São Tomé and Principe, ranked 144 out of 186 on the 2013 Human Development Index, continues to experience financial and socio-economic difficulties. According to the most recent household consumption survey conducted by the National Statistics Institute in 2010, around 23 percent of São Tomé and Principe’s population faces severe poverty. One in eight children dies before the age of five, and the Global Acute Malnutrition (GAM) rate is 10 percent.