As wide segments of Egyptians suffer from the consequences of an ongoing economic crisis, including a nearly 40% devaluation of the Egyptian pound and an annual inflation rate of 12.5% as of February 2024, the impact on food prices has been particularly harsh. Food and beverage inflation averaged around 31.6% in 2024, compared to 63.5% in 2023. This surge has severely affected many Egyptian families’ ability to afford nutritious food. According to health data released in March by Minister of Health Khaled Abdel Ghaffar, 40% of Egyptians suffer from anemia—a condition that undermines individual productivity and places a significant economic burden on the state.
Egypt currently ranks first among the ten countries with the highest food price inflation globally, according to a World Bank report dated November 13, 2023, with a rate of 36%. In recent months, the price of animal protein has reached record highs: one kilogram of chicken now costs over 105 EGP, local beef exceeds 400 EGP/kg, and tilapia fish sells at 90 EGP/kg. Meat consumption has declined sharply, dropping from 18 tons per 1,000 people in 2018 to just 9 tons per 1,000 in 2022, according to a report by the Baseera Center. Meanwhile, global averages show that individual annual meat consumption is approximately 41.90 kg.
A 2022 study by the Central Agency for Public Mobilization and Statistics (CAPMAS) revealed that 74% of Egyptian households reduced their food consumption due to price hikes. Specifically, 90% cut down on animal protein, 68% on eggs, 57% on vegetables, and 69% on fruits. As a result, many low-income families are increasingly relying on starchy foods to meet basic caloric needs for survival.
In the 2022 Global Food Security Index, Egypt ranked 77th out of 113 countries. It also ranked 57th out of 121 countries on the Global Hunger Index. Egypt is among 36 countries that bear 90% of the global burden of malnutrition, according to UNICEF. In 2014, stunting among children under five was estimated at 21%, wasting at 8%, underweight at 6%, and anemia at 27.2% among children and 25% among women of reproductive age. World Health Organization (WHO) data from 2019 estimated that 28.3% of Egyptian women aged 15–49 suffer from anemia. At the same time, 29.7% of Egyptians live below the poverty line, and 14.4% experience food insecurity, according to the World Food Programme (WFP).
Nutrition status indicators from CAPMAS show that stunting affects one in every seven children under five, with a national stunting rate of 13% in 2021. Around 4% of children under five suffer from underweight, while one in every nine children is overweight, with an overall overweight prevalence of 11.5%. Egypt’s southern governorates report the highest levels of child malnutrition.
UNICEF attributes the high rates of malnutrition in Egypt to several factors: inadequate food intake, low exclusive breastfeeding rates, poor access to balanced diets—especially among the poorest communities—as well as unhealthy dietary habits and a general lack of nutritional awareness among the population.
Rising Anemia, Declining Stunting: Nutrition Expert Warns of Worsening Malnutrition in Egypt
Dr. Islam Annan, Professor of Health Economics and Epidemiology at the Faculties of Pharmacy at Ain Shams and Misr International Universities, and CEO of “AXCIT” for pharmaceutical and health research, attributes the rise in anemia and malnutrition in Egypt to the poor quality of the national diet. He highlights increased reliance on refined carbohydrates, harmful fats, and sugars, combined with decreased consumption of fruits and vegetables, which negatively affect immunity and child development. He also notes disparities in access and affordability: more than 81% of Egyptians cannot afford a healthy diet, while 45% cannot secure a diet that meets minimum nutritional needs. With 29.7% of Egyptians living below the poverty line, malnutrition is most concentrated in rural Upper Egypt and impoverished urban areas. Annan also points to widespread nutritional illiteracy, particularly among women—30.8% of whom are illiterate—as a major contributor to poor family dietary choices. He warns of the decline in exclusive breastfeeding rates for children under six months to 40%, and the high rate of cesarean births (72.2%), which affect early breastfeeding and infant nutrition, leading to widespread malnutrition.
Speaking to Zawia3, Annan explains: “The problem of malnutrition in Egypt begins during pregnancy, then continues through breastfeeding and the first years of a child’s life.” Since 2019, Egypt has screened about 10 million school children annually under a presidential initiative to detect malnutrition-related diseases. This initiative has helped reduce malnutrition rates and yielded economic benefits: in the past year alone, the anemia initiative preserved an estimated 649,000 life-years for children through early diagnosis, added 2.9 million quality-adjusted life-years, and saved the economy 8.4 billion EGP. The initiative had a 29% return on investment. Annan calls for expanding the program to include children under school age and those beyond sixth grade, especially given the rise in anemia rates in Egypt from 2014 to 2022. He highlights the importance of the “Golden 1,000 Days” initiative for child health and the National Strategy for Food and Nutrition launched in 2023, which both aim to curb anemia and malnutrition.
Annan emphasizes that the ongoing economic crisis and high poverty rates have worsened malnutrition and anemia. The decline in purchasing power has pushed families toward calorie-dense but nutrient-poor foods due to limited resources. He also notes that income losses during the COVID-19 pandemic, especially in the informal sector, contributed to decreased food quality. Anemia, he warns, affects children’s cognitive development, educational attainment, and future opportunities. Among adults, it reduces productivity and increases healthcare costs. Early detection programs for anemia, breast cancer, and hepatitis have proven cost-effective in reducing treatment expenses and productivity losses.
The presidential initiative to screen for malnutrition began in January 2019, focusing on early detection of obesity and anemia among school students, at a total cost of 165 million EGP, according to the official website of the Egyptian Presidency. It has so far covered nearly 15 million children aged 6 to 12 across more than 22,000 schools, with affected children referred to public insurance committees for free treatment.
Stunting rates in Egypt improved from 21% in 2014 to 13% in 2021, and wasting declined from 8% to 3%. However, anemia among children under five increased from 27% to 43% over the same period, according to Dr. Annan.
He also explains that Egypt’s National Food and Nutrition Strategy (2023–2030), which he helped draft as a UNICEF representative, stresses the importance of reviving the national micronutrient fortification program for bread with iron and folic acid, which was halted in 2014. The strategy calls for resuming the program as a tool to combat anemia, updating additive formulas according to WHO recommendations, enhancing quality control mechanisms, and expanding public awareness of the nutritional value of subsidized bread.
Annan affirms that food fortification with micronutrients is scientifically proven to reduce anemia and malnutrition and is a low-cost intervention compared to treatment programs. However, he stresses that the program alone is insufficient, as malnutrition is a multidimensional issue. Fortified bread cannot compensate for protein or other vitamin deficiencies. Thus, investments are also needed in breastfeeding programs, school feeding schemes, taxes on sugary drinks, and reductions in salt and saturated fats in processed foods. He further advocates for nutritional education in schools and media, and for linking agriculture with nutrition through the production of nutrient-rich crops.
Stalled School Feeding Program in Egypt
Amid rising rates of anemia and malnutrition among children in Egypt, many are questioning the reasons behind the stalled expansion of the national school feeding project. This initiative was established under Cabinet Decree No. 160, issued on September 15, 2021, which mandated a contract with Silo Foods, a government-owned company, to implement the school feeding system. Meals were to be provided to all governorates across the country.
According to 2023 data from the Ministry of Education, the school feeding program was implemented in 18,306 kindergartens, 32,331 primary schools, 2,931 preparatory schools, 388 secondary schools, 436 vocational secondary schools, and 1,048 special education schools.
In December 2024, Member of Parliament Amira Saber—Secretary of the Foreign Relations Committee and a member of the Coordination of Youth Parties and Politicians—submitted a formal inquiry to the Prime Minister and the Minister of Education regarding the stalled rollout of the school feeding program. She emphasized that the program constitutes a key element of Egypt’s national security and social protection strategy. It supports millions of families affected by the economic crisis by providing children with a daily meal, easing the financial burden of school expenses, promoting equality among students, and addressing nutritional issues such as stunting and obesity. Currently, over 30% of Egyptian schoolchildren suffer from malnutrition-related conditions. Saber highlighted that the program is crucial for improving children’s health, physical and mental development, and academic performance, which will later impact their employment prospects.
The MP noted that Egypt has provided school meals since the issuance of Law No. 25 of 1942. However, the program was suspended in recent years due to reported cases of food poisoning. It resumed on a limited basis in August 2021 when the President announced a state-led initiative to provide meals that would cover 25% of students’ daily nutritional needs. A company was contracted to implement the program under Cabinet Decree No. 160 of 2021.
According to the latest data, from the beginning of the 2023/2024 academic year until the end of November, a total of 435 million school meals were produced and distributed: 368 million meals for Ministry of Education schools, 67 million for Al-Azhar schools, and an additional 10.8 million meals for other institutions.
Despite these efforts, the program still faces several challenges. These include ensuring its sustainability and nationwide inclusiveness—issues that can only be resolved by integrating the program into Egypt’s national policy and general budget. The program’s high cost—approximately 8 billion pounds ($160 million)—and the need to strengthen safety protocols remain significant hurdles. Saber stressed that the project remains relatively stalled due to overlapping responsibilities among various authorities, a lack of transparency, and an inability to scale up effectively amid inflation and limited budgetary capacity.
In January of this year, a cooperation agreement was signed between Bel Egypt, a company specializing in food distribution, and the Egyptian Food Bank, in the presence of the Ministers of Health and Education. The agreement aimed to support the school feeding program under the initiative “Hand in Hand… Because Nutrition is a Right for All.” The objective is to improve public health, combat malnutrition-related diseases such as obesity, anemia, and stunting, and reduce school dropout rates.
Economic Reform Failures
Rates of anemia, stunting among children, declining birth rates, and increased miscarriages among pregnant women are among the most critical indicators of poverty and hunger globally—all of which are currently present in Egypt, according to Nader Nour El-Din, strategic expert at the General Assembly of the FAO (Food and Agriculture Organization), in remarks to Zawia3. He held the Egyptian government responsible, citing declining income levels and rising poverty rates that led to the lowest birth rate in Egypt’s history last year, along with a spike in stunting and anemia among Egyptians. He also referred to a study by the Egyptian polling center Baseera, which found that meat consumption among Egyptians fell by half last year—despite already being slightly below the global average.
The FAO expert explained that hemoglobin levels falling below the natural range—15 to 17 grams in men and 13 to 15 grams in women—reduces workers’ productivity. Poor Egyptians, he said, rely heavily on starches and carbohydrates such as bread, rice, and pasta to meet their dietary needs, which results in anemia, pseudo-obesity, osteoporosis, stunted children, and miscarriages. He attributed these health outcomes to the missteps of Egypt’s economic reform program and called on the government to devise a plan to improve the health of the poor, which would in turn enhance national productivity.
On March 10, the Ministry of Supply and Internal Trade launched the National Program to Fortify Subsidized Baladi Bread to Combat Iron Deficiency Anemia. The initiative, implemented in cooperation with the World Food Programme (WFP) and the Ministry of Health and Population, aims to enrich Egypt’s staple subsidized bread with micronutrients to help reduce health issues caused by deficiencies in essential nutrients—particularly iron deficiency anemia.
Nour El-Din told Zawia3, “In any country where the World Bank intervenes to implement economic reform, the cost is borne by the poor, who end up paying the price.” He argued that the state should increase and double food subsidies, distribute meat and fish rations, and ensure school children are provided with daily meals—especially breakfast. He further stressed the importance of adding iron to subsidized bread, noting that iodine had previously been added to Egyptian bread in 2005 to combat the spread of thyroid disorders.
He pointed out that the distribution of school meals should focus more on children in the poorest governorates—foremost among them Sohag, where the poverty rate is approximately 67%, followed by Assiut at 65%, and then Qena and Aswan. However, he emphasized that meal distribution—partly supported by international organizations—should also reach all governorates, taking into account the presence of slums in Cairo and other major cities. He called attention to poor communities living in affluent neighborhoods, such as the children of building guards and workers, who deserve access to these meals to prevent school dropouts and support academic achievement.
Nour El-Din argued that initiatives and data from health surveys revealing the prevalence of malnutrition and miscarriage should be followed by tangible policy recommendations—such as increasing incomes, expanding food subsidies, distributing legumes, soybean oil, and molasses along with staple goods, and enriching subsidized bread with iron and folic acid. He stressed that applying the World Bank’s recommendations to cut or reduce subsidies must not come at the expense of public health or children’s wellbeing. Otherwise, Egypt risks a decline in life expectancy, reduced productivity, and accelerated population aging—especially since, according to UN and FAO principles, eliminating food subsidies should be the very last step in economic restructuring.
Speaking to Zawia3, he said: “Before the launch of the presidential initiative for early detection of malnutrition, the World Health Organization (WHO) issued a report with alarming statistics on obesity and malnutrition in Egypt, indicating that nearly half of Egyptians are affected. This prompted the Ministry of Health to conduct a broader medical survey, with a special focus on children and pregnant women, by providing them with vitamins, folic acid, and iodine.” He added that Egypt suffers from high rates of underweight and stunting among children, as well as morbid obesity, in addition to anemia and deficiencies in vitamins and minerals among children and women of reproductive age.
Impacts of Inflation and Currency Devaluation
Some experts and analysts argue that the devaluation of the Egyptian pound has negatively affected allocations within the state budget. For instance, the Ministry of Health’s budget in 2014–2015 was approximately 42.4 billion Egyptian pounds ($5.7 billion at the official exchange rate of 7.5 pounds per dollar at the time). In contrast, the 2023–2024 budget reached 147.9 billion pounds ($2.96 billion at an official rate of 49 pounds per dollar), marking a value drop of approximately 47%.
Mohamed Ramadan, an economic researcher at the Egyptian Initiative for Personal Rights (EIPR), explained that Egypt’s economic policies in recent years—leading to high inflation and a decline in the value of the local currency—have reduced citizens’ access to quality food. A large segment of the population has turned to cheap, low-quality food options, relying heavily on starches, carbohydrates, and hydrogenated oils to meet their caloric needs. This, he said, has resulted in a dual nutritional burden: obesity coupled with anemia. These conditions impact public health, increase healthcare spending, and reduce national productivity. He also noted that there are no impact assessment studies measuring the effects of social protection packages on the nutritional status of beneficiary households.
Speaking to Zawia3, he stated: “When comparing the economic cost of productivity loss due to anemia and malnutrition with the cost of implementing a national school meal program, the latter proves more beneficial. However, this requires political will. While the national initiative to fortify subsidized bread with micronutrients is a positive step, it is not a root solution to the malnutrition crisis, which demands comprehensive strategies addressing poverty through agricultural, food, and health policies.”
The researcher added that while increased spending on the health sector in Egypt has been acknowledged, this does not necessarily reflect a real increase in value due to high inflation and the currency’s devaluation. Comparing current health spending in US dollars with its value in 2019, before the currency floatation, reveals an actual decline rather than an increase.
Lack of Nutritional Awareness Among Citizens
Dr. Sayed Hammad, Professor of Nutrition at the National Nutrition Institute, believes that the primary reason behind the high rates of malnutrition in Egypt—such as anemia, stunting, and widespread obesity—is the lack of nutritional awareness among citizens. He notes that people often do not understand the contents of food products, and this lack of knowledge coincides with their limited ability to access healthy food due to economic hardship. Furthermore, a general unawareness of available healthy alternatives pushes many to purchase cheaper food items that offer satiety, such as carbohydrates, starches, and sugars, while neglecting proteins and sources of vitamins—leading to obesity and anemia.
The professor highlights the availability of iron-rich alternatives that are less expensive than red meat, such as organ meats, egg yolks, and plant-based sources like leafy green vegetables, legumes, and certain fruits. However, there is a lack of awareness about the importance of consuming foods rich in Vitamin C to aid the absorption of iron from plant sources. Dr. Hammad considers the universal implementation of school meal programs a sound solution to tackle child malnutrition, as these meals are nutritionally calculated and calorie-controlled, covering about one-third of children’s daily nutritional needs.
At a time when the state is intensifying its efforts to combat anemia and malnutrition—which have significantly increased in recent years—through presidential initiatives such as screenings for malnutrition in schoolchildren, the “Golden 1,000 Days of a Child’s Life” initiative, the Anemia Initiative, the launch of the National Food and Nutrition Strategy, and the National Program to Fortify Subsidized Baladi Bread to Prevent Iron Deficiency Anemia, experts stress that the root solution to this crisis lies in strengthening government efforts to eliminate poverty. This poverty, they argue, has deepened as a result of the economic reform program and the policy recommendations of the World Bank.
