Acute malnutrition crisis among children in Papua New Guinea's Highlands

Deep in Papua New Guinea's mountain interior, children are disappearing into a crisis that the world has largely decided not to see. The numbers have been counted, the reports written, the severity graded. In 2025, PNG ranked 114th out of 123 countries on the Global Hunger Index, scoring 31.0, almost identical to its score of 31.3 a quarter century ago. 25 years. Near-zero progress.

The Highland provinces sit at the epicentre. A 2024 study of 3,380 children found stunting rates of 71% across the region, alongside an underweight rate of 33%. UNICEF estimates that close to 700,000 children under 5 across PNG are stunted, and that 1 child in 13 dies before reaching their 5th birthday. Malnutrition contributes to up to 50% of all hospital admissions in the country. In comparison, malnutrition contributed to less than 1% of hospital admissions in the UK from 2023-2024.

What makes this crisis particularly brutal is what stunting actually does. It is not simply a matter of small bodies.

‘If a child has a stunted body, the brain is stunted as well,’ says Professor Barbara Pamphilon, Program Director of the Family Farm Teams initiative and Professor of Community Learning and Development at the University of Canberra. ‘A lot of this growth can't be recovered even if nutrition improves. You end up with a stunted community.’

Much of the Highlands population lives as semi-subsistence farmers, growing food but selling surpluses for cash, cash that then goes on white rice, instant noodles, white bread, and soft drinks. The nutritional cliff this creates is steep. Protein is the critical deficiency. Chickens are easily stolen and pigs are reserved for cultural exchange, bride prices and funerals, so despite being physically present, they rarely make it onto a child's plate. Tinned fish and meat are available in trade stores, but remain largely unconsumed.

Meanwhile, 95% of caregivers in surveyed Highland communities had less than a primary school education, and only 21% of children had completed all scheduled vaccines, malnutrition and infectious disease grinding against each other in a cycle that compounds both.

The terrain enforces its own logic. PNG is the most geographically challenging nation in the Pacific, extraordinarily mountainous, largely un-roaded, with over 800 languages spoken nationally meaning even Tok Pisin, the most widely spoken language, is a second or third language for many Highland communities. Government services thin out the further you go, and in the Highlands they were already thin. Schools require children to travel harsh distances, and parents, particularly in more conservative families, will send boys but not girls, often producing female school completion rates of just 2 to 3 years. Everything that might interrupt the malnutrition cycle depends on education reaching the next generation, and it isn't.

Critically, the crisis is also a political one. PNG's extractive industries generate enormous wealth, mining, liquefied natural gas and timber, but Professor Pamphilon is direct about where that money goes. ‘There is massive money coming from extractive industries,’ she says, ‘but this money is not serving the people.’ The story of Bougainville island makes the point starkly: a vast copper mine gutted the land, poisoned rivers that remain dead decades after its closure, and triggered a civil war that lasted 10 years. The mine is now considering reopening to fund Bougainville's bid for independence. The pattern, extraction without reinvestment in the population left behind runs through Highland PNG like a fault line.

Development responses have struggled in part because they have consistently misread the problem. Food security programmes have framed malnutrition as a women's issue, piling responsibility onto mothers who are already carrying what Pamphilon calls a triple burden, growing food, caring for the family and contributing to community, often through church. Her Family Farm Teams programme works with whole extended households, including men, and has found that fathers engage readily when the conversation is reframed around family rather than female responsibility. That reframe alone, modest in cost, significant in effect, has been largely absent from conventional development programming.

The solutions, in many cases, are not exotic. Radio campaigns with clear, catchy nutrition messaging can reach communities that no health worker ever visits. The Pacific food groups framework, foods that build the body, protect health and give energy, translates well and generates its own practical revelations. Highland farmers quickly recognise that they have abundant energy and protective foods but almost no protein. Rainbow eating, bright-coloured vegetables carrying the highest nutrients, builds on what is already growing. These approaches cost relatively little. They are not being deployed at anything like the scale required.

In October 2024, the PNG government and UNICEF launched a Nutrition Intervention Acceleration campaign targeting 11 provinces including Eastern Highlands. It is a start. But for children already stunted, bodies and brains both, the window closed long before the campaign launched. The question is whether the next generation gets a different answer, or whether in another 25 years, the score still simply reads 31.

Further information and opportunities to engage with organisations working in this area are listed below:
https://www.highlandsfoundation.org.au/
https://www.wvi.org/papua-new-guinea
https://www.care.org/our-work/where-we-work/papua-new-guinea/

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