As scientists and members of the Standing Together for Nutrition Consortium (ST4N) who have been Standing Together For Nutritionduring recent crises, we use evidence of the impact of crises on nutrition to advocate for the people most affected.1–3Now, in the face of the world's indifference, we are compelled to speak out about the horrifying human-made famine unfolding in Gaza and other conflict areas, including Sudan, South Sudan, and Yemen.4–9

Widespread starvation is deliberately used as a weapon of war,10 at a scale that we never thought possible.11I t is a moral failure that in 2025 more than 1·2 million people are living in Integrated Food Security Phase Classification (IPC) phase 5 (catastrophe) famine conditions—the most extreme food insecurity level according to the gold-standard IPC.12

These famines are not only claiming lives today, but they are also inflicting irreversible intergenerational trauma and damage.13–16 Undernutrition in early childhood, particularly during the first 1000 days of life, disrupts physical growth, weakens immune systems, and impairs cognitive development.17 Wasted children are about 12 times more likely to die before their fifth birthday than children with a healthy weight.18 Those children who do survive famine will bear the impacts for life: stunted growth, chronic diseases, and reduced educational and economic potential.

Evidence from the Dutch famine birth cohort and other famine-based studies shows that prenatal exposure to undernutrition impacts cardiometabolic health, mental health, and cognitive function at age 50 years and older.19

The economic cost of malnutrition, through lost human capital and increased health-care expenses, can reduce nations' gross domestic product by 3–16%.20 Additionally, the biological impacts might persist across generations through epigenetic changes, perpetuating a cycle of poverty and poor health.17,21 The science of malnutrition and the solutions are known. Treatment of severe acute malnutrition, access to nutritious foods, clean water, nutrient supplements, and medical care are not radical ideas—they are proven strategies that save lives and rebuild communities.22 Yet in Gaza and other conflict zones, humanitarian organisations are systematically obstructed to an extent we have not seen before.

Aid is blocked, health infrastructure is targeted, and families are left to face starvation, constituting grave violations of international humanitarian law.23Undernutrition is not only a consequence of war, it is also the seed for future conflict.24Desperation breeds instability. If an entire generation is allowed to grow up hungry, traumatised, and without hope, we all are complicit in setting the stage for further suffering. Careful data collection and scientific evidence to inform policy making are important. But this is not a moment for analysis, this is a moment for action.

ST4N is calling for the nutrition, medical, public health, and scientific community to support a call to action on ST4N's website.25Using hunger as a weapon of war must stop. Aid must flow today. Every child—every person—has the right to the nutrition they need to survive and thrive. Immediate, sufficient, unimpeded, and unconditional humanitarian access is urgent; it is the only path to avert further famine-related deaths and suffering. To delay humanitarian assistance is to deepen the crisis; to act is to break the chains of complicity.

Saskia Osendarpa [email protected] ∙ Lawrence Haddadb ∙ Cecilia Fabrizioa ∙ Caroline Andridgec ∙ Robert E Blackd ∙ Molly E Browne ∙ Elizabeth Bryanf ∙ Bruce M Campbellg ∙ Mary D'Alimontec ∙ Jessica Fanzoh ∙ Derek Headeyf ∙ Rebecca Heidkampd ∙ Abbe McCarterc ∙ Purnima Menonf,i ∙ Kristina Michauxa ∙ Stella Nordhagenb ∙ Lais Miachon Silvaa ∙ Roosmarijn Verstraetenj ∙ Zulfiqar A Bhutta

We are all members of the Standing Together for Nutrition Consortium (ST4N). SO and LH are co-founders of ST4N. SO, LH, BMC, JF, EB, MEB, and ZAB are members of the ST4N Steering Committee and CF is the ST4N Program Lead. SO, CF, and LMS report funding from Global Affairs Canada. BMC is a consultant to the Global Centre on Adaptation and Clim-Eat. SO, CF, KM, and LMS are employees of the Micronutrient Forum, which hosts ST4N and led the development of this Comment. RH is a consultant to the Micronutrient Forum. RV is a researcher at the European Commission's Joint Research Centre (JRC); the JRC is a public research body under the European Commission, and RV reports institutional support for work in supporting the Technical Advisory Group for Nutrition in Integrated Food Security Phase Classification (IPC); RV is a scientific expert supporting the IPC's Technical Advisory Group as well as the Nutrition Working Group. ZAB reports an institutional grant from the Larsson Foundation for evaluating breastfeeding support for women and children in conflict and humanitarian settings and is the Founding Coordinator for the BRANCH consortium Bridging Research to Action for Women and Children in Conflict and Humanitarian Settings 2017–2023. All other authors declare no competing interests.

Source: The Lancet

References

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