Modeling the dynamics of human starvation: incorporating lessons from famines past and present.

Famines are crises characterized by starvation and malnutrition-related mortality. But representative nutrition and mortality data is often impossible to collect under common famine conditions, impeding real-time estimations and near-term projections of famine severity and therefore allocation of humanitarian assistance. As a supplement to survey data, systems models may be able to project individual outcomes based on more readily available data, to guide food assistance rations, and to predict trajectories of population-level malnutrition and starvation mortality. We provide an overview of systems dynamics modeling, discuss how it has been used to understand energy and nutrient dynamics in the human body, and discuss possible applications of these models, as well as the critical research needs to apply systems dynamics models to real-world crises. We then highlight complicating aspects of famine systems that should be considered as these models are applied. The literature includes several models that could be adapted to help identify critical areas for nutrition research on the biological progression of starvation under famine conditions. By incorporating additional physiological detail, these models could be parameterized to inform humanitarian public health responses to food crises, but improved data sharing will be crucial to model development.