Experts call for famine mortality measure overhaul amid delayed responses to global crises
Key takeaways
- Experts argue that the IPC thresholds, designed for rural Africa, fail in urban or middle-income areas, leaving mass starvation unclassified until too late.
- Researchers suggest using earlier indicators, such as declining birth weights or mortality spikes in specific age groups, to set new mortality benchmarks.
- In conflict zones, demographic data is often missing or manipulated, as the current classification system is vulnerable to politicization.
A new publication is calling out universal mortality benchmarks for being outdated, as they were designed for rural African contexts, not for middle-income, urbanized populations. It urges these thresholds to be re-examined and reset to earlier indicators of famine stress. The authors hope new measures can enable more efficient responses to hunger.
“The mortality thresholds used by the Integrated Food Security Phase Classification (IPC) were developed for rural African settings, not middle-income urban populations,” says L.H. Lumey, M.D., Ph.D., Columbia University’s professor of Epidemiology. “There are stark disparities in how famine mortality is assessed across contexts.”
The researchers reflect on recent global crises, such as in Gaza, that have shown the inadequacies of the universal mortality threshold for declaring famine.
Starvation can remain unclassified
The study in The Lancet argues that starvation on a mass scale can remain officially unclassified for long periods because it fails to meet IPC’s Phase 5 benchmark. This requires two deaths per 10,000 people per day, meaning starvation may fail to be recognized until it reaches an advanced level.
Furthermore, the researchers say that IPC relies on absolute mortality rates and overlooks spiked relative increases within specific age groups. For example, the authors point to the example of the Dutch Hunger Winter (1944–1945), where current famine measures would have failed to capture its severity at that time. Child mortality at that time would not meet the current threshold.
During that crisis in the Netherlands, birth weight and births in populations declined with a sharp rise in child mortality. Infant mortality in some cities reached four times the prewar level, and one- to four-year-olds’ mortality increased sevenfold. Lumey adds: “These dramatic increases would not meet the current IPC famine threshold for children under five.”
Mortality lags action
The researchers state that mortality is a lagging indicator. This is because when the benchmarks are reached, preventable deaths have already occurred.
“In war zones, where most modern mass starvation occurs, reliable demographic data are usually missing. For several 20th-century famines, including the Ukraine Holodomor, demographic data became available only decades later,” reads the correspondence.
“Classification systems that depend on hard-to-obtain data in conflict settings risk systematic under-recognition.”
Additionally, they warn that the classification process used in current systems can be politicized. People could restrict access or manipulate mortality data.
“Identifying earlier indicators of famine stress could shorten the time between acute food insecurity and rising mortality,” says Lumey. “A more sensitive and context-specific approach would support faster humanitarian action.”
The other authors are based at Wageningen University in the Netherlands and at Tufts University in the US.
After releasing its 2026 Global Hunger Hotspots report, Nutrition Insight spoke with Action Against Hunger. To tackle acute food insecurity, the organization urged nutrition companies to collaborate with NGOs and innovate essential food distribution methods, rather than just increasing production.
