Public Health Blog: War Suffering and Nutrition

We all condemn war.  It is the most senseless of all human foibles.  In the case of Ukraine, we are witnessing a combination of a leader’s ego, a clash of governing principles and the ongoing conflict over religion that has defied a loving solution in Europe for a thousand years.  The leaders in Moscow remain safe in their extravagance while those in the rest of the world condemn their actions and then relax in luxury.

Meanwhile, the people suffer.  Soldiers and civilians die. It is a feature of modern warfare that in the countries with advanced technology, fewer die, but more are left with long-term physical and psychological disabilities.  This of course does not apply in the poorer countries of the world where death rates during fighting remain very high

The invasion of Ukraine will disrupt the export of food from the Black Sea region.  During the past 120 years, the world’s population has increased from 1.6 billion to about 8 billion at the present time. During that time the staple foods that feed the world have become concentrated into fewer crops.   While there are more than 50 000 edible plant species in the world, only a few hundred contribute significantly to food supplies. Just 15 crop plants provide 90 percent of the world’s food energy intake, with three rice, maize and wheat – making up two-thirds of this. These three are the staples for 4 -5 billion people.

Rice feeds almost half of the world. Per caput, rice consumption has generally remained stable or risen slightly since the 1960s, but it has declined in recent years in many of the wealthier rice-consuming countries, in Asia as rising incomes have resulted in a more varied diet.  Wheat and roots, maize and tubers (eg sweet potato, cassava) are the other members of the top four.

Per caput consumption of roots and tubers has been falling in many countries since the beginning of the 1970s, mainly because urban populations have found it cheaper and easier to buy imported cereals. Since 1970, consumption of roots and tubers in the Pacific Islands has fallen by 8 percent, while cereal consumption jumped by 40 percent, from 61 to 85 kilograms per person. (Information from FAO)

Ukraine and Russia were predicted to export 55-60 million tonnes of wheat from the Black Sea region this year, about 30% of global exports.  The disruption of these exports is predicted to increase world prices by up to 60%.  In the past 24 hours, China has announced that it will receive Russian wheat, but that is a long land route compared to seaborne exports. By comparison, Australia exports 35 million tonnes and Canada 26 million tonnes. Economic sanctions are now being imposed on the Russian economy and if this includes restricting wheat exports, it will cause further long-term disruption of food supplies.

As in most major conflicts, mothers and their children will suffer the most.  Already millions are fleeing and becoming refugees in neighbouring countries.  This will have dire consequences for the COVID19 pandemic.  For countries outside the immediate conflict zone, the increase in food prices may lead to even more nutritional suffering than the COVID epidemic by itself1,2.

  1. Binns C. Walter Patrick Memorial Lecture: COVID Pandemic Public Health Consequences and Prospects and How It Will Change Public Health Education. Asia-Pacific journal of public health / Asia-Pacific Academic Consortium for Public Health. 2021;33(1):7-12.
  2. Binns C, Low WY. The Rich Get Richer and the Poor Get Poorer: The Inequality of COVID-19. Asia-Pacific journal of public health / Asia-Pacific Academic Consortium for Public Health. 2021;33(2-3):185-187.

Colin Binns, MBBS, PhD
Editor-in-Chief, Asia-Pacific Journal of Public Health
School of Public Health, Curtin University, Perth, Australia

Wah Yun Low, PhD
Managing Editor, Asia-Pacific Journal of Public Health
President, Asia-Pacific Academic Consortium for Public Health
Deputy Executive Director, Asia Europe Institute
University of Malaya, Kuala Lumpur, Malaysia

Victor Hoe Chee Wai, MBBS, PhD
Webmaster, Asia-Pacific Academic Consortium for Public Health
Department of Social and Preventive Medicine, Faculty of Medicine
University of Malaya, Kuala Lumpur, Malaysia