United Nations World Food Programme

El Niño Southern Oscillation (ENSO) is a significant form of internal climate variability resulting from the interactions between the atmosphere and ocean in the tropical Pacific. It is a main driver of interannual rainfall variability in Northeast Thailand, where rainfed agriculture is one of the largest economic sectors. Therefore, it is essential to understand the ability of climate models to simulate the basic characteristics of ENSO phenomena and project its impacts in the region. We evaluated the ability of 12 climate models from the sixth phase of the Coupled Model Intercomparison Project (CMIP6) and their 12 predecessor models from the fifth phase (CMIP5) to simulate ENSO and its impact on rainfall over Northeast Thailand using thirteen performance metrics under seven criteria considering the simulation of observed indices, pattern, variability, peaks and seasonal phase locking of ENSO. The intensity and frequency of the ENSO events were projected for the near future (2021–2050). Although six CMIP5 and eight CMIP6 models performed well in simulating half of the ENSO evaluation metrics (performance score > 40%) such as ENSO variability, seasonal phase locking, location of ENSO variability, and dominant secondary peak in SST variability, we did not find very compelling evidence of improved ENSO simulation in CMIP6 compared to CMIP5 models. However, high rainfall in extreme La Niña events and low rainfall in extreme El Niño events with rainfall anomalies of 0.4 mm/day and − 0.3 mm/day, respectively were observed over Northeast Thailand due to the interaction of the easterly winds from the Pacific Ocean with the south-westerly flow from the Indian Ocean. The corresponding sea level pressure maps further confirmed the mechanisms associated with this phenomenon over the region. The ensemble averages of models from both phases predicted an increase in intensity (by 32–47%) and frequency (by 10–50%) in the near-future (2021–2050) with a slightly higher increase by CMIP6 models compared to CMIP5 models under medium and high emission scenarios.

Global access to deworming treatment is one of the public health success stories of low-income countries in the twenty-first century. Parasitic worm infections are among the most ubiquitous chronic infections of humans, and early success with mass treatment programmes for these infections was the key catalyst for the neglected tropical disease (NTD) agenda. Since the launch of the ‘London Declaration’ in 2012, school-based deworming programmes have become the world's largest public health interventions. WHO estimates that by 2020, some 3.3 billion school-based drug treatments had been delivered. The success of this approach was brought to a dramatic halt in April 2020 when schools were closed worldwide in response to the COVID-19 pandemic. These closures immediately excluded 1.5 billion children not only from access to education but also from all school-based health services, including deworming. WHO Pulse surveys in 2021 identified NTD treatment as among the most negatively affected health interventions worldwide, second only to mental health interventions. In reaction, governments created a global Coalition with the twin aims of reopening schools and of rebuilding more resilient school-based health systems. Today, some 86 countries, comprising more than half the world's population, are delivering on this response, and school-based coverage of some key school-based programmes exceeds those from January 2020. This paper explores how science, and a combination of new policy and epidemiological perspectives that began in the 1980s, led to the exceptional growth in school-based NTD programmes after 2012, and are again driving new momentum in response to the COVID-19 pandemic. This article is part of the theme issue ‘Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs’.

During adolescence, many young people gain greater food choice agency but also become increasingly exposed and susceptible to environmental pressures that influence their food choices. This coincides with increased nutritional needs, especially for girls. In urban Colombia, adolescent diets are often high in undesirable foods and low in nutritious foods, contributing to overweight and micronutrient deficiencies. This study aimed to explore the potential of improving diet quality using food-based recommendations (FBRs) within the parameters of local food systems and adolescents' existing dietary patterns to inform context-specific programmatic responses to malnutrition. We applied linear programming analysis to dietary data from 13- to 20-year-old girls in Medellin to identify problem nutrients, local micronutrient sources, and promising FBRs. Iron and, to a lesser extent, calcium targets were difficult to meet using optimized diets based on local foods, especially for 13- to 17-year-olds. High habitual consumption of foods with excessive salt, fat, or sugar provided >5% of micronutrients in optimized diets. Otherwise, significant micronutrient sources included legumes, meat, dairy, bread, potatoes, and fruit. FBRs met targets for 10 micronutrients but only 32%-39% recommended nutrient intake for iron. FBRs, including occasionally consumed foods and supplements, met all intake targets for less cost, indicating a need to increase access to nutrient-dense products.

Introduction: Achieving nutritional goals depends on individual, organisational and environmental capacities. The aim of this study was to analyse and identify capacity gaps among the coordination platforms and networks, and the key technical institutions related to nutrition in Burkina Faso for a capacity development plan formulation. Methods: Using the new Nutrition Capacity Framework developed by the United Nations Network, information were collected using the Nutrition Stakeholder Mapping and Analysis tool, and the Checklist for Capacity Areas. Capacity needs were analysed in terms of Human resource and infrastructure, functional, organisational, coordination and partnership, and financial and resource mobilisation. Results: Limited human resource capacity in nutrition was highlighted in most cases by the structures, and the nutrition coordination structure and more than 4/5 of the technical structures are faced with the unavailability of working materials, tools and basic Internet connection. Only 10 among the 30 structures have a unit or service for exchange on nutrition, and only three of them have integrated nutrition actions. Shortfalls were noted in terms of functional, facilitation, communication and advocacy skills, as well as a weak diversification of resource mobilisation strategies. Conclusion: The use of the analytical framework helped to identify the gaps and to propose paths for capacity development. Efforts need to be strengthened, intensified, coordinated, monitored, evaluated and funded.

Unhealthy eating habits are common among adolescents in Vietnam, where transitioning food environments increasingly offer energy-dense micronutrient-poor foods. Successful behavior change approaches must be feasible and acceptable, promoting local foods that are available, accessible, and preferred. Yet, few studies have investigated the potential of food-based approaches for adolescents. We used linear programming to identify problem nutrients, local nutrient sources, and realistic food-based recommendations (FBRs) to improve nutrient intake among girls 16-22 years in Thai Nguyen, Vietnam. We then identified a reduced set of FBRs to prioritize the most critical micronutrient gaps. Calcium and iron targets could not be met in any realistic diet modeling scenario. The best set of FBRs included seven recommendations which could meet intake targets for 9 of 11 modeled micronutrients. The best reduced set of three FBRs targeting iron and calcium only-although more feasible for behavior change-was less effective at improving intake of these nutrients since fewer foods were recommended. Given the difficulty of meeting calcium and iron targets using local foods within acceptable dietary patterns, additional interventions, such as supplementation, staple food fortification, or increasing the availability of affordable calcium- and iron-rich foods, may be necessary to promote dietary adequacy for adolescent girls.

Adequate calcium intake is essential for health, especially for infants, children, adolescents, and women, yet is difficult to achieve with local foods in many low- and middle-income countries. Previous analysis found it was not always possible to identify food-based recommendations (FBRs) that reached the calcium population recommended intake (PRI) for these groups in Bangladesh, Guatemala, and Uganda. We have modeled the potential contribution of calcium-fortified drinking water or wheat flour to FBR sets, to fill the remaining intake gaps. Optimized diets containing fortified products, with calcium-rich local foods, achieved the calcium PRI for all target groups. Combining fortified water or flour with FBRs met dietary intake targets for adolescent girls in all geographies and allowed a reduction from 3-4 to the more feasible 1-2 FBRs. Water with a calcium concentration of 100 mg/L with FBRs was sufficient to meet calcium targets in Uganda, but higher concentrations (400-500 mg/L) were mostly required in Guatemala and Bangladesh. Combining calcium-fortified wheat flour at 400 mg/100 g of flour and the FBR for small fish resulted in diets meeting the calcium PRI in Bangladesh. Calcium-fortified water or flour could improve calcium intake for vulnerable populations, especially when combined with FBRs based on locally available foods.

Globally, dietary intake of calcium is often insufficient, and it is unclear if adequacy could be achieved by promoting calcium-rich local foods. This study used linear programming and household consumption data from Uganda, Bangladesh, and Guatemala to assess whether local foods could meet calcium population reference intakes (Ca PRIs). The most promising food-based approaches to promote dietary calcium adequacy were identified for 12- to 23-month-old breastfed children, 4- to 6-year-old children, 10- to 14-year-old girls, and nonpregnant and nonbreastfeeding (NPNB) women of reproductive age living in two regions of each country. Calcium-optimized diets achieved 75-253% of the Ca PRI, depending on the population, and were <100% for 4- to 6-year-olds in one region of each country and 10- to 14-year-old girls in Sylhet, Bangladesh. The best food sources of calcium were green leafy vegetables and milk, across geographic locations, and species of small fish, nixtamalized (lime-treated) maize products, sesame seeds, and bean varieties, where consumed. Food-based recommendations (FBRs) achieving the minimum calcium threshold were identified for 12- to 23-month-olds and NPNB women across geographic locations, and for 4- to 6-year-olds and 10-to 14-year-old girls in Uganda. However, for 4- to 6-year-olds and 10- to 14-year-old girls in Bangladesh and Guatemala, calcium-adequate FBRs could not be identified, indicating a need for alternative calcium sources or increased access to and consumption of local calcium-rich foods.

Background: Iron-deficiency anemia among school-aged children is widespread in India. The efficacy of micronutrient and iron fortified school-served meals in reducing iron deficiency anemia has been demonstrated in randomized controlled trials in other parts of the globe. The current study evaluates its effectiveness in real-world Indian settings. Methods: Mid-day-Meal (MDM) programme provides free lunch to students of grade 1 to 8 in all public-funded Indian schools. An implementation research project fortified MDM of all public schools of 4 out of 8 sub-districts ("blocks") of Dhenkanal district of Odisha state with fortified rice kernel (FRK). All the schools of the other 4 blocks fortified with micronutrient powders (MNP)-both FRK and MNP containing equal amounts of supplementary iron and other micronutrients. Schools of 4 matched blocks of neighboring nonimplementing Angul district served as control. Cross-sectional representative samples of students were drawn from the 3 arms, before and after intervention (n = 1764 and n = 1640 respectively). Pre-post changes in anemia prevalence and hemoglobin levels were estimated in the sampled children using difference-in-difference analysis after controlling for inter-arm differences in socioeconomic status, and iron and deworming tablet consumptions. Results: Factoring in pre-post changes in control and adjusting for potential confounders, the proportion of children without anemia and mean hemoglobin improved by 1.93 (1.38, 2.24, P < .001) times and 0.24 (-0.03, 0.51, P = .083) g/dL in MNP; and 1.63 (1.18, 2.24, P = .002) times and 0.18 (-0.09, 0.45, P = .198) g/dL in FRK arms. Conclusions: Fortified MDM could effectively improve anemia status among Indian school-aged children under real-world conditions.

Background: Behavioral weight management programs (BWMPs) enhance weight loss in the short term, but longer term cardiometabolic effects are uncertain as weight is commonly regained. We assessed the impact of weight regain after BWMPs on cardiovascular risk factors, diabetes, and cardiovascular disease. Methods: Trial registries, 11 databases, and forward-citation searching (latest search, December 19) were used to identify articles published in English, from any geographical region. Randomized trials of BWMPs in adults with overweight/obesity reporting cardiometabolic outcomes at ≥12 months at and after program end were included. Differences between more intensive interventions and comparator groups were synthesized using mixed-effects, meta-regression, and time-to-event models to assess the impact of weight regain on cardiovascular disease incidence and risk. Results: One hundred twenty-four trials reporting on ≥1 cardiometabolic outcomes with a median follow-up of 28 (range, 11-360) months after program end were included. Median baseline participant body mass index was 33 kg/m2; median age was 51 years. Eight and 15 study arms (7889 and 4202 participants, respectively) examined the incidence of cardiovascular disease and type 2 diabetes, respectively, with imprecise evidence of a lower incidence for at least 5 years. Weight regain in BWMPs relative to comparators reduced these differences. One and 5 years after program end, total cholesterol/HDL (high-density lipoprotein) ratio was 1.5 points lower at both times (82 studies; 19 003 participants), systolic blood pressure was 1.5 mm mercury and 0.4 mm lower (84 studies; 30 836 participants), and HbA1c (%) 0.38 lower at both times (94 studies; 28 083 participants). Of the included studies, 22% were judged at high risk of bias; removing these did not meaningfully change results. Conclusions: Despite weight regain, BWMPs reduce cardiometabolic risk factors with effects lasting at least 5 years after program end and dwindling with weight regain. Evidence that they reduce the incidence of cardiovascular disease or diabetes is less certain. Few studies followed participants for ≥5 years. Registration: URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42018105744.

Agri-insurance, a loss-stabilizing measure among farmers, is a complex process in a diverse democracy like India with varied sociocultural norms and weather anomalies. The advent of emerging civilian unmanned aerial vehicle (UAV) innovations in agri-insurance has simplified crop damage assessment, crop cutting experiment, and claim settlement. The deployment and governance of the civilian UAVs involve diverse actors and stakeholders. The responsible innovation (RI) approach, which takes care of emerging technology, governance, and sustainability issues, explores the challenges of civilian UAV innovations amidst varied culture-specific values in Indian society. An extensive literature survey is conducted by deploying a literature survey questionnaire. Gathered literature is analyzed to fulfill the objectives of sustainability in agri-insurance innovations. The findings highlight that the evolving regulations and laws make UAV governance intricate. However, the dimensions of RI, anticipation, deliberation, reflexivity, participation, and responsiveness help in responsible collaboration among actors and stakeholders of UAV innovations in agri-insurance applications. The different features of civilian UAVs promote safety, privacy, autonomy, transparency, trust, and accountability, further juxtaposing social, economic, and environmental sustainability. Training to pilots, adhering to prescribed regulations, and involving local farmers and stakeholders promote the responsible deployment of civilian UAVs.

To support Mozambique in the mitigation and management of droughts, the World Food Programme (WFP) is seeking to implement innovative approaches to protect people’s livelihood who face drought risk. The approach that has potential of closing the humanitarian funding gap is Forecast-based Financing (FbF). FbF enables anticipatory actions against droughts using seasonal forecasts, which are implemented to reduce impacts in the critical window between a forecast and an event. An important step for leveraging seasonal forecasting information to implement FbF is the development of an operational trigger system for drought anticipatory action. Our study describes WFP’s FbF system for droughts being tested in Mozambique using the ECMWF 7-month rainfall ensemble forecast. We showed that the fore- casting information has skill to detect most of the drought events, measured by the Standardized Precipitation Index (SPI) with lead time varying from 6 to 1 month. We observed that information of different lead times produces a marginal improvement on the average skill of the predictions. After deriving probability values that can trigger anticipatory action, we found that the overall system yields a mean Hit Rate and False Alarm Ratio of 74 % and 59 %, respectively. However, there are opportunities for reducing the false alarm ratio and increasing the hit rate when focusing on key specific lead times. We believe that implementing FbF against droughts based on forecast information can help humanitarian organizations to reduce losses to livelihoods and cost of humanitarian operations while supporting communities in a more dignified manner

‘Loss and damage’ is seen as a new paradigm for international climate action, but has long affected the operational realities of institutions that keep responding to climate-induced food system breakdowns. Without stronger systems for climate prediction and protection, escalating humanitarian needs risk crowding out the financial space for loss and damage prevention.

Background: Complementary feeding of infants in refugee settlements remains inadequate. Furthermore, there has been limited evaluation of interventions addressing these nutrition challenges. Objective: This study examined the effects of a peer-led integrated nutrition education intervention on infant complementary feeding by South Sudanese refugee mothers in the West-Nile region in Uganda. Methods: A community-based randomized trial enrolled 390 pregnant women (during third trimester) as the baseline. Two arms [mothers-only and parents-combined (both mothers and fathers)] comprised treatments with a control. Infant feeding was assessed using WHO and UNICEF guidelines. Data were collected at Midline-II and Endline. The medical outcomes study (MOS) social support index was used to measure social support. An overall mean score of >4 was considered optimal social support, a score of ≤2 was none or little support. Adjusted multivariable logistic regression models determined the effects of the intervention on infant complementary feeding. Results: At the end of the study, infant complementary feeding improved significantly in both mothers-only and parents-combined arms. There was a positive effect on the introduction of solid, semisolid, and soft foods (ISSSF) in the mothers-only arm at both Midline-II {adjusted odds ratio (AOR) = 4.0]} and Endline (AOR = 3.8). Likewise, ISSSF was better for the parents-combined arm at both Midline-II (AOR = 4.5) and Endline (AOR = 3.4). Minimum dietary diversity (MDD) was significantly better at the Endline for the parents-combined arm (AOR = 3.0). Minimum acceptable diet (MAD) was significantly better at Endline for both mothers-only (AOR = 2.3) and parents-combined arms (AOR = 2.7). Infant consumption of eggs and flesh foods (EFF) was improved only in the parents-combined arm at both Midline-II (AOR = 3.3) and Endline (AOR = 2.4). Higher maternal social support was associated with better infant MDD (AOR = 3.3), MAD (AOR = 3.6), and EFF (AOR = 4.7). Conclusion: Engaging both fathers and mothers in care groups benefited complementary feeding of infants. Overall, this peer-led integrated nutrition education intervention through care groups improved infant complementary feeding in the West-Nile postemergency settlements in Uganda.This trial was registered at clinicaltrials.gov as NCT05584969.

This paper adds to a sparse but growing literature on the economic costs and benefits of hosting refugees, including a unique policy of providing refugees with access to cultivable land. We construct a general equilibrium model from microsurvey data to simulate the spillover effects of giving land to refugees on income and production in the host‐country economy surrounding a refugee settlement in Uganda. Reduced‐form econometric analysis of land allocations at the refugee settlement, robust to several specifications, confirms the simulation finding that providing refugees with agricultural land significantly improves their welfare and self‐reliance. Simulations reveal that refugee aid and land allocations generate positive income spillovers in the local economy out to a 15‐km radius around the refugee settlement. Host‐country households benefit significantly from the income spillovers that refugee assistance creates, and host‐country agriculture is the largest beneficiary among production sectors.

Water scarcity is a major challenge in the Sahel region of West Africa. Water scarcity in combination with prevalent soil degradation has severely reduced the land productivity in the region. The decrease in resiliency of food security systems of marginalized population has huge societal implications which often leads to mass migrations and conflicts. The U.S. Agency for International Development (USAID) and development organizations have made major investments in the Sahel to improve resilience through land rehabilitation activities in recent years. To help restore degraded lands at the farm level, the World Food Programme (WFP) with assistance from USAID’s Bureau for Humanitarian Assistance supported the construction of water and soil retention structures called half-moons. The vegetation growing in the half-moons is vitally important to increase agricultural productivity and feed animals, a critical element of sustainable food security in the region. This paper investigates the effectiveness of interventions at 18 WFP sites in southern Niger using vegetative greenness observations from the Landsat 7 satellite. The pre - and post-intervention analysis shows that vegetation greenness after the half-moon intervention was nearly 50% higher than in the pre-intervention years. The vegetation in the intervened area was more than 25% greener than the nearby control area. Together, the results indicate that the half-moons are effective adaptations to the traditional land management systems to increase agricultural production in arid ecosystems, which is evident through improved vegetation conditions in southern Niger. The analysis shows that the improvement brought by the interventions continue to provide the benefits. Continued application of these adaptation techniques on a larger scale will increase agricultural production and build resilience to drought for subsistence farmers in West Africa. Quantifiable increase in efficacy of local-scale land and water management techniques, and the resulting jump in large-scale investments to scale similar efforts will help farmers enhance their resiliency in a sustainable manner will lead to a reduction in food security shortages.

We use the WRF-Chem atmospheric chemical transport model, driven by local emission inventories, to quantify the contribution of on-road transport emissions to surface PM2.5 over Delhi during the post-monsoon season. We compare this contribution to other local (within Delhi) and regional (within the broader National Capital Region, NCR) anthropogenic sectors during the post-monsoon period when seasonal burning and stagnating meteorological conditions exacerbate baseline pollution levels. We find that local on-road transport contributes approximately 10% to daily mean PM2.5 over Delhi, rising to 17% if regional on-road transport sources in the NCR are included. The largest individual contributions to Delhi daily mean PM2.5 are from regional power and industry (14%) and domestic (11%) sectors, dominating nighttime and almost all daytime concentrations. Long range transport contribution from sources beyond the NCR is found to account for approximately 40%. The contribution from the local on-road transport sector to diurnal mean PM2.5 is largest (18%) during the evening traffic peak. It is dominated by contributions from two- and three-wheelers (50%) followed by heavy-duty vehicles (30%), which also collectively represent 60–70% of the total on-road transport sector at any hour of the day. The combined contribution from passenger cars and light duty vehicles and from resuspended road dust to daily mean PM2.5 is small (20%). Our work highlights two important factors which need to be considered in developing effective policies to meet PM2.5 air quality standards in Delhi during post-monsoon. First, a multi-sector and multi-scale approach is needed, which prioritise the reduction in local transport emissions within Delhi, and, in the order, regional industries, domestic and transport emissions from NCR. Second, two-and three-wheelers and heavy-duty vehicles dominate on-road transport impact to PM2.5, thus reductions from these vehicles should be given priority, both within Delhi and in the NCR.

Climate change and climate variability drive rapid glacier melt and snowpack loss, extreme precipitation and temperature events, and alteration of water availability in the Himalayas. There is increasing observational evidence of climate change impacts on water resource availability and agricultural productivity in the central Himalayan region. Here, we assess the farmers' perception of climate change and its impacts on agriculture in western Nepal. We interviewed 554 households and conducted eight focus group discussions to collect farmers' perceptions of temperature and rainfall characteristics, water availability, onset and duration of different seasons, and the impacts of such changes on their lives and livelihoods. Our results indicate that the farmers' perceptions of rising annual and summer temperatures are consistent with observations. Perception, however, contradicts observed trends in winter temperature as well as annual, monsoon, and winter precipitation. In addition, farmers are increasingly facing incidences of extreme events, including rainfall, floods, landslides, and droughts. These hazards often impact agricultural production, reducing household income and exacerbating the economic impacts on subsistence farmers. Integrated assessment of farmers' perceptions and hydrometeorological observations is crucial to improving climate change impact assessment and informing the design of mitigation and adaptation strategies.

Purpose: This paper describes a collaborative project between Trinity College Dublin in Ireland and the United Nations’ World Food Programme (WFP) Mozambique country office. The Sphere standards require that information on humanitarian assistance should be in languages and formats accessible to people who cannot read or who have communication difficulties. Nevertheless, there remains a gap in both implementing this guidance consistently and in understanding the impact of doing so when engaging with affected populations. Method: This commentary describes the process of developing key messages regarding targeting of humanitarian food assistance in communication-accessible formats, and field testing of these materials with community committees and partners Result: The communication-accessible materials were well received by communities, and humanitarian staff and partners found them to be useful in community engagement. Conclusion: Materials designed to be maximally accessible to people with communication differences and disabilities may also address inclusion for affected populations with different education, literacy, and language backgrounds. This commentary focuses on Sustainable Development Goal (SDG) 2 as an exemplar of the use of communication accessible messaging in humanitarian response.

Aims: We used data from a recent systematic review to investigate weight regain after behavioural weight management programmes (BWMPs, sometimes referred to as lifestyle modification programmes) and its impact on quality-of-life and cost-effectiveness. Materials and methods: Trial registries, databases, and forward-citation searching (latest search Dec-19) were used to identify randomised trials of BWMPs in adults with overweight/obesity reporting outcomes at ≥12 months, and after programme end. Two independent reviewers screened records. One reviewer extracted data; a second checked them. Differences between intervention and control groups were synthesised using mixed-effect, meta-regression, and time-to-event models. We examined associations between weight difference and difference in quality-of-life. Cost-effectiveness was estimated from a health sector perspective. Results: 155 trials (n>150,000) contributed to analyses. Longest follow-up was 23 years post-programme. At programme end, intervention groups achieved -2.8kg (95%CI -3.2 to -2.4) greater weight loss than controls. Weight regain after programme end was 0.12-0.32kg/year greater in intervention relative to control groups, with a between-group difference evident for at least five years. Quality-of-life increased in intervention groups relative to control at programme end and thereafter returned to control as the difference in weight between groups diminished. BWMPs with this initial weight loss and subsequent regain would be cost-effective if delivered for under £560 (£8.80 to £3900) per person. Conclusions: Modest rates of weight regain, with persistent benefits for several years, should encourage healthcare practitioners and policymakers to offer obesity treatments that cost less than our suggested thresholds as a cost-effective intervention to improve long term weight management. This article is protected by copyright. All rights reserved.