Hunger and Obesity – a Development Policy Challenge

Actually, the declining prevalence of hunger is a success story. A story that inspires hope and shows that progress can be made and development cooperation can be effective. But it is also a story that shows how quickly hard-won successes can be undermined or even disappear. Or how these successes can be overshadowed and displaced by other problems. It is about hunger and chronic undernutrition on the one hand, and overweight and obesity on the other.

According to the UN Food and Agriculture Organization (FAO), the number of people suffering from hunger has declined since 1990. And with it, the number of illnesses and deaths associated with hunger and undernutrition. But the trend is not consistent. There have been repeated setbacks. In sub-Saharan Africa in particular, the number of people suffering from hunger and malnutrition has been rising steadily again since 2015.

At the same time, the proportion of severely overweight people worldwide has doubled over the past 30 years — and among children and adolescents, it has quadrupled. For the first time in human history, more than three billion people are severely overweight.

“Double Burden”

The simultaneous prevalence of undernutrition and obesity, particularly in poorer countries, points to a common cause: people lack access to healthy food. What’s more, these countries in particular suffer from what is known as the “double burden.” This is because the consequences — including a weakened immune system, muscle wasting, high blood pressure, and diabetes — place a strain on already struggling health systems.

So far, investment in nutritional measures falls far short of requirements. “A world free of hunger by 2030 is unrealistic,” states Matin Qaim, director of the Bonn Center for Development Research (ZEF). Nutrition expert Cecilia Maina, also at the ZEF, puts it less dramatically: “The fight continues, but more needs to be done.” She adds: “Results so far are positive.” According to UN data, around 700 million people worldwide still suffer from hunger and undernutrition. Three billion are affected by micronutrient deficiencies. And 150 million children suffer from stunted growth.

Pioneers Kenya and Cambodia

And yet the 21st century began so promisingly. Even countries with extremely high poverty rates, such as Mozambique, Malawi, Madagascar, Zambia, Ethiopia, Liberia, Kenya, Nepal, and Cambodia, managed to nearly halve the proportion of children whose growth was impeded between 2000 and 2024. In Zambia, the rate fell from 52 percent to 32 percent during this period; in Malawi, from 56 percent to 37 percent; in Uganda, from 44 percent to 23 percent; in Ethiopia, from 57 percent to 35 percent; and in Kenya, from 38 percent to 18 percent.

This success is based on a package of measures that were implemented with different priorities depending on the country: economic growth leading to higher household incomes, the expansion of health care for mothers and children, social transfer programs, school meals, support for agricultural production, and nutrition counseling.

The affected countries received support from international donors in implementing these measures. This is because the fight against hunger is one of the 17 goals agreed upon by the global community in 2015 as part of the 2030 Agenda.

Stagnation Instead of Progress

But in the meanwhile, not only have international donors reduced their support. Conditions in the countries affected have also become more challenging. In Kenya, Zambia and Malawi, economic and political circumstances have worsened in the past ten years. According to Mania, per capita income, poverty rates, inflation, unemployment as well as public investment in education and health are key factors.

“A lack of funding, insufficient political will, and economic instability have caused the fight against hunger and undernutrition to stagnate.” The declining support from many international donors for food security programs is hitting many poorer countries particularly hard right now.

Added to this are external shocks such as droughts and floods, rising food and energy prices since the start of the war against Ukraine, and the COVID-19 pandemic. In light of the increasingly evident impacts of climate change, experts are also calling for greater investment in agricultural adaptation, including through more resilient seeds and social transfer programs.

Rural-urban migration: Hunger in the cities

The German Federal Ministry for Economic Cooperation and Development (BMZ) continues to be active in Malawi. Among other things, it supports the government in building institutional capacity to better protect local agricultural and food systems against the consequences of climate change. The project will run until 2027.

Team leader Vitowe Batch, who is implementing the project on the ground with the German Society for International Cooperation (GIZ), reports:  

“The situation is deteriorating. People in urban slums are having a particularly hard time right now.” People were migrating from rural areas to cities and struggling to survive every day,  says Batch. The monthly cost of a balanced diet per household has risen by over 200 percent between 2021 and 2024.

The result: In Malawi, stunting among children is now also on the rise in cities and larger towns. According to the National Demographic Health Survey, the rate has been rising steadily since 2015 and is now almost on par with the 37 percent rate observed among children under five in rural areas, GIZ reports.According to UN data, while around 80 percent of Malawi’s population still lives in rural areas, the urban population is currently estimated to be growing by a around 200’000 people per year. This makes Malawi one of the fastest-urbanizing countries in Africa.

The Challenge of Obesity

At the same time, however, childhood obesity is also on the rise in Malawi. According to GIZ, the rate rose from 1.6 percent in 2017 to 6.1 percent in 2024. In urban areas, the rate (8.1 percent) was higher than in rural regions (5.8 percent).

By comparison: In Germany, the proportion of 5- to 19-year-olds who were severely overweight stood at 8.5 percent in 2022. Among the population aged 18 and older, the figure was as high as 20 percent. In addition, according to WHO data, in 2024, approximately 24 percent of the female population in Malawi aged 15 to 49 suffered from overweight or obesity.

At the same time, overweight and obesity rates among women and children have risen sharply. According to official figures, the proportion of affected women aged 20 to 49 rose from 17 percent to 45 percent between 1998 and 2022.

“45 percent is a staggering figure,” explains expert Cecilia Maina. She attributes the trend to aggressive marketing of junk food in urban areas, rising incomes, and the urban population’s lack of time. For overweight children, Kenya’s rate of 4.3 percent is below the African average of 4.9 percent (2022). Rates are consistently higher in urban areas than in rural regions.

No time to cook

Cultural factors also play a role. “Junk food is often seen as something modern, something people in European countries eat, so people want to try it,” says Maina.

Malawi project manager Vitowe Batch also points to the harsh daily reality in cities: “The workload is so heavy that parents often don’t have time to prepare healthy meals for themselves and their children.” It was also often assumed that educational levels are higher in cities, she said, and that people there were better informed. But this was not the case, because people from rural areas brought their problems with them to the cities, she added.

And she criticizes the fact that development policy interventions, in particular, have been slow to catch on to this trend. “So far, we’ve mainly focused on rural regions; we’ve neglected the population in urban areas.” Cecilia Maina confirms this as well. “Governments aren’t addressing the issue of obesity; they’re focusing on the fight against hunger, wasting, and stunted growth,” she says. “That has to change.”

This article is published with kind permission of GIZ, which commissioned a report based on an expert discussion at the ZEF - Center for Development Research at Bonn University.