Private food distribution may be discouraged by excessive regulations and by unfair competition from subsidized and inefficient government-run parastatals. Food insecurity can be exacerbated by disease, poor water and sanitation systems, inadequate nutritional knowledge, and cultural conditions which affect consumption patterns. The integration of food security initiatives with other health and education programs can effectively address many of these problems. Civil war and ethnic conflicts also threaten food security by cutting off whole segments of a country's population from food supplies and disrupting traditional agriculture. Chronic food shortages in the Horn of Africa have been exacerbated by civil conflict.
All countries confront natural disasters at one time or another.
All countries experience some form of political conflict. However, food insecure countries are particularly vulnerable. In Africa, the number of refugees and internally displaced has risen from one million in the early 1970s to over twelve million now. The demand for emergency food aid has grown dramatically. One of the reasons for this phenomenon is the increase in protracted emergencies.