The Food and Agriculture Organization of the United Nations (FAO) and the World Food Programme (WFP) warn that acute food insecurity is likely to deteriorate further in 20 countries or situation (including one region) - called hunger hotspots - during the outlook period from February to May 2022.

Ethiopia, Nigeria, South Sudan and Yemen remain at the highest alert level from the previous edition of this report. In their last available assessments, these countries all had parts of populations identified or projected to experience starvation and death (Catastrophe, Integrated Food Security Phase Classification [IPC] Phase 5), requiring the most urgent attention.

The lack of updated assessment data for Ethiopia is a major concern. Acute food insecurity levels are likely to have increased and could rise further beyond the Emergency and Catastrophic levels (IPC Phase 4 and 5) already identified in the last report. These included a projection of famine-like conditions for 401 000 people for July to September 2021 in the Tigray region. A risk that famine would occur in Tigray region by end of 2021 was identified by the IPC Famine Review Committee, conditional on the conflict worsening, humanitarian access shrinking and private sector and supply lines becoming non-functional. While an updated assessment of the situation is not available, according to the Famine Review Committee's worst case scenario, there would be a high Risk of Famine, if conflict was to resume in Tigray.

In Nigeria, while some populations in conflict-affected areas in the northeast are now projected to slide into catastrophic food insecurity at the peak of the lean season, from June 2022 onwards, it cannot be excluded that some may start to experience this even earlier, in the next months, and that the magnitude may be higher than what projections anticipate.

Across South Sudan, the magnitude and severity of already very high levels of acute food insecurity is likely to increase further. Food insecurity has likely further deteriorated beyond the latest available IPC projections and is expected to continue increasing. Preliminary results of the sectoral analysis undertaken in November 2021 identified 11 counties of extreme concern for food insecurity in 2022 as compared to 6 in 2021. In Pibor County, Jonglei State, the IPC FRC had alerted in December 2020 that several payams were in famine likely or at risk of famine for the projected period from December to July 2021.

In Yemen, the latest available IPC analysis, issued in December 2020, projected rising Catastrophic levels of food insecurity in three governorates and deteriorating Emergency levels in other parts by June 2021. While increased humanitarian assistance by July 2021 contributed to a stabilization of food insecurity, recent data across the north and south of Yemen gives indicative evidence of a deteriorating trend in the food insecurity situation while underlying drivers of food insecurity continue to deteriorate.

Compared to the previous edition of this report, the situation in Madagascar is no longer at the highest alert level as the risk of a catastrophic food insecurity situation – 28 000 people were previously projected to face Catastrophe (IPC Phase 5) by October– December 2021 has been averted for now as a result of the broad coverage of humanitarian food assistance. Nonetheless, Madagascar remains a hunger hotspot due to persisting high levels of acute food insecurity.

Afghanistan, the Central African Republic, the Democratic Republic of the Congo, Haiti, Honduras, the Sudan and the Syrian Arab Republic remain countries of particular concern, as in the previous edition of this report. This is due to the high numbers of people in critical food insecurity coupled with worsening drivers expected to further intensify life-threatening conditions. Afghanistan in particular is projected to face a record high of people in critical food insecurity and there is a serious risk that parts of the population will face starvation and death (IPC Phase 5) if the crisis is not contained. Sahel, as a region, is the new entry for this category of countries of particular concern, likely to reach the highest number of acutely food-insecure people in the past eight years under the combined effects of erratic rainfall, record high food prices and – for Central Sahel – further security deterioration.
Mauritania has been added in the list of hotspots countries compared to the July 2021 edition of the report.

Organized violence or conflict remains the primary drivers, actual or potential, for acute hunger in the hunger hotspots and globally.
Weather extremes such as heavy rains, tropical storms, hurricanes, flooding, drought and climate variability remain significant drivers in some countries and regions. The ongoing La Niña conditions additionally lead to an elevated risk of a two-year sequence of dry conditions, particularly in East Africa and Central Asia. Almost two years into the COVID-19 pandemic, global and national economic disruptions caused by several contagion waves have escalated while new variants bring new uncertainties and might negatively affect their economies. Overall, high food prices and low household purchasing power are major economic concerns for further increasing acute food insecurity.

Targeted humanitarian action is urgently needed to save lives and livelihoods in the 20 hunger hotspots. Moreover, in four of these hotspots – Ethiopia, Nigeria South Sudan and Yemen – humanitarian actions are critical to preventing starvation and death. The report provides country-specific recommendations on priorities for emergency response as well as anticipatory action to address existing humanitarian needs and ensure short-term protective interventions before new needs materialize. - OCHA/ReliefWeb

Women enjoy a laugh together while working on a soil conservation Quick Impact Project. Photo IOM/Amaury Falt-Brown

Burundi, 20 Jan 2022 – Pushing his prized bicycle along the fissured dirt roads of Tura Hill, past lush banana plantations and earthen huts, Anicet beams with pride as he traces the story of his reintegration from life as a refugee in Tanzania to his return to Burundi.

“During the political instability of 2015, there was a shortage of food [in the community] so my family and I left Burundi to look for something to eat,” says Anicet. Unaware of the struggle that awaited them, he went on to find out that life as a refugee was itself a life of hardship.

Without land of his own, for three years the proud farmer lived in squalid conditions while working on other people’s farms to make ends meet. As time went by, however, he heard that stability might be returning to Burundi.

Eventually, in 2018, news of a more peaceful environment back home pushed the father of three and his wife to migrate once more – this time, as returnees to their native Burundi.

“I was so happy to come home to the country of my birth,” he says, “[even though] the livelihood of a returnee is not always easy.”

With initial support from the UN Refugee Agency (UNHCR), the family benefitted from an assisted voluntary return programme and was given transportation to Burundi and a starter fund to get back on their feet.

Nevertheless, without land or a source of income, Anicet, like tens of thousands of others, faced the struggle of reintegrating into the community he was once a part of.

“With some money that I obtained from a community microfinance scheme, I tried to open a fish trading business, but it failed,” he says. As time went by and living conditions did not improve, a weary Anicet began to once again consider life as a refugee.

Refugees returning to their country of origin often face high risks and have no steady income – a key component of the reintegration process. Returning to communities where resources are already scarce can strain the local population and lead to social conflicts between host communities, returnees and the many internally displaced persons (IDPs) who are there.

The International Organization for Migration ’s (IOM) Quick Impact Projects (QIPs) help ease tensions in provinces of high refugee returns in Burundi.

QIPs are designed to cushion the dual blows of instability and poverty, while offering beneficiaries hope of a decent life. They also serve to reduce the risk of social conflict by providing communities with opportunity.

Alva Fredman Klockar, project manager with IOM's transition and recovery department, says stronger social ties follow. "When returnees, IDPs and host community members come together to decide which public infrastructure to rehabilitate, it strengthens social ties between the different groups, gives them an opportunity to earn an income and contributes to the common good of the community."

IOM-organized dialogues guide the process of selecting and implementing a pertinent QIP – in collaboration with the local population, authorities and IOM’s implementing partner – Help a Child.

Anicet was a beneficiary of a QIP. Like thousands of others, he benefitted from the Cash for Work system that is the backbone of Quick Impact Projects – essentially, cash in exchange for labour.

With the funds earned from IOM, he decided to stay in Burundi rather than to migrate again. He used the cash to invest in livestock and then revived his fish trading business.

“After buying my livestock, I worked very hard, going to the river every day to buy fish and my capital started to grow,” Anicet says. “With the funds I earned I then bought a bicycle. This allowed me to bring back even more fish [to sell] from the river. Now, I also gather grasses, which I transport on my bicycle to feed my livestock.”

With the support of the Federal Republic of Germany and the United Kingdom’s Foreign and Commonwealth Development Office (FCDO), families such as Anicet’s are rebuilding their livelihoods and investing in their futures.

UNHCR estimates that there are around 300,000 Burundian refugees still living abroad, many of whom are in the process of coming home. In 2021 alone, over 60,000 have returned, prompted by an increasingly stable climate since the Burundian presidential elections of 2020.

The lingering question is, how do provinces of high returns accommodate citizens who wish to come home without cracking an already fragile social system?

Michel Ndururutse, a member of the local Tura administration in the country’s north-east, believes that QIPs are a key part of the solution. “The population is very happy with the work being done by IOM. It is creating lasting change as the people benefit from the long-term effects of these projects,” he says.

Belise, a 21-year-old returnee from Tanzania, shares that view: “With the money that I earned from building the two classrooms of our community, I was able to buy livestock that has helped to stabilize my family life. I am very proud to have been a part of the school building,” she says.

Belise explains that thanks to her involvement in the school building project, her family is connected to their neighbours. Soon, she adds, her four-year-old daughter will be going to school in the same classrooms she helped to build.

IOM’s reintegration programme not only seeks to promote community cohesion in areas of voluntary return but aims to provide communities with the means to shape more prosperous and stable futures.

Anicet says IOM’s help made all the difference. “Everything I have now is thanks to the support I received. Before that, I was ready to go back to Tanzania. This assistance allowed me to stay [in Burundi].” - This email address is being protected from spambots. You need JavaScript enabled to view it., IOM Burundi

MUTATED PARASITE: Malaria is caused by Plasmodium parasites, which are spread to people through the bites of infected female Anopheles mosquitoes. Photo via The Star

Individuals who carry the sickle cell trait, a condition in which red blood cells are abnormally shaped, have always been highly protected against severe malaria.

However, new research by the Kenya Medical Research Institute shows the malaria parasite has adapted to overcome this protection.

The study, published in Nature, found variants of the malaria parasites that have evolved to infect and cause serious disease in people who carry sickle haemoglobin.

“In this study, we searched for an association between candidate host and parasite genetic variants in 3,346 Gambian and Kenyan children ascertained with severe malaria due to Plasmodium falciparum,” the researchers said.

They found that malaria in children with sickle cell tended to be caused by a certain type of mutated parasite.

The researchers suggested that the sickle cell trait may have applied pressure on the plasmodium parasite over time, forcing it to adapt.

This led to a variant that can now infect people with sickle cell as well as those with normal red blood cells.

“We identified a strong association between sickle haemoglobin in the host and three regions of the parasite genome, that is not explained by population structure or other covariates, and that is replicated in additional samples,” the researchers said.

The study is titled "Malaria protection due to sickle haemoglobin depends on parasite genotype."

The researchers are from Kemri-Wellcome Trust Research Programme, Wellcome Sanger Institute, the University of Oxford, the MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine (LSHTM), along with collaborators from the US and Mali.

The scientists said this is the first time this phenomenon has been observed in a study and further research is needed to understand the biological mechanisms behind this.

Prof Tom Williams, a senior fellow at Kemri, said, “Previously, sickle haemoglobin was believed to have a protective effect against severe disease.

"However, this study highlights the importance of continually investigating this parasite so that we can be informed about how it adapts against selective pressures.”

Normal blood cells are disc-shaped while sickle cells are irregularly shaped. Individuals carrying just one copy of the sickle cell can lead normal lives and do not develop sickle cell anaemia.

Past research has confirmed these individuals are highly protected against severe malaria. This explained the high prevalence of sickle cell in geographical areas where malaria is endemic, such as western Kenya.

The sickle-shaped cells have porous membranes that leak nutrients that the malaria parasites need to survive and reproduce. The immune system then clears the infected cells before the parasite can complete its life cycle and infect other red blood cells.

Individuals, therefore, tend to get milder forms of malaria rather than the life-threatening kind that can afflict people with normal blood cells.

But from the Kemri study, the defiant malaria parasites are now overcoming this protection.

The researchers said understanding how this happens could lead to new ways to protect against and treat malaria.

“Greater clarity on the ways that P. falciparum evades the human body’s defences could lead to new opportunities for protecting against malaria and treating those living in the most affected areas,” Prof David Conway, the study author and professor of biology at LSHTM, said in a statement. - John Muchangi, The Star

(Edited by Bilha Makokha)