“I just ran the numbers. I think I figured out how to increase your organization’s funding by 50%.”
“What?! How?!”
“Declare famine in Guatemala.”
Last month, I gave a keynote at the largest tech conference in Latin America. My talk followed the president of Guatemala’s largest food and beverage conglomerate, who had just outlined his company’s ambitious effort to combat hunger in his country. As I listened to him reel off sobering statistics about the country’s malnutrition crisis, I had a striking realization. I pulled out Excel and some AI tools to test my hunch.
Gaza and Guatemala
Last month, the UN’s Integrated Food Security Phase Classification (IPC) declared famine conditions in Gaza. Not across the entire strip, but in specific areas.
To reach that decision, the IPC departed from the standards it had used in Somalia, Sudan, and South Sudan, stretching the criteria further than ever before to apply the word ‘famine.’
It seems the IPC deliberately waited until Israel resumed allowing aid convoys in. Realizing that the nutrition situation had likely bottomed out, that this was as bad as it was going to get, they went ahead and declared famine.
Now, let’s look at Guatemala.
Here, the crisis isn’t sudden; it’s permanent. Nearly one out of every two children under five is chronically malnourished nationwide. That’s about 47 percent - among the very worst in the world. In some predominantly indigenous regions, the figure soars as high as 70–90%.
When it comes to acute malnutrition (wasting), Guatemala’s national rate is “only” about 0.8% - low on paper. But zoom into vulnerable departments like Alta Verapaz, Huehuetenango, or the Dry Corridor, and a different picture emerges: tens of thousands of acute cases every year, clusters where 5–10% of children fall below survival thresholds, and seasonal hunger that spikes predictably every lean season.
Officially, dozens of Guatemalan children die of malnutrition each year. Most experts agree this is almost certainly an undercount.
By the raw numbers, chronic malnutrition in Guatemala is five to ten times worse than Gaza’s pre-war baseline. Yet because Guatemala’s crisis is labeled “chronic” instead of “famine,” it rarely triggers global outrage or global funding.
Applying the new IPC “Gaza standard” to Guatemala
Several criteria must be met for a famine classification (IPC Phase 5).
The first is mortality – the crude death rate must exceed 2 deaths per 10,000 people per day. In Gaza, that would mean roughly 400 deaths every single day. Since that threshold was nowhere near met, the IPC simply set it aside.
The second is acute malnutrition (wasting) – at least 30% of children must be suffering from acute malnutrition, measured by weight-for-height.
Gaza isn’t close to that, so how did the IPC get there?
First, they used a different measurement approach. Instead of using the children’s weight-for-height (WHZ, the gold standard), they used MUAC (Mid-Upper Arm Circumference) - a simple tape measure wrapped around a child’s upper arm.
Secondly, they didn’t use broad, randomized household surveys. They came from clinic-based screenings. By definition, those figures are skewed: only the sickest and poorest families make it to clinics, so the data is never representative of the population at large.
And they only used certain clinics: The IPC formally classified the Gaza Governorate (including Gaza City) as in famine (IPC Phase 5) and projected famine conditions for Deir al-Balah and Khan Younis. Other areas remained in Emergency (IPC Phase 4).
In these clinics, by only looking at the MUAC measurements, they were able to reach a malnutrition rate of 28%. Then they rounded up to 30%.
Both of these methods (MUAC and Clinics) are known to measure much higher rates of malnutrition than the gold standard (WHZ by household surveys).
Here’s the thing: robust studies have been conducted in places like Sudan and Guatemala, where they measure both WHZ and MUAC, and they measured both clinic-based and through random household sampling. With a little math, we can calculate (and reverse) the bias.
For example, when a 2022 Guatemalan study measured WZH and MUAC in children, they found 2.8% were acutely malnourished by WHZ, but the number jumped to 10.6% when they used MUAC. That’s a 3.8x multiplier.
What about the clinic bias? We have that data as well, including from conflict zones. Multiple studies in South Sudan (Rumbek, Juba) showed that clinic screenings routinely find 2-4.0x higher prevalence than household surveys. Let’s take the average – a 3.0x multiplier.
Guatemala has never declared famine because they’ve followed the IPC’s ‘old’ method: randomized community measurement of WHZ that yields a 2.8% wasting rate. According to the math, if you only measured patients arriving at clinics (x3.0) and used MUAC instead of WHZ (3.8x), your wasting rate would be 32%. Higher than Gaza, and [actually] higher than the 28% threshold.
Here’s what that means: If you do it the right way, through randomized community surveys, Guatemala looks like a chronic crisis, but not famine.
However, if you do it the Gaza way, walk into rural clinics in Alta Verapaz, Quiché, Huehuetenango, or the Dry Corridor, and just measure the kids who show up, you will reliably find MUAC rates that exceed Gaza’s 28.5% clinic figure.
And if you then treat those clinic samples as if they represent the entire population, just as IPC did in Gaza, you would have to declare famine in multiple Guatemalan regions.
Politics influences famine classification
In other words, if famine is the right classification for Gaza, then by the same logic, Guatemala has been living in famine conditions for years. The only difference is methodology — and politics.
Why do this?
So what? Who benefits from declaring famine in Guatemala?
Two reasons: funding and fairness.
Funding
A famine declaration isn’t just semantics; it’s a trigger. Once the IPC calls famine, billions of dollars in earmarked relief funding suddenly become available.
In Sudan and Somalia, famine declarations increased donor flows by 1.6x and 2x, respectively, within months.
Today, Guatemala receives only about $100–150M annually in external food security and nutrition aid. Apply the Somalia or Sudan multiplier, and a famine designation for Guatemala’s hardest-hit regions would unlock an extra $60–150M a year. That’s not abstract money: it means more feeding centers, more community health workers, and more kids kept alive.
Fairness
While walking through the main square in Antigua the next day, I passed a crowd of protestors waving Palestinian flags and railing against the famine in Gaza. The irony was hard to miss: people marching about a nutrition crisis 12,000 kilometers away, one that, by the numbers, isn’t as acute as the malnutrition and hunger playing out within walking distance of their protest.
And the imbalance doesn’t stop in Guatemala. In the US and Canada, campus protests and media coverage have spent months fuming over famine in Gaza, while ignoring the fact that half of Guatemala’s children are permanently stunted, a country on their own continent. You could fill a van with food and drive from a US college campus to Guatemala, and you’d arrive in two days to feed a starving village.
That double standard matters. Because when we apply Gaza’s lowered bar for famine to Guatemala, it exposes a truth: either Guatemala deserves the same urgency, or Gaza never merited the label.
'The uncomfortable reality'
Here’s the uncomfortable reality: If we apply the same standards the IPC used to declare famine in Gaza, Guatemala has been in a state of famine for years. All you’d have to do is skip the household surveys, walk into clinics in Alta Verapaz or Quiché, measure the kids who show up, and you’d find MUAC rates that surpass Gaza’s headline 28.5%.
Guatemala’s crisis is also man-made. This isn’t a natural disaster that came out of nowhere; it’s a result of decades of policy neglect, inequitable healthcare access, indigenous marginalization, underinvestment in rural areas, and a global humanitarian funding architecture that bypasses chronic malnutrition until it becomes sensational.
This isn’t about downplaying Gaza’s suffering; it’s about holding the system to its own logic. If Gaza’s malnutrition crisis merits the word “famine,” then Guatemala’s deserves it, too.
The world can’t have it both ways.
The writer is the founder and CEO of Level Ex, a company that creates revolutionary video games for doctors to understand the challenges of practicing medicine. He was previously the CEO of the top independent game publisher in Hollywood, acquired by Playtech (PTEC) in 2016. Sam holds an M.S. in Computer Science, Graphics from Stanford University and a B.S. in Computer Engineering from the University of Illinois Urbana-Champaign. He is a member of the Forbes Technology Council.