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close this bookOvercoming Global Hunger (WB)
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View the documentAppendix 1 - overcoming global hunger: an issues paper
View the documentAppendix 2 - addressing hunger: a historical of international initiatives
View the documentAppendix 3 - lessons of experience: twelve case studies
View the documentAppendix 4 - ending hunger soon: concepts and priorities
View the documentAppendix 5 - hunger and the world bank: an NGO perspective

Appendix 1 - overcoming global hunger: an issues paper

The problem of hunger can be broadly divided into two types, viz, (1) famines, and (2) endemic deprivation famines kill millions through starvation and epidemic diseases, endemic deprivation can affect hundreds of millions through debilitation and illness, increasing mortality rates and shortening people's lives.

One of the problems that makes the task of the prevention of famines and hunger particularly difficult is the general sense of pessimism and defeatism that characterizes so much of the discussion on poverty and hunger in the modern world.

There is, in fact, little factual basis for such pessimism and no grounds at all for assuming the immutability of hunger and deprivation Yet those unreasoned feelings dominate a good deal of public reaction to misery in the world today.

Amartya Sen

The Objectives

The Conference on Overcoming Global Hunger set four goals:

· To identify the major elements or an effective strategy to reduce world hunger and the political, economic, and institutional actions needed to implement it

· To build a consensus on the priority actions that would form the core of such a strategy

· To help the World Bank rethink the actions it is taking and define the actions it is prepared to take to reduce hunger
· To raise awareness in North America about the seriousness of global hunger and the actions that can be taken to overcome it.

This paper supports the goals of the conference by:

· Reviewing the experience of previous hunger initiatives to identity what we have learned from them and why, even though progress has been made, they have not resulted in actions commensurate with their objectives. Hunger has not been overcome.

· Clarifying the issues involved so that we can understand the efforts to overcome hunger in the short, medium, and long term within the larger political, economic, and social contexts within which specifications need to take place.

· Identifying the actions the World Bank is taking that contribute to the reduction of hunger, and the actions that the Bank could take to support a larger effort to overcome hunger

· Identifying an action program that has reasonable prospects for success

· Highlighting some major issues this conference could resolve.

The Larger Perspective

The conference is not taking place in a vacuum

Many earlier conferences with similar objectives have preceded it Some established bold goals, such as the World Food Conference in 1974, which proposed to eradicate hunger and malnutrition within a decade. While such efforts have achieved a great deal, they have fallen far short of overcoming hunger. Many governments and organization the United Nations (UN) and bilateral and nongovernmental entities-are concerned with overcoming hunger. Major research institutions now work actively on hunger issues. These combined efforts have contributed significantly to the reduction of hunger in some parts of the world, but many complex issues remain unresolved. These range from the level and kinds of actions needed to increase food production to the size and types of programs needed to improve food consumption and nutrition These in turn involve even more complex economic, social, and political considerations. Because some countries have made remarkable progress in overcoming hunger while others have not, overcoming hunger clearly depends on decisions made at the national level, and also at the local, community, and household levels However, other decisions need action internationally While there is a shared concern to overcome hunger, different groups have different perceptions about which of the multiple issues that influence hunger deserve priority, particularly about how the larger economic, social, and political factors impinge on hunger.

Sen has juxtaposed famine and endemic deprivation as the two essential dimensions of hunger Famine is acute and dramatic, but involves a relatively small proportion of the hungry: tens of millions. Endemic deprivation is largely hidden, but accounts for most of the world's hungry: hundreds of millions. To this we can add malnutrition caused by specific nutrient deficiencies and a lack of knowledge about nutrition. Thus hunger has three elements:

· Starvation a life-threatening condition caused by insufficient food that is generally associated with acute situations like famine.

· Chronic hunger or undernutrition: a persistent lack of calories (food energy) that may impair the ability to lead a fully healthy and active life.

· Other forms of malnutrition: a pathological condition resulting from the inadequacy (or excess) of calories, protein, and micronutrients, often in combination with diseases, parasites, and inadequate knowledge about nutrition.

While these elements define hunger, food security, as defined by the Bank and discussed in a companion paper by the International Food Policy Research Institute (IFPRI), is "access by all people at all times to enough food for an active and healthy life.”

Among the chronically hungry or undernourished three useful distinctions are important for policy and action The largest subgroup among the chronically undernourished consists of small farmers, landless rural workers, and urban nonprofessionals. In normal times people in this group subsist. They typically spend the bulk of their incomes on food, so a rise in the price of food or a fall in their incomes deepens their food curity. Another group among the chronically undernourished is the unemployed Adults may work when employment opportunities exist, but their incomes are not sufficient to satisfy their families' dietary requirements. Frequent illnesses further limit their employment capacity A third subgroup is the chronically ill, the aged, the crippled, and the orphaned, who are still less able to earn enough money to support themselves.

People in the first group can take part in the economic development process. The unemployed, the second group, remain at the fringe of economic development. Poverty marked by chronic undernutrition, poor health, unsanitary drinking water, large families, and crowded housing increases their vulnerability to infectious diseases, stifles their motivation, and reduces their capacity to work and study For them, development at the aggregate level offers little relief. An increase in total food production may not improve their nutritional status by much, because they would still not have enough money to buy the food. People in the third group will have to rely- on direct help, including such basic assistance as free food, housing, and health care.

How Many People Are Hungry

Estimates about how many people are hungry differ, but more for reasons of methodology and definition than disagreement about essentials The Food and Agriculture Organization of the United Nations (FAO) has calculated that in 1988 to 1990, 786 million people faced chronic undernutrition in developing regions, or 20 percent of their populations (table 1). Most of these people—528 million are in Asia. the next largest group— 168 million—is in Africa The FAO's calculations suggest a significant drop in the proportion and absolute number of chronically undernourished people in developing countries: from 36 to 20 percent and from 941 to 786 million since 1970.5 The most dramatic decline was in the Far East from 751 to 528 million people, and from 40 to 19 percent of that region's population In Africa, despite a small decline in the proportion of malnourished, the absolute number has risen dramatically, from 101 to 168 million Both the proportion and absolute numbers in the Near East and Latin America are relatively smaller. In both regions the proportion has declined from near 20 to 12 and 13 percent, but the absolute numbers have remained relatively unchanged.

Table 1. Prevalence of chronic undernutrition in developing regions. selected years.



Chronic undernutrition

Total population (millions)

Proportion of total population (percent)

Number (millions)














Far East













Latin America













Near East

























786 .

a Twenty-two countries with a population of less than 1 million are excluded from these totals The combined population of these countries represents 0.6 percent of the fatal population of the developing countries.

Source: FAO, Statistic Division, World Food Supplies - and the Prevalence of Chronic Undernutrition in Developing Regions as Assessed in I 992 (Rome FAO, 1992).

The figures cited represent the lower limit of the hungry. Hunger in the industrial world and in some seventy-two countries with populations of less than 1 million is excluded, as is the impact of famine. The upper limit is indicated by the World Bank's estimates of poverty (table 2). In 1989 1,133 million people were poor at a poverty line of US$1 per day per person The geographical distribution of the poor is similar but larger than that of the chronically malnourished for obvious reasons: hunger is a prime reflection and indicator of extreme poverty.

Why Are People Hungry?

The reasons why people are hungry differ IFPRI's companion paper suggests a conceptual framework that integrates a number of these factors and portrays the long-term relationships between root causes and symptoms of hunger. Poverty, for example, including natural and man-made shocks, is a root cause of hunger The framework also depicts the broad interactions between policy failures, resource poverty, disasters, and the population transition that impact on hunger Within this context, the main reasons why people are hungry are lack of assets and resources to produce enough food, lack of income to buy enough food, and lack of specific essential nutrients and knowledge These conditions are in turn affected by the natural resource environment and the economic and social environment in which the hungry live. These influence the level and distribution of assets and incomes; the level and nature of employment; and the availability of social services, especially health, housing, water supply, and education. They also influence the degree to which people participate in government and economic decision making, including decisions relating to how hunger can be overcome.

Table 1 Estimates of the magnitude and depth of poverty in the developing world, 1985 and 1990


Number of poor


Poverty gap index














East Asia and the Pacific







Eastern Europe







Latin America and the Caribbean



22 4




Middle East and North Africa .







South Asia







Sub Saharan Africa







Note: the poverty estimates are for eighty-six countries representing percent of the population in developing countries. have been updated from those used in the 1990 World Development Report and are based on national household sample surveys from thirty-one countries, representing roughly 80 percent of the population on of developing countries, , and on an econometric model to extrapolate poverty estimates to the remaining fifty-five countries. The estimates do not include Indochina or the Former Soviet Union The poverty line is US$31.3 per person per month at 1985 prices. It is derived from an international survey of poverty lines and represents the typical consumption standard of a number of low-income countries The poverty line in local currency is chosen to have constant purchasing power parity across countries based on 1985 purchasing power below the poverty line The poverty gap Index is the mean distance below the poverty tine (zero for the nonpoor) expressed as a percentage of the poverty fine. See Martin Ravalion, Gaurarv Datt. and Dominique van de Walle, 'Quantifying Absolute Poverty in the Developing World," Review of Income and Wealth 37 (1991): 345 61. for details of the methodology. The updated estimates are documented in the source publication.

Source: World d Bank, Implementing the World Bank's Strategy to Reduce Poverty (Washington, D.C: World Bank. 1993), 3-7.

Solutions to overcome hunger thus encompass a wide array of issues and possible actions At the most direct level these include the following:

· Actions to deal with droughts and other disasters that can lead to famine.

· Actions to provide essential nutrients such as vitamin A and iodine and the education to be aware of the need for these vital elements in the diet

· Actions to increase access to food through improved incomes, employment, technology, and so on, and through food transfers or other measures that increase entitlements to food.

· Actions to increase and sustain food production in the world, within countries, and at the household level. These actions influence the total supply and price of food for all consumers, and the supply of food available to hungry people (if they are farmers or farm workers) Most of the world's hungry are farmers, farm workers, or others in rural areas. Their direct access to food and to incomes is thus closely linked to increased food and agricultural production.

At a more complex level are such issues as:

· The functioning of the world economic system and its impact on equity, that is, on income, asset, and food distribution

· The functioning of the world food system and its implications for food production, consumption, and trade in and between industrial and developing countries, and thus for hunger

· The balance of resource allocation and use between industrial and developing countries, including the relevance of industrial country consumption patterns (life styles), both as they currently affect global food and income distribution and their implications as a long term guide to future growth and consumption patterns

· The relationship between the need for efficient household, local, and national food self reliance relative to the need for an efficient and smoothly functioning world market.

The concern with global hunger is most often stimulated by short-term phenomena such as famines, which activate people's humanitarian concerns, or by disruptions in the world food supply, which spark Malthusian anxieties of a world running short of food While these are important elements of the hunger problem, they are in a sense transitory. When the anxiety diminishes people tend to feel that the problem has been solved. However, the major cause of hunger is what Sen calls endemic deprivation, for which the solutions have less to do with global food production and more to do with poverty and inequality, economic and employment growth, and distribution within countries and in the world as a whole. These issues involve a much more complex set of considerations Among groups concerned with hunger, however, there are strong, divergent views on these issues, which affect policy recommendations and action proposals.

Recently, some other concerns have become prominent on the same agenda as overcoming hunger The following paragraphs discuss these issues.

The global food balance looks adequate in the aggregate and points to a progressively improving food situation in the industrial and developing world through 2010 for those with an effective demand for food, that is, the resources to produce it or the income to buy it But this masks the people who are chronically malnourished and lack the essential elements of an adequate diet As the World Development Report of 1990 recognizes: “The burden of poverty is spread unevenly among the regions of the developing world, among countries within those regions, and among localities within those countries "7 Two issues are involved One is recognition that greater equity in the distribution of assets needed to produce food or income would result in less hunger. This view focuses on the redistribution of existing resources as a means to overcome hunger. The other issue emphasizes that raising hungry people's commend over food through more productive employment and higher incomes will raise people out of poverty and reduce hunger, which focuses on the future. Each approach has strong proponents. Overcoming hunger now and in the future requires greater attention to equity in people's access to food and the resources to produce it, and to measures to enable them to escape from poverty. Proponents of each approach will need to find ways to reconcile their differences if a consistent approach to overcoming hunger is to be achieved.

Sustainability has become an increasingly pressing concern for viable approaches to development, and is particularly important for overcoming hunger. The prevalence of hunger among poor farmers and their families, often in environmentally fragile regions, makes clear the link between unsustainable natural resource exploitation and meeting household food needs. The 1992 World Development Report highlighted this link: "Alleviating poverty is both a moral imperative and a prerequisite for environmental sustainability The poor are both victims and agents of environmental damage." More important, however, is the dependence of the incomes, and hence of the command over food, of most of the world's hungry on agriculture, often in the most environmentally stressed areas. Thus environmental degradation is an important hunger (and poverty) issue. Actions to achieve sustainable development and reduce hunger have to reinforce one another if the world is to achieve a sustainable reduction of hunger and a sustainable environment in the larger sense.

Overcoming hunger will not be achieved solely by donors, governments, or concerned outsiders. The poor who are hungry must be key players, not only as recipients of assistance, but as producers. The poor are disenfranchised in every sense, which means a global agenda to overcome hunger will have to find ways to enable the poor to produce their own food or the income needed to buy food. This inevitably involves questions of human rights and the development of civil society Ensuring that the poor participate in the design of programs and projects to alleviate their own hunger is far from common practice. As antihunger efforts increasingly focus on people who are excluded and marginalized, the issue of participation and empowerment becomes increasingly crucial to their success.

Securing the full participation of women is also essential to overcome hunger Women and children suffer the most from hunger Women are not only central to the preparation and distribution of food within households, but in many parts of the world, especially in Africa, they are the major producers of food. Often the key entry point in targeted food and nutrition interventions is through women to their children. Finding ways to enhance women's participation in food production is equally important Legal issues, as well as issues of access to land, credit, and other inputs, are involved not only to produce food, but to generate other sources of income, and to share fully in the marketing and distribution of food.

These larger concerns with equity, sustainability, participation, and the role of women need to be seen in two perspectives. Each is an objective in its own right, and the reasons for pursuing each go well beyond the concern with overcoming hunger Each also has dimensions that relate directly to overcoming hunger Identifying these direct and indirect links and clarifying how they help reduce hunger is essential, and should be an important objective of this conference. The issue need not be one of tradeoffs or of confrontation between these concerns and the goals of overcoming hunger, but should concern integration and phasing. Some of these concerns can only be adequately addressed in the longer term. Others are directly relevant.

Two other elements of the larger perspective need to be clarified. One is the political nature of the hunger problem; the other is the practical possibilities for action.

People often see the hunger problem in its direct food production or nutrition dimensions, but it also has important political dimensions. People are hungry because they are poor, and because they are poor their participation in the political process is weak. At some point, all solutions for overcoming hunger, no matter how seemingly technical, must face the reality that transfers of income or resources, either to consume or produce food or to gain access to other sources of income and social services, are needed. Access to these economic and social opportunities are ultimately issues of the functioning of political systems. Proposals for overcoming hunger often call for political will, but how to achieve this is left vague. This conference can seek to clarify how to develop a basis for political action at the national and international levels that is commensurate with the objective of overcoming hunger.

Despite this huge package of issues that obviously impinge on hunger, and must in some way be resolved, overcoming hunger also involves many practical actions that can be put in place even if larger social and political factors can only be changed slowly. These actions form the basis of the action program discussed later.

Previous Hunger Initiatives

Overcoming hunger has been a recurring theme for decades The paper Addressing Hunger: A Historical Perspective of International Initiatives (appendix 2), reviews some of these Progress has been significant. Global food production has increased faster than population, and food consumption has improved (see section, "Time Frame for Reducing Hunger") Hunger has been reduced both absolutely and proportionately in many developing countries, but the goal of eradicating world hunger remains elusive. Why?

Earlier Hunger Initiatives

Overcoming hunger was a central issue at the time of the establishment of the FAO in 1945, when a proposal was made and rejected to establish a world food board to ensure adequate food for all.

Concern with slow food production growth in developing countries and food shortages in South Asia, China, and the former U.S.S.R in the mid 1960s led to a number of major conferences held in the United States concerned with food and hunger. Among the more significant were the Strategy for the Conquest of Hunger by the Rockefeller Foundation (1963), The World Food Problem by the U.S. President's Science Advisory Committee (1967), and Overcoming World Hunger by the American Assembly (1969). These resulted in detailed studies of the causes of hunger and related food problems and proposals to overcome these problems These undertakings contributed to some degree to the green revolution, which produced dramatic increases in food production and reductions in hunger in South and Southeast Asia and in Latin America in the 1960s and 1970s The FAO also established Freedom from Hunger nongovernmental organizations (NGOs) in the 1960s with networks that continue to operate in Asia and elsewhere.

The green revolution and the mid-1960s emphasis on expanding food production and the availability of agricultural inputs such as fertilizer worldwide, which these initiatives contributed to, resulted in dramatic global food surpluses by 1970. Real world food and fertilizer prices were at historical lows in 1970 and food seemed abundant These global food surpluses led to dramatic cutbacks in production by major industrial food producing countries by 1971 These cutbacks coincided with sharp, mostly weather induced, shortfalls in food production in the former U.S.S.R, Africa, and Asia in 1972 to 1973, and with the first oil crisis This combination of events, which caused a nearly 200 percent increase in world food and input prices, shortages of internationally traded food supplies, and a dramatic drop in food aid, resulted in the world food crisis of 1972 to 1974.

The World Food Conference, held in Rome in November 1974, was the culmination of worldwide concern with the world food crisis. It brought together leaders of 130 countries, officials of the major UN and bilateral agencies, and representatives of concerned NGOs It gave rise to the most comprehensive effort ever to address the global food and hunger problem. Its twenty major resolutions covered nearly all aspects of world food production, consumption, and trade The conference adopted the Universal Declaration on the Eradication of Hunger and created the World Food Council, the International Fund for Agricultural Development (IFAD), and the Consultative Group on Food Production and Investment The world food crisis also spawned a new generation of NGOs, such as Bread for the World and the Hunger Project in the United States. The International Food Policy Research Institute was also created at that time.

Despite the comprehensive framework of recommendations and Institutions put in place by the World Food Conference and the network of new hunger- and food-centered NGOs and research centers that emerged, the intense worldwide concern with the food and hunger problem subsided as the global food supply improved after 1974. The newly created UN institutions lacked effective support, and most were gradually abandoned or marginalized IFAD is one of the few surviving entities The major recommendations, especially the Universal Declaration on the Eradication of Hunger, became dead letters. Progress has been made on many fronts, but more outside than inside the framework created by the World Food Conference, and the goal of eradicating hunger had clearly not been achieved.

Recognizing this, and concerned that action be initiated on at least the most serious hunger problems, two conferences were convened. The 1989 Bellagio, Italy, conference proposed a sharply focused objective to reduce hunger by one half in the 1990s through four "achievable goals," namely, to (a) eliminate deaths from famine, (b) end hunger in half of the world's poorest households, (c) cut malnutrition in half for mothers and small children, and (d) eradicate iodine and vitamin A deficiencies. The International Conference on Nutrition/ held in Rome in December 1992 and attended by representatives of 159 countries, adopted the World Declaration on Nutrition, which also had as its central element the pledge to eliminate, before the end of this decade (a) famine and famine-related deaths, (b) starvation and nutritional deficiency diseases in communities affected by natural and man-made disasters, and (c) iodine and vitamin A deficiencies .

Accomplishments of Earlier Hunger Initiatives

The earlier attempts to overcome hunger have resulted in a number of significant accomplishments. First, they testify to the continuing concern of many people, governments agencies, and NGOs to overcome hunger. This concern waxes and wanes, however, and ways have yet to be found to galvanize it into effective and sustained world action to eradicate hunger. Second, they reflect a conviction that overcoming hunger is achievable. For some this should be through more equitable distribution of existing "adequate" food supplies, with the emphasis on equity and redistribution of existing world resources, incomes, and food, because food is a basic human right or a humanitarian obligation. For others it is because of a belief that what needs to be done and what is needed to do it is reasonably well understood. Third, they have generated a large body of analysis on how to identify who is hungry, why, and what can be done, and a number of strong research and NGO groups have emerged to support and expand this effort. Fourth they have achieved real progress. Per capita world food production and consumption have increased and world food prices have declined. Even more important, hunger has been reduced. Fifth, they have clarified the causes of hunger and how it can be reduced. During the past thirty years many countries, such as Indonesia, Malaysia, the Republic of Korea, and Thailand, have demonstrated how an emphasis on growth using the talents and resources of the poor, with strong reinforcing social services, sharply reduces poverty and hunger Other countries, such as China, Sri Lanka end parts of India, have demonstrated that even though people remain poor, reducing hunger significantly is possible International agencies have also devised approaches to development that shift the focus toward poverty reduction or address specific hunger-related problems, for example, the World Bank's orientation toward poverty reduction, the United Nations Children's Fund's (UNICEF's) program of oral rehydration, and IFAD's effort) to alleviate rural poverty and target specific hunger groups. A large number of grassroots institutions and NGOs are also now in place that directly help the hungry and seek to empower em to solve their own food problems. All these efforts show that hunger can be reduced though multiple measures: growth that is well distributed and uses the resources of the poor, public action that assures adequate social services even where growth is constrained, and actions targeted directly at the hungry.

Despite these successes, however, the goal of overcoming or eradicating hunger remains elusive. Why the hunger gap persists despite progress is the central issues Some of the reasons for this lie in the difficult lessons that have been learned from past initiatives.

Difficult Lessons If Learned from Earlier Initiatives

The first lesson learned from past initiatives is that them is little support for such global mechanisms to reduce hunger as either a world food board or a world food council. The reasons for this deserve careful thought. They probably have less to do with the lack of support such mechanisms received, although this is one factor, than the [act that multiple and complex issues are involved and decisions need to be made at many levels. Expecting a global mechanism to bridge this gap is probably unrealistic, and therefore the goal of eradicating hunger through such mechanisms is not taken seriously. Nevertheless, a vacuom exists at the international level if a global effort is to be mounted to overcome hunger and an outstanding issue remains: what mechanism is needed and can work that will focus the multiple efforts of others to overcome global hunger?

The second lesson is that hunger problems are country specific. within countries they also have regional-, community-, and household-specific elements. At the country level issues range from national economic and social policies to details such as land ownership and distribution, agricultural techniques, and the types of social services that are needed to reach the hungry.

The third lesson is that many problems have to be resolved at multiple levels. Some of these problems are large and complex: governance, equity, approaches to development Others are technical, but often complex as well: which actions produce the best results in the specific circumstances?

The fourth lesson is that overcoming hunger is clearly not a one-dimensional problem It is not simply an issue of food and its allocation. Many different approaches to overcoming hunger are relevant and work. How fast growth takes place and how equitable it is are major factors. Hunger has been reduced quickly in those countries in East Asia where growth has been rapid and has used the resources of the poor, where the benefits have been equitably distributed, and where social services such as health and education have been supported. The proportion of East Asia's population living in poverty fell from a third to a tenth between 1970 and 1990. Although the population increased by 40 percent in these countries, the number of poor decreased by 60 percent The absolute poor in six East Asian countries numbered 380 million in 1970 and 150 million in 1990. Not only were 230 million poor lifted out of poverty, but another 425 million people were added to the population and are living above the poverty line By contrast, Africa's hunger and poverty problems are getting worse, in large measure reflecting the lack of growth.

However, experts recognize that growth by itself is not enough. Some countries have experienced rapid growth, but its distribution was not equitable and it was not supported by growth in social services, for example, Brazil, whereas other countries have {ailed to grow very rapidly, but have achieved significant improvements in health and in hunger reduction, for example, Sri Lanka.

The fifth lesson is that despite the improved knowledge about who is hungry and how hunger can be reduced, many differences persist among practitioners and policymakers. One reason for this is that the concern about hunger often centers on food as "the staff of life." Like water and air it is essential for life. Food is a basic human right and therefore on equity and humanitarian grounds it should be provided to everyone . This is a powerful driving force behind many hunger initiatives, and was the basis for the World Food Conference's declaration to eradicate hunger. In practice, however, food is a commodity. Access to it is largely a function of income and asset distribution, as well as of the functioning (or malfunctioning) of food production and marketing systems From this perspective, access to food is governed by the same factors that govern access to any other commodity. It is for this reason that hunger and poverty arc so closely linked. The vision of global hunger, which seems so dear in terms of the basic human right to food, quickly balloons into a larger settee of political, economic, and social issues that go to the very heart of political and social systems, and on which there is less agreement. There are important differences between approaches to overcoming hunger that rely on the redistribution of existing food, income, or assets and those that stress the need to enable people to earn enough to afford the commodity food.

Another major issue separates those who emphasize food self-reliance at the local or national level and these who stress the role for a well functioning world market for food. Resolving this issue involves a major effort to reconcile the advocates of two valid approaches.

The final lesson is that global action on hunger requires multiple decisions at many levels. Unless governments put in place mechanisms to identify the hungry and initiate actions to reduce hunger, little can be accomplished. At the same time, unless the international community is prepared to support national efforts and to address those hunger issues that are influenced by international action, national efforts will be constrained. Currently, mechanisms focused on overcoming hunger are weak at both levels.

Time Frame for Reducing Hunger

How one deals with reducing hunger depends on the time frame within which this objective is sought. If, as the World Food Conference proposed, the intent was to eradicate hunger in a decade, then a high priority would have had to be placed on direct interventions and equity actions. Actions would also have had to include proposals for dealing with some extremely difficult situations, such as what to do in war and conflict situations, what to do in cases where government support and policies were lacking, and what to do in the most intractable hunger areas. If the intent is to overcome hunger eventually, as part of a broadly based growth strategy, then a broader array of tools is available, but many people would remain hungry.

There are three broad, overlapping, approaches to reducing hunger: (a) through economic growth, (b) through poverty reduction, and (c) through public provisioning. Dr and Sen have reduced these to "growth mediated security" and "supported security” In practice, all these approaches have had their successes and failures. The following section describes how the World Bank approaches the reduction of hunger through these three approaches. Here we are concerned with the issue of a tune frame to overcome hunger in the short, medium, and longer term.

Table 3 illustrates the relationship between the short-term, medium-term, and long-term actions needed to end hunger.

Such a time frame brings into focus the degree to which the effort to reduce hunger needs to be incorporated into longer-term concerns with growth and poverty reduction. While it recognizes that some elements of hunger reduction can only be achieved by long-term solutions, it concentrates attention on the actions needed to reduce hunger to the maximum extent well before long-run solutions are achieved. However, this does not mean that elements of both long-term and short-term actions are not part of the solution, and inevitably shifts the balance of concern toward equity, entitlement, and intervention solutions.

Table 3. Continuum of actions to reduce hunger


Famine relief

Food security

Poverty elimination

Time scale


1-10 years. near to medium value

10-50 years, long term


Feeding centres

Vulnerable areas

Whole country


Distribution of food aid

Entitement direct intervention

Production, economic growth, poverty reduction

Long-Term Measures

Three things are of overriding importance for overcoming hunger in the long term:

· Sustained economic growth works when it uses the resources of the poor and is equally distributed.

· Public policies that support human resource development and expanded social services (poverty reduction or support-led security) also work.

· Sustained increases in food (and agricultural) production work.

Growth. Examples of dynamic growth-led poverty reduction in Asia have already been cited. Clearly growth by itself is not enough, but it is nevertheless essential. Why does economic growth matter? Growth reduces hunger to the extent that it (a) reduces income poverty, that is, the poor are active participants in the growth process; and (b) is used to finance public support in key areas where markets work poorly, notably, in the provision of basic health, nutrition, and education services. Such an approach is more directly linked to concerns with empowerment and equity than might appear on the surface. While growth alone does not ensure the reduction of poverty or hunger, there are many examples of where it has, Asia being a notable one. Africa is an example of where lack of growth has impeded progress in increasing food production, in generating more employment and higher incomes, and in providing public revenues to support improved social services.

Poverty reduction and support-led growth. Evidence also exists that in countries such as Sri Lanka or in parts of countries such as Kerala, India, where incomes are low and growth has been slow, but there is a high degree of equity or targeted social programs focusing on food, health, and education, hunger has also been reduced and human life greatly extended. Actions in these areas include those health, education, nutrition, and other social services that sustain human life and build human capacity to enable people to participate in the development process.

Increasing agricultural and food production. One important factor in the reduction of hunger in the past three decades, and also an indicator of the future, is the longer-term development of the supply of and demand for food. The World Bank recently reviewed the pattern of food production and consumption over the past thirty years and the outlook to the year 2010. The analysis shows that growth in food production continued to exceed population growth during the past thirty years. World per capita cereal consumption has increased by 20 percent since 1960, and in developing countries it increased by 36 percent. Cereal yields continue to increase faster than population growth, while the amount of land used for cereal production has declined: since 1950, 90 percent of the increase in cereal production has come from yield increases.

The analysis also found that the demand for food is not growing as fast as in the past, and as a result, the period of greatest stress on the world's food production capacity may have passed. During the 1970s, world cereal consumption increased by an average of 2 7 percent per year, but during the 1980s it slowed to 1.7 percent per year despite a decline in real world cereal prices of more than 40 percent. By 2010 world cereal consumption is expected to slow further as incomes grow, consumption patterns change, and world population growth slows.

Diets in developing countries haste also changed dramatically during the past thirty years. Per capita calorie supplies in developing countries increased by 27 percent with rising real incomes and declining commodity prices. Asia, which accounts for 59 percent of the world's population, has seen the greatest improvement in diets, while Africa, which accounts for 12 percent of the world's population, has had the fewest gains. World population growth slowed from 2.06 percent per year during 1965 70 to 1.74 percent in 1990, and is projected to fall to less than 1 percent by 2025. The countries being left behind present the greatest challenge. Most of these countries are in Africa and the problems are economy wide.

The prices of basic staples such as cereals are expected to continue to decline relative to other consumer prices and relative to incomes. By 2010, real wheat prices are projected to decline by 33 percent, real rice prices by 31 percent, and real maize prices by 21 percent The declines in real food prices have helped large numbers of the poor achieve food security in recent decades, and their continued decline will underpin much of the anticipated progress in future decades. It is the lowered real price of such basic energy-supplying food commodities that provides the simplest market related means of reducing hunger, even if it adds to the economic viability challenge faced by small-scale agricultural producers who derive some of their cash income through the sale of such grains. World cereal consumption is projected to grow by about 1.4 percent per year, with developing countries increasing their cereal consumption by 2.2 percent per year. To achieve these consumption levels, however, cereal imports by the developing countries are projected to increase from 87 million tons in 1990 to 210 million tons by 2010, continuing the trend toward increased imports that started in the 1960s.

These are simply projections however. They do not deal directly with those who are left hungry nor do they take account of the random elements that contribute to food insecurity, and the raise other issues as well.

First is the need for sustained support to agriculture, including increased support to the Consultative Group on International Agricultural Research (CGIAR) and to national research centers (see box 1).

While the pattern of past and possible future growth underscores the contribution of sustained agricultural growth to overcoming hunger, the projections also raise long-term issues. One is the implied underlying pattern of future growth, which reflects developing countries' adaptation to the consumption patterns of the developed world. This has clearly happened and is projected to continue, but many argue that such a growth pattern is not sustainable. Where does the truth lie?

Another concern is that projections of growing food consumption in developing countries indicate increases in imports from the industrial countries. While this reflects a more fully developed world market for food, some question whether it is feasible, sustainable, or desirable. These projections argue strongly that it is. Others argue that it is not.

Short-Term Measures

Much of the concern with hunger is focused on short-term problems: droughts, floods, natural disasters, and civil and military conflicts. Both the Bellagio conference and the International Conference on Nutrition proposed that ending death from famine should be a specific near-term goal. These conferences provide good examples of ways to address the problems of people experiencing these disasters. Ending death from famine should be an essential short-term component of a hunger reduction strategy.

In recent years, many, including Dr and Sen and IFPRI have undertaken major research on how droughts affect those who experience them and how their impact of these events can be kept from resulting in famines. The World Food Programme (WFP), the FAO, and many bilateral agencies are also well equipped to act quickly. The basis for action to avoid famine includes having in place early wanting systems, supporting traditional coping strategies, ensuring against loss of assets, and, most important, sustaining entitlements (see also the accompanying IFPRI paper, Ending Hunger Soon: Concepts and Priorities).25 Many NGOs are actively involved in such relief efforts. The outstanding issues remain: how to deal with famines driven by conflict and how to overcome national policy neglect.

Traditionally the Bank has viewed these problems largely as relief efforts for which other UN and bilateral agencies are better suited. This position is changing, although the pre-eminence of other agencies is recognized In Africa, where famine remains a serious recurring event, the Bank is rethinking its approach to the problems of drought as a guide to new policy and lending actions.

Box 1. Research to sustain long-term food production

Another recent World Bank study finds that meeting the doubled food demand that is anticipated by 2030 seems feasible, but that given the increasingly constrained resource base, supporting agriculture will require substantial productivity gains. Fundamental to meeting the challenge of increasing agricultural productivity will be better application of existing (but underused) knowledge about resource management, and the development of new agricultural technologies and knowledge.

Among the incentives that would encourage farmers to adopt improved technologies and methods, none is more important than the allocation end protection of property rights In a addition as technologies become more sophisticated, educating farmers and strengthening extension systems is essential, not just to increase production, but to find better ways to use increasingly scarce water supplies The spread of practices such as conservation tillage and integrated pest management demonstrates that environmentally friendly and economically attractive technologies offer practical alternatives to regulation and subsidies in controlling the environmental costs of agriculture.

Even if existing knowledge is fully exploited, the availability and quality of land and irrigation water will be insufficient to meet demand. Plant genetic resources and climate change are less immediate constraints on increasing global output Further expansion of cropland by perhaps 25 percent and of irrigated land by 5{) percent may be possible, but will have high environmental and other costs. New knowledge will be necessary.

Experience over the past few decades has demonstrated that the generation of new knowledge is the most potent and least costly way to improve productivity The expansion of knowledge through research and development will need to encompass human capital, institutional innovation, and new technology New and higher-yielding cultivars of plants will be needed, aloe:, with farming systems research that Focuses on integrating livestock and crop activities as well as forest and aquatic resources, and on modifying the physical environment in which plants grow, for example, measures that conserve soil moisture and permit more continuous cultivation on the infertile, acidic soils common in many tropical areas.

Deliberate and sustained investment in agricultural research and development has never been more important Yet expenditures for agricultural research are stagnating or shrinking, both nationally in most parts of the world, and internationally. Research must address the increasing constraints posed by the environmental consequences of agricultural development. The Consultative Group on International Agricultural Research (CGIAR) is placing much greater emphasis on agricultural resource systems and on relatively neglected areas, such as forestry, pest manage meet, and soil conservation and irrigation, to complement the more traditional focus on commodity programs These changes by the CGIAR need to be reinforced and matched by commitments to strengthen national research systems in these and more traditional direction Such investments feature long gestation periods, yet have yielded high rates of return It will only be through continued investment in the agricultural knowledge (education, research, and extention) systems of the developing countries that long-term food security can be safely approached and achieved.

Source: Crosson and Anderson, Resources and Global Food Prospects: Supply and Demand for Cereals to 2030.

The response to the 1992 drought in southern Africa illustrates that action to deal with droughts, famines, and other disasters need not wait on further research. The combined efforts of countries and international agencies to respond to that drought is a good example of how effective action can forestall the famine consequences of a major drought. Without these efforts, a major famine could have been expected in southern Africa in 1992-93. That it did not occur was a major achievement.

The fact that war and other conflicts are a major cause of femme poses important issues for the Bank and other organizations Often Bank operations are halted in such cases. Other agencies and NGOs have been on the leading edge in dealing with the food problems of people facing these conflicts, but these conflicts still impede action in most cases.

Medium-Term Measures

While long- and short-term approaches to overcoming hunger are essential, a realistic attempt to overcome hunger must concentrate on actions that complement these long- and short-term elements, but focus on action that will have a large impact in a relatively short time Many such actions exist, and they are discussed in the section, "An Action Agenda to Overcome Hunger".

Current World Bank Actions to Address Hunger

Actions by the Bank address hunger in the three ways cited earlier, that is, through (a) economic growth, (b) poverty reduction, and (c) public provisioning Bank approaches also include specially targeted actions to address such issues as nutrition, food security, gender, and safety nets.

A long-standing focus of the Bank has been to support countries' economic growth by financing productive investments (loans and International Development Association credits) Whether for infrastructure, industry, agriculture, power,, and so on, the objective is to increase the production potential and the growth of incomes in developing countries, and thereby contribute to the reduction of poverty and hunger. Over time, Bank lending has spread to other sectors, such as health, education, nutrition, urban housing, and water supply, which may have a more direct impact on hunger, but not necessarily a greater impact The reason why economic growth matters was discussed earlier. While appropriately designed growth strategies alone do not ensure the reduction of poverty or hunger, there are examples where they have done so When done well, economic growth that uses the resources of the poor not only empowers them, but also enables them to participate.

The Bank has long recognized that growth alone is not the sole measure of development In the early 1970s the Bank shifted its efforts toward poverty reduction, particularly through its rural development and health and human services projects. By the end of the 1980s these efforts had crystallized into a decisive shift toward poverty alleviation By means of such publications as the World Development Report 1990, Assistance Strategies to Reduce Poverty, and the Poverty Reduction Handbook, the Bank has demonstrated that "the basic mission of the World Bank and the core of its assistance program is the reduction of poverty The Bank's strategy is based on supporting labor absorbing growth and systematic investment in the development of human resources, especially among the poor. It also includes supporting well targeted transfers and social safety nets These are actions that reduce hunger.

Recognizing that action at the country level is essential, the Bank is committed to preparing country poverty assessments in all developing countries, most of which will be completed in 1994 These assessments provide the basis for developing the two-part strategy described earlier. They analyze and make recommendations on the following:

· Extent and nature of poverty in each country

· Effectiveness of economic management (short term and long term) in generating growth that makes productive use of labor. Adequacy of government efforts to provide basic social and infrastructural services to the poor

· Extent, effectiveness, and affordability of social safety nets.

Based on these poverty assessments, the Bank is designing assistance strategies to support poverty reduction that will shape both the volume and composition of its lending The volume will be linked to a country's efforts to reduce poverty, and the composition will support these efforts.

Simultaneously, but within the context of its poverty reduction strategy, the has initiated a number of other programs directed at reducing hunger, improving nutrition, or achieving food security.

Nutrition Interventions.

Nutrition projects are one of the main direct ways the Bank acts to reduce hunger and malnutrition, specifically targeting nutrition services (including food) to the poorest and most vulnerable elements of populations. In these projects women play a central role both as beneficiaries and as project providers or administrators. Nutrition lending has increased exponentially since 1987. Total project resources mobilized for nutrition in Bank-financed projects increased from US$49 million in fiscal 1987-89 to US$894 million in fiscal 1990-92 Projected nutrition lending in fiscal 1993-95 is US$1.2 billion.

This rapid growth in nutrition lending reflects research findings that show the negative consequences of malnutrition The Bank recognizes that while economic growth is essential to long-term growth and poverty reduction, for most countries to achieve significant progress for the lowest-income groups though growth alone will take more than a generation. More direct support is needed Increasing incomes, even among low-income groups, is also insufficient. A series of IFPRI studies demonstrates that behavioral issues and health and environmental factors are also critical in determining nutritional status Awareness that the Bank needs to consider the consequences of adjustment operations on nutrition and to provide compensatory programs to the most needy has also played a role. After some years of experimentation, the Bank has supported successful models for nutrition projects with a demonstrated impact, for example, the Tamil Nadu Integrated Nutrition Project, which has reached 2 million women and children in 20,000 villages, has reduced the prevalence of severe malnutrition by 55 percent.

Food Security

The Bank has directly addressed hunger in Africa through its food security initiative launched m 1989. In The Challenge of Hunger in Africa, the Bank defined food security as "access by all people at all times to enough food for an active and healthy life," a condition that some 200 million Africans lack today. The initiative set out a five-point program of action:

- Preparing specific action programs to promote food security in each Sub-Saharan country

- Giving priority to projects and policies that raise the incomes of the food insecure and dampen fluctuations in food prices and supplies

- Strengthening the institutional capabilities of African Governments to manage food security programs

- Increasing the effectiveness of food aid, which includes improving the preparation and coordination of responses to emergency food situations

- Making more systematic efforts ' to identify the people at risk of food insecurity.

The initiative also proposed that a partnership be formed among donors, NGOs, and African governments to support comprehensive policies and programs for food security.

As a result of this initiative the Bank has learned much about the hunger problem and what can be done about it. It has also learned some of the sobering lessons discussed earlier The Bank has earned out food security studies in a dozen African countries, from which have emerged a number of food security strategies. The Bank has also supported food security projects in six countries: Benin, Burkina Faso, Cameroon, Madagascar, Mozambique, and Rwanda (see box 2). Depending on the specific circumstances of each country, these projects include income generating components targeted on the food insecure, such as public works, nutrition interventions targeted on the food insecure; support for early warning systems, capacity building to identify the food insecure and to design programs and projects to reach them; agricultural activities targeted on the food insecure; and improved uses of food aid for food security. Many of these projects involve reliance on local community action and NGO support The Bank has also undertaken an analysis of food aid in Africa with the WFP and an analysis of droughts as they affect people and economies. From these efforts the bank has learned a number of lessons.

While food security strategies are essential to identify problems in specific countries and to make proposals for action, they can be costly if done well, have often lacked national or beneficiary inputs, and do not by themselves result in action. The resources devoted to such strategies within the Bank and within countries must compete with the resources devoted to other strategies: environmental, agricultural, forestry, and so on. Given the current overwhelming demands on staff and resources, the feasibility of launching separate food or hunger strategy studies is limited and thus the needed analysis may need to be included in poverty assessments.

The greatest impact on food security, given the Bank's operational orientation, is achieved when analysis is combined with the design and implementation of food security projects Such projects focus the attention and resources of both governments and Bank staff and managers on the issue of food security, and they are the vehicle through which concrete results can be achieved Projects also provide the Bank with the possibility to support developments on the ground and at the same time to fund the analysis needed to go further.

An Action Agenda to Overcome Hunger

Overcoming hunger requires action in the short, medium, and long term, at multiple levels, in multiple directions, and by many actors Governments must take the lead, complemented by NGOs and supported by external agencies The following agenda focuses first on immediate steps that can be taken that will have a high payoff, and then considers priority longer-term actions that are needed to improve small farmer output or raise the purchasing power of the poor.

Drought-Rellated Famines

The response to slow onset disasters (for example, drought) that result in famines should be substantially improved. A more collaborative effort by the UN agencies, international financial institutions, and NGOs is needed to:

· Integrate a drought response strategy into the country assistance strategies and project designs of drought prone countries or regions

· Strengthen countries' capacity to prepare for and mitigate drought. This will reduce the need for emergency relief and smooth the transition from drought to recovery

· Improve lending instruments to provide greater flexibility for foreign exchange require meets associated with famines.

Box 2 - The Rwanda food security project

The food crisis in Rwanda is the result of the interaction between scarce land and a growing population, which is leading to exhaustion of the soil, smaller farm size, poorer harvests, and increased incidence of plant disease Income earned from coffee, which varies with the world market price, also shapes the magnitude and intensity of the food crisis.

Population density is among the highest in the world, with 300 people per square kilometer Increased fragmentation of the land is taking place and is also making high demands on agriculture (intensification and specialization) The labor force is growing by 90,000 people per year, the majority of whom will have to find their main source of income outside agriculture, but nonagricultural jobs are scarce Rwanda has reached a stage where virtually all tillable land is cultivated. Hence, increased production is dependent on intensification to increase yields The issue of food security in Rwanda will be increasingly dominated by the overwhelming need to create jobs and income outside family agriculture.

Food availability in Rwanda has increasingly depended on cross border imports from neighboring countries: Burundi, Tanzania, and Uganda. Food is available in the region and much of it is being officially and unofficially imported into Rwanda The food security action plan for Rwanda recommended (a) harmonizing economic policies among neighboring countries to increase the efficiency of interregional trade, (b) improving the performance of the small enterprise sector (formal and informal) to broaden the sources of employment and income creation, (c) developing a nutrition policy, (d) supporting intensive agriculture and policies to halt further fragmentation of the land, and (e) strengthening early warning and emergency preparedness systems.

In support of this action plan the Bank has financed a food security project with (a) food aid and nutrition components, (b) labor-based public works components, (c) microenterprise and development components, and (d) social surveys to enable improved targeting of future interventions The objectives are to improve the food security and social welfare of the poor improve the government's capacity to monitor food security, and initiate a long-term poverty alleviation strategy.

Other World Bank-supported food security projects include the following.

· Republic of Cameroon Food Security Project, February 1991
· Burkina Faso Food Security and Nutrition Project, June 1992
· Madagascar Food and Nutrition Project, February 1993
· Republic of Mozambique Food Security Capacity Building Project, April 1993
· Benin Food Security Project, appraised June 1993.

Source: World Bank Rwanda Food Security and Social Action Project (Washington, D C: World Bank, 1992)

Immediate Actions to Address Chronic Hunger

As a follow-up to the World Development Report 1593, the goals of the September 1990 World Summit for Children, and the December 1992 International Conference on Nutrition, countries need help to prepare, implement, and finance action plans for synergistic, low-cost, hunger-reducing health and nutrition interventions A few specific low-cost interventions are relatively easy to implement and can have an immense impact on the health and nutritional well-being of poor people, especially women and children. These include the following.

· Reducing vitamin A, iodine, and iron deficiencies through fortification, supplementation, and dietary modification

· Expanding childhood immunization coverage from 80 to 95 percent

· Implementing low-cost programs for controlling parasitic infections that cause anemia and malnutrition.

These services should be linked to nutrition education through community-level delivery. Such action plans would be sharply targeted on the most cost-effective interventions similar to the successful UNICEF program on oral rehydration There is no reason why all developing countries should not achieve comprehensive coverage of their populations within five to seven years.

Targeted food assistance programs should be mounted that provide food entitlements to children and to entire families whose children and mothers have been identified as malnourished in health posts, schools, or other social programs through growth monitoring Entitlements should preferably be provided in the form of food stamps, free ration cards, or vouchers (see, for example, the Chile and Honduras case studies) unless direct food supplements can be shown to be more effective and efficient }food assistance delivered to undernourished mothers and children at health posts combined with nutrition and health education is particularly effective, especially as the impact can be closely monitored (see Chile, Tamil Nadu, and Zimbabwe case studies) Close collaboration in these interventions is needed between UNICEF, the WFP, the World Bank, and community-based organizations and NGOs.

Food aid is a valuable tool to overcome hunger, and it is often preferable for it to be monetized, and the counterpart funds made available to finance food entitlements These interventions should be supported by assistance for nutrition education and the provision of micronutrients and health services. The WFP and contributions from bilateral food aid donors are essential in this effort The Committee on Food Aid Policies and Programs is one institution through which to develop such programs.

Where the potential for income generation is poor, help can be provided to finance employment generation programs along the lines of the Botswana Food-for-Work Program or the largely self-targeting Maharashtra Employment Guarantee Scheme.

Actions to Address Chronic Hunger in the Medium Term

In development projects, and especially in adjustment lending, it is essential to encourage employment-intensive growth as the most powerful approach to reducing poverty in the medium to long run. Governments should be encouraged to undertake measures that.

· Promote macroeconomic stability and open ness of the trade regime

· Eliminate direct and indirect taxation of the farm sector to encourage domestic food production and rural income and employment growth

· Eliminate anti-employment taxes and credit subsidies

· Reduce the extent of direct and indirect labor taxation and increase cost-effective, labor intensive infrastructure construction.

Countries should be encouraged and assisted to mount income generation programs in rural and urban areas, including following specific key actions.

Much can be done to focus government extension and research on the needs of small farmers to help overcome hunger, both to produce more food and to generate more income to do this Specifically this includes.

· Continued emphasis on small farmer extension and other agricultural programs targeted at the poor

· Strong support for national agricultural research systems, with special emphasis on the farming systems characteristic of the poor

· Intensified support for the CGIAR to undertake research on food commodities that are particularly important in the consumption and production of the poor, and on policies and programs intended to help small farmers, and especially poor women farmers.

Within the context of overall financial sector reform, increased attention should be given to policies and programs that provide small loans to the rural and urban poor, particularly women, along the lines pioneered by the Grameen Bank in Bangladesh, and more recently by the Foundation for International Community Assistance (FINCA) in Latin America and the Freedom from Hunger Campaign (FFHC) in Africa Programs of the Grameen type combine credit with the provision of advice and public education on sound nutrition and health practices, family planning, and sanitation External aid agencies should encourage the exploration and establishment of programs that address the credit and savings needs of the self employed poor In particular, donors could.

· Explore the possibilities for establishing funding mechanisms to support micro-credit schemes One beneficiary of such support could include the program for establishing and supporting Grameen Bank replicators, FINCA's village banks, or their equivalents world wide (see FINCA and FFHC case studies)

· Provide grants to NGOs that are experimenting with new ways to reach the poorest and hungriest people.

Group-based micro-enterprise credit is often most appropriate for situations of high population density, landlessness, and a thriving urban or rural nonfarm economy. In some countries it is being tested in an urban setting. Such credit, however, is more difficult to manage in more sparsely populated and highly risky agroclimate zones such as the semi-arid tropics. Nonetheless, informal credit mechanisms that could be fostered exist even in these areas (see Indonesia case study).

Actions to Achieve Sustained Long-Term Poverty Reduction

Reform measures to reduce fiscal and monetary imbalances, reduce market distortions, and promote efficient public management are essential to foster economic growth (see World Development Report 1951 for a detailed exposition of successful development strategies). Development practitioners recognize that such measures may have a short-term negative impact on the poor and the hungry unless special compensating actions are undertaken Consequently, it is imperative that every effort is made to protect and help such vulnerable groups (see box 3), including:

· Protecting primary health, nutrition, and targeted food assistance programs from cuts

· Increasing targeted compensatory expenditures for vulnerable groups through safety net actions, including social funds and public works employment programs, where basic food prices are likely to rise

· Improving the targeting of food subsidies to the poorest and most vulnerable groups

· Introducing cost effective strategies and financing plans to stabilize the prices of the most essential staple foods under conditions of large temporary international price shocks. Expanding the access of the poor to credit to enable them to acquire assets so as to become productive.

For the rural poor, who comprise the largest segment of poor people in the world, the key to income generation is getting land, because they have no assets other than their labor. Having land not only allows them to produce income and food for themselves, but also allows them to tap commercial bank credit and to be integrated into broader social networks, thereby allowing them to withstand droughts and other shocks better. By shifting assets to poor rural people, we can give them a buffer. Moreover, in low-wage countries, large farms tend to have lower productivity and to employ fewer workers than small farms Therefore land reform can improve the efficiency of agricultural production and help absorb increasing labor forces (see World Development Report 1990). Land reform in countries with highly unequal land distribution can use market assisted programs to make agricultural land available to the landless. The African National Congress is considering such a land reform option in South Africa, where the party proposes to transfer land to the victims of apartheid during a five- to ten-year period.

There are critical areas in which the line between hunger and environmental sustainability is most sharply drawn In such cases too communities need special assistance to tackle their critical natural resource management problems (see the Niger case study).

Issues for Discussion

Widespread agreement exists that persistent chronic hunger is primarily a consequence of extensive continuing poverty The experiences of the past twenty-five years indicate clearly which development strategies have been successful and which have not, both in raising per capita incomes generally, and in achieving a reduction in poverty specifically These were discussed in some detail in the world development reports for 1990 and 1991 The persistence of considerable poverty in many countries is caused not so much by a lack of knowledge about what measures need to be adopted, but rather by a failure to adopt sound economic and social policies and to implement them with persistence and determination The reasons for this are weak Institutions and capacities, political blockages and disagreements, and poor governance A lack of natural resources and a harsh climate are drawbacks, but not insuperable obstacles, as the Republic of Korea has dramatically demonstrated.

Box 3 Addressing hunger in structural adjustment

One of the most sensitive areas where reducing hunger and achieving growth impinge concerns structural adjustment operations Ensuring that the macroeconomic environment is right for sustained growth is important for the long-term development of a country, but this concern with the long term must not eclipse actions urgently needed today to overcome hunger An important principle in adjustment operations is that, at a minimum, there should be no net losers among the hungry. How this might be done in two key areas of adjustment is described below.

Maximizing Benefits

Stress the creation of employment for unskilled workers in hunger prone areas and seasons (there may be opportunities for incentives to encourage investment in such schemes).

· Provide vocational training programs, extension services, and credit that would help the ultra-poor take advantage of the opportunities in cases where devaluation has increased the opportunities for domestic production.
· Ensure that where agricultural incentives are improved, that marginal farmers also benefit through special programs introduced to overcome constraints (for example, access to credit' labor constraints at critical seasons). This particularly applies to women farmers.
· Gear agricultural extension and other services toward helping improve household nutritional status.
· Ensure that when adjusting relative prices, goods produced or consumed by the poorest are favored
· Ensure that priority is given to provision of primary health care in hunger prone regions, that services are free to the ultra-poor, and that adequate stress is given to appropriate nutrition education and to reducing diarrhea! disease through such measures as improving sanitation when restructuring health services
· Ensure that stress is given to improving vocational education, adult literacy, and other programs that develop human capital, and therefore the income earning capacity of the ultra-poor when restructuring education services
· Ensure that agricultural services give priority to extension services that are of special value to marginal farmers, particularly women farmers.

Protecting the Hungry from Shocks

· Adjustment programs should include monitoring of the impact of reform measures on the poor and, within this, focus especially on the nutritional status of vulnerable groups and on the income levels of the ultra-poor
· Whenever an adjustment measure might create hardships for the ultra-poor, the cost to specific population groups should be calculated and studies conducted to identify the most effective mechanism for ensuring that at least an equivalent benefit is provided Such a study should involve consultation with the vulnerable groups themselves, who should also be involved in the execution of the compensatory program to ensure minimum leakage to local elites and others.
· When cuts in subsidies are required, they should be concentrated on those subsidies enjoyed mostly by the better off (for example, those provided for rail and air travel, energy, and certain kinds of foods)
· When subsidies are cut, those used significantly by the ultra-poor should be retained wherever possible
· When expenditure cuts require reduced services, those that benefit the hungry should be retained, and when adjustment programs lead to increased food prices, additional measures are required to ensure that the poor are compensated.

Even though economic growth does result in a reduction of poverty, and hence of hunger, growth alone will not be enough to overcome malnutrition and food insecurity, as can be seen from the experience of Indonesia. Specific targeted interventions are also needed to address chronic hunger, protein and micronutrient deficiencies, and transitory food shortages.

To achieve a rapid reduction in global hunger, a number of issues need to be resolved.

· Countries need to establish a focal point to initiate and coordinate a well-articulated strategy for overcoming hunger Because hunger reduction is multisectoral, such a focal point must succeed in coordinating actions that are the responsibility of several sectoral ministries which is inherently a difficult task. Where should such a focal point be located to be effective?

· External agencies have a major role to play in providing food and financial aid to countries with hungry populations To be effective they too need to establish a focal point capable of achieving a coordinated and pro-active response How can they best do this?

· How can a global program to overcome hunger be given sustained global support? If a world food board or world food council is not the answer, what is the answer?

· A great range of direct interventions is possible, but resources are inevitably limited. Which interventions are the most cost effective? Which set of interventions is best adapted to a particular country's circumstances? In general, answering these questions will require a systematic economic and social evaluation of these interventions and a knowledge of country conditions that can only be acquired through household surveys like those now being undertaker in Africa as a follow-up to the Social Dimensions of Adjustment Program, and the Living Standards Measurement Study surveys being carried out elsewhere. How can this process be accelerated?

A division of opinion exists between those who stress growth and poverty reduction as the best means of addressing poverty, and advocates of direct interventions that stress empowerment, equity, and the right to food. Both groups are working in the same direction to a great extent Are these two options alternatives or complementary actions?

· If hunger reduction in the short term involves food or cash transfers to the poor, what share Of government and international budgets should be devoted to this goal?

· How can existing knowledge about how to prevent famines be applied in Africa, and especially to avert slow-onset (drought) disasters?

· Given that in a number of countries poor governance leads to a lack of leadership concern about hunger, what can be clone to give hunger alleviation greater priority in government agencies in those countries?

· Because food is both essential to sustaining human life and a commodity, how can these concerns be brought together? The first emphasizes social and political analysis, the latter economic analysis Important methodological differences as well as value judgments are involved. How can each concern inform the other?

· How can the need for empowerment, which places a high priority on household, community, and national food self-reliance, be more effectively linked with the equally important need for an expanding and well-functioning world food market? Both are essential for overcoming hunger worldwide. Both need to be efficient, sustainable, and equitable

· What is the place of overcoming hunger in the context of development and poverty reduction? If overcoming hunger is to have a high priority, how can this be realistically achieved?


1 Amartya Sen Public Action to Remedy Hunger (London The Hunger Project, 1990).

2. Sen, Public Action to Remedy Hunger.

3 World Bank, The Challenge of Hunger in Africa (Washington, D.C: World Bank, 1988), 3. The companion paper referred to is Ending Hunger Soon: Concepts and Priorities, in this volume.

4 P. Berek and D Digman, Food Security and Food Inventories in Developing Countries (Wellington, Oxfordshire, U.K. CAB International, al, 1993).

5 In part this decline reflects the inclusion of countries, in particular China, that were not included in earlier FAO estimates. If excluded, the proportion of the malnourished would have fallen from 31 to 21 percent but the number would have increased from 536 to 579 million between 1970 and 1989 FAO, State of Food and Agriculture (Rome FAO, 1992), 21.

6 Donald O. Mitchell and Merlinda D Ingco, The World Food Outlook (Washington D C: World Bank 1993).

7 World Bank, World Development Report 1990 "Washington, D C: World Bank 1990), 2.

8 World Bank, World Development Report I992 "Washington, D C.: World Bank, 1992), 7.

9 See Bread for the World, Hunger 1994 (Silver Spring, Md: Bread for the World, 1993).

10 Sterling Wortman and Ralph W. Commings, Jr, To Fred This World (Baltimore, Md: Johns Hopkins University Press, 1978), 85.

11. U.S. Department of Agriculture, The World Food Situation and Prospects to 1985 (Washington, D.C: U.S. Department of Agriculture, 1974).

12. The Bellagio Declaration Overcoming Hunger in the 1900s (Bellagio, Italy, November 1989).

13. FAO and World Health Organization, International Conference on Nutrition and Plan of Action far Nutrition (Rome FAO and World Health Organization 1992).

14 World Bank, World Development Report 1990; World Bank, 1990 Assistance Strategies to Reduce Poverty (Washington, D.C.: World Bank, 1991); World Bank, Poverty Reduction Handbook (Washington, D.C: World Bank, 1992).

15. UNICEF, Chila Malnutrition: Progress toward the World Summit for Children Goals (Geneva: UNICEF, 1993).

16. IFAD, The State of Rural Poverty (New York: New York University Press, 1993).

17 Bread for the World, Hunger 1994; United Nations Development Programme, World Development Report 1993 (New York UNDP, 1993).

18. World Bank, The East Asian Miracle (Oxford: Oxford University Press, 1993); Frieda Johansen, Poverty.

Reduction in East Asia, World Bank Discussion Paper 203 (Washington, D C: World Bank, 1993).

19 World Bank, World Development Report 1990, chap 3.

20. UN Declaration on Human Rights.

21. Jean Dr and Amartya Sen, Hunger and Public Policy (Oxford: Oxford University Press, 1989).

22 World Bank, World Development Report 1990, chap. 3.

23. Amartya Sen, "The Economics of Life and Death, Scientific American (May 1993); Dr and Sen, Hunger and Public Policy, chap. 10.

24. Pierre Crosson and Jock R Anderson, Resources and Global Food Prospects: Supply and Demand for &reals to 2030, World Bank Technical Paper no. 184 (Washington, D.C: World Bank, 1992).

25. Jean Dr and Amartya Sen, The Political Economy of Hunger, vol. II, Famine Prevention (Oxford: Oxford University Press, 1990).

26. World Bank, World Development Report 1990; World Bank, Assistance Strategies to Reduce Poverty World Bank, Poverty Reduction Handbook The quote is from Assistance Strategies to Reduce Poverty, 5.

27. Joy Miller Del Rosso, Investing in Nutrition (Washington, D.C: World Bank, 1992).

28. World Bank, The Challenge of Hunger in Africa (Washington, D.C, 1988).

29. The FAO has also prepared a number of food security strategies in African countries, namely, in Chad Niger, Tanzania, and Zambia.

30. See World Bank, World Development Report 1990.

31. World Bank, World Development Report 1991 (Washington, D.C. World Bank, 1991).

32. World Bank, World Development Report 1990.