Global Hunger as a Non-Communicable Pandemic: An Agent-Neutral Reconceptualization via Twaddle's Triad and the Biopsychosocial Model

This article examines whether chronic hunger meets agent-neutral criteria for its treatment as a non-communicable pandemic in global health. It integrates Twaddle’s disease–illness–sickness triad with Engel’s biopsychosocial model and operationalizes pandemic through six criteria: transnational extension, high burden, socioeconomic disruption, international coordination, cross-border externalities, and stable governance/financing requirements. An explicit bioethical anchor is incorporated: the right to food, distributive justice, structural non-maleficence, solidarity, and intergenerational responsibility. Verification draws on recent institutional evidence and literature on population nutrition, social determinants, syndemics, and governance. The analysis derives multi-level intervention packages (community, national, global) supported by countercyclical financing and integrated surveillance, and addresses key objections (dilution, medicalization, terminology, thresholds). The proposal is linked to SDG-2 and the 2030 Agenda. The article concludes that an agent-neutral pandemic framing does not dilute the concept; rather, it sharpens it for decision-making in contexts where burden and disruption mandate prioritization. Keywords: bioethics; food insecurity; syndemics; health justice; governance.