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December 2018 marks five years since the outbreak of the current conflict in South Sudan, which has resulted in an estimated 380,000 excess deaths, 4.4 million people displaced, substantial macroeconomic decline, and widespread acute food insecurity. Although the conflict was initially most severe in Greater Upper Nile, it intensified in many areas of Greater Equatoria and Greater Bahr el Ghazal following an eruption of violence in Juba in July 2016, and conflict still persists in parts of the country.
Acute food security has deteriorated substantially since the outbreak of conflict. By September 2018, the South Sudan IPC Technical Working Group estimated 6.1 million people were in Crisis (IPC Phase 3) or worse, nearly 4 times the 1.6 million people estimated in Crisis (IPC Phase 3) or worse in August 2013. The severity of acute food insecurity, as evidenced by the proportion of the population in Emergency (IPC Phase 4) and Catastrophe (IPC Phase 5), has also increased. Furthermore, at a number of times and locations there has been concern that extreme outcomes existed, but sufficient information to confirm or deny was not available.
Humanitarian food assistance has played a significant role in lessening food consumption gaps throughout the conflict. The monthly metric tonnage (MT) of food assistance delivered has increased by roughly 60 percent over the past three years, from around 15,000 MT per month in 2015 to around 24,000 MT per month in 2018. Despite this, the need is outpacing increases in humanitarian assistance delivery, and current food assistance needs are the highest on record.
As a result of the five-year conflict, large-scale humanitarian assistance needs are expected throughout 2019, and Famine (IPC Phase 5) would be likely in 2019 in the prolonged absence of humanitarian assistance. A notable decrease in conflict may be possible in 2019 given recent declines in violence in November and December and steps that are being taken towards implementing the September 2018 peace agreement. However, even in the event of a significant decrease in conflict in the coming year, extreme needs will persist as many households have lost access to typical food and income sources as a result of the conflict. Should there be high levels of conflict, food security would likely deteriorate even further, and Famine (IPC Phase 5) would be likely among populations who face severe restrictions to movement.
Conflict’s impact on displacement
December 15, 2018 marks five years since the outbreak of the current conflict in South Sudan, which has persisted across the country (Figure 1). The five-year conflict has likely led to an estimated 380,000 excess deaths and forced millions of people to flee their homes: roughly 30 percent of South Sudan’s population remains displaced internally or in neighboring countries, representing one of the world’s largest refugee crises.
Conflict’s impact on the macroeconomy
Persistent conflict in South Sudan has also led to significant macroeconomic decline, driven in large part by conflict-related disruption to oil production, that has in turn resulted in very low hard currency earnings and massive depreciation of the South Sudanese Pound (SSP) since 2015. The depreciation of the currency and conflict-related disruptions to trade flows have driven extremely high food prices across South Sudan. Over the past five years, increases in casual labor wage rates have not kept pace with staple food price increases, leading to a large decline in purchasing power, though with slight improvement in 2018 (Figure 2). Furthermore, many poor households no longer have regular access to casual labor, a key source of income prior to the conflict, given the disruptive nature of the ongoing violence on business functioning.
Conflict’s impact on livelihoods
Conflict has also negatively impacted crop production in many areas of the country (Figure 3). According to the Crop and Food Security Assessment Mission (CFSAM), net cereal production has declined each year since 2014, from 1,022,000 MT in 2014/15 to 764,000 MT in 2017/18, driven both by lower production at the household level in several states and the loss of many farming households who have fled the country. Furthermore, CFSAM estimates that the percentage of households farming in the country has declined, from 72 percent of all households in 2013/14 to 57 percent in 2017/18. It is expected the decline is due in part to some households having lost the assets necessary to engage in farming, either due to theft, sales as a coping mechanism, or displacement away from household assets. FEWS NET’s analyses of high-resolution imagery also support that there has been a decline in crop
ping in recent years, including an analysis in August 2014, which found the area planted in Tharker of Mayendit declined roughly 30 percent between 2012 and 2014, and a 2016 analysis of nine sentinel sites throughout the country found a 7.7 percent decline in the area planted in 2016 compared to 2012/2013.
In addition to conflict, rainfall was more erratically distributed in some areas of South Sudan in 2017 and 2018, which led to crop losses. Crop monitoring reports indicates that the area under cultivation for the 2018/19 season was higher than the preceding year, due primarily to a decline in conflict in several areas, though total production for 2018/19 is estimated to be similar to 2017/18 due in part to poor rainfall.
Many poor households have also lost a significant number of livestock during the five years of conflict, another key source of food and income, and 2015 and 2016 recorded very high rates of livestock looting. According to data collected during the Food Security and Nutrition Monitoring System (FSNMS), 33 percent of households reported access to a milking cow in mid-2018, down by nearly half from the 64 percent who reported access to a milking cow in mid-2014. In Unity, an epicenter of the conflict throughout the five years, the percentage of households reporting access to a milking cow decreased from 89 percent in mid-2014 to 50 percent in mid-2018, with only 6 percent of households in Leer reporting accessing a milking cow by mid-2018.
Acute food insecurity and the role of humanitarian assistance, 2013-2018
As a result of the conflict’s significant disruption to typical livelihoods and the macroeconomy, food security in South Sudan has continuously deteriorated in the past five years. Prior to the outbreak of conflict, FSNMS data reported national mean Food Consumption Scores (FCS) over 40, a score indicative of a household likely consuming cereals, lentils/beans, and oil every day, and other foods periodically, during the past seven days. From 2016-2018, the mean FCS was around 25, a score that would be achieved if a household consumed only cereal, wild foods/vegetables, and oil daily. The reporting of Poor FCS (<=21) went up signficantly over this time, from roughly 10-15 percent between 2011 and 2013 to around 55 percent after 2016 (Figure 4).
The reporting of consumption-based coping, per the reduced Coping Strategies Index (rCSI), and the reporting of moderate and severe hunger, per the Household Hunger Scale (HHS), have also both increased over the past five years. In 2013, roughly 20 percent of households reported using consumption-based coping strategies that would be indicative of Stressed (IPC Phase 2) or worse outcomes, compared to 2017 and 2018 when over 80 percent of households reported using consumption-based coping indicative of Stressed (IPC Phase 2) or worse outcomes. The collection of HHS in the FSNMS survey began in October 2014, and availabe data indicates that by early 2016, 55 percent reported moderate hunger and 6 percent reported severe hunger. In 2017 and 2018, roughly 60 percent of households nationally reported moderate hunger and around 10 percent reported severe hunger, approximately 3 percent of whom reported a severe hunger score that is indicative of Catastrophe (IPC Phase 5).
Admissions to Outpatient Therapeutic Programs (OTP) for Severe Acute Malnutrition (SAM) have increased between 2014 and 2018 (Figure 5). This is likely due to lower levels of food availability and access and high disease incidence particularly among populations who are displaced away from health services and often to remote areas. It is also likely that the increase in operating OTP sites over the same time period increased treatment access, and more SAM cases were able to seek treatment. However, based on data from over 250 SMART surveys conducted between January 2014 and July 2018 there is no statistically significant change in Global Acute Malnutrition (as measured by weight-for-height z-score (WHZ) or Mid-Upper Arm Circumference (MUAC)) across the past five years at a national level or regionally. In Lakes State, though, the GAM (WHZ) prevelance has peristently increased over this time period. Overall, the prevalance of GAM across South Sudan remains extremely concerning: of the 30 SMART surveys conducted in the first half of 2018, 7 (23%) recorded a GAM (WHZ) between 10 and 14.9 percent, indicative of Crisis (IPC Phase 3), and 19 (63%) recorded a GAM (WHZ) between 15 and 29.9 percent, indicative of Emergency (IPC Phase 4).
Throughout the conflict, humanitarian food assistance has played a significant role in lessening food consumption gaps and has likely prevented many households from engaging in more extreme coping. The scale of humanitarian food assistance delivered has grown notably throughout the conflict, from around 15,000 MT per month in 2015 to around 24,000 MT per month in 2018. It is expected that humanitarian food assistance has prevented more widespread Catastrophe (IPC Phase 5) outcomes and is likely preventing the occurrence of Famine (IPC Phase 5), though a risk of Famine (IPC Phase 5) persists.
Although humanitarian assistance has been significant, it has been insufficient to meet the persistently high need. Throughout the conflict, the total MT delivered has provided the equivalent of 1.0-1.6 million full rations monthly. However, it is expected that humanitarian food assistance equivalent to an additional 500,000-700,000 full rations was needed monthly throughout 2015 and 2016 to reach the unmet need. The gap between assistance needed and assistance delivered has increased in 2017 and 2018, as the need outpaces increases in humanitarian assistance delivery. It is estimated that food assistance equivalent to 800,000 to 1.1 million full rations was needed in 2017 and 2018 in addition to the assistance that was delivered (Figure 6).
It is anticipated the gap in food assistance needs and delivery is due to both insufficient resources and severe access restrictions. Of the 78 former counties in South Sudan, OCHA estimates that 18 are extremely difficult or impossible to access and 34 are regularly restricted as of late 2018. According to the Financial Tracking service, funding for the food security and livelihood cluster was at its highest in 2014 and has since declined: in 2014, over 800 million USD (94%) was provided to the Food Security and Livelihoods sector, while between 330 and 530 million has been provided annually between 2015 and 2018; in 2016 this was over 100 percent of the requested, but in 2017 and 2018 it was only 60-70 percent of requested funds.
 rCSI is not an indicator in the IPC Version 2.0 reference table but has been added to the IPC Version 3.0; the above references rCSI thresholds from the IPC Version 3.0 reference table
 Estimated by converting the MT of monthly food assistance into a kilocalorie equivalent and dividing by the approximate 63,000 kilocalories needed per person per month
 This need is defined by the population estimated by the South Sudan IPC TWG to be in Crisis (IPC Phase 3) or worse in the presence of ongoing humanitarian food assistance, and a calculation of this population’s expected kilocalorie needs
Continuation of high humanitarian assistance needs to prevent Famine
The number of conflict incidents in November and early December 2018 represents a notable decline from early 2018 and the same months in 2016 and 2017, and this has allowed for increased humanitarian access in recent months. It is expected this is due at least in part to the ongoing efforts towards implementing the peace agreement and building confidence between parties to the conflict. Despite the signing of the September 2018 peace deal and these ongoing efforts, however, conflict incidents continues in parts of the country and is likely to continue disrupting livelihoods and macroeconomic functioning, resulting in persistent high acute food insecurity. Should successful implementation of the peace agreement occur, high levels of humanitarian need would still be expected throughout 2019 given the fact that many households have lost access to typical income-earning livelihood options including livestock sales and assets with which to farm, and high staple food prices will continue to prohibit many from purchasing sufficient food to meet their basic needs. Assistance at currently planned levels is likely to prevent more Catastrophic outcomes in many areas and Famine (IPC Phase 5) in at least central Unity; however, current levels of assistance are insufficient to prevent food consumption gaps and associated high levels of excess mortality. Crisis (IPC Phase 3) and Emergency (IPC Phase 4) are likely throughout 2019 even in the presence of planned humanitarian food assistance. Additional food assistance beyond levels already planned and funded is needed throughout 2019 to save lives and prevent further erosion of livelihoods. Ultimately, successful implementation of the peace agreement and an end to the conflict is needed to end the risk of Famine (IPC Phase 5) and widespread acute food insecurity in South Sudan, and to support re-establishment of typical livelihoods.
Figures 1. Location and occurrence of conflict incidents in South Sudan, 2013-2018
Fuente: ACLED data
Figure 2. Three-month moving average of casual labor-to-sorghum terms of trade March 2013 - November 2018
Fuente: WFP data
Figure 3. Change in state-wide cereal production in 2018 compared to 2014, versus number of conflict incidents from Dec. 2013-Dec. 2018
Fuente: CFSAM data; ACLED data
Figure 4. Food Consumption Score in South Sudan, October 2011 - August 2018
Fuente: FSNMS data, Rounds 9-22
Figure 5. Severe Acute Malnutrition (SAM) admissions and Outpatient Therapeutic Program (OTP) Facilities, 2014-2018
Figure 6. Estimated number of full rations of humanitarian food assistance delivered and needed, 2015-2018
Fuente: WFP data; SS IPC TWG needs estimates
Figure 7. Current acute food insecurity in the presence of humanitarian assistance, as estimated by the South Sudan IPC TWG, August 2013-September 2018
Fuente: South Sudan IPC TWG; UNOCHA, Financial Tracking Service, SS HRP
Annex 1. Evolution of lean season acute food insecurity in South Sudan, 2013-2018
Fuente: FEWS NET