About 200 million children under age five—40% of all children of this age in the developing world—lack sufficient nutrition to lead fully active lives (3, 128). One indicator of chronic malnutrition among children is the percentage who are stunted—that is, short for their age compared with international standards set by the World Health Organization (WHO). Stunting among children ages 3 months to 3 years varies widely among countries, but at least one child in every three was stunted in over 40% of countries surveyed by the Demographic and Health Surveys between 1987 and 1996 (80, 92).

Recent projections by the International Food Policy Research Institute (IFPRI) indicate that child hunger and malnutrition are not likely to be reduced much over the course of the next several decades. According to IFPRI, 150 million children under the age of six will still be malnourished in 2020, just 20% fewer than in 1993. In Africa the number of malnourished children is expected to increase by 45% between 1993 and 2020, reaching 40 million (137).

IFPRI projects that by 2020 nearly 70% of the people suffering from food insecurity will live in sub-Saharan Africa and South Asia. By 2020 every third person in sub-Saharan Africa is likely to lack food security,every eighth person in South Asia, and every 20th person in East Asia (137).

In many parts of sub-Saharan Africa, people often go without enough food. Worldwide, each year about 18 million people, most of them children, die from starvation, malnutrition, and related causes.

As they have throughout history, famines periodically kill millions of the world's poorest people. In 1974, for example, Bangladesh was hit by famine. While food remained available in many districts, it did not reach poor farmers who had lost their crops to widespread flooding. With their harvests ruined, and lacking cash to buy food, many starved (69).

The households most vulnerable to hunger and its consequences are large, poor families in rural areas and those in urban squatter settlements (98, 117). Because poor families must spend most of their incomes just to eat, little remains for education, health care, sanitation, or housing (99, 132). Often, villagers say that they cannot afford to feed large families and provide a decent life for themselves or their children (90). It is difficult to escape from this cycle of poverty (98, 131, 133). Many rural people say that, if they had known about and had used family planning when they were just entering their reproductive years, they would have had fewer children (see profiles, Zongo Adulsallam, Rangit Kaur, and Leopoldo Torrez).

Seasonal food shortages threaten the health and well- being of many subsistence farmers and their families. To survive, many farmers must move temporarily to towns and cities, looking for wage employment, or else work as farm laborers for wealthier land owners. In hard times subsistence farmers may even have to sell some of their land to buy food and pay their debts. If they cannot buy back their land in better times, they must struggle to live off smaller and smaller parcels of land. Some lose all their land (62).