Since 2020, stunting in children is on the rise. For those in denial about the impacts of population growth in poor countries, the inevitable is presented as a mystery as ideology trumps honesty and compassion.
by Jane O’Sullivan
Heralding World Food Day on 16 October, an editorial in Nature focused on the disturbing rise in the global prevalence of stunting in children. It cited a recent UN report on “Levels and Trends in Child Malnutrition.” After years of improving nutrition, this trend reversal was presented as an unexpected shock. Nature begged scientists to “determine the reasons why malnutrition is increasing.”
Stunting (children who are markedly shorter than normal for their age) is a consequence of chronic undernutrition. Stunted children become short adults, often with some cognitive impairment. It used to be a fairly normal condition through much of the world: we’re familiar with the low doors and ceilings of European houses a few centuries old, and the caricature of East Asians being short – they no longer are.
Yet, even at the turn of the century, a third of children under five were affected by stunting. Encouragingly, this declined to around 23% by 2020. But then the decline petered out and numbers started to increase.
Prevalence is now concentrated in South Asia (almost one in three children) and sub-Saharan Africa (in some countries over 40% of children). Sadly, but not coincidentally, these are the regions in which most children reside: in 2024, some 77 million of the total 132 million births worldwide occurred in these two regions.
In its plea to better understand how this reversal came about, Nature pointed to the role of conflict and the jump in food prices due to the Covid-19 pandemic supply chain disruptions and the 2022 Russian invasion of Ukraine. It failed to mention that hunger has been on the rise since 2015, well before these events. The 2017 edition of the State of Food Security and Nutrition in the World stated that the number of chronically hungry people grew from 777 million in 2015 to 815 million in 2016, reversing years of decline. Although hunger has since declined in most regions, it continues to rise in Western Asia and, especially, Africa. It would seem logical that a rise in the prevalence of hunger almost inevitably leads to a rise in the incidence of child stunting.
What none of these UN reports or Nature articles mention is the population growth rate in these hungry, conflict-ridden countries. The term “population growth” appeared only once in the UN’s “Levels and trends in child malnutrition” report, in a footnote explaining a calculation relating the number to the percentage of stunted children. It is entirely absent from the 2025 edition of “The State of Food Security and Nutrition in the World”.
Nature links us to various related articles focusing on the value of cross-disciplinary collaboration, of reducing food waste, of giving a leg-up to smallholder farmers, of avoiding trade sanctions that reduce food access for the poor – always zooming in to smaller facets of the problem rather than zooming out to the bigger picture.
The picture in which, in the space of 75 years, sub-Saharan Africa’s population has increased by a factor of seven.
More people, more hunger
Since 1950, the land area sown to crops in sub-Saharan Africa has roughly doubled, but cropland per person went from three-quarters of a hectare to only one-quarter. That’s above the global average of about 0.2 ha, but on average Africa’s cropland is much drier and less fertile. It’s unlikely the next population doubling will see as much expansion of cropping: most communities have long since run out of forests to fell and fallows to shorten. Soil degradation due to overclearing, overgrazing and overcultivation is worsening rapidly. Deforestation and overgrazing reduce rainfall, lowering crop yields and exacerbating soil degradation.
In Africa and South Asia, the sentimental myth that smallholders feed the world confronts the reality that many don’t adequately feed themselves, let alone provide a surplus for townsfolk. Hungry people flock to urban centres where they increasingly rely on imported foods, while global food prices rise and local currency values fall.
Nor is the increment of population growth slowing. Sub-Saharan Africa added less than 4 million people per year in 1950 but now adds over 30 million per year and still rising. The region’s population has doubled since the year 2000 – a single generation. A recent study found the fertility decline in several African countries has not kept pace with improvements in child survival, so the number of surviving children per woman has risen until very recently. They conclude, “In Middle Africa, TFR data suggest that fertility peaked in 1987 and has since declined, while [net reproduction rate] measurements indicate that fertility has yet to decline at all in this region.” Elsewhere, countries like Pakistan and Iraq have failed to achieve a consistent slowing of growth as their painfully slow fertility decline is countered by ever bigger cohorts of mothers.
The links between population growth, hunger and conflict are well known, and well summarised in the Population Institute’s 2015 Demographic Vulnerability report. A 2003 study by Population Action International found the risk of conflict related to three stress factors: the proportion of those aged 15 to 29 in the adult population, the rate of urban population growth, and the per capita availability of cropland and fresh water. A 2011 study demonstrated spikes in food prices triggered violence during the ‘Arab Spring’ and elsewhere. In Africa, while conflict tended to increase food prices, rising food prices increased the incidence of conflict with greater certainty. And food prices rise wherever demand outstrips supply.
Yet, more support for family planning programs does not feature in any of the food security reports from the UN or Nature. The United States, until recently the world’s largest funder, has drastically cut aid for family planning, and other developed nations are failing to pick up the slack. Why would they, when the scientific community is silent on the need?
Even if one believes population growth is tapering off and requires no help to do so, science demands we acknowledge it as a still-relevant and powerful counter-current against today’s efforts to reduce hunger and conflict in the world. Increasing food production might have outpaced population for a while but this doesn’t refute its impact. If that progress has now foundered, it is no mystery.
But heavens no, we can’t say that! As long as this taboo persists, more children will go to bed hungry.
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