regions. Projections for 2030, even without considering a
potential global recession, serve as an added warning that the current level of effort is
not anywhere near enough to end malnutrition in the next decade.
We can still succeed, but only by ensuring all people’s access not only to food, but tonutritious foods that make up a healthy diet. With this report, all five agencies are
sending a strong message: A key reason why millions of people around the world sufferfrom hunger, food insecurity and malnutrition is because they cannot afford the cost ofhealthy diets. Costly and unaffordable healthy diets are associated with increasing foodinsecurity and all forms of malnutrition, including stunting, wasting, overweight andobesity. Food supply disruptions and the lack of income due to the loss of livelihoods
and remittances as a result of COVID-19 means that households across the globe arefacing increased difficulties to access nutritious foods and are only making it even moredifficult for the poorer and vulnerable populations to have access to healthy diets.
It is unacceptable that, in a world that produces enough food to feed its entire
population, more than 1.5 billion people cannot afford a diet that meets the required
levels of essential nutrients and over 3 billion people cannot even afford the cheapest
healthy diet. People without access to healthy diets live in all regions of the world; thus,
we are facing a global problem that affects us all.
Current food consumption patterns also generate what this year’s report calls “hidden
costs” related to health costs (SDG 3) and climate-change costs (SDG 13). If current foodconsumption patterns continue, diet-related health costs linked to mortality anddiet-related non-communicable diseases are projected to exceed USD 1.3 trillion per| 8 |T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

IN BRIEF

year by 2030. The diet-related social cost of greenhouse gas emissions associated withcurrent dietary patterns is estimated to reach more than USD 1.7 trillion per year by2030. Both of these hidden costs are a significant underestimation. The environmental
costs do not account for other negative environmental impacts and the health costs do
not account for the negative impacts of undernutrition due to data constraints. In lightof this evidence, it is clear that the adoption of healthy diets that include sustainability
considerations can significantly reduce these hidden costs, generating importantsynergies with other SDGs.
We must look throughout the food system to address the factors that are driving up thecost of nutritious foods. This means supporting food producers – especially small-scale
producers – to get nutritious foods to markets at low cost, making sure people haveaccess to these food markets, and making food supply chains work for vulnerable people– from small-scale producers to the billions of consumers whose income is simply
insufficient to afford healthy diets.
Clearly, then, we face the challenge of transforming food systems to ensure that no one
is constrained by the high prices of nutritious foods or the lack of income to afford ahealthy diet, while we ensure that food production and consumption contribute toenvironmental sustainability. However, there is no one-size-fits-all solution for
countries, and policymakers will need to assess the context-specific barriers, manage
trade-offs and maximize synergies – such as potential environment gains – to achieve
the required transformations.
We trust that the recommendations in this report, once tailored to each country context,
will help governments to reduce the cost of nutritious foods, make healthy diets
affordable for everyone and enable vulnerable people working in food systems to earn
decent incomes that enhance their own food security. This will set in motion atransformation of existing food systems that makes them resilient and sustainable.
Areas of policy emphasis should include rebalancing of agricultural policies andincentives towards more nutrition-sensitive investment; and policy actions all alongfood supply chains, with a focus on nutritious foods for healthy diets, to reduce foodlosses, create opportunities for vulnerable small-scale producers and others working infood systems, and enhance efficiencies. Nutrition-sensitive social protection policies will
also be central to increase the purchasing power and affordability of healthy diets by
the most vulnerable populations. An enabling environment should also be promoted bypolicies that, more generally, improve the nutritional quality of the food produced andavailable on the market, support the marketing of diverse and nutritious food, andprovide education and information for fostering individual and social behaviour change
towards healthy diets.

| 9 |FOREWORD

These policy recommendations are in line with key recommendations under theUnited Nations Decade of Action on Nutrition, 2016–2025. We believe that the analysis
conducted and policy recommendations provided in this report will also help set theagenda for the first UN Food Systems Summit, which will take place in 2021 with theoverarching goal of helping stakeholders better understand and manage complex
choices that affect the future of food systems and their needed transformation tosignificantly accelerate progress towards achieving the SDGs by 2030.
Our agencies stand firmly committed to support a shift that makes healthy diets
affordable to all and contributes to the eradication of hunger, food insecurity and allforms of malnutrition in children and adults. Our efforts shall ensure that this shiftunfolds in a sustainable way, for people and the planet, and creates synergies to spur
progress on other SDGs.

Qu Dongyu

Gilbert F. Houngbo

Henrietta H. ForeFAO Director-General

IFAD President

UNICEF Executive Director

David BeasleyTedros Adhanom Ghebreyesus

WFP Executive Director

WHO Director-General| 10 |

PART 1

FOOD SECURITY AND NUTRITION AROUND THE WORLD IN 2020

F

ive years into the 2030 Agenda,
it is time to assess progress andto question whether continuing
efforts implemented thus far will allow
countries to reach SDG 2 targets. For
this reason, this year’s reportcomplements the usual assessment of
the state of food security and nutritionin the world with projections of what
the world may look like in 2030 if
trends of the last decade continue.
Importantly, as the COVID-19 pandemic
continues to evolve, this reportattempts to foresee some of the impactsof this global pandemic on foodsecurity and nutrition. However, giventhat the full extent of the devastationthat COVID-19 will cause is still largely
unknown, it is important to recognizethat any assessment at this stage issubject to a high degree of uncertainty
and should be interpreted with caution.

1.1 PROGRESS TOWARDSHUNGER AND FOOD
INSECURITY TARGETS
KEY MESSAGESè Updates for many countries have made it
possible to estimate hunger in the world with greater
accuracy this year. In particular, newly accessible data
enabled the revision of the entire series of annual
undernourishment estimates for China back to 2000,

resulting in a substantial downward shift of the seriesof the number of undernourished in the world.
Nevertheless, the revision confirms the trend
reported in past editions of this report: the number ofpeople affected by hunger globally has been slowly
on the rise since 2014.
è Current estimates are that nearly 690 million
people are hungry, or 8.9 percent of the world
population – up by 10 million people in one year
and by nearly 60 million in five years.
è Despite the re-assessment of the extent of hunger in
China, the majority of the world’s undernourished –381 million – are still found in Asia. More than
250 million live in Africa, where the number ofundernourished people is growing faster than in any
other region of the world.
è The number of people affected by severe foodinsecurity, which is another measure that approximates
hunger, also shows an upward trend. In 2019, close to
750 million – or nearly one in ten people in the world– were exposed to severe levels of food insecurity.
è Considering the total affected by moderate or severe
levels of food insecurity, an estimated 2 billion people in
the world did not have regular access to safe, nutritious
and sufficient food in 2019.
è The world is not on track to achieve Zero Hunger by
2030. If recent trends continue, the number of people
affected by hunger will surpass 840 million by 2030,
or 9.8 percent of the population.
| 11 |

PART 1FIGURE 1 THE NUMBER OF UNDERNOURISHED PEOPLE IN THE WORLD CONTINUED TO INCREASE IN 2019.
IF RECENT TRENDS ARE NOT REVERSED, THE SDG 2.1 ZERO HUNGER TARGET WILL NOT BE MET
1 000

20%
841.4

825.6
678.1

628.9

687.8

750

12.6%
500

10%
8.9%

8.6%

9.8%

8.9%

MILLIONSPERCENTAGE

15%

250

5%

0%

0
2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

2015

2016

2017

2018

2019*

...

2030**YEARS
Prevalence of undernourishment (percentage)

Number of undernourished (millions)

NOTES: Projected values in the figure are illustrated by dotted lines and empty circles. The shaded area represents projections for the longer period from 2019
to the 2030 target year. The entire series was carefully revised to reflect new information made available since the publication of the last edition of the report;
it replaces all series published previously. * See Box 2 in the report for a description of the projection method. ** Projections to 2030 do not consider the
potential impact of the COVID-19 pandemic.
SOURCE: FAO.

è A preliminary assessment suggests that the COVID-19
pandemic may add between 83 and 132 million people
to the total number of undernourished in the world in
2020. The expected recovery in 2021 would bring thenumber of undernourished down but still above what was
projected in a scenario without the pandemic.

SDG Indicator 2.1.1
Prevalence of undernourishment (PoU)
The three most recent editions of thisreport already presented evidence thatthe decades-long decline in hunger inthe world, as measured using theprevalence of undernourishment (PoU),
had unfortunately ended. Additional
evidence and several important data
updates, including a revision of theentire PoU series for China back to 2000,
shows that almost 690 million people in
the world (8.9 percent of the world
population) are estimated to have been
undernourished in 2019 (Figure 1). Revisionin light of the new data, which results ina parallel downward shift of the entire
global PoU series, confirms theconclusion of past editions of this report:
the number of people affected by hunger| 12 |

T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

IN BRIEF

in the world continues to increase
slowly. This trend started in 2014 andextends to 2019. There are nearly
60 million more undernourished people
now than in 2014, when the prevalence
was 8.6 percent – up by 10 million
people between 2018 and 2019.

in 2019. Yet, the PoU in the population
for the region is 8.3 percent, below theworld average (8.9 percent), and lessthan half of that of Africa. Asia has
shown progress in reducing the numberof hungry people in recent years, downby 8 million since 2015.

The reasons for the observed increase of
the last few years are multiple. Much of
the recent increase in food insecurity canbe traced to the greater number ofconf licts, often exacerbated byclimate-related shocks. Even in somepeaceful settings, food security has
deteriorated as economic slowdowns
challenge access to food for the poor.

In Latin America and the Caribbean, thePoU was 7.4 percent in 2019, below theworld prevalence of 8.9 percent, whichstill translates into almost 48 million
undernourished people. The region has
seen a rise in hunger in the past few
years, with the number of undernourishedpeople increasing by 9 million between
2015 and 2019.

The evidence also reveals that the worldis not on track to achieve the SDG 2.1
Zero Hunger target by 2030. Combined
projections of recent trends in the sizeand composition of the population, in the
total food availability, and in the degreeof inequality in food access point to anincrease of the PoU by 1 percentage
point. As a result, the global number ofundernourished people in 2030 would
exceed 840 million.

In terms of the outlook for 2030, Africa
is significantly off track to achieve theZero Hunger target in 2030. If recent
rates of increase persist, the PoU willrise from 19.1 to 25.7 percent. Latin
America and the Caribbean is also off
track, even though at a much lower level.
Mostly due to deterioration in recent
years, the trend will bring the PoU from
7.4 percent in 2019 to 9.5 in 2030. Asia,
while making progress, will also notachieve the target by 2030 based onrecent trends.

The PoU in Africa was 19.1 percent of
the population in 2019, or more than
250 million undernourished people,
up from 17.6 percent in 2014. Thisprevalence is more than twice theworld average (8.9 percent) and is thehighest among all regions.
Asia is home to more than half of thetotal undernourished people in theworld – an estimated 381 million people

Overall, and without considering theeffects of COVID-19, projected trends inundernourishment would change thegeographic distribution of world hunger
dramatically (Figure 5, right chart).
While Asia would still be home to almost
330 million hungry people in 2030, its
share of the world’s hunger would shrink
substantially. Africa would overtake| 13 |

PART 1FIGURE 5 IF RECENT TRENDS PERSIST, THE DISTRIBUTION OF HUNGER IN THE WORLD WILL CHANGE
SUBSTANTIALLY, MAKING AFRICA THE REGION WITH THE HIGHEST NUMBER OF UNDERNOURISHED IN 2030
OCEANIA
2.4 (0.4%)

LATIN AMERICA
AND THE CARIBBEAN

OCEANIANORTHERN AMERICA
AND EUROPE
n.r. (0.9%)

47.7 (6.9%)

3.4 (0.4%)

LATIN AMERICA
AND THE CARIBBEANNORTHERN AMERICA
AND EUROPE
n.r. (1.0%)

66.9 (7.9%)

AFRICA
250.3 (36.4%)

ASIA
329.2 (39.1%)

ASIA

AFRICA
433.2 (51.5%)

381.1 (55.4%)

2019*: TOTAL 687.8 MILLION

2030**: TOTAL 841.4 MILLIONNOTES: Number of undernourished people in millions. * Projected values. ** Projections to 2030 do not consider the potential impact of the COVID-19 pandemic.
n.r. = not reported, as the prevalence is less than 2.5 percent.
SOURCE: FAO.

Asia to become the region with thehighest number of undernourishedpeople, accounting for 51.5 percentof the total.
At the time of this writing, the
COVID-19 pandemic was spreading
across the globe, clearly posing aserious threat to food security.
Preliminary assessments based on thelatest available global economic
outlooks suggest that the COVID-19
pandemic may add between 83 and132 million people to the total numberof undernourished in the world in 2020
depending on the economic growthscenario (losses ranging from 4.9 to10 percentage points in global GDP
growth). The expected recovery in 2021
would bring the number ofundernourished down but still above
what was projected in a scenario
without the pandemic. It is important torecognize that any assessment at thisstage is subject to a high degree of
uncertainty and should be interpretedwith caution.

| 14 |

IN BRIEF

T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

FIGURE 7 MODERATE OR SEVERE FOOD INSECURITY AFFECTS ONE QUARTER OF THE WORLD POPULATION, AND IT
HAS BEEN INCREASING OVER THE PAST SIX YEARS. OVER HALF OF THE POPULATION IN AFRICA, ALMOST ONE-THIRDIN LATIN AMERICA AND THE CARIBBEAN AND MORE THAN ONE-FIFTH IN ASIA ARE FOOD INSECURE
60

49.4

50

51.4 50.6 51.6

46.3 46.5

31.2

33.0 32.4 32.6

32.0 31.6 31.7

29.7 29.7
25.8 25.9

25.1

19.4 18.9 18.9

20
14.1 14.4 15.1

16.3

22.9

21.4

16.4 16.3
11.4 11.4 11.8 13.0

1022.6 22.3

13.5 13.2

15.8

22.7 22.4 22.1

18.7

18.5 18.3 19.0
16.7 16.8 18.2
8.3

7.9

8.1

8.6

9.4

8.0

9.7

7.5

7.6

7.1

9.1

9.2

7.1

6.4

8.1

9.3

9.2

9.6

WORLD

Moderate food insecurity

AFRICAASIALATIN AMERICA
AND THE CARIBBEAN

2019

2018

2017

2016

2015

2014

2019

2018

2017

2016

2015

2014

2019

2018

2017

2016

2015

2014

2019

2018

2017

2016

2015

2014

0

9.4

9.4

8.8

8.5

7.6

7.9

8.0

8.0

7.5

7.2

6.7

6.9

1.4

1.4

1.3

1.2

1.0

1.1

2019

20.6

2018

24.8

2017

23.2

2016

22.4 22.4

29.4

2015

30

2014

PERCENTAGE

40

NORTHERN AMERICA
AND EUROPE

Severe food insecurity

NOTES: Differences in total are due to rounding of figures to the nearest decimal point.
SOURCE: FAO.

SDG Indicator 2.1.2
Prevalence of moderate or severe foodinsecurity in the population, based on the FIES
The latest estimates suggest that
9.7 percent of the world population(slightly less than 750 million people) was
exposed to severe levels of foodinsecurity in 2019. In all regions of theworld except Northern America andEurope, the prevalence of severe foodinsecurity has increased from 2014 to2019. This is also broadly consistent withrecent trends in the PoU in the world andacross regions, with the partial exceptionof Asia (Figure 7).
While the 746 million people facing
severe food insecurity are of utmost
concern, an additional 16 percent of theworld population, or more than
1.25 billion people, have experienced
food insecurity at moderate levels.

| 15 |

PART 1

1.2 PROGRESS TOWARDSGLOBAL NUTRITION TARGETS

People who are moderately foodinsecure do not have regular access tonutritious and sufficient food, even if
not necessarily suffering from hunger.

KEY MESSAGESè Globally, the burden of malnutrition in all its forms
remains a challenge. According to estimates, in 2019,21.3 percent (144.0 million) of children under 5 yearsof age were stunted, 6.9 percent (47.0 million) wasted
and 5.6 percent (38.3 million) overweight.

The prevalence of both moderate andsevere levels of food insecurity (SDG
Indicator 2.1.2) is estimated to be
25.9 percent in 2019 for the world as awhole. This translates into a total of
2 billion people. Total food insecurity(moderate or severe) has consistently
increased at the global level since 2014,
mostly because of the increase inmoderate food insecurity.

è The world is making progress but is not on track toachieve the 2025 and 2030 targets for child stunting
and low birthweight, and for exclusive breastfeeding,is on track only for the 2025 target. The prevalence ofwasting is notably above the targets.

Although Africa is where the highest
levels of total food insecurity areobserved, it is in Latin America and the
Caribbean where food insecurity is rising
the fastest: from 22.9 percent in 2014 to
31.7 percent in 2019, due to a sharp
increase in South America.
In terms of the distribution of total foodinsecure (moderate or severe) people in
the world, out of the 2 billion people
suffering from food insecurity,
1.03 billion are in Asia, 675 million in
Africa, 205 million in Latin America andthe Caribbean, 88 million in Northern
America and Europe, and 5.9 million in
Oceania. At the global level, theprevalence of food insecurity at
moderate-or-severe level, and severe level
only, is higher among women than men.
The gender gap in accessing foodincreased from 2018 to 2019, particularly
at the moderate or severe level. nè Central Asia, Eastern Asia and the Caribbean havethe largest rates of reduction in the prevalence ofstunting and are the only subregions on track to achieve
the 2025 and 2030 stunting targets.
è Most regions are not on track to achieve thetargets for child overweight. Adult obesity is on therise in all regions.
Worldwide, the prevalence of childstunting was 21.3 percent in 2019, or
144 million children. Although there has
been some progress, rates of stunting
reduction are far below what is needed
to reach the World Health Assembly(WHA) target for 2025 and the SDG
target for 2030. If recent trends continue,
these targets will only be achieved in
2035 and 2043, respectively (Figure 10).
In 2019, more than nine out of ten
stunted children lived in Africa or Asia,
representing 40 percent and 54 percent
of all stunted children in the world,| 16 |»

T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

IN BRIEF

FIGURE 10 DESPITE SOME PROGRESS FOR MOST INDICATORS, ONLY THE 2025 TARGET FOR EXCLUSIVE
BREASTFEEDING IS ON TRACK TO BE ACHIEVED. CHILDHOOD OVERWEIGHT AND ADULT OBESITY TRENDS
NEED TO BE REVERSEDSTUNTING

OVERWEIGHT

60
40

WASTING*

60

60

40

40

AARR = 2.3
20

20

20

PREVALENCE (%)

AARR = −0.9
0

2012

2019

2025

2030

0

2012

LOW BIRTHWEIGHT

2019

2025

2030

0

2019

EXCLUSIVE BREASTFEEDING

60

2025

2030

ADULT OBESITY

60

60
AARI = 2.5

40
20
0

AARR = 1.0

2012 2015

Trend

2025

2030

40

40

20

20

0

2012

2019

2025

2030

0

AARR = −2.6

2012

2016

2025

2030

TargetNOTES: * No projection over time is generated for wasting, as it is an acute condition that can change frequently and rapidly over the course of a calendar
year, not captured by input data available. Average Annual Rate of Reduction (AARR) and Average Annual Rate of Increase (AARI) are calculated using alldata from 2008 onwards for stunting, overweight and low birthweight (recent trend period), and from 2012 (baseline) for the other indicators.
SOURCES: UNICEF, WHO & World Bank. 2020. UNICEF-WHO-World Bank: Joint child malnutrition estimates - levels and trends in child malnutrition: key findingsof the 2020 edition. [online]. data.unicef.org/resources/jme, www.who.int/nutgrowthdb/estimates, data.worldbank.org/child-malnutrition; NCD Risk Factor
Collaboration (NCD-RisC). 2017. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416
population-based measurement studies in 128.9 million children, adolescents, and adults. The Lancet, 390(10113): 2627–2642; UNICEF & WHO. 2019.
UNICEF-WHO Joint Low Birthweight Estimates. [online]. [Cited 28 April 2020]. www.unicef.org/reports/UNICEF-WHO-low-birthweight-estimates-2019;www.who.int/nutrition/publications/UNICEF-WHO-lowbirthweight-estimates-2019; UNICEF. 2020. UNICEF Global Database on Infant and Young Child
Feeding. In: UNICEF [online]. New York, USA. [Cited 28 April 2020]. data.unicef.org/topic/nutrition/infant-and-young-child-feeding| 17 |

PART 1»

respectively. Most regions have madesome progress in reducing stunting
between 2012 and 2019 but not at therate needed to achieve the 2025 and 2030
targets. Globally, stunting estimates vary
by wealth. Children from the poorest
wealth quintile had a stunting prevalence
that was more than double that ofchildren from the richest quintile.
The global prevalence of overweight
among children under 5 years of age
has not improved, going from
5.3 percent in 2012 to 5.6 percent,or 38.3 million children, in 2019.
Of these, 24 percent lived in Africa
and 45 percent in Asia. Australia and
New Zealand is the only subregion witha very high prevalence (20.7 percent).
Southern Africa (12.7 percent) andNorthern Africa (11.3 percent) haveprevalences considered high.
Globally, 6.9 percent of children under
5 (47 million) were affected by wastingin 2019 – a figure significantly above
the 2025 target (5 percent) and the 2030
target (3 percent) for this indicator.
Worldwide, 14.6 percent of infants
were born with low birthweight(less than 2 500 g) in 2015. The trends
for this indicator at global and regional
levels show that some progress has been
made in recent years, but not enough toachieve the target of a 30 percent
reduction in low birthweight by 2025
or even by 2030.

Globally, as of 2019, it was estimatedthat 44 percent of infants aged lessthan six months were exclusively
breastfed. Currently, the world is on
track to achieve the 2025 target of atleast 50 percent of babies younger thansix months being exclusively breastfed.
If additional efforts are not made,however, the global target for 2030 ofat least 70 percent will not be achieved
before 2038. Most subregions aremaking at least some progress, except
Eastern Asia and the Caribbean. If theEastern Africa, Central Asia andSouthern Asia subregions maintaintheir current rates of progress, they
will reach the targets set for both 2025
and 2030.
Adult obesity continues to rise, from
11.8 percent in 2012 to 13.1 percent in2016 and is not on track to reach theglobal target to halt the rise in adultobesity by 2025. If the prevalence
continues to increase by 2.6 percent per
year, adult obesity will increase by
40 percent by 2025, compared to the2012 level. All subregions show
increasing trends in the prevalence ofadult obesity between 2012 and 2016. n| 18 |

T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

1.3 THE CRITICAL LINKBETWEEN FOOD SECURITY
AND NUTRITION OUTCOMES:FOOD CONSUMPTION AND
DIET QUALITY
KEY MESSAGESè The exact make-up of a healthy diet varies
depending on individual characteristics, culturalcontext, local availability of foods and dietary customs,
but the basic principles of what constitutes a healthy
diet remain the same.
è There are large discrepancies in the per capita
availability of foods from different food groups acrossdifferent country income groups. Low-income
countries rely more on staple foods and less on fruits
and vegetables and animal source foods thanhigh-income countries.
è Only in Asia, and globally in upper-middle-income
countries, are there enough fruits and vegetables
available for human consumption to be able to meet
the FAO/WHO recommendation of consuming aminimum of 400 g/person/day.
è Globally, only one in three children 6 to
23 months of age meets the recommended minimum
dietary diversity, with wide variation among theregions of the world.
è Diet quality is negatively affected by foodinsecurity, even at moderate levels of severity. People
who experience moderate or severe food insecurity
consume less meat, and fewer dairy products andfruits and vegetables, than those who are food secureor mildly food insecure.

IN BRIEF

Diet quality comprises four key aspects:
variety/diversity, adequacy, moderation,and overall balance. According to WHO,a healthy diet protects against
malnutrition in all its forms, as well as
non-communicable diseases (NCDs) suchas diabetes, heart disease, stroke andcancer. It contains a balanced, diverse
and appropriate selection of foods eatenover a period of time. A healthy dietensures that a person’s needs for
macronutrients (proteins, fats andcarbohydrates including dietary fibres)and essential micronutrients (vitamins
and minerals) are met, specific to theirgender, age, physical activity level andphysiological state. Healthy diets include
less than 30 percent of total energy intake
from fats, with a shift in fat consumption
away from saturated fats to unsaturated
fats and the elimination of industrial
trans fats; less than 10 percent of totalenergy intake from free sugars (preferably
less than 5 percent); consumption of atleast 400 g of fruits and vegetables perday; and not more than 5 g per day of salt
(to be iodized). While the exact make-up
of a healthy diet varies depending on
individual characteristics, as well as
cultural context, locally available foods
and dietary customs, the basic principles
of what constitutes a healthy diet are
the same.
Global assessment of food consumption
and diet quality poses many challenges.
To date, there is no single, validated
composite index to measure themultiple dimensions of diet quality
across all countries.

| 19 |

PART 1

Trends in food availability
Data on food availability at the country
level show large discrepancies in the
per capita availability of foods fromdifferent food groups across different
country income groups. Low-income
and lower-middle-income countries
rely heavily on staple foods like cereals,roots, tubers and plantains. Overall,
the availability of staple foods for theworld has changed little between
2000 and 2017. Availability of roots,
tubers and plantains increased inlower-middle-income countries, driven
by a rise in Africa, whereas it
decreased in high-income countries.
In low-income countries, cereals,roots, tubers and plantains represent
nearly 60 percent of all food available
in 2017 (Figure 20). This percentage
decreases gradually with country
income groups, down to 22 percent inhigh-income countries.
The world average availability of fruits
and vegetables increased; however,
only in Asia, and globally inupper-middle-income countries, arethere enough fruits and vegetables
available to meet the FAO/WHO
recommendation of consuming aminimum of 400 g per day.
Availability of animal source foods
overall is highest in high-income
countries, but it is growing rapidly inupper-middle-income countries. Most of
the global increases in animal source
foods were observed in lower- andupper-middle-income countries.

Asia showed the largest increase in the
total amount of animal source foods
available.
The contribution from animal source
foods varies with the country income
group. It is higher in high-income
countries (29 percent) compared toupper-middle and lower-middle-income
countries (20 percent), and lowest in
low-income countries (11 percent)(Figure 20).

Dietary diversity
According to UNICEF, dietary diversity
in infants and young children was low
in the majority of the regions, with lessthan 40 percent of children meeting
minimum dietary diversity in seven outof the eleven subregions. In addition,
there are stark disparities in theprevalence of minimum dietary
diversity by the place of residence(urban/rural) and wealth status.
The prevalence of children eating foodsfrom at least five out of eight foodgroups is on average 1.7 times higher
among children living in urbanhouseholds than in rural, and among
those living in the richest households
compared to the poorest.

How does food insecurity affectwhat people eat?
An analysis of dietary patterns
according to levels of food insecurity
found that diet quality worsens withincreasing severity of food insecurity.

| 20 |»

T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

IN BRIEF

FIGURE 20 THE PROPORTIONS OF DIFFERENT FOOD GROUPS AVAILABLE FOR HUMAN CONSUMPTION DIFFERACROSS COUNTRY INCOME GROUPS: A SNAPSHOT OF 2017
A) EDIBLE QUANTITIES AVAILABLE

WORLDUPPER-MIDDLE-INCOME
COUNTRIESHIGH-INCOME
COUNTRIES

8.1%

5.2%

6.7%
9.1%

13.1% 11.2%
27.5%

7.6%
2.7%

15.6%

13.0%

28.8%

22.2%

20.1%

34.4%

37.7%

16.2%
10.0%

1.6%

7.4%
TOTAL 1 709
g/capita/day

TOTAL 1 687
g/capita/day

TOTAL 1 416
g/capita/day

LOW-INCOME
COUNTRIESLOWER-MIDDLE-INCOME
COUNTRIES
4.8%

3.3%

6.5%
44.5%

4.0%

3.3%

6.5%

20.8%

1.8%

14.6%

5.1%

16.1%

4.5%

58.3%

7.7%

TOTAL 1 146
g/capita/day

TOTAL 974
g/capita/day

Cereals, roots, tubers and plantains

Eggs and dairy

Pulses, seeds and nuts

Fruits and vegetables

Fish and meat

Sugar and fats

Other

NOTES: The estimates presented here are adjusted for food losses that happen along part of the supply chain, from post-harvest up to (and including) retail,and are adjusted for inedible portions. The “other” group includes beverages (i.e. alcoholic, fruit juice, fruit juice concentrate, vegetable juice, vegetable juice
concentrate and sweetened beverages), stimulants (tea, coffee and cocoa), spices and condiments, and sugar-preserved fruits. For more details about the foodgroupings, see Annex 2 in the report.
SOURCE: FAO.

| 21 |

PART 1»

The ways in which moderately foodinsecure people modify their diets vary
according to the income level of thecountry. In two lower-middle-income
countries studied (Kenya and Sudan),there is a marked decrease in
consumption of most food groups, andan increase in the share of staples inthe diet. In two upper-middle-income
countries examined (Mexico andSamoa), people who are moderately
food insecure consume more foods thatare typically cheaper on a per-calorie
basis (cereals, roots, tubers andplantains), and consume lesser
amounts of expensive foods (meat anddairy), compared with those who arefood secure. Mexico in particularshows a decrease in fruit and dairy
consumption as the severity of foodinsecurity increases. n

As for nutrition, progress is being madeon decreasing child stunting and low
birthweight and on increasing exclusive
breastfeeding for the first six months oflife. However, the prevalence of wasting
is notably above the targets and theprevalence of both child overweight andadult obesity is increasing in almost all
regions. COVID-19 is expected toexacerbate these trends, rendering
vulnerable people even more vulnerable.
Increasing availability of and access tonutritious foods that comprise healthy
diets must be a key component ofstronger efforts to achieve the 2030
targets. The remaining years of the UN
Decade of Action on Nutrition 2016–2025
present an opportunity for policymakers,
civil society and the private sector towork together and accelerate efforts. n

1.4 CONCLUSIONSWith ten years to go until 2030, theworld is off track to achieve the SDG
targets for hunger and malnutrition.
After decades of long decline, thenumber of people suffering from hunger
has been slowly increasing since 2014.
Beyond hunger, a growing number ofpeople have been forced to compromiseon the quality and/or quantity of thefood they consume, as ref lected in theincrease in moderate or severe foodinsecurity since 2014. Projections for2030, even without considering thepotential impact of COVID-19, serve as awarning that the current level of effort
is not enough to reach Zero Hunger ten
years from now.

| 22 |

PART 2

TRANSFORMING FOOD SYSTEMS TO DELIVER AFFORDABLEHEALTHY DIETS FOR ALLP

art 2 of this year’s report looks
closely at the cost andaffordability of healthy diets.
As noted in Part 1, diet quality is a
critical link between food security andnutrition outcomes that needs to bepresent as part of all efforts to achieve
the hunger, food security and nutrition
targets of SDG 2. Meeting these targets
will only be possible if we ensure thatpeople have enough food to eat, and thatwhat they are eating is nutritious.
One of the biggest challenges toachieving this is the current cost andaffordability of healthy diets. New
evidence presented in this part of thereport shows that healthy diets areunaffordable for many people in every
region of the world, especially for thepoor and those facing economic
challenges. However, the story does notend here, because there are also hidden
costs and externalities associated withcurrent food consumption patterns,
notably those related to the health andenvironmental consequences of our
dietary choices.
Further, this part of the report also
identifies the main drivers behind thehigh cost of nutritious foods andprovides guidance on policy andinvestments for countries to transformtheir food systems to provide access toaffordable healthy diets for everyone,
while tackling trade-offs and making themost of synergies for environmental
sustainability.

2.1 THE COST AND
AFFORDABILITY OF HEALTHYDIETS AROUND THE WORLDKEY MESSAGESè Analyses conducted for this report show that healthy
diets cost 60 percent more than diets that only meet therequirements for essential nutrients and almost 5 times
as much as diets that meet only the dietary energy
needs through a starchy staple.
è The cost of a diet increases incrementally as the dietquality increases – from a basic energy sufficient diet toa nutrient adequate diet and then a healthy dietincluding more diversified and desirable food groups– across all regions and country income groups globally.
è The high cost and unaffordability of healthy dietsis associated with increasing food insecurity anddifferent forms of malnutrition, including child stunting
and adult obesity.
è Healthy diets – that reflect global guidelines andinclude foods from several groups and have greater
diversity within food groups – are unaffordable formore than 3 billion people, and more than 1.5 billion
people cannot even afford a diet that only meetsrequired levels of essential nutrients.

| 23 |

PART 2è The cost of a healthy diet is much higher than theinternational poverty line, established at USD 1.90
purchasing power parity (PPP) per day. This puts
healthy diets beyond the reach of those living inpoverty or just above the poverty line.

healthy diet is, the greater theprevalence of undernourishment (PoU)
and child stunting becomes. The
association between adult obesity andaffordability of a healthy diet is theinverse of the other associations.
High-income countries have thehighest affordability figures for thehealthy diet and, at the same time,
the highest rates of adult obesity.

è Food systems transformation is required toaddress the problem of millions of people not being
able to afford healthy diets because of high foodprice and income constraints. At the same time, thistransformation should create supportive foodenvironments, encourage people to learn about
nutrition and spur behaviour change that can leadto healthy food choices.

Healthy diets are unaffordable for many
people in all regions of the world, especiallythe poor

Cost and affordability of healthy diets are
critical for food security and nutrition
The world faces immediate challenges ofmaking healthy diets accessible foreveryone, an essential requirement inmeeting the hunger and nutrition targetsof SDG 2. The COVID-19 pandemic has
made the situation even more difficult.
One of the biggest challenges is thecurrent cost and unaffordability ofhealthy diets.

What does the evidence tell us?
The cost and affordability of the foods
that form a healthy diet are important
determinants of food choices. As such,they can affect food security, nutritionand health. The cost refers to what people
have to pay to secure a specific diet.
Affordability, on the other hand, is thecost of the diet relative to income.
New analysis in this report shows that,across regions and country income
groups, the more unaffordable a

New evidence presented below showsthat healthy diets are unaffordable tomany people, especially for the poor, inevery region of the world. This evidence
emanates from analysing the estimatedcost of three reference diets denoting
increasing levels of diet quality,
starting from a basic energy sufficient
diet meeting calorie needs, to anutrient adequate diet and then ahealthy diet, the latter including an
estimation of recommended intake ofmore diversified and desirable foodgroups. Subsequently, the affordability– or cost relative to people’s income –of the three diets was estimated andcompared across regions and country
income groups.
The ultimate aim of the analysis
presented is to measure whether the foodsystem brings the three levels of dietquality within reach of the poorest, using
those foods that meet each standard at
the lowest possible cost.

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T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

Analysis of cost and affordability of three diets
Lowest cost of the three diets
around the world
As expected, the cost of a dietincreases incrementally as the dietquality increases. This pattern holds
across all regions and country income
groups (Table 7). The cost of a healthy
diet is 60 percent higher than the costof the nutrient adequate diet, andalmost 5 times the cost of the energy
sufficient diet.
To understand what is driving the highcost of healthy diets, we need to look at
cost contribution of each food group ina healthy diet to identify the most
costly food groups. An analysis of thepercentage share of the total cost ofeach food in a healthy diet shows thatthe highest-cost food groups are thosethat are more nutritious: dairy, fruits,
vegetables and protein-rich foods(plant-based and animal source), withsome variations by region.

Affordability of the three diets
around the world
The affordability analysis shows thatwhile most of the poor around theworld can afford an energy sufficientdiet, as defined here, they cannot
afford either a nutrient adequate or ahealthy diet (Figure 28). A healthy diet isfar more expensive than the full valueof the international poverty line of
USD 1.90 PPP per day, let alone theupper bound portion of the poverty linethat can credibly be reserved for foodof USD 1.20 PPP per day.

IN BRIEF

It is estimated that more than
3 billion people in the world could notafford a healthy diet in 2017.1 Most ofthese people live in Asia (1.9 billion) and
Africa (965 million), although there are
millions that live in Latin America andthe Caribbean (104.2 million), and in
Northern America and Europe(18 million).
Countries in food crisis face even greater
challenges in accessing a healthy diet,especially countries with a protracted
crisis situation which are characterizedby complex, multidimensional conf licts
and extreme fragility. In these contexts,
most or 86 percent of the population
cannot afford a healthy diet. This is
more than double the world average
figure (38 percent) and is 57 percent
higher than what is estimated for the
Global South.
These findings imply that: i) the cost of
nutritious foods that constitute healthy
diets need to decrease, particularly
nutritious foods that contribute to ahealthy diet including dairy, fruits,
vegetables and protein-rich foods; andii) poverty lines may need to rise, as they
are the basis for programme targets andsocial safety net programmes, andcurrently do not provide a good gauge of
people’s ability to access even theleast-cost versions of a healthy diet.

To estimate the cost of the aforementioned three diets, this report uses retailprices from the World Bank’s International Comparison Program (ICP) forinternationally standardized items for 2017, which was the most updated
available at the time of writing.

1| 25 |

KENYA
Women harvesting
French beans at oneof Kenya's Njukini
Corporative farms.
©FAO/Fredrik Lerneryd

T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

IN BRIEF

TABLE 7 THE COST OF A HEALTHY DIET IS 60 PERCENT HIGHER THAN THE COST OF THE NUTRIENT ADEQUATE DIET, AND ALMOST
5 TIMES THE COST OF THE ENERGY SUFFICIENT DIET IN 2017
Regions

Energy sufficient diet

Nutrient adequate diet

Healthy diet

WORLD

0.79

2.33

3.75

AFRICA

0.73

2.15

3.87

Northern Africa

0.75

2.90

4.12

Sub-Saharan Africa

0.73

2.06

3.84

Eastern Africa

0.61

1.98

3.67

Middle Africa

0.73

2.09

3.73

Southern Africa

0.86

2.29

3.99

Western Africa

0.80

2.05

4.03

ASIA

0.88

2.18

3.97

Central Asia

0.84

2.04

3.39

Eastern Asia

1.27

2.63

4.69

South-eastern Asia

0.92

2.42

4.20

Southern Asia

0.80

2.12

4.07

Western Asia

0.74

1.87

3.58

LATIN AMERICA AND THE CARIBBEAN

1.06

2.83

3.98

Caribbean

1.12

2.89

4.21

Latin America

1.00

2.78

3.75

Central America

1.13

3.04

3.81

South America

0.91

2.61

3.71

OCEANIA

0.55

2.07

3.06

NORTHERN AMERICA AND EUROPE

0.54

2.29

3.21

COUNTRY INCOME GROUPS
LOW-INCOME COUNTRIES

0.70

1.98

3.82

LOWER-MIDDLE-INCOME COUNTRIES

0.88

2.40

3.98

UPPER-MIDDLE-INCOME COUNTRIES

0.87

2.52

3.95

HIGH-INCOME COUNTRIES

0.71

2.31

3.43

NOTES: The table shows the USD cost per person per day of the three reference diets (energy sufficient, nutrient adequate and healthy diet) by region and country
income group in 2017. The analysis is based on a sample of 170 countries for which retail food price data are available in year 2017. Prices are obtained from the WorldBank’s International Comparison Program (ICP) for internationally standardized items, converted to international dollars using purchasing power parity (PPP). The costof each diet represents a simple average of the cost incurred by countries belonging to a specific region or country income group. In the report, see Box 10 for thedefinition of the three diets and Box 11 for a brief description of the cost methodology. For the full methodological notes and data sources, see Annex 3 in the report.
SOURCE: Herforth, A., Bai, Y., Venkat, A., Mahrt, K., Ebel, A. & Masters, W.A. 2020. Cost and affordability of healthy diets across and within countries. Background paper
for The State of Food Security and Nutrition in the World 2020. Rome, FAO.

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PART 2

FIGURE 28 A HEALTHY DIET IS UNAFFORDABLE FOR THE POOR IN EVERY REGION OF THE WORLD IN 2017
A) COST OF AN ENERGY SUFFICIENT DIET COMPARED WITH THE INTERNATIONAL POVERTY LINEB) COST OF A NUTRIENT ADEQUATE DIET COMPARED WITH THE INTERNATIONAL POVERTY LINEC) COST OF A HEALTHY DIET COMPARED WITH THE INTERNATIONAL POVERTY LINE

No data< USD 1.20

USD 1.20−USD 1.90

> USD 1.90

NOTES: The maps show the cost of the three reference diets (energy sufficient, nutrient adequate and healthy diet) compared with the international poverty line
(USD 1.90 purchasing power parity (PPP) per day) for 170 countries in year 2017. A diet is considered unaffordable when its cost exceeds USD 1.20, i.e. 63 percent
of USD 1.90 PPP per day. The 63 percent accounts for a portion of the poverty line that can be credibly reserved for food. In the report, see Box 10 for thedefinition of the three diets and Boxes 11 and 12 for a brief description of the cost and affordability methodology. For the full methodological notes and data
sources, see Annex 3 in the report. For disclaimers on map boundary lines, see Annex 5 in the report.
SOURCE: Herforth, A., Bai, Y., Venkat, A., Mahrt, K., Ebel, A. & Masters, W.A. 2020. Cost and affordability of healthy diets across and within countries. Background
paper for The State of Food Security and Nutrition in the World 2020. Rome, FAO.
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T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

Costs and affordability within countries
The cost and affordability of diets varies
around the world, across regions and indifferent development contexts. They
may also vary within countries due totemporal and geographical factors, aswell as variations in the nutritional
needs of individuals across the life cycle.
These within-country variations in cost
are not captured in the above global andregional analysis – but evidence fromcase studies makes it clear suchvariations can be substantial. n

2.2 THE HIDDEN HEALTH
AND ENVIRONMENTAL COSTS
OF WHAT WE EAT
KEY MESSAGESè All diets around the world, from those that meet
only dietary energy needs to those that areconsidered nutrient adequate and healthy diets,
have hidden costs whose understanding is critical toidentify trade-offs and synergies that affect theachievement of other SDGs.
è Two hidden costs of our dietary choices and foodsystems that support these that are most critical relate
to the healthcare cost for many people in the world(SDG 3) and the climate-related costs that the world
as a whole incurs (SDG 13).
è The first hidden cost: If current foodconsumption patterns continue, diet-related healthcosts linked to mortality and non-communicablediseases are projected to exceed USD 1.3 trillion
per year by 2030. On the other hand, shifting tohealthy diets is estimated to lead to a reduction of
up to 97 percent in direct and indirect health costs,

IN BRIEF

respectively, thus creating significant savings that
could be invested now to lower the cost of
nutritious foods.
è The second hidden cost: The diet-related social
cost of greenhouse gas (GHG) emissions associatedwith current dietary patterns is projected to exceed
USD 1.7 trillion per year by 2030. The adoption ofhealthy diets that include sustainability
considerations would reduce the social cost of GHG
emissions by an estimated 41–74 percent in 2030.
è Shifting to healthy diets that include
sustainability considerations could help to reduce
health and climate-change costs by 2030, as theirhidden costs are lower compared with those ofcurrent food consumption patterns.
è Assessing the context-specific barriers,
managing short-term and long-term trade-offs
and exploiting synergies will be critical to achieve
such transformations.
Valuing the hidden costs (or negative
externalities) associated with the different
diets could also modify significantly ourassessment of what is “affordable” from a
broader societal perspective and reveal
how dietary choices affect other SDGs.
Two hidden costs that are most critical
relate to the health (SDG 3) andclimate-related (SDG 13) consequences ofour dietary choices and the food systems
that support these.

A valuation of hidden costs to dietary patterns
New analysis for this report estimates thehealth and climate-change costs of fivedifferent dietary patterns: one
benchmark diet (BMK), representing| 29 |

PART 2current food consumption patterns, andfour alternative healthy diet patterns that
include sustainability considerations.
Four alternative healthy diet patterns
are analysed: a predominantly
plant-based f lexitarian diet whichcontains small to moderate amounts ofanimal source foods (FLX); a pescatarian
diet based on sustainable aquaculture
which contains moderate amounts offish but no other meat (PSC); avegetarian diet which contains moderateamounts of dairy and eggs, but no fish orother meat (VEG); and a completelyplant-based, vegan diet that is based ona variety of fruits and vegetables, wholegrains and plant-based protein sources,
such as legumes and nuts (VGN).

plant-based foods; in the case of young
children and pregnant or lactating
women who have higher nutrient
requirements; or where populations are
already suffering nutrient deficiencies.

Hidden health costs

The purpose of identifying the four
alternative diet patterns is to examine thehidden costs for different healthy dietsthat include aspects of environmental
sustainability, rather than to endorse any
particular dietary pattern. The four
alternative diet scenarios are only
examples, and other variations could be
developed for a similar analysis of hidden
costs. While there is a range of healthy
diets, based on global guidelines, that canbe designed to include sustainability
considerations, not all are the mosthealthy and appropriate diets for all
population groups. The purely plantbased diets in particular can carry large
risks of nutrient inadequacies. This canbe the case in settings where overall dietquality is low: e.g. where micronutrientscannot easily be supplied or managed
through an abundance of nutrient-richAssuming that current food consumption
patterns accommodate expected changes
in income and population, as per in thebenchmark scenario (BMK), health costs
are projected to amount to an average of
USD 1.3 trillion in 2030. More than half
(57 percent) of these are direct healthcare
costs as they are associated withexpenses related to treating the different
diet-related diseases. The other part
(43 percent) accounts for indirect costs,
including losses in labour productivity(11 percent) and informal care
(32 percent).
If, instead, any of the four alternative dietpatterns used for the analyses are
adopted (FLX, PSC, VEG, VGN),
diet-related health costs dramaticallydecrease by USD 1.2–1.3 trillion,
representing an average reduction of
95 percent of the diet-related healthexpenditures worldwide compared to thebenchmark diet in 2030 (Figure 34).

Hidden climate-change costs
What people eat, and how that food is
produced, not only affects their health, butalso has major ramifications for the stateof the environment and for climatechange. The food system underpinning theworld’s current food consumption patterns| 30 |

T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

IN BRIEF

FIGURE 34 ADOPTION OF ANY OF THE FOUR ALTERNATIVE HEALTHY DIET PATTERNS WOULD DRAMATICALLYDECREASE DIET-RELATED HEALTH COSTS BY 2030

DIET-RELATED HEALTH COSTS (USD BILLION)

1 400
1 200
1 000
800
600
400
200
0
BMK
Direct

PSC

VGN

FLX

VEG

Indirect

NOTES: The figure shows diet-related health costs in 2030 (USD billion) by direct and indirect cost component, under current consumption patterns (BMK) and
four alternative healthy diet patterns: flexitarian (FLX), pescatarian (PSC), vegetarian (VEG) and vegan (VGN) (see footnote y in the report for more
information). Costs are shown for 157 countries. Direct costs include direct medical and healthcare costs associated with treating a specific disease. Indirect
costs include loss of productivity per working days and the costs of informal care associated with a specific disease. Health costs refer to four diet-relateddiseases included in the analysis: coronary heart disease, stroke, cancer and type-2 diabetes mellitus. See Box 14 in the report for the definition of the five
diets and a summary of the methods and data sources. For the full methodological notes, see Annex 7 in the report.
SOURCE: Springmann, M. 2020. Valuation of the health and climate-change benefits of healthy diets. Background paper for The State of Food Security andNutrition in the World 2020. Rome, FAO.

is responsible for 21–37 percent of total
anthropogenic greenhouse gas (GHG)
emissions, meaning originating in humanactivity, which reveals it to be a major
driver of climate change, even without
considering other environmental effects.
The diet-related social cost of GHG
emissions related to current foodconsumption patterns (Figure 37) isestimated to be around USD 1.7 trillion

in 2030 for an emissions-stabilization
scenario that keeps global temperature
limited to a 2.5 degree increase(averaged over 100 years). Adoption of
any of the four alternative healthy dietpatterns (FLX, PSC, VEG and VGN)
could potentially contribute tosignificant reductions of the social
cost of GHG emissions, ranging
from USD 0.7 to USD 1.3 trillion(41–74 percent) in 2030 (Figure 37).

| 31 |

PART 2

FIGURE 37 ADOPTION OF PLANT-BASED DIETARY PATTERNS WOULD REDUCE THE SOCIAL COST OF GHG EMISSIONSBY 41–74 PERCENT IN 2030

SOCIAL COST OF GREENHOUSE GAS EMISSIONS (USD BILLION)

1 800
1 600
1 400
1 200
1 000
800
600
400
200
0
BMK
High-income countries

FLX
Low-income countries

PSC
Lower-middle-income countries

VEG

VGN

Upper-middle-income countries

NOTES: The figure shows diet-related social cost of GHG emissions in 2030 (USD billion) under current food consumption patterns (BMK) and four alternative
healthy diet patterns: flexitarian (FLX), pescatarian (PSC), vegetarian (VEG) and vegan (VGN) (see footnote y in the report for more information). Costs areshown for 157 countries. See Box 14 in the report for the definition of the five diets and a summary of the methods and data sources. For the full
methodological notes, see Annex 7 in the report.
SOURCE: Springmann, M. 2020. Valuation of the health and climate-change benefits of healthy diets. Background paper for The State of Food Security andNutrition in the World 2020. Rome, FAO.

Health and climate-change costs:
putting them into context
To put the health and climate-change
costs into context, it is useful tocompare the hidden costs with thewholesale costs of the diets, estimatedat the consumption level and valuatedbased on estimates of commodity
prices by region.

If the diet-related health andclimate-change costs were added to thetotal wholesale cost of the benchmark
diet representing the current
consumption pattern, then the full cost of
this benchmark diet would increase by
50 percent globally, from USD 6.0 to
USD 8.9 trillion by 2030. On the other
hand, the full cost of these diets globally
would only increase between 8 and| 32 |

T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 202019 percent as a result of the adoption of
any of the four alternative diet patterns(FLX, PSC, VEG or VGN). Overall, thistranslates into a significant cost savings,
compared with the benchmark diet.

Managing trade-offs and exploiting synergies
in the transition towards healthy diets
To achieve the dietary patterns forhealthy diets that include
sustainability considerations, largetransformative changes in foodsystems will be needed at all levels.
Given the large diversity of current
food systems and wide discrepancies
in food security and nutrition statusacross and within countries, there isno one-size-fits-all solution for
countries to shift towards healthy dietsand create synergies to reduce theirenvironmental footprints.
There is also no one healthy diet, letalone one that includes sustainability
considerations for every context.
Furthermore, there could be othertechnological and productivity
advancements that may be more costeffective in addressing sustainability
concerns and mitigating climatechange. Assessing the context-specificbarriers, managing short-term andlong-term trade-offs and exploitingsynergies will be critical to achieve
such transformations.

IN BRIEF

contexts, there are other important
indirect costs and trade-offs. For
countries where the food system not
only provides food, but also drives therural economy, it will be important toconsider the impact of shifting tohealthy diet patterns in terms of thelivelihoods of small farmers and therural poor as well. In these cases, caremust be taken to mitigate the negative
impact on incomes and livelihoods as
food systems transform to deliver
affordable healthy diets.
Many lower-income countries, where
populations already suffer nutrient
deficiencies, may need to increase theircarbon footprint in order to first meet
recommended dietary needs and meet
nutrition targets, including those onundernutrition. On the other hand, othercountries, especially upper-middle-income
and high-income countries, where dietpatterns exceed optimal energy
requirements, and where people
consume more animal source foods thanrequired, will need major changes in
dietary practices and system-widechanges in food production, foodenvironments and trade. n

While the cost of the healthy diet islower than current food consumption
patterns when one considers health andclimate-related externalities, in some| 33 |

PART 2

2.3 WHAT IS DRIVING THE
COST OF NUTRITIOUS FOOD?
KEY MESSAGES
è Factors driving the cost of nutritious foods arefound throughout food systems, in the realms offood production, food supply chains, foodenvironments, as well as consumer demand and thepolitical economy of food.
è Food production: Low levels of productivity, highproduction risks and insufficient diversification
towards the production of more nutritious foods are
key drivers of the cost of healthy diets, especially in
low-income countries.
è Food supply chains: Inadequate food storage, poorroad infrastructure and limited food preservation
capacity, especially for highly perishable foods, lead tofood losses and inefficiencies along the food supply
chain that drive up the cost of nutritious foods.
è Consumer demand: Rapid rates of urbanization
have resulted in more work-away andeat-away-from-home habits, with a direct impact on
the demand for easy-to-prepare, highly processed
foods or convenience foods that are often energy
dense and high in fats, sugars and/or salt and do
not necessarily contribute to healthy diets.
è Political economy: Trade policies, mainly
protectionary trade measures and input subsidy
programmes, tend to protect and incentivize thedomestic production of staple foods, such as rice andmaize, often at the detriment of nutritious foods,
like fruits and vegetables. Non-tariff trade measures
can help improve food safety, quality standards andthe nutritional value of food, but they can also drive
up the costs of trade and hence food prices,
negatively affecting affordability of healthy diets.

è Addressing some of these drivers to reduce thecost of nutritious foods implies the need to also
tackle environmental externalities associated withcurrent food systems and the hidden cost theycreate, particularly at the food production level, butalso at the consumption level.
To increase the affordability of healthy
diets, the cost of nutritious foods mustcome down. Many factors determine theconsumer price of nutritious food, fromthe point of production throughout the
food supply chain, and also within thefood environment when consumers
engage with the food system to makedecisions about acquiring, preparing andconsuming foods.
This section focuses on four main setsof drivers determining the cost of food.
The cost drivers specifically covered
include those that relate to 1) the
production of diverse nutritious foods
that contribute to healthy diets;
2) the food supply chain beyond foodproduction; 3) the food environment
as well as consumer demand andbehaviour; and 4) the political economy
of food.

Cost drivers in the production of diverse
nutritious food
Low levels of technology, innovation andinvestment in food production
Addressing low productivity in nutritious
food production can be an effective wayof raising the overall supply of nutritious
foods, reducing food prices and raisingincomes, especially for the poorer family
farmers and smallholder producers in| 34 |

T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

low-income and lower-middle-income
countries, like farmers, pastoralists
and fisherfolk. Sustained productivity
growth, without unsustainably depleting
natural resources, depends on foodproducers having the capacities toinnovate (enabling them to raise yields),
manage inputs more efficiently, adopt
new crops or breeds and improve
quality, while also conserving
natural resources.

IN BRIEF

compared to the production of higher
value and more nutritious foods. In theabsence of access to knowledge,
information and credit, all of the above
are risks that inf luence food producers’
decisions on whether to invest in crop
production, livestock or aquaculture,
which ultimately inf luences the overall
availability of nutritious foods andtheir prices.

Seasonality and climate factors
Insufficient diversification towards the
production of horticultural products,
legumes, small-scale fisheries,
aquaculture, livestock and othernutritious food products also limits the
supply of diverse and nutritious foods inmarkets, resulting in higher food prices.
Diversified and well-integrated
production systems not only increase
the availability of nutritious foods, butalso help vulnerable populations toincrease their resilience to climate andprice shocks and reduce seasonalvariation in food production.

Managing risks in food andagricultural production
Engaging in the food and agriculture
sector can be an intrinsically risky
endeavour, be it in crop or livestock
production, fisheries and aquaculture orforestry. This is particularly the case forpoorer family farmers and smallholder
producers on marginal lands or thosewith limited access to technology, capitalor other productive resources.

Climate change is expected to further
aggravate seasonality throughincreased drought frequency,
disruption of food production by f loods
and tropical storms, increasing andmore variable temperatures and more
erratic rainfall. This will lead to a
general decline in agricultural
production over the next two to three
decades, turning into a major cost
driver for food in the near future.
Current food consumption patterns
and the food systems that support
them are both major drivers ofnegative environmental impacts andclimate change, creating a vicious
circle. Climate variability andextremes and unpredictableseasonality are exacerbated because
these hidden environmental andclimate-change costs are left
unaddressed. This, in turn, negatively
impacts productivity in the food andagricultural sectors, ultimately
increasing the cost of nutritious foods
and healthy diets.

In crop production, traditional staple
foods generally carry a lower risk

| 35 |

PART 2

Cost drivers along the food supply chain
Food losses and waste
Reducing pre-harvest and post-harvest
losses in quantity and quality at the
production level in the agriculture,
fisheries and forestry sectors is an
important starting point to reduce thecost of nutritious foods along the foodsupply chain. This is because losses
decrease the overall availability of thesefoods, while also possibly undermining
environmental sustainability.
Important causes of losses at the
production level include exposure toadverse weather conditions, harvestand handling practices, as well as
marketing challenges. Inadequate
storage conditions and decisions madeat earlier stages of the supply chain
lead to products with a shorter shelflife. Adequate cold storage, inparticular, can be crucial to prevent
quantitative and qualitative food lossesof perishable commodities. Duringtransportation, good physicalinfrastructure and efficient tradelogistics are of key importance toprevent food losses.

Technology and infrastructure
Fruits and vegetables and many animal
source foods are highly perishable,
especially fish, fresh milk, meat andeggs. Lack of adequate market
infrastructure and limited processing
technology result in food losses andhigher food prices. Improved
technology and infrastructure inhandling, storage and processing (coolstorage systems, cold chains, drying

techniques, improved packaging) offers
opportunities to reduce losses andlower consumer food prices.
Another important component ofmarket infrastructure is the overall
quality and efficiency of the nationalroad and transportation network,
which is critical in getting produce fromthe farm gate to markets at reasonable
cost. Investment in all-weather ruralroads is particularly important. This
reduces the time it takes to reach ruraland urban markets, thus helping to
reduce pre-harvest and post-harvest
losses, including of perishable fruits
and vegetables.

The food environment and consumer
demand as a cost driver
The distance to food marketplaces andthe time required to prepare a healthy
meal are among the key barriers thatprevent many consumers from having
access to, and hence deciding to pay ahigher cost for healthy diets. Thesebarriers can be seen as cost drivers
because people who try to overcome
them would have to accept an
additional cost on top of the cost offood itself.
The rapid rate of urbanization,
combined with changing lifestyles andincreasing involvement of women in
economic activities, is leading tostructural changes in consumer
behaviour and food culture. As suchconsumer demand is also an important
cost driver to consider. These changes| 36 |

IN BRIEF

T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

FIGURE 39 PROTECTIONARY TRADE POLICIES PROTECT AND INCENTIVIZE DOMESTIC PRODUCTION OF STAPLEFOODS, SUCH AS RICE, BUT OFTEN TO THE DETRIMENT OF NUTRITIOUS FOODS IN LOW-INCOME COUNTRIESAVERAGE NOMINAL RATE OF PROTECTION
FOR RICE, UNWEIGHTED (%)

80
70
60
50
40
30
20
10
0
2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

2015

2016

YEARS

NOTES: The figure shows the average nominal rate of protection (NRP) for rice in low-income countries, between 2005 and 2016. NRP for rice is the ratio of
the price gap (difference between observed and reference prices of rice at farm gate) and the reference price of rice at farm gate.
SOURCE: Ag-Incentives. 2020. Nominal rate of protection. In: Ag-Incentives [online]. Washington, DC. [Cited 26 April 2020].
http://ag-incentives.org/indicator/nominal-rate-protection

are making it more difficult, especiallyfor women with jobs, to be able toafford the time that it takes to preparea healthy meal, and prior to that, tobuy the needed nutritious ingredients.
The opportunity cost of eating healthy
in the face of these changes is too
high, because of the availability ofcheap energy-dense fast foods ofminimal nutritional value andeasy-to-prepare, highly processed
foods, already half cooked to reduce
the time spent on preparation.

The political economy as a cost driver
Food and agricultural policies havethe power, either directly or indirectly,
to affect the cost of food. In particular,
the food and agriculture policy
framework encapsulates the difficultbalancing act required when choosing
between actions in agriculture versus
other sectors; among different
government objectives and fiscal
policies; between benefits for
producers, consumers andintermediaries; and even between
different agricultural subsectors.

| 37 |

PART 2

Trade policies affect the cost andaffordability of healthy diets byaltering the relative prices between
imported and import-competing foods.
Protectionary trade measures such asimport tariffs, bans and quotas –together with input subsidy
programmes – have often been
embedded in self-sufficiency andimport substitution strategies. In
low-income countries, this policy hasprotected and incentivized thedomestic production of energy-dense
foods such as rice (Figure 39) and maize,
but often at the detriment of vitaminand micronutrient-rich foods (i.e.
fruits and vegetables). n

2.4 POLICIES TO REDUCE THE
COST OF NUTRITIOUS FOODSAND ENSURE AFFORDABILITYOF HEALTHY DIETSKEY MESSAGESè Reducing the costs of nutritious foods andensuring the affordability of healthy diets foreveryone requires significant transformations ofexisting food systems worldwide, including
strengthening their resilience in the face of shocks
from the COVID-19 pandemic.
è Given the diversity and complexity of foodsystems, countries will need to implement a set ofcontext-specific policies and strategies, and step up
public and private sector investments withsignificant policy coherence, improved planning andcoordination across sectors and actors.
è This starts with an urgent rebalancing ofagricultural policies and incentives towards more
nutrition-sensitive investment in food andagricultural production, especially fruits andvegetables, protein-rich plant-based and animal
source foods, such as legumes, poultry, fish anddairy products.
è Policy actions along food supply chains are
critical in reducing the costs of nutritious foods. Suchactions should enhance efficiencies in food storage,
processing, packaging, distribution and marketing,thereby reducing food losses.
è The efficiency of internal trade and marketingmechanisms are key to reducing the cost of nutritious
foods and determining the affordability of healthy
diets for both urban and rural consumers.

| 38 |

T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

è Raising the affordability of healthy diets
requires policies that enhance employment andincome-generating activities, reduce income
inequality and ensure that no one is left behind.
Nutrition-sensitive social protection programmes will
be particularly necessary to support the poor andthose living through humanitarian crises, without
basic access to sufficient nutritious food to meetdietary requirements.

towards greater affordability of healthy
diets, and in line with various policy
recommendations made below, ispresented in Figure 41.

Policies and investments to reduce the costof nutritious foods
Reducing the cost of nutritious foods andincreasing the affordability of healthy
diets must start with a reorientation ofagricultural priorities towards more
nutrition-sensitive food and agricultural
production. Public expenditures will need
to be stepped up to raise productivity,
encourage diversification in foodproduction and ensure that nutritious
foods are made abundantly available.

è Additional policy measures that are beyond thescope of this report, but are designed to promotehealthy diets, need to be put in place as well. These
include the promotion of healthy food environments,
taxation of energy-dense foods, food industry andmarketing regulation, and policies supporting
nutrition education, sustainable food consumption
and food waste reduction.

Setting the stage for effective
food systems transformation
Ten years remain to achieve the ambitious
SDG targets within the current economic,
social and political environment – anenvironment vulnerable to climate shocks
and unexpected consequences of the
COVID-19 pandemic. With this shorttimeline, countries must identify andimplement critical policy and investmentchanges that will transform their current
food systems to ensure everybody canafford healthy diets that include
sustainability considerations.

Policy options to reduce the cost andenhance affordability of healthy diets
A summary of policy options andinvestments to be considered totransform food systems worldwide

IN BRIEF

Policies that penalize food andagricultural production (through direct
or indirect taxation) should be avoided,
as they tend to have adverse effects on
the production of nutritious foods.
Subsidy levels in the food and agriculture
sectors should also be revisited,
especially in low-income countries, toavoid taxation of nutritious foods.
Policies should promote investment in
irrigation infrastructure specificallytargeting strengthened capacity for
all-season vegetable production, andother high-value commodities to increaseavailability of nutritious foods. Moreinvestments are needed in research anddevelopment to raise productivity ofnutritious foods and help reduce theircost, while enhancing access to improved
technologies, especially for family
farmers and smallholders, to maintainadequate levels of profitability.

| 39 |

PART 2

FIGURE 41 POLICY OPTIONS TO REDUCE THE COST OF NUTRITIOUS FOODS AND ENHANCE AFFORDABILITY OF
HEALTHY DIETS WITH COMPLEMENTARY POLICIES TO PROMOTE HEALTHY DIETSPOLICIES AND INVESTMENTS
TO REDUCE THE COST OF
NUTRITIOUS FOODSCONSUMER-ORIENTED POLICIESTO ENHANCE AFFORDABILITY OF
HEALTHY DIETS Investment in nutrition-sensitive agricultural
productivity increases and diversification
 Promotion of urban and peri-urban agriculture Avoiding taxation of nutritious foods
 Investment in research, innovation andextension Policies and investment in nutrition-sensitive
value chains Policies and investment to reduce food losses Policies and investment in nutrition-sensitive
handling and processing Food fortification
 Investment in road networks, transport, market
infrastructure Ensuring trade and marketing policies balance
producer and consumer interests
 Strengthening food supply chains underhumanitarian conditions

 Policies to reduce poverty and income
inequality
 Strengthening nutrition-sensitive social
protection mechanisms, including:— cash transfer programmes— in-kind transfers/food distribution— school feeding programmes
 Subsidization of nutritious foods

AFFORDABLEHEALTHY DIETSFOR ALLCOMPLEMENTARY POLICIESTHAT PROMOTE HEALTHY DIETS
 Promotion of healthy food environments
 Taxation of energy-dense foods andbeverages of minimal nutritional value
 Food industry regulations
 Regulation of food marketing Promote breastfeeding, regulate marketingof breastmilk substitutes, ensure access tonutritious foods by infants Policies supporting nutrition education
 Policies in support of sustainable foodconsumption and food waste reduction

SOURCE: FAO.
| 40 |

T H E S TAT E O F FO O D S ECU RI T Y A N D N U T RI T I O N I N T H E WO RL D 2020

Policy options along the food value chain
There is a need for stronger policies
towards more nutrition-sensitive value
chains. Key policy actions include
investments in improved storage,
processing and preservation to retain
the nutritional value of food products,
rather than investing in highly
processed foods. Improving the nationalroad network, as well as transport andmarket infrastructure, can go a long way
to ensuring greater affordability ofhealthy diets. In addition to food storage,
appropriate food handling andprocessing facilities are central toincreasing efficiencies along the value
chain for nutritious foods.
Policies and investments to reducefood losses in more nutritious
perishable commodities, such as
fruits and vegetables, dairy, fish andmeat, can increase their affordability
in two ways. First, by focusing on theearlier (production) stages of the foodsupply chain, as this tends to boost
supplies and hence reduce food prices
at the farm gate. Second, by targetingthe parts of the food supply chain
where food losses are greatest, as thiswill more likely have a greater impact
on reducing the cost of the targetedfood item.

Consumer-oriented policies to ensure
affordability of healthy diets
Policies aimed at reducing poverty andincome inequality, while enhancing
employment and income-generating
activities, are also key to raising

IN BRIEF

people’s incomes and hence theaffordability of healthy diets. While
there are important synergies between
policies enhancing employment andreducing income inequality forincreased food security and better
nutrition, including social protection,these have been addressed in depth in
the 2019 edition of this report.
Nutrition-sensitive social protection
policies are needed to provide better
access to nutritious foods tolower-income consumers and thus
raise their affordability of healthy
diets. They can be particularly
important in the face of adversity,
as we are seeing today during the
COVID-19 pandemic. It is important
to strengthen these mechanisms toensure they can support micronutrient
supplementation where needed,
as well as create healthy foodenvironments by encouraging
consumers to diversify their diets to
reduce dependence on starchy staples,
reduce consumption of foods high infats, sugars and/or salt, and include
more diverse, nutritious foods.

Complementary policies that promotehealthy diets
To achieve healthy dietary patterns,
large transformative changes in foodsystems will be needed at all levels. It is
important to underscore that, although
there are some overlaps, these changes
go beyond the policy options andinvestments that are explicitly designed
and implemented to reduce the cost of| 41 |

PART 2and increase the affordability of healthy
diets. That is to say, other conditions
must also be met, requiring a whole
range of other policies that are more
explicitly tailored to raise awarenessand inf luence consumer behaviour infavour of healthy diets, possibly with
important synergies for environmental
sustainability.
These include, for example, promoting
healthy food environments that are safeand provide physical access to nutritious
foods for healthy diets; implementing tax
policies to increase the price of highly

processed, energy-dense foods ofminimal nutritional value; food industry
regulations to help ensure easier andmore affordable access to healthy diets,by reducing the content of fat, sugar andsalt in foods; introducing regulations on
the marketing of energy-dense foods ofminimal nutritional value, while also
lowering the exposure of children tomarketing techniques; ensuring access tonutritious foods by infants and conditions
for households to provide it; and policies
supporting nutrition education and thepromotion of healthy diets that include
sustainability considerations. n| 42 |

THE STATE OF

THE WORLD

2020
THE STATE OF

FOOD SECURITY
AND NUTRITION
IN THE WORLDTRANSFORMING FOOD SYSTEMSFOR AFFORDABLE HEALTHY DIETS

Updates for many countries have made it possible to estimate hunger in the world with greater accuracy thisyear. In particular, newly accessible data enabled the revision of the entire series of undernourishment estimatesfor China back to 2000, resulting in a substantial downward shift of the series of the number of undernourishedin the world. Nevertheless, the revision confirms the trend reported in past editions: the number of people
affected by hunger globally has been slowly on the rise since 2014. The report also shows that the burden of
malnutrition in all its forms continues to be a challenge. There has been some progress for child stunting, lowbirthweight and exclusive breastfeeding, but at a pace that is still too slow. Childhood overweight is not
improving and adult obesity is on the rise in all regions.
The report complements the usual assessment of food security and nutrition with projections of what the world
may look like in 2030, if trends of the last decade continue. Projections show that the world is not on track toachieve Zero Hunger by 2030 and, despite some progress, most indicators are also not on track to meet global
nutrition targets. The food security and nutritional status of the most vulnerable population groups is likely todeteriorate further due to the health and socio-economic impacts of the COVID-19 pandemic.

The State of Food Security andNutrition in the World 2020 (full text)

Some rights reserved. This work is available
under a CC BY-NC-SA 3.0 IGO licence©FAO, 2020
CA9699EN/1/07.20

The report puts a spotlight on diet quality as a critical link between food security and nutrition. Meeting SDG 2targets will only be possible if people have enough food to eat and if what they are eating is nutritious andaffordable. The report also introduces new analysis of the cost and affordability of healthy diets around theworld, by region and in different development contexts. It presents valuations of the health and climate-change
costs associated with current food consumption patterns, as well as the potential cost savings if foodconsumption patterns were to shift towards healthy diets that include sustainability considerations. The reportthen concludes with a discussion of the policies and strategies to transform food systems to ensure affordable
healthy diets, as part of the required efforts to end both hunger and all forms of malnutrition.