As malnutrition deaths are reported and hunger grows, will ‘famine’ be declared

After months of aid agencies’ warnings that Palestinians in Gaza Strip were at a high risk of famine, many worry it is now taking hold in the northern part of the enclave where children have begun to die of malnutrition and dehydration.

Gaza’s Ministry of Health said Wednesday at least 20 people have died of malnutrition at hospitals and warned that it believes “dozens are dying silently” unable to reach medical facilities. The World Health Organization visited northern Gaza over the weekend and confirmed at least 10 child starvation deaths at the time of the team’s visit.

Israeli officials have repeatedly stated that they are committed to humanitarian assistance for civilians and have not placed any limits on aid entering the Palestinian enclave.

A famine has not yet been declared in Gaza, but the Integrated Food Security Phase Classification (IPC) has activated its famine review committee to assess the situation.

While hunger is a longstanding issue around the world, a declaration of famine is relatively rare.

What is famine?

The dictionary defines famine simply as an “extreme scarcity of food,” but among world aid agencies addressing food insecurity, it has a much clearer definition and specific guidelines for when to classify a situation as such. According to the IPC, famine is a situation where starvation and extremely critical levels of acute malnutrition are evident.

“It’s a technical term that sort of encapsulates a series of conditions,” said Tobias Stillman, Action Against Hunger’s director of technical services and innovation. “So very significant food insecurity, meaning people don’t have sufficient food to support their physiological need … so they are both experiencing hunger and physiologically in many cases, compensating for the lack of food.”

What pushes food insecurity into a famine declaration?

Both the IPC and the World Food Programme offer a mathematical threshold for what constitutes a famine for the population of a specific area: 20% of households with an extreme lack of food, 30% of children suffering from acute malnutrition, and two in 10,000 people dying per day “due to outright starvation or to the interaction of malnutrition and disease.”

The IPC was created in 2004 by the United Nations’ Food and Agriculture Organization but partners with more than a dozen organizations worldwide as well as governments to examine food insecurity using evidence-based analysis.

It uses a five-phase index that measures food insecurity, with Phase 5 being catastrophe or famine. Currently, Gaza is in the “emergency” phase, which is a step below famine.

“Even though the levels of acute malnutrition and non-trauma related mortality might not have yet crossed famine thresholds, these are typically the outcomes of prolonged and extreme food consumption gaps,” the website states.

NBC News reached out to the IPC, but a representative noted that its experts are working on an upcoming report on Gaza and not available for interview.

Who declares a famine?

Declaring a famine is a multi-step process for the IPC, according to Stillman, and requires complete consensus from five people on the independent committee.

Currently, a group of 25 to 30 people are assessing data from Gaza to offer its recommendation for analysis to the famine review committee. If there is a specific point of contention on a particular data point, that would be noted in a manner similar to what someone might see in the U.S. Supreme Court, Stillman noted.

“If the five of them can’t achieve consensus — if there’s one, for example, that digresses — they can they can draft a dissenting statement,” Stillman said. “So that that committee will still come out with an overall recommendation or an overall classification, but there may be a dissenting voice.”

After the review committee makes its designation, the analysis is sent to IPC’s global steering committee, which Action Against Hunger currently chairs, to make the official declaration of famine.

Those who work on hunger and food insecurity understand that it’s a complex system, Stillman said. But the teams working on these declarations “will be justifying their conclusions every step of the way.”

“It needs to be complicated because it is so incredibly important,” Stillman said. “And, you know, famine carries such important political connotations that nobody wants to take that lightly … it is very, very process-oriented.”

How is hunger being assessed in Gaza?

The situation in Gaza has posed unique challenges because the limited access has complicated the ordinary process. But teams are collecting real-time data to provide to the IPC, Stillman said.

Usually, the larger country-level committee that…