Poor quality care is now a bigger barrier to reducing mortality than insufficient access to healthcare, said Dr. Margaret Kruk, Chair of The Lancet Global Health Commission on High Quality Health Systems in the Sustainable Development Goal Era. She spoke at a recent Wilson Center event on strategies to improve and sustain high-quality reproductive, maternal, and newborn care at scale. “We estimate that 8.6 million lives are lost every year due to lack of access to high quality care, and of that 8.6 million, five million lives are lost by people who have already reached out to the health system.”

“Community mobilization, local capacity-building, and innovation are the cornerstones of successful development. And that for us includes resilience,” said Franklin Moore, Africare’s Chief of Programs, at a Wilson Center event on family planning and sustainable development. As rapid population growth intersects with challenges like food insecurity and water scarcity, communities in developing countries need not only the capacity to absorb short-term shocks, they also need transformative capacity to address long-term challenges.

Nigeria is ranked among the most fragile states in the world. The country faces significant water challenges, which vary greatly from one region to another. Weak governance exacerbates these water challenges, while conflicts over water resources make governance more difficult. There are three main geographical flashpoints where conflict over water is likely to break out. In the north and northeast, Boko Haram has waged a violent insurgent campaign since 2010; among their demands is government provision of clean water. In Nigeria’s Middle Belt, changing rainfall patterns are limiting the grazing area of Muslim Fulani herders, who then encroach on the land of predominantly Christian farmers. Conflict over these lands killed more Nigerians than Boko Haram in 2016. Finally, in the Niger Delta, militant groups are attacking oil infrastructure, partially motivated by conflict over rights to land and waterways. Oil spills also contribute to food insecurity and malnutrition in this region.

In 1981, Nobel Laureate Amartya Sen noted that “starvation is the characteristic of some people not having enough food to eat. It is not the characteristic of there being not enough food to eat.” Sen was referring to the idea that hunger is not always related to food supply; even in places where ample food exists, many people do not have regular access to it. Yet, more than three decades later, research into the effects of agriculture on armed conflict is still focused much more on the former than the latter.

An international food crisis is currently unfolding on a scale not seen since World War II. More than 20 million people in Somalia, Nigeria, South Sudan, and Yemen are in danger of famine. UN Under-Secretary-General and Emergency Relief Coordinator Stephen O’Brien said in March, “We are facing the largest humanitarian crisis since the creation of the United Nations.”

Water scarcity has contributed to an “arc of instability” characterized by conflict and displacement that stretches from West Africa to the Middle East, said a panel of experts at the Wilson Center on March 1. Two authors from an upcoming compilation of case studies on water security and violent conflict by World Wildlife Fund gave overviews of challenges in Nigeria and Iran and recommendations for U.S. engagement.

Forecasts of future climate conditions are fairly good, but forecasts of future socioeconomic conditions are another story. To get a sense of how climate change will impact society, many resort to simply layering future climate conditions on top of current socioeconomic conditions. That’s a mistake, write Wolfgang Lutz and Raya Muttarak in Nature Climate Change. “We see little value in the purely hypothetical exercise of assessing potential impacts of the future climate on a society that will not exist in the future.”