The coronavirus pandemic unleashed cascades of suffering in 2020. People around the globe faced the threat of the virus, along with the devastating ripple effects of efforts to control its spread.

For much of the world, the legacy of the pandemic will be impossible to untangle from the stark material inequities that worsened it — and that it exacerbated. Among the most dangerous of these: a mounting hunger crisis, set to grow even more dire in 2021.

The World Food Program, the branch of the United Nations responsible for delivering lifesaving food assistance, expects to need to serve 138 million people this year — more than ever in its 60-year history.

The rise in hunger is “due to what I call ‘the three Cs’ — conflict, covid and climate,” said Steve Taravella, a WFP spokesman. “We don’t take the word ‘famine’ loosely, but with famine looming in several countries at once, we’re facing a genuine crisis.”

And as the situation worsens, the agency is also facing major funding shortfalls. It expects to raise only around half of the $15.1 billion it projects it will need in 2021, Taravella said.

The agency is steeling itself “for an especially heartbreaking year,” he said.

Jackson Alemi, a refugee from South Sudan, is among those worried about how he will continue to feed his family. In 2016, they fled the country’s brutal civil war for safety in neighboring Uganda. Since then, they and their neighbors in the Bidi Bidi refugee settlement, like many displaced people around the world, have relied heavily on WFP rations.

But this year, budget insufficiencies forced the agency to slash its aid for refugees in Uganda by 30 percent. The cuts coincided with the start of the pandemic, when work opportunities — already limited — also dried up. And last month, amid ongoing funding shortages, WFP announced that aid for refugees in Uganda would be reduced again.

Bidi Bidi has avoided a widespread coronavirus outbreak that some worried would occur due to refugees living in close quarters. But Alemi fears that another deadly danger has emerged, between aid cuts and fallout from the global health crisis.

“People might die of hunger, not the pandemic. That is my worry,” Alemi said in a phone conversation over the summer. “Hunger is hitting hard.”

Neighbors share what little they have, but Alemi fears that after months and months of smaller rations, the situation is growing more precarious.

His siblings are “not eating enough,” he said at the time. “They are not in school and there are lots of needs that arise that I can’t afford.”

Ryan Anderson, deputy country director for WFP in Uganda, said that his team has already seen some refugees adopt unhealthy coping strategies to manage the lack of food. “I’m worried about people’s lives getting much more difficult, particularly children in the settlements,” he said.

The hunger crisis has a long reach, affecting countries both rich and poor.

In the United States, Census Bureau data from mid-November showed that around 26 million adults reported not having enough to eat. Many are relying on food banks and a growing number of people have had to resort to shoplifting basic necessities, including baby formula.

In the early months of the pandemic, when many countries implemented shutdowns or other restrictions, hunger began to rise in urban areas. In rural areas, some of the impacts could be more long-term, if farmers missed planting cycles because of lockdowns or difficulties acquiring seeds, said Emily Farr, who works on food security issues at Oxfam. Her organization warned last year that more people could die of hunger globally than from coronavirus infections.

“Even before covid, going into [2020] we were already seeing extremely high numbers of people facing acute food insecurity,” Farr said.

In some parts of the world, the pandemic exacerbated levels of hunger that were already dangerous. In Yemen, where civil war has created the world’s largest humanitarian crisis, around 80 percent of the population relies on aid. Hunger is widespread and the U.N. has warned that famine is looming. In October, UNICEF raised alarm that 1 in 5 children under the age of 5 is acutely malnourished in parts of southern Yemen.

When the coronavirus pandemic struck, many Yemenis “didn’t have the choice of staying at home,” said Radhya Almutawakel, chair of Mwatana for Human Rights, a Yemeni organization. If they did, she said, “they will die from hunger.”

In Afghanistan, a government lockdown early on in the pandemic left many families who were already living hand-to-mouth more desperate.

Alireza Yousufi, 41, used to find enough work as a day laborer in Kabul to pay rent for the single room he shares with his five children. But his work disappeared when the city went into lockdown in March.

By summer, months behind on rent, he resorted to wandering the capital’s streets, hoping a passerby would offer some change. But to beg in Kabul, where many residents are suffering and the pandemic has thrown more people like Yousufi into economic uncertainty, meant he was often left asking for help from people who had nothing to spare.

Even if he knocked on 100 doors in a day, Yousufi said in June, he would be lucky to scrape together a small amount of cash by nightfall. Still, he said, he felt it was his only option left.

“My family would 100 percent starve if I don’t beg,” he said. “What else can I do to feed them when there is no work?”

In Uganda, Alemi said in December, the conditions remained precarious. After a difficult year, some people began to sell their few belongings in search of funds for the holidays, he said.

“There’s too much pressure to celebrate with special meals and clothing especially for children because this is how they used to celebrate in South Sudan,” he said. “And it’s so difficult convincing them that things are never the same.”

Sharif Hassan in Kabul contributed to this report.