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FoodSecurityinthe DevelopingWorld Companion website:
http://booksite.elsevier.com/9780128015940
Food Security in the Developing World John M. Ashley
Resources for Professors:
Global and Country Food Security Case Studies
Africa
Case Study 1. Ethiopia: The Productive Safety Net Program (PSNP) (with particular reference to the Public Works component)
Case Study 2. Southern Africa and beyond: Conservation Agriculture
Latin America & Caribbean (LAC)
Case Study 3. Belize: Causes of undernutrition and poverty, and plans to address them
Case Study 4. Ecuador: Food security challenges from natural and man-made disasters
Case Study 5. Amazonia and La Plata Basin: regional food and other insecurities
Asia
Case Study 6. Lao PDR: causes of food insecurity in the mountainous north
Case Study 7. The Kuchi pastoralists of Afghanistan
Global
Case Study 8. Millennium Development Goals (MDGs), in particular MDG 1c relating to hunger and nutrition
Case Study 9. The food price crises of 2007-09 and 2011
Case Study 10. Urban slums: epicentres of deprivation and food insecurity
References for companion site
FoodSecurityinthe DevelopingWorld JohnM.Ashley
SeniorInternationalConsultant, GeopolicityInc.,Dubai,UAE
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CoverCredits: Shutterstock#246931576:Malagasyfarmerpuddlinghisricepaddy Shutterstock#175718696:AerialviewofFaveladaRochinha,thebiggestsluminBrazil,onthemountaininRiodeJaneiro, withtheskylineofthesmartcapitalbehind Shutterstock#230865490:Corncobinaparchedfield Shutterstock#270676751:Farmersplantingpaddyrice,Thailand Shutterstock#19148428:TibetannomadsintheHimalayas
Dedication TomymotherIrene,whokeptmefedinEnglandduringthefood-rationed yearsfollowingWorldWarII,andatwhosekneeIhadmyfirstlessonsin nutrition—andtomyfatherRufuswhoearnedthemoneytomakeitpossible.
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1.4Short-TermFoodInsecurityComparedwithLong-Term
1.5FlashpointGrainDeficitAreasComparedwithTraditional
3.7PredispositionoftheCommunitytoDiseaseandIntestinal
3.8Large-ScaleLandLeasebyOneCountryinAnother.............................47
3.9LargeAreasofArableLandSetAsideforBiofuelProduction..............49
4MitigationofCurrentFoodInsecurity.................................................57
4.1CopingStrategiesatMicrolevel...............................................................57
4.2HumanitarianAid.....................................................................................58
4.3Food-for-WorkandCash-for-WorkSchemes..........................................61
4.4EUFoodFacilityProgram.......................................................................64
4.5OtherEffortsbyDonorProgramstoImproveAgricultural
4.6EnhancingtheResponsetoCrisis............................................................72
4.7AddressingNutritionInsecurity...............................................................73
5PreventionofFutureFoodInsecurity...................................................81
5.1AnticipatingCrisesbyAssessingandMitigating
5.2NationalFoodSecurityStrategies...........................................................87 5.3AddressingFoodAvailability..................................................................92
5.4AddressingBetterAccessto,andUtilizationof,
5.5AddressingBothAvailabilityandAccessTogether..............................117
5.6AddressingNutritionSecuritythroughBiofortification........................129
5.8TheDifficultyofEnhancingtheStabilityAspect
6Cross-CuttingIssues..............................................................................141
6.1RighttoFood..........................................................................................141
6.6FoodSecurityGovernance.....................................................................164
6.7GovernmentCapacitytoFormulate,Implement, andInstitutionalizeChangeandReform...............................................167
6.8FoodSovereignty...................................................................................171
6.9ClimateChange......................................................................................178
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AbouttheAuthor JohnAshley isapractitioneroffoodsecurityatthelevelsofformulating nationalfoodsecuritystrategies,projectdesignandfieldimplementation,and evaluatingprogramsandprojectswhichhavesoughttoincreaseresilienceto foodinsecurity.Hehasalsoengagedwithagriculturalresearchand Universityteaching.HegraduatedinbotanyfromLondonUniversity,and thenappliedthatbasictrainingtothefieldofagricultureforhisdoctorate, workingwiththegroundnutcropatMakerereUniversity,Uganda.Healso holdsadegreeinpsychologyfromCambridge.Hehasworkedinsome20 vulnerableand/orconflict-pronecountriesover40years.Hemarriedinto Ugandaand,whennotonconsultingmissionsinothercountries,helpshis wifeandotherfamilymembersmanagetheir65-acrefarmthere,whichsupportscrop,livestockandforestcomponents.
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Preface ThisbookisdesignedtoprovideanentrypointprimerinthesubjectofFood Security,somethingnotdonesincethetermfirstcameintothepublicdomain intheearly1970s.Booksaddressingthetopicwhicharecurrentlyavailable containlearneddebateonpolicyandresearchfindings,analysisorcollections ofspecialistpapers.Despitetheirvalue,itisunfairtoexpectarelativenovice tograpplewithsuchwithoutfirsthavingreadabasictext,whichdefinesand describesthesubject’sboundaries,contoursandparameters.Withoutthat firsttextthestudentmayfindithardtodeveloptheinterestandconfidence toproceed.Thisbookofferstofillthespace,withtheintentiontoinformand facilitatebeneficialchangeinthelivesofthefoodinsecure,whowillnever readthebook.
Withouthavingacomprehensiveoverviewofthesubject,thoseinvolved innationalplanning,andpolicyandstrategyformulationmaybeunderinformed,asalsothoseinvolvedinaidpolicy,andthosewhoseroleistoidentify anddesignfoodsecurityprograms.Indeed,thisbookmayserveasatextbook/ fieldguideforawiderangeofreaders—undergraduate/diploma/vocational/ adulteducationstudentsandteachers;agricultural,ruraldevelopmentand planningministriesanddepartments;extensionworkersandnongovernmental organizations(NGOs);UNandotherinternationalorganizations;bilateraland multilateraldonorpartnersanddevelopmentbanks.
“FoodSecurity”isnotwellunderstoodbythegeneralpublic.Toooften thetermequatesonlytofood“availability”.Oftenmissingorinsufficientis theimperativeofseamlessandholisticintegrationoffood availability with economic,socialandphysical access tofood,andthe nutritional,utilization andfoodsafety components,asalsotheimperativethatalltheseparameters ofachievingfoodsecurityneedtobeaccountedforonasimultaneous,presentcontinuousand stable basis.
Chapter1 providesanoverviewoftheboundariesofthesubject,andthe topicsaddressedareexpandedinsubsequentchapters. Chapters2 5 coverthe manifestationandmeasurementoffoodinsecurity,andthelinkagebetween foodsecurityandnutritionsecurity;thecausesofthisinsecurity;andthe mitigationoffoodinsecurityofcurrentlyaffectedindividualsandcommunities,anditsfuturepreventionforthemostvulnerable. Chapter6 addresses ninecross-cuttingissues,followedbyafinalchapterwithconclusions.
Acompanionwebsitewith10foodsecurity“casestudies”fromaround theworldisprovidedonthepublisher’swebsite,thesebeingtoolengthyfor inclusioninthebookitself.Eachofthesecasestudiesreferstooneormore ofthekeyissuesgoverningfoodsecurityandnutritionsecuritymentionedin xiii
thebook,providingamoredetailedcontext.Yetthebookandcompanion websitecombinedcanstillgiveonlyanoverviewoftheall-embracingsubjectof“FoodSecurity”,whichcoversagalaxyofspecialistfields.Morethan 250referencesarecitedwhereevenmoredetailmaybefound.Thelistof acronymsandglossaryoftermsrelatedtothisbookarebothlocatedonthe companionwebsite.
Theauthorhasaddressedthesubjectasseenfromtheperspectiveofthe developingworld,thisbeingthemostpressingneed.Yet,manycountries havereceivednotonemention,beingomittedthroughshortageofspace.Itis hoped,however,thatmostcategoriesandconditionsofdevelopingcountries havebeenrepresented,drylandormonsoonal,land-lockedorislandState. Theequivalentbookfromtheperspectiveofthedevelopedworldwouldhave givenmorespacethanallocatedheretoaspectsoffoodsecuritywhichmay notbetheprimaryconcernofthedevelopingworld.
Definitionofthe“developingworld”: Theconceptof“developingcountries”isrelative,andfarfromclear-cut.Severalinternationalbodies,suchas theUnitedNationsDevelopmentProgram(UNDP),WorldBankandthe InternationalMonetaryFund(IMF)usedifferentclassifications,andanIMF workingpaperby Nielsen(2011) examinesthem.Theyarefoundlackingin claritywithregardtotheirunderlyingrationale,thoughtheyagreethat between20%and25%ofallcountriesintheworldare“developed”.Nielsen arguesthatthereisnoonegenerallyacceptedcriterionforthedefinition, eithergroundedintheoryorbasedonanobjectivebenchmark,andthata countryclassificationsystembasedonatransparent,data-drivenmethodologyispreferabletoonebasedonjudgmentor adhoc rules.
Therearelargeandeasilydiscernibledifferencesinthestandardofliving enjoyedbycitizensofdifferentcountries,withregardtohouseholdincome andlifeexpectancyforinstance.Whileeconomistswouldlikelyagreethat BurkinaFasoisa“developing”countryandthatJapanis“developed”,there aremanycountries“inbetween”whichwouldbehardertoclassifyasoneor theother.Thiscouldsuggestthatadeveloping/developedcountrydichotomy istoorestrictive,andthataclassificationsystemwithmorethantwocategoriescouldbettercapturethediversityindevelopmentcharacterizationacross countries,withagreednumericalthresholds.
Classicaleconomistsdeterminedthateconomicdevelopmentwasthenub ofthedichotomy,themainproxymeasureofdevelopment,referringtosustainedincreasesinpercapitarealincome.Yettherearesocialindicatorstoo whichareimportantmeasuresofdevelopment,suchasaccesstohealthfacilitiesandeducation,sufficiencyofnutritiousfoodandnutritiousdiets, expectedlifespanatbirth,theprevalenceofdemocracyandupholdingof humanrightsbytheState.
The“definition”ofdevelopingcountrieswhichhasbeenadoptedinthis bookreferencesUNDP,whichfrom1990adoptedtheHumanDevelopment Index(HDI),andproducesanannualauditofcountriesaccordingtoa
multipleproxyofindicators,calledtheHumanDevelopmentReport(HDR). Tocapturethemultifacetednatureofdevelopment,theHDIisacomposite indexofthreeindicesmeasuringcountries’achievementsregardingits citizens’lifeexpectancyatbirth,education(twoindicators)andincome. Otheraspectsofdevelopment—suchaspoliticalfreedomandpersonal security—arealsorecognizedasimportant,butlackofdataacrosscountries preventedtheirinclusionintheHDI.
TheIndexissubjecttointerrogationandamendmentyearonyear.Each year,“development”islookedatfromtheperspectiveofthe people within countries,ratherthancountriesthemselves,asthetitle Human Development Reportaffirms.StatisticalTable1,onpage160ofthe2014HDR,showsa listof187countries,categorizedintofourgroupscorrespondingtoveryhigh (1 49),high(50 102),medium(103 144)andlow(145 187)human development.Countriesinthelasttwocategoriesarethoseforwhichthe term“developingcountries”and“developingworld”mostclearlyresonates, andarethesubjectofthisbook.Sub-SaharanAfricancountriesconstitute almostthewholeofthe“low”humandevelopmentgroup.
ThecurrentauthorisawarethatusingnationalHDIasthe“developing world”referencepointexcludesforconsiderationinthisbookcertainsubnationalgroups,suchasthoseamongtheInuitinnorthernCanadawhostill followthenomadicfishing,huntingand/orpastorallivelihood.Canadiangovernmentdatain2008showedthatlifespanexpectationofthesepeopleis 12 15yearsshorterthanpeoplelivingintherestofCanada.However,this isprobablyduetoadearthofmedicalandothersocialservicesintheremote andinhospitablenorth,andunhealthyovercrowdeddwellingunits,rather thantofoodornutritionalinsecurity,orincomepoverty.
REFERENCE Nielsen,L.,2011.Classificationsofcountriesbasedontheirlevelofdevelopment:howit isdoneandhowitcouldbedone.IMFWorkingPaper.Strategy,PolicyandReview Department,49pp.
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Acknowledgments Theauthorisgratefultohiscolleaguesaroundtheworldwhohaveprovided assistanceduringtheproductionofthisbookandcompanionwebsite. Hehasgivencreditsasnecessaryforgenerouspermissionfrominstitutions andindividualstoreproducequotes,figures,tables,mapsandphotographs. Everyefforthasbeenmadetotracethecopyrightholdersofpublications citedbutifanyhavebeeninadvertentlyoverlookedthepublisherswillbe pleasedtomakethenecessaryarrangementatthefirstopportunity.Healso thankscolleagueswhoagreedtoreadthroughpartsofthetextandoffer comments—JamesBreen,TariqButt,GinoHenryandJessicaLumala.Any errorsoromissionsthroughoutthebookorcompanionwebsiteareofcourse theresponsibilityoftheauthor.NancyMaragioglio,CarrieBolgerand Billie-JeanFernandezofElsevierFoodSciencehavekepttheauthoronthe straightandnarrow,offeringencouragementinthelonelytaskconfronting everyauthor,assuringthisonethathewasneveralone!
Theauthorwouldliketoofferthankstoallthoseduringhisprofessional lifewhohavetaughthimmuchofwhatheknows,fromhisearlypostgraduatedaysinUgandauntilhismostrecentfieldassignmentin2014 2015, amongstthefarmersandshepherdsoftheJordanValley.Finally,thanksare duetoTrinityCollege,UniversityofCambridge,andGianlucaOlivieriof TheInternationalManagementGroup(WestBankandGazaoffice)for providingtheauthorwithaccesstotheirfacilitiesduringthepreparationof thisbook.
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Epilogue:ARude Awakening Inanyone’slifetherearewatershedmomentsinwhichonefindsoneself onanearupwardlyverticallearningtrajectory.Fortheauthor,onesuch momentwasatthebedsideofachildinthegovernmentmalnutritionclinic atMulagohospital,Uganda.Thechilddiedinhispresence,thefirstchild hehadeverseendie.Themother,withouttouchinghersonburstinto loudwailingandfledthebedside,leavinghimandtheUgandanstaffnurse withherdeadchild.Thenurseabusedthemotherassheleftbecauseshe hadrespondedso.Strangely,asanon-Ugandan,theauthorgentlychastised thenursethatsheshouldbemoreconsiderateoflocalcustom.Looking backonit,howsuperfluousthethreeseparatebehaviorpatternswere onemorechildhaddied,foraningloriousandpreventablereasonfor whichweshouldallbeashamedandtakeresponsibility,whoeverweare, whereverweare.
Asarookielecturerinhumannutritiontoagriculturalstudentsat MakerereUniversityduringGeneralIdiAmin’sregime,thiswasalessonfor theauthoronhowpovertyisamoresilentstalkeroflifethanthegun,and howcloselypoverty,conflict,hungerandundernutritionareconjoined.He stillmeetshisformerwomenstudentsonthestreetsofKampalasometimes, whotellhimthattheMulagopracticalswerethebestthingthathappenedto themintheirundergraduatelife.Anafternooninwhichtheylearnedthatthe sciencesofagricultureandmedicineareinextricablylinkedtoeachother, andtothecontinuumofhealth,morbidityanddeath.Thisisanalogoustothe greatadvancesmadeinthescienceswhentwoerstwhileseparatefieldshave beenboughttogetherinthesameresearchprogram,allowingcommonalities andsynergiestobebetterunderstoodandexploited,likebiochemistryand biophysicsinthetreatmentofcancer,orthermodynamicsandmechanicsin advancingpropulsionengineering.
Withscientiststellingusthattheworldhasembarkedonthesixthphase ofmassextinctionofspecies(see Section3.3)wemustshakeoffanyfeeling thatwecancontinueinabusiness-as-usualmodality,toexpectourfood, waterandenergysuppliestobeassured adinfinitum.Neverhasamore urgentcalltoactionbeenwarrantedthannow.Weallneedtoworktogether seamlesslyandurgently,withwiserpoliticalleadershipthancurrentlywe oftenhave,marshallingallthetechnical,economicandanthropological
expertiseinamultisectoralandcoherentway,toensuresustainablefood securityforusandourdescendantsinperpetuity.
Thereadermaynowwishtoconsultthecompanionwebsiteassociated withthisbook,comprising10casestudiesprovidingsnapshotstoelaborate onkeyconceptsandvariablesthathavebeendiscussedinthisbook.Readers requiringyetmoredetailcanrefertothereferencelistsprovided,forboththe bookandthecompanionwebsite.
1.1GENERALSCOPEOFTHESUBJECT 1.1.1Introduction
In2014theFoodandAgricultureOrganization(FAO)estimatedthatmore than800millionpeopleareundernourishedintermsofdietaryenergyintake. Anothermanifestationofundernourishment,micronutrientdeficiencies, affectsabout2billionpeople.Eachyearmorethan3millionchildrendieof undernutritionbeforetheirfifthbirthday.
SincetheWorldFoodConferenceinRomein1974,theconceptoffood securityhas“evolved,developed,multiplied,anddiversified”(Maxwell, 1996).Some200definitionsofthetermhavebeenproposed,indicatinga breadthofperspectives.However,thedefinitionthathasinvariablybeen acceptednowisthatagreedattheWorldFoodSummit(WFS)inNovember 1996,andthismeaningisthatendorsedinthecurrentbook,namely“Food security existswhenallpeople,atalltimes,havephysical,socialandeconomicaccesstosufficient,safeandnutritiousfoodwhichmeetstheirdietary needsandfoodpreferencesforanactiveandhealthylife”.
Conversely,theFAOdefinitionof foodinsecurity is“Asituationthat existswherepeoplelacksecureaccessforsufficientamountsofsafeand nutritiousfoodfornormalgrowthanddevelopmentandanactiveandhealthy life”.Foodsecurity,anditsconversefoodinsecurity,hasrightlybecomea multidimensionalindex(Smithetal.,1993).Theterm“foodinsecurity”is notmerelyaboutthe concepts ofhungerandundernutrition,butthe experience ofthesebythoseaffectedbyorvulnerabletoit,andtheanguishof beingunsurewhenonecannextprovidefoodforone’sfamily.“Foodinsecurity”alsoinflamesthepassionofhumanitariananddevelopmentpartners whoengagewithitaroundtheclock.
Inthe1970s,foodinsecuritywasunderstood(bythosewhodidnothave tobearitsburdenontheirbacks)assimplyameasureof availability offood, evidencedinthevariousfoodcrisesandfaminesofthetimes.TheGreen Revolution,whichsignificantlyimpacteddevelopingcountriesinSouth AmericaandAsiabythe1960s,certainlyincreasedthefoodsupply,yethungercontinuedinmuchoftheworld.Therealizationdawnedthatmanyof thoseaffectedwereunableto access thesupplyoffood.AmartyaSen 1
epitomizedthisinthestatement“Starvationisthecharacteristicofsomepeoplenothavingenoughfoodtoeat.Itisnotthecharacteristicoftherebeing notenoughfoodtoeat”(Sen,1981).
1.1.2TheMultipleDimensionsofFoodSecurity Theprevalenceof undernourishment isameasureofdietaryenergydeprivation(hunger),thoughasastand-aloneindicatorcannotcapturethecomplexityandmanydimensionsof foodsecurity.Thejointpublication TheStateof FoodInsecurityintheWorld in20131 presentedandanalyzedasuiteofindicatorsthataddressthefourdimensionsoffoodsecurity:foodavailability, economicandphysicalaccesstofood,foodconsumption/utilizationand stabilityovertime.
Foodsecurity isatermreferringtotheabilityofacommunity,familyor individualtobeabletoeatsufficiently,intermsofbothquantityandquality, asprescribedbyinternationalstandardsofcalorie,proteinandvitaminintake. Asindicatedabove,thetermcomprisesseveralinterrelatedcomponents(food availability,accessandalsoquality/safety/consumption-utilization),allof whichmustbe simultaneously achieved,toavoidtheonsetof“foodinsecurity”.Morerecentlytheimportantcomponentof stability offoodsupplyover timehasalsobeenstressed,relatedtomanagingtheriskstoalloftheabove componentsduetoabruptshocksofaneconomic,conflictorclimaticnature.
Foodneedstobe available inordertobeaccessed,fromthefamilyfarm, thegranary,thekitchen,andthelocalstoreormarket.Asawhole,overthe 20yearsupto2014,foodsupplieshavegrownfasterthanpopulationinthe developingworld,resultinginrisingfoodavailabilityperperson(FAO StatisticsDivision,2014).Thisisinspiteofglobalfoodsuppliesexhibiting larger-than-normalvariabilityinrecentyears,reflectingtheincreasedfrequencyofextremeeventssuchasdroughtsandfloods(see Section5.5.1).
Yet,availabilityaloneisnotenoughtoconferfoodsecurity,forsufficient access toavailablefoodisoftendenied.Thismaycomeaboutasaresultof economic constraints(poverty),andthereforetheinabilityofanindividualto purchasethefoodneeded(ifnotreceivinghumanitarianaid).Improvements ineconomicaccesstofoodarereflectedbyreductioninpovertyrates,which fellfrom47%to24%between1990and2008inthedevelopingworldasa whole.However,economicaccesstofood,basedonfoodpricesandpeople’s purchasingpower,hasfluctuatedmorerecently.
Accesstofoodmayalsobedenieddueto physical constraints,suchasa roadnetworkwhichfloodsorgetswashedawayinthemonsoon,cutting accesstomarketsandraisingthepricesoffoodwhichcangetthrough,or simplybylivinginaremotelocation.Also,the“separationwall”between IsraelandPalestine,asaresultofwhichpeoplemaybeunabletoaccesstheir resources(arablelandtoplantorharvesttheircrops,orthewaterfor
1 ByFAO,theInternationalFundforAgriculturalDevelopment(IFAD)andtheWorld FoodProgram(WFP).
irrigationorlivestock),sothatbothfoodself-sufficiencyandagricultural incomegenerationarehopelesslycompromised.Theseparationwall,by restrictingpersonalmovement,keepsmanywould-beworkersawayfrom employmentopportunities,sotheycannotearnenoughtoenablethemtobuy thefoodtheyneedforthemselvesandthefamily.
Inmanypartsoftheworld,thereisa social or political barrier,suchas thatwhichpreventsaccesstojobs(throughclassorpartisanconflict,lackof opportunityforagoodeducation,culturalnorms),thiskeepingapersonand her/hisfamilypoorandhungry.
Inadditiontoavailabilityandaccess,athirdcomponentoffoodsecurity isconsumption/utilization.Foodmaybebothavailableandaccessibleina community,butifanindividualdoesnotproperlyuseorconsumeit,then thatpersonisfood-insecure,unabletobenefitproperlyfromeitheritsavailabilityorhavingaccesstoit.Reasonsunderlyingthiscouldbecompliance withsocietalsocial/religiousnorms,illhealth,inabilitytocookitorstoreit safely(soitdoesnotrotorbecomeattackedbypests),thefoodbeingnutritionallyinadequate,orthepersonunabletoabsorbitsnourishmentsufficiently(duetodiarrheaorintestinalwormscausedbypoorhygieneor contaminatedwater).
Outcomeindicatorsof foodutilization conveytheimpactofinadequate foodintakeandpoorhealth. Wasting,forinstance,istheresultofshort-term inadequacyoffoodintake,anillnessoraninfection,whereas stunting is oftencausedbyprolongedinadequacyoffoodintake,repeatedepisodesof infectionsand/orrepeatedepisodesofacuteundernutrition.Prevalencerates forstuntingand underweight (aweight15 20%belowthe“norm”forthe ageandheightgroup)inchildrenunder5yearsofagehavedeclinedinall regionsofthedevelopingworldsince1990,indicatingimprovednutrition resultingfromenhancedaccesstoandavailabilityoffood,althoughprogress hasvariedacrossregions.
Thefourthcomponentoffoodsecurityis stability overtimeofthefood source,whichrelatestoavailability,accessandpredictability.Foodprice spikescanresultfromlocal,regionalorinternationalevents,overwhicha givencommunityhaslittleornocontrol(seeCaseStudy9onthebook’s companionwebsite, http://booksite.elsevier.com/9780128015940)andclearly influencethestabilityofaffordablefoodsupply.Anothercauseofsupply instabilityiscyclicseasonalevents(suchasalternatingseasonsofbumper andpooroliveharvestsintheWestBankofPalestine).
Whereandwhenfood insecurityisinevidence,atthelevelsofregion, nation,community,householdsand/orindividuals,notonlyisthereanimmediatehumanandsocialcostofincipienthungerandundernutritionbutalso detrimentallong-termeconomicscomesintoplay.Apopulationcanbeseriouslydamagedthroughbeingill-fed,intermsofirreversiblelossofcognitive functioninchildren,adiscouragedandunemployedyouth,vulnerabilityto diseaseandthecostofthistothehealthserviceandproductive sectors.Causalityisbidirectional—thefood-insecuregetsick,andthesick
getfood-insecureastheyhavenottheenergytowork,orlookforwork,to relievethatfoodinsecurity. Anation’shumanhealthisastrongpredictorof thehealthofitseconomy.Itfollowsthatthereisa hugemacroeconomiccost totakingnoactiontorelievefoodinsecurityinasustainablemanner—“we”, theworldcommunity,cannotaffordtodonothingaboutit.
Itmaybeseenfromtheabovediscussionthattheterm“nutrition”frequentlyoccursinthenarrative.Theconceptof nutritionsecurity isclosely relatedto foodsecurity,theformerbeingpartlydependentonthelatter. Withoutfoodsecurity,itisimpossibletohavesustainednutritionsecurity (see Section2.1.3).Undernutritionofchildrenunder5yearsofageisespeciallyconcerning,particularlyofchildrenunder2yearsofage,whoareso completelydependentfortheirwell-beingonthemother(orcaregiverinthe absenceofthemother).TheUnitedNationsChildren’sFundstressesthatthe mostirreversibledamagecausedbyundernutritiongloballyhappensduring gestationandinthefirst24monthsoflife(thefirst1000days),andthisis thefocuswindowaddressedbymanydevelopmentpartners(UNICEF,2009). Beyondthat,theperiodfrom2until5yearsisalsoregardedasacrucialwindow.AsexpressedtothecurrentauthorinnorthernNigeria“Onceachildis five,hecanbeg,steal,scavengeanduseacatapult”(toachieveadegreeof foodandnutritionsecurity).
Oneineveryfivechildreninthedevelopingworldisundernourished,and poornutritionisassociatedwithhalfofallchilddeathsworldwide. Undernutritioninearlychildhoodcanleadtocognitiveandphysicaldeficits, andmaycausesimilardeficitsinfuturegenerationsasundernourished mothersgivebirthtolowbirthweightbabies.Undernutrition,throughweakeningthebody,alsoincreasessusceptibilitytoandincidenceofinfections, anddiminishedresponsetovaccines.Undernutritionandinfectiousdiseases arebi-causalandsynergistic—undernutritionreducesimmunologicalresistanceanddiseasesdepletethebodyofessentialnutrients.
Oneaspectoffoodinsecuritywhichistakingholdinbothdevelopedand developingcountries,forindividualsandcommunitieswherefoodandwealth arereadilyavailable,isthatofobesity.Suchindividualsareconsumingmore than“sufficiently”(asperthedefinitionabove)andare“malnourished”inthe sensethattheirhealthisatriskfromconditionssuchasheartandvasculardisease,anddiabetes.Thefrequentinactiveandsedentarylifestyleofsuchpeoplemeansthatexcesscaloriesarenotburntoff,throughlaboringorexercise.
1.1.3TheCausesofUndernutrition Nutritionalproblemsindevelopingcountriesarenormallycausedbydeficienciesorimbalancesindietaryintake.Theseareconditionedbypoverty,nearexclusiverelianceonplantsourcesofnutrients,andhighratesofinfections. Undernutritionandinfectiousdiseasesfurtherexacerbatepovertythroughlost wages,increasedhealthcarecostsandimpairedintellectualdevelopmentthat canreduceearningpotential(Caulfieldetal.,2006).Populationsubgroupsat
particularriskarethechildrenandwomenofpoorfamilies.Therootofundernutritioninearlychildhoodiscomplexwithavarietyofdirectandunderlying contributorsrelatedtolackofbalancedfood,includinginsufficientbreastfeedingandinadequatecomplementaryfoods;nutrientlossfromgastrointestinal infections;chronicimmunestimulationduetopersistentparasiticintestinal infections;and,inadequatehygieneandsanitation,andcontaminateddrinking water(Psakietal.,2012)(seeChapter3:CausesofFoodInsecurity).
1.1.4MeasurementofFoodInsecurity Ofthethreehierarchicalcomponents(availability,access,andutilization), availabilityisoftenmeasuredthroughproxiesatthepopulationlevel,suchas nationalagriculturaloutput,whileaccessandutilizationaremoreoftenmeasuredatthehouseholdandindividuallevels,respectively.Whiledirectmeasuresoffoodutilizationexist,suchasfoodfrequencyquestionnaires, householdfoodaccesshasoftenbeenmeasuredindirectly,throughchild anthropometryoragriculturalproductivity.Measurementofallthreeaspects offoodinsecurityhasposedpersistentchallenges,suchasthedifficultyof measuringtheimpactofshort-termshocksonhouseholdfoodaccess.Recent research,however,showspromiseintheareaoffoodaccessmeasurement, withtheconstructionofsimplehouseholdsurveymeasuressuchasthe HouseholdFoodInsecurityAccessScale.Low-costandvalidmeasuresof householdfoodinsecurityarenecessarytoaccuratelypredicttheprevalence offoodinsecurityinresponsetochangingconditions.Suchmeasurements cantheninformtargetedinterventionstodiminishchildhoodmorbidityand mortality(Psakietal.,2012)(see Section4.7).
Beforeproceedingwithmoredetailinthisbook,itisimportanttorealizethattheterm“foodsecurity”isnotwellarticulatedbythegeneral public(see Box1.1 ).
1.2WORLDWIDEDISTRIBUTIONOFFOOD INSECURITY Foodinsecurityisclearlynotevenlydistributedacrosstheworld,currentlyor historically.Therearepocketsoffoodinsecurity,examinationofthedistribution ofwhichinevitablyleadstoaconsiderationofitscauses(see Chapter3:Causes ofFoodInsecurity)andprogressinachievingMillenniumDevelopmentGoal (MDG)1,target1c(seeCaseStudy8onthebook’scompanionwebsite).
Globaltrendsinhungerreductionmaskdisparitieswithinandamongregions. LatinAmericaandtheCaribbean(LAC)istheregionthathasshownthegreatest progressinhungerreduction,withtheprevalenceofhungerreducedbyalmost two-thirdssincetheearly1990s.Asawhole,by2014LAChadalreadyreached theMDGhungertargetandwasveryclosetomeetingthemorestringentWFS target.Government-ledeffortscombiningsupportforproductionwithsocial protectionhavebeensupportedbymuchwidercommitment—societieshave
