WASHINGTON  - With the number of hungry people growing to more than a billion last year, the world is "nowhere near" reaching the objectives outlined in the Millennium Development Goals (MDGs), according to the latest Global Hunger Index (GHI) released Monday.

Global Hunger Index: A malnourished boy at a feeding center in Damota Pulassa village, southern Ethiopia. Photograph: Jose Cendon/AFP The first MDG - to halve the proportion of hungry people between 1990 and 2015 - is an unlikely hope, says the 2010 GHI report.

Though the percentage of undernourished people fell from 20 percent in 1990-92 to 16 percent in 2004-06, recent global events have reversed that progress. The widespread economic recession and lingering effects of the 2007-08 global food crisis saw the number of undernourished people surpass one billion in 2009.

The GHI, a multidimensional measure of global hunger, is published jointly by the International Food Policy Research Institute, Concern Worldwide, and Welthungerhilfe.

It combines three equally-weighted indicators to assess hunger - the proportion of undernourished in the population, the prevalence of underweight in children under the age of five, and the mortality rate of children under the age of five - and to establish a score.

Of the three components that compose the current world GHI score of 15.1, child underweight contributes nearly half the points, about 7.4.

Stunting affects about 195 million children under the age of five in the developing world - about one in three children. Nearly one in four children under age five - 129 million - is underweight, and one in 10 is severely underweight.

"To improve their scores, many countries must accelerate progress in reducing child malnutrition," explained Marie Ruel, director of the Poverty, Health and Nutrition division of the International Food Policy Research Institute and co- author of the report.

"Considerable research shows that the window of opportunity for improving nutrition spans from conception to age two. After age two, the negative effects of undernutrition are largely irreversible," she said.

Efforts to combat child undernutrition have not been widely successful. After 20 years, the proportion of children underweight in Sub-Saharan Africa has improved a meager .6 percent, from 27.2 to 23.6.

Past policies and programs targeted children under the age of five for intervention in many countries. But recent evidence in the 2010 GHI report shows that more effective intervention programs require greater precision.

The window of opportunity for improving nutrition is much narrower, spanning the 1,000 days between conception and a child's second birthday.

After the age of two, the effects of undernutrition are largely irreversible. Lack of nutrition during this vital window can cause lifelong damage, including poor physical and cognitive development, poor health, and even death.

The newfound importance of the 1,000 days between conception and two years of age presents a need to refocus intervention methods more toward women in the future, the report says.

"The health of women, specifically mothers, is crucial to reducing child malnutrition. Mothers who were poorly nourished as girls tend to give birth to underweight babies, perpetuating the cycle of malnutrition," noted Welthungerhilfe chairperson Bärbel Dieckmann.

"Nutrition interventions should be targeted towards girls and women throughout the life cycle and especially as adolescents before they become pregnant," she said.

Going forward, the report recommends countries target pregnant and breastfeeding women and children in their first two years of life. In addition, successful policies that address the underlying causes of undernutrition, including poverty, gender inequality, and conflict should be continued.

The global score fell from 19.8 in 1990 to 15.1 in 2010, but the picture varies greatly by region and country.

Twenty-nine countries still have levels of hunger that are "extremely alarming" or "alarming." All countries with "extremely alarming" hunger statistics - Burundi, Chad, the Democratic Republic of Congo, and Eritrea - are in Sub- Saharan Africa.

The regions of highest hunger are South Asia and Sub-Saharan Africa, with GHI scores of 22.9 and 21.7 respectively.

In South Asia, the low nutritional, educational, and social status of women is among the major factors that contributed to a high prevalence of underweight children under five.

High child mortality and a high proportion of people who cannot meet their calorie requirements in Sub-Saharan Africa is due to low government effectiveness, conflict, political instability, and high rates of HIV and AIDS, the report says.

Every region has experienced improvements since 1990. But South Asia improved much greater than Sub-Saharan Africa.

GHI scores from the last 20 years have fallen 14 percent in Sub-Saharan Africa, about 25 percent in South Asia, and 33 percent in Near East and North Africa.

The inverse relationship between economic performance and hunger levels helps explain GHI improvements to some degree.

"Countries with high levels of gross national income (GNI) per capita - an important measure of economic performance - tend to have low 2010 GHI scores," the report says. "And countries with low levels of GNI per capita tend to have high GHI scores."

However, the relationship does not always hold, as conflict, disease, inequality, poor governance and gender discrimination can negatively outweigh the benefits of increased income.

Some countries made great improvements to their scores, reducing by 13 points or more, including Angola, Ethiopia, Ghana, Mozambique, Nicaragua, and Vietnam.

But nine countries, all Sub-Saharan except North Korea, saw their GHI scores rise.

The most disturbing outlier is the Democratic Republic of Congo. Plagued with violent conflict and political instability, the GHI increased 65 percent since 1990. Three- quarters of the population is now undernourished.

Similar circumstances contributed to GHI rises in Burundi, Comoros, Guinea-Bissau, and Liberia.

North Korea experienced increased undernourishment due to negative trends in economic growth and food production, while the economic collapse in Zimbabwe caused an increase in the proportion of underweight children and child mortality.

Food security was undermined in Swaziland because of a high prevalence of HIV/AIDS, coupled with high inequality. And undernourishment rose in the Gambia due to lower social protection spending for vulnerable households.