An estimated 155 million people across the globe faced severe food insecurity and were in need of urgent assistance in 2020, according to a U.N. report published Wednesday. Researchers found the number of people experiencing food insecurity at or above a “crisis” level has risen to its highest level in five years, with an increase of nearly 20 million people compared to 2019 — and are warning that millions are at risk of famine if action isn’t taken. 

“155 million people in 55 countries relied on humanitarian assistance just to survive — an unprecedented high and just the tip of the iceberg” World Food Programme Executive Director David Beasley said as he announced the report’s results. 

According to the 307-page report, 155 million people were in one of the three most severe phases it uses to characterize food insecurity: “Crisis,” “Emergency,” and “Catastrophe/Famine.” All 155 million people in the estimated tally are at least experiencing “Crisis,” which signifies “high or above usual acute malnutrition” or people who can only meet their minimum food needs “by depleting essential livelihoods or through crisis-coping strategies.” 

Approximately 133,000 people were at the “Catastrophe/Famine” phase, in which “Starvation, death, destitution and extremely critical acute malnutrition levels are evident” and urgent action is needed to “prevent widespread death and total collapse of livelihoods.” The vast majority of those people lived in South Sudan, with the remaining 28,000 spread between Yemen and Burkina Faso. 

Africa remained the continent most impacted by hunger crises, accounting for 63% of the people experiencing food insecurity in “crisis” or worse, the report said. 

The report highlighted the impact that food insecurity has on children, especially when it comes to children who did not grow to their expected height because of lack of food and poor nutrition (stunting), children who are significantly underweight underweight (wasting). 

“Before the pandemic, one in three children were already not growing adequately because of malnutrition. Despite progress over the years, 149 million children are still affected by stunting … 45 million children are suffering from wasting… and at least 340 million have vitamin and mineral deficiencies,” said UNICEF chief Henrietta Fore.  

“For the children living in the 55 countries experiencing a food crisis, the situation is especially grave,” Fore added. “More than one in three of all wasted children – 16 million – and just under one half of all stunted children – 75 million children – live in these countries.” 

“If current trends are not reversed, food crises will increase in frequency and severity,” the European Union and multiple humanitarian groups said in a joint statement.  

USAID Administrator Samantha Power on Wednesday announced a five-year, up to $300 million funding increase for UNICEF, the United Nations’ children’s fund. U.S. Ambassador to the U.N. Linda Thomas-Greenfield tweeted that the aid “will continue to improve the health and well-being of mothers, children, and families around the world.” 

Although the coronavirus pandemic dominated headlines in 2020, the report said it was not entirely to blame for the hunger crises. The report cited conflict and war, weather extremes, and economic shocks — including those caused by the coronavirus pandemic — as the “three primary drivers” of food insecurity. 

The report warned that if urgent action is not taken, the alarming trends will continue. More than 142 million people are predicted to be in “Crisis” or worse in 2021, and approximately 150,000 will likely face “Catastrophe” through mid-2021, according to the report. 

“We must do everything we can to end the vicious cycle,” Guterres said. “There is no place for famine and starvation in the 21st century.”