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close this bookOvercoming Global Hunger (WB)
close this folderAppendixes
View the document(introduction...)
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 2 - addressing hunger: a historical of international initiatives

Hunger has been the focus of international policy pronouncements and conferences for a long time Development institutions such as the World Bank, the International Fund for Agricultural Development (IFAD), the World Food Programme (WFP), the Food and Agriculture Organization of the United Nations (FAO), and the United Nations Children's Fund (UNICEF), along with governments and nongovernmental organizations (NGOs), have emphasized the hunger focus of their assistance programs This cursory review of the history of hunger initiatives can only touch on some of its highlights. It attempts to explain why some dimensions of hunger have been more successfully addressed than others and some institutional frameworks have worked better than others.

There are three basic manifestations of hunger and malnutrition (a) starvation, which is a life retaining condition caused by insufficient food that is generally associated with acute situations like famine; (b) chronic hunger or undernutrition, which is caused by a long-term intake of calories that is insufficient to cover nutritional needs; and (c) pathological conditions, which result from inadequate consumption of calories, protein, and micronutrients, and are often found in combination with infections and inappropriate nutritionrelated behaviors.

Major conferences, such as the World Food Conference or the World Nutrition Conference, as well as development organizations and donor governments, deplore hunger in all its manifestations and recommend remedies for its eradication. Often, however, actions are selectively applied to only the more readily tackled forms of hunger While this is understandable and may well be the cost effective thing to do, one must be on guard that this should not become a "smoke-screen" (unintentional or otherwise) that obscures the failure to act on the most difficult manifestation of hunger, chronic undernutrition.

The world has made progress toward eradicating starvation and some forms of malnutrition, but less (and some might say very little) toward alleviating chrome hunger and food insecurity. The reason is that one can address starvation and malnutrition through relatively short-term superficial interventions that do not significantly alter prevailing economic and power structures. The alleviation of chronic hunger, by contrast, requires politically far more difficult solutions. Chronic hunger is a reflection of poverty, and therefore of the existing distribution of wealth and power within a country.

Hunger initiatives arc directed toward different audiences. This review covers primarily initiatives emerging from institutions or conferences intended to provide blueprints for action This selective emphasis on action oriented initiatives does not imply that we underestimate the value of hunger initiatives that reach out to the much broader audience of public opinion.

Without support from public opinion and political pressure, both in rich and poor nations, the implementation of specific action initiatives would have little chance. Thus, many of the conferences and organizations covered in this review may well have made important additional contributions through their impact on creating public awareness "Media events" directed exclusively to broader audiences are of immeasurable value. These include such events as Live Aid, Band Aid, and the less glamorous, but perhaps even more influential continuous educational work of (often church-related) NGOs. Such humanitarian-oriented initiatives increase the availability of resources from private and public sources for relief aid and give governments an incentive to act.

In recent years developmental and humanitarian orientations have converged noticeably Humanitarian-oriented efforts, properly administered, do increase resource mobilization significantly. Authorities are increasingly aware that development is a prerequisite for the prevention of future, more severe emergencies Those concerned with development now recognize the need for remedial action or safety nets for those families suffering from hunger today.

Many different proposals for addressing the hunger problem have been made These can be classified into two broad headings as shown table 1. The first group is the macro solutions, which aim at changing the environment in which all people, including the hungry, live They include measures that are intended to increase or stabilize global and national food supplies by promoting food production, trade, and stockholding They also include measures to increase the wealth of nations.

The second group, poverty-oriented solutions, emphasizes the inadequacy of purchasing power and attempt to improve directly the present living conditions of people who are hungry either by enabling them to earn higher incomes with which to procure more food, or by enabling them to pro duce more food, or both Efforts generally rely upon ways to increase poor households' access to more adequate and higher-quality diets, primarily through gains in income from all sources, but also through nutrition education and nutrition related health programs.

Agricultural or supply-oriented solutions view hunger as a symptom of inadequate performance by the agricultural sector, either globally or in particular nations. Those solutions that concentrate on increases in GNP view hunger as the result of poor performance by national economies as reflected in national per capita income.

Preventing starvation arising from natural or man-made calamities or eliminating a particular malnutrition problem usually calls for direct delivery (last column of table 1) The solutions to tackle chronic hunger are much less obvious and will be duly noted later.

Table 1 Classification of hunger solutions.


Macro

Poverty-oriented household


International

National


Food

Increasing supply

Increasing supply

Increasing consumption


- Research sod extension

- Production and research

- Emergency and drought relief


- Conservation of natural resources

- Imports

- Feeding and nutrition programs


- Postharvest food loss elimination.

- Stocks

- Subsidized food ration


Stabilizing supply

Stabilizing supply

Improving nutrition and well-being


- Stocks

- Stocks

- Information and education


- Early warning

- Trade

- Micronutrient supplements


- Research

- Sarty warning

- Access to adequate water and sanitation.



Increasing consumption and improving distribution




- Food market intervention.


Income


Level of income

Increasing production



- GNP growth

- Small farmer



- Aid in money or in kind

- Resource-poor regions




- Employment programs



Stability of income

- Human resource development



- Food compensatory financing facilities




- Grain reverses

Income distribution




- Social security




- Unemployment insurance




- Food subsides or vouchers .

Starvation, Famine, and Emergency Relief.

The number of people affected by famine, an estimated 15 to 35 million, is small compared with the close to 1 billion people who suffer from a more chronic form of hunger. Since the 1950s the incidence of famines has shifted from Asia to Africa One estimate suggests that the population of countries reported to be affected by famine has declined from a peak in 1957-63, with a yearly average of 788 million people, to 264 million in 1978 84. This downward trend continued during the next seven years (1985-91), when the population of famine-plagued countries averaged 141 million. In 1992 famine was reported only in Somalia and the Sudan, with combined national populations of 35 million.

International and national emergency relief efforts to combat starvation and famines have been extensive and relatively successful Natural disasters used to claim millions of lives Today, outside of Africa, with few exceptions only people who are subject to ruthless neglect or active pursuit by their own governments arc threatened with starvation Intolerance of famine caused by natural or manmade disasters is one of the most striking accomplishments in the international community struggle against hunger.

With the important exception of Africa, famines resulting from natural causes have become less frequent and severe, but not because climates and food production have become more stable. More efficient transportation and better communications have improved international and domestic preventive and relief operations In addition, the greater effectiveness of trade as a stabilizer and stronger international and national solidarity, backed up by public action, have reduced the ravages of famine.

In Africa, by contrast, drought-related disasters are occurring with greater frequency and impact. Estimates of deaths in Africa during the 1980s range from 400,000 to as high as 2 to 3 million for the 1983 84 drought alone In 1991, 23 million people were seriously affected by drought in Africa. Indeed, between 1987 and 1989 nearly 58 percent of all food aid for disaster relief was shipped to Sub-Saharan Africa.

Relief Agencies, Early Warning Systems, and Food Aid

Several international agencies are involved in relief activities. Since 1992, the United Nations (UN) Department of Humanitarian Affairs, under which the Office of the UN Disaster Relief Coordinator and the UN Disaster and Rehabilitation Office operate, has been responsible for coordinating international relief and assisting countries with disaster prevention and preparedness. Under its authority is a revolving fund of US$50 million and a register of stand-by worldwide capacities to ensure rapid and coordinated response by the organizations of the UN system.

Effective early warning systems at the international, regional, and national levels have averted or mitigated the effects of natural disasters, especially those caused by local harvest failures. The FAO's Global Information and Early Warning System, an international information network that relies on such sources as satellite convenied data and reports provided by NGOs, anticipates and assesses severe food shortages throughout the world. It provides assessments on a regular and an alert basis, largely in terms of national food balance sheets and food import gaps oriented to provide information to food aid donors. The Famine Early Warning System, funded by the U.S. Agency for International Development, provides detailed agricultural information, but geographic coverage is relatively limited. The System d'Alertes Precocious, established by the European Economic Community and implemented by an NGO, has been particularly effective in Chad and Mali A number of separately funded early warning systems now exists in Africa.

Emergency food aid is the primary means by which the international community responds to disasters. In 1990, approximately 32 percent of food aid for emergency purposes was provided through the WFP. In addition, the WFP made procurement, transport, and monitoring services available to bilateral donors, whose contributions accounted for some 15 percent of emergency food aid Food aid distributed by the NGOs from their own resources and from those of the bilateral donor programs accounted for more than one third of the total. Other multilateral programs distributed the balance.

The International Emergency Food Reserve, established in 1975, is a reserve for which participating donor countries pledge in advance to make grain available when the WFP alerts them that such aid is necessary to avert starvation in the face of nonrecurring natural disasters or wars. It is the only international mechanism specifically designed to respond to food emergencies. Relief for long-term refugee operations is handled under a special fund separate from the International Emergency Food Reserve.

Response of the World Bank and NGOs

Since its earliest days, the World Bank has responded to emergencies by providing advice and financial assistance, mostly through emergency recovery loans, the modification of existing loans (notably the reallocation of funds to critical investments of the Bank's existing lending program for the country related to emergency relief), or both Bank policy specifies that ale emergency recovery loans and, when appropriate, other investment operations in disaster prone countries, should include disaster prevention and mitigation components, such as the installation of early warning systems and studies to prepare a disaster prevention strategy and develop the institutional framework best suited to implement it.

The importance of NGOs in international responses to famine is unparalleled. The nature of NGOs has permitted them, at times, to side-step some of the thorny issues of national sovereignty. The role of the private voluntary agencies, particularly CARE in Somalia, is a dramatic example of the growing commitment to eradicating starvation and of the sophistication of modern relief efforts in terms of capacity to distribute large volumes of food quickly in a hostile environment. In many countries, particularly in Africa, the authorities see the NGOs as effective in the responsibilities that they assume, namely, targeting food distribution to vulnerable groups, engaging in emergency water and sanitation activities, helping displaced people, and supporting the recovery of agriculture.

Alleviating Malnutrition

Earlier we noted the three basic manifestations of hunger and malnutrition starvation, chronic hunger or undernutrition, and the pathological conditions resulting from inadequate consumption of calories, protein, and micronutrients, often in combination with infections and inappropriate nutrition-related behaviors. One of the essential characteristics of the latter is that while it is often symptomatic of poverty, some of its effects can be dealt with quite effectively with modest resources and without major improvements in the economy. Indeed, Alan Berg writes:

Although malnutrition is closely linked to a country's level of economic development, nutritional improvements need not await development... Addressing the underlying causes of poverty remains a vitally important development objective. But the time required to reach the most impoverished and the immediacy of the malnutrition problem argue for a continuing direct attack on nutrition deficiencies as well.... Efficacious and affordable measures are at hand.

The remedies for malnutrition can cure some of the effects of the lack of access to an adequate diet and circumvent the causes. Malnutrition interventions, frequently financed with international assistance, include highly targeted food distribution and supplemental feeding programs for mothers and children, food supplements, fortified foods, and nutrition education. These measures are efficacious, and they are sometimes supported by powerful national interests precisely because the measures reduce human suffering, yet do not threaten existing political and economic structures.

Foreign Assistance Agencies

International attention to the problem of malnutrition in large populations led to the establishment of the Sub-Committee on Nutrition, a forum in which all UN and bilateral aid agencies exchange information and issue pronouncements about the nature and causes of and remedies for malnutrition.

In the forefront of supporting measures to alleviate malnutrition over the years have been UNICEF, the World Health Organization (WHO), the FAO, and several bilateral assistance agencies, particularly the US. Agency for International Development. In recent years, the World Bank has also become an active participant.

One of the earliest successes of nutrition intervention was the promotion of salt ionization, which began in the 1950s through organizations such as the WHO and UNICEF. While the practice has been adopted throughout the world, political indifference has prompted lack of compliance, and in many developing countries endemic goiter remains a serious problem.

Iron deficiency is the most widespread nutrient deficiency in the world. Despite the recognition of its contribution to morbidity and mortality from infectious disease, its damage to effectiveness in education, and its direct effect on work productivity, consensus on an appropriate, easy technology to prevent it is lacking. As interventions to prevent iron deficiency have held a low priority on national and international nutrition agendas, the fortification of foods, including beverages, salt, and sugar, is rarely adequately implemented.

Attention to the significance of vitamin A was previously limited to the severe ocular manifestations of xerophthalmia and keratomalacia, but recent research has established a relationship between vitamin A status and mortality and morbidity in young children from infectious diseases. The WHO and UNICEF have strongly promote the distribution of vitamin A palmitate to all children up to two years old in countries at risk of vitamin A deficiency. This program has been well administered and aggressively pursued, and has met with considerable success However, success has been limited by the extremely poor infrastructure in some risk areas and the possibility of incomplete protection because of the difficulty of ensuring that children receive adequate dosages.

The major nutritional intervention efforts of the 1960s were the FAO, WHO, and UNICEF applied child nutrition programs. The three external agencies collaborated in sponsoring programs that would involve the ministries of education, health, and agriculture and included school and home gardens, nutrition education, and supplementary feeding. In at least forty countries, demonstration communities were carefully selected and external resources were provided to supplement those available from the government While the pilot programs were for the most part successful, the governments lacked the resources to extend these programs nationally.

In the 1960s nutritional rehabilitation and mothercraft centers, with their emphasis on nutrition education, came into vogue. Community weight-for-age surveys were conducted to determine which children were suffering from moderate to severe malnutrition. Supplementary feeding was combined with maternal education.

Antedating all other nutritional interventions, supplementary feeding programs have been by far the most prevalent. Food aid made readily available from large donor surpluses supplied these programs. UNICEF, as well as CARE, CARITAS, and other private voluntary agencies, provided food aid to school feeding programs and mother and child feeding centers. Despite their relatively high counterpart costs in terms of storage, transportation, and personnel, host governments usually welcomed these programs.

World Bank Nutrition Initiatives.

Nutrition became an object of World Bank attention in the 1970s as part of its basic needs approach. At the time, Bank staff were concerned about the potentially harmful effects of malnutrition on the mental development of hundreds of millions of children. While there was much uncertainty about what could be done, arguing that malnutrition should not be a central concern for a development agency became difficult.

Later, a new professional consensus established that often malnutrition is not caused by inadequate protein intake, as earlier studies had emphasized, but by insufficient food energy. With this understanding, malnutrition could no longer be regarded as just another disease that could be cured by administering the appropriate medicines or vaccines. Furthermore, the work of two Bank economists—Selowsky and Reutlinger— showed that even if the cost of increasing poor people's food consumption to meet caloric requirements were not low, highly targeted subsidized food programs could show positive economic benefit-cost ratios. Discrediting the notion that there was necessarily a tradeoff between growth and poverty alleviation justified the implementation of policy interventions that provided minimum adequate food, health, education, and shelter for specific groups.

In the mid-1970s the World Bank began to explore how it might contribute to the improvement of nutrition. A learning-by-doing approach was adopted for large nutrition projects in Brazil, Colombia, India (the state of Tamil Gnat), and Indonesia. Each included components for institution building, a food subsidy program, and nutrition education. Later the Bank decided that it should try to incorporate nutritional concerns into agricultural and rural development projects, and that improvements in nutritional status should become an objective and part of the design of health projects. The thrust of the Bank's nutrition programs concentrated on its particular advantage in drawing officials' attention to problems, assisting in planning, furthering the development of project analysis, and providing enough resources to make significant interventions possible. Recent years have seen the development of a sizable portfolio of nutrition operations in the Bank.

Recent International Conferences

Recently, several major conferences have concluded by endorsing targets for reducing malnutrition. While having little direct bearing on reducing malnutrition as such, development practitioners see target setting as useful in establishing international priorities, providing a yardstick against which to measure progress, and influencing the budgetary allocations of international and national donors. Substantial efforts would be needed to achieve these goals. According to the UN Administrative Committee on Coordination/Sub-Committee on Nutrition's Second Report on the World Nutrition Situation 1992, the rate of improvement in the nutrition situation is generally far below that needed to meet internationally agreed goals.

The nutrition goals of the World Food Council's 1989 Cairo Declaration, later incorporated into the UN international development strategy for the 1990s, called for, among other things, the elimination of major nutritional deficiency diseases. The Bellagio Declaration of 1990 proposed nutrition goals, including the eradication of iodine and vitamin A deficiencies, along with cutting hunger in the poorest households by half in ten years.

The UNICEF 1990 Children's Summit also set nutrition goals to be achieved by 2000 that were subsequently endorsed at the WHO/FAD 1992 International Conference on Nutrition. These goals included reducing iron deficiency in women by one-third of 1990 levels, virtually eliminating iodine deficiency disorders and vitamin A deficiency, promoting exclusive breast-feeding for the first four to six months of a child's life, and reducing severe and moderate malnutrition of children under age five to one-half of 1990 levels.

Chronic Hunger and Undernutrition and Food Insecurity

Chronic hunger persists: nearly 1 billion people silently suffer from chronic hunger. Today about as many people as in the 1970s do not earn enough money to secure an adequate diet. Progress in alleviating hunger has certainly fallen short of the targets set by numerous forums that have been convened to give expression to the global communitys abhorrence of the persistent presence of chronic hunger To be sure, there have been dramatic success stories, particularly in Asia. Unfortunately, hunger has become more severe in many other countries, predominately in Africa.

Chronic hunger has been the target of many pronouncements and initiatives. It is not our intention here to evaluate whether all or any of these initiatives have been effective in reducing hunger. Sorting out the positive and negative consequences of deliberately pursued policies and actions and of uncontrollable factors in the environment on the observed outcome would be a major undertaking. The best we can hope to accomplish is to record the approaches that have been tried and to speculate why, in our opinion, some have worked better than others so as to distill some lessons.

The World Food Conference and Its Aftermath

The World Food Conference held in Rome in 1974 is widely claimed to have been a major milestone in drawing attention to the hunger problem in developing countries. However, did this conference put the train on the right track or actually derail what could have been a promising beginning?

Although subsequently billed as a major hunger initiative, the World Food Conference was actually convened as a reaction to a sharp rise in world food prices (together with the prices of many other commodities), which were misinterpreted as an indication of an impending supply scarcity. At the same time, the framers of the Club of Rome formulated their pronouncements of doom. Managers of the economies of the industrial as well as the developing countries become concerned about the inflationary effects of food prices and their political consequences.

With Malthusian fears in the air, the conference identified inadequate food production in the developing countries and flaws in the international commodity markets as major contributors to hunger Its resolutions were designed to address these culprits. In so doing, the conference endorsed much of the supply initiatives that dominated international hunger dialogue in the ensuing decades Despite the adoption of the Universal Declaration of the Eradication of Hunger, which proclaimed that "every man, woman and child has the inalienable right to be free from hunger and malnutrition in order to develop fully and maintain their physical facilities," the fate of the poor people afflicted with hunger was not central to the conference deliberations.

The first resolution of the conference report declared that agricultural production in developing countries should grow at an annual rate of 4 percent. To supplement inadequate production in developing countries, the conference recommended that food aid donors "provide commodities and/or financial assistance that will ensure in physical terms at least 10 million tons of grain as food aid a year, starting from 1975. As a means of increasing stability in the world grain market, the conference endorsed the establishment of an international coordinated system of national al grain reserves, the provision of additional assistance to developing countries to establish these reserves, and the conclusion of international negotiations for a reserve system agreement.

The conference also established three international organizations to deal with the hunger problem: the Consultative Group on Investment in Food Production, the FAO Committee on World Food Security, and the World Food Council. All these organizations were either meant to address food supply issues or ended up doing so for a good part of their existence The relationship between hunger and poverty was only tangentially addressed.

The Consultative Group on Investment in Food Production. The Consultative Group on investment in Food Production went out of business soon after it was founded, but not because of a lack of interest in investment in food production To the contrary, by that time the World Bank, under the leadership of its activist president Robert McNamara, had already reshuffled its portfolio of investments and otherwise expanded the resources going into agriculture and food production Moreover, once IFAD was funded, the consultative group had little reason to exist.

The FAO Committee on World Food Security. The FAO Committee on World Food Security was set up to assess the world food security situation During the early years of its existence, one of its major preoccupations was monitoring the level of world cereal stocks as compared with consumption The committee considered that stocks equivalent to 17 to 1X percent of consumption were the minimum level required for world food security. In addition, during its annual meetings, at which delegates convene to discuss the world food situation and measures to address hunger, the committee is presented with reports for its consideration on various FAO initiatives with more or less relevance to hunger and food security.

In recent years, the committee has given much attention to the FAO's Food Security Assistance Scheme and the Global Information and Early Warning System. The Food Security Assistance Scheme provides developing countries with technical and financial assistance to design and implement food security strategies. This assistance frequently includes improved data and information networks, food stocks, and programs to increase production. .

In 1985 the FAO unanimously approved the World Food Security Compact, which reaffirmed "a moral commitment to achieve the ultimate objective of ensuring that all people at all times are in a position to produce or procure the basic food they need The compact marked an important departure by the FAO from its earlier definition of world food security, with its emphasis on global food supplies and stocks, to one that focused more on the victims of food insecurity By 1991 the FAO Council had endorsed the following.

Food security was becoming less a problem of global food supplies, overall stability and global stock levels as such, but more a problem of inadequate access to food supplies for vulnerable groups resulting from, inter alia, lack of purchasing power.

World Food Council The general assembly established the World Food Council as a coordinating mechanism for initiating policies pertinent to food production, nutrition, food security food trade, food aid, and related matters The council was to review, guide, and coordinate the conduct of food and hunger actions by multilateral agencies, national governments, and the international community as a whole and to act as a political advocate for the world's hungry poor. By nominating ministers of agriculture as delegates, governments had in mind a council that would link agricultural development, as the primary instrument to reduce hunger, to economic and social policy and political considerations. While its mandate was to promote initiatives to reduce hunger, the council primarily discussed policies that met the interests of agricultural producers in both the industrial and developing countries, for example, how to expand markets or how to make production more profitable. Proposals centered on food aid and food stocks and on how to promote greater self-sufficiency, even at a high economic cost.

For years the council supported the need for larger, internationally agreed, nationally held stocks This was a dubious proposition from several perspectives, particularly as the proposals never confronted the issue of mismatches in costs and benefits to participating nations. Most of the proposals implied large benefits from additional stocks for food importing nations, while the food exporting countries were to bear the costs of holding the stocks. However, an even more important weakness of these proposals was that global stocks would have done very little to alleviate hunger, because the primary causes of food shortages in low-income, drought prone countries are bad harvests within their own borders and a shortage of foreign exchange and purchasing power in the hands of many of their households. The final collapse of the discussions contributed to the erosion of the council's credibility and prestige.

By the early 1980s, when it became clear that countries would not be able to agree to an internationally coordinated system of grain reserves, the council finally turned its attention to an initiative more closely related to the hunger issue: the poverty of nations. Following up on the writings of several economists at the World Bank and the International Food Policy Research Institute in the late 1970s, the council asked the International Monetary Fund (IMD) to establish a cereal financing facility.

An extension of the IMF compensatory financing facility became operative with the 1981 IMF Cereal Derision, which enabled the IMF to provide assistance to members to finance temporary increases in the cost of cereal imports Its purpose was to protect domestic food consumption levels in the face of shortfalls in domestic food production or increases in world cereal prices As it turned out, the extended Cereal [Financing Facility was not used much for various reasons, mainly its unfavorable credit terms, the extensive availability of food aid on better terms and the inviolability of upper limits on the IMF's country allotments.

One of the most significant World Food Council proposals was to establish national food strategies in the developing countries. The strategies were premised on the belief that regardless of the possible losses fin economic efficiency, a country could eliminate hunger within its borders only by producing enough food domestically to meet its food requirements The strategies, which the UN General Assembly endorsed in 1981, were intended to be a means "by which a country can achieve food self sufficiency through an integrated effort to increase food production, improve consumption and eliminate hunger They were intended to link consumption needs more directly to production observes, emphasize the integration of policies and project activities, sustain adequate priority for the food sector, facilitate national decisions related to the food sector, and increase and coordinate international assistance.

While some of the studies underlying the preparation of the strategies are valuable additions to the understanding of countries' food systems, the central perception underlying the strategies—that hunger can be eliminated through food self-sufficiency and that importing food while exporting agricultural commodities is bad for food security—was flawed Fortunately, the council did not have the resources or authority to implement these strategies, but the plans embodying them made it more difficult to develop and fund plans that would have genuinely addressed hunger.

Beginning in the mid-1980s, the council attempted to redirect the focus of international initiatives from supply-oriented actions to actions that directly addressed poverty-related hunger through the Beijing, Cairo, and Cyprus initiatives. The perception that structural adjustment and stabilization programs were having an adverse impact focused renewed attention on the vulnerability of the food security of certain segments of the population. At one of the consultations called by the council during 1987, the participants considered a proposal to compensate 50 million of the poorest households in countries undergoing structural adjustments Half of the package's estimated cost of US$5 billion could have been funded with food aid (equivalent to 15 million tons of cereals) The participants further suggested that part of the cash component be obtained through partial debt forgiveness by donors and multilateral banks While little progress was made toward implementing this proposal, it did galvanize thinking about the effects of economic adjustment and stabilization programs upon the very poor and the need to provide interim compensation to protect them from deeper poverty and greater hunger and malnutrition.

The council's Cyprus Initiative enphased the urgent need to protect the poor and vulnerable from the specific hardships posed by structural adjustment programs and their associated fiscal constraints. The view emerged that.

The elimination of hunger, malnutrition and poverty requires special policy attention; and that neither economic growth, important as it is, nor market forces by themselves will spread the burden of adjustment and distribute the benefits of development in the equitable way needed to protect the poor and improve their situation in the foreseeable future.

Unfortunately, the calls for effective programs to alleviate the twin predicaments of hunger and poverty and the requests for resource transfers yielded only declarations. Agriculture ministers had neither the interest, the expertise, nor the authority to implement such action. Proposals such as the use of vastly expanded food aid programs to provide short- and long-term assistance to the hungry, as originally proposed in the Cyprus Initiative, were rejected. Food supply considerations formed the basis for the opposition to these proposals, that is, would the food aid be harmful to exporting countries supplying commercially transacted food? Would the food aid be harmful to the producers of marketed food surpluses in recipient countries?

With its narrow focus on food supply and market issues, the council was never able to become a true advocate of initiatives broad enough to encompass the problem of hunger.

Food Aid and the World Food Programme

The World Food Programme plays a unique role among agencies concerned with the alleviation of chronic hunger. It promotes its own brand of strategies, primarily in its role as the convener of the Committee on Food Aid, while at the same time it has command over sizable resources to implement a great variety of programs As already noted, the WFP is the front-line agency in implementing emergency hunger relief programs and, together with UNICEF, is also supporting many programs designed to reduce malnutrition. But what has been its contribution and, more generally, what has been the contribution of food aid to the alleviation of chronic hunger?

Contrary to what might be inferred from public pronouncements, a relatively minor share (23.4 percent in 1989-90) of food aid is used in child feeding programs, income transfer, or employment programs. For the most part, food aid is used for balance of payments assistance (57 percent in 1989 90) and, to a lesser extent, for emergency relief (l? percent in 1989-90) The failure of food aid to make a more significant contribution to the alleviation of chronic hunger is disappointing for a number of reasons.

While conceived primarily as a means for surplus disposal, political support for continued food aid derives increasingly from organizations advocating the alienation of hunger. Seen in this context, it is disappointing that the WFP (or more precisely, the Committee on Food Aid) has not been able to provide more leadership to turn food aid into a major instrument for alleviating chronic hunger.

The low utilization of food aid for programs that directly contribute to the reduction of chronic hunger is disappointing given that development practitioners now widely accept that food aid can be, and under many circumstances should be monetized. With monetization as a viable option, money derived from the sale of food aid could be used, for instance, for granting credit to peasants in locations and seasons in which it would have been useless, or even counterproductive, to transfer food to them Now that food aid can foe used effectively for programs specifically designed to benefit the poor, there is little justification for untargeted food aid.

Development Agencies: IFAD and the World Bank

The impact of development agencies, such as the World Bank and IFAD, on the alleviation of world hunger is less a consequence of what they say and more of what they do or fail to do However, this does not mean that their influence is exclusively, or even primarily, related to the relative success of their investment projects The World Bank, for instance, attempts to influence macroeconomic and microeconomic public policies and actions through its annual World Development Report and numerous economic and sector policy papers.

One of the most promising initiatives of the FAO World Food Conference in 1974 was the founding of the International Fund for Agricultural Development because it rested on an explicit understanding that hunger should be addressed by focusing financial assistance on investments that directly benefit the hungry IFAD became operational in 1977 "to finance projects primarily for food production m the developing countries. Unfortunately, an excessive concern with the food supply during the first decade of IFAD's existence probably limited its effectiveness in terms of combating hunger.

Later, IFAD's original mandate was more broadly interpreted to encompass investments that lead to the alleviation of rural poverty IFAD's experience taught the fund to aim at the productive potential of the poorest in their specific social and economic circumstances. It has learned, through considerable field experience, that investment for the poor is a good investment, and that it can have a larger economic as well as social impact than if deployed elsewhere .

The World Bank's approach to hunger has evolved over the years in response to changing external conditions and institutional factors Not surprisingly, the Bank's actions often reflect more than one approach.

In its early years, the World Bank primarily promoted policies and projects to increase the growth in national product The assumption was that national authorities could subsequently attend to poverty and hunger according to their own political philosophies. Also, based in part on its experience with the reconstruction of wartom European economies, the Bank initially stressed the development of the industrial sector and related infrastructure.

With the arrival of Robert McNamara in 1968, the Bank's priorities rapidly shifted into new directions. For one, McNarnara, with much support from his chief economist, Hollis Chenery, promoted a quantum jump in lending This strategy was consistent with the then popular growth models, which suggested that slow growth of developing country economies could be "fixed" by transferring more resources to close the "resources gap".

Concurrently, the Bank began to pay more attention to the agricultural sector because of industry's limited capacity to expand rapidly, the renewed flair-up of Malthusian scares about food and population growth, and the promising reports about technological breakthroughs in agriculture the green revolution As a result, lending to agriculture increased significantly in the Bank's portfolio, and the Bank led in the establishment and administration of the Consultative Group on International Agricultural Research which by all accounts turned out to be one of the most successful international technical assistance ventures. The phenomenal growth in grain productivity has certainly mace a major contribution to the abundance of food in markets and the observed decline in food grain prices during recent decades This growth in productivity is linked to sustained investment in international and national agricultural research relevant to basic food production.

Thus the Bank, like the World Food Conference, confronted hunger with measures that promoted agricultural production to ameliorate a potential food supply shortage Yet the imperative to expand agriculture quickly led the Bank to realize that increasing food production in developing countries is highly complex, because it requires increasing the productivity of a multitude of poor peasants.

In the early 1970s the Bank initiated its integrated rural development projects, which were primarily intended to increase the agricultural productivity of peasant farmers through the provision of improved agricultural inputs and of new extension and social services. This was consistent with the basic needs approach To carry out these projects, the Bank commissioned numerous policy and research papers on employment, land reform, low-income housing, population and health, nutrition and education, and extension.

From the outset, it was clear that the integrated rural development projects would not directly benefit the landless or near landless, but the Bank expected them to benefit from increased demand for labor and from better access to basic social services in rural areas. The basic needs approach did not significantly alter the Bank's conviction that projects, including integrated rural development projects, designed primarily to benefit the rural poor should meet the usual cost-benefit criteria. While this approach facilitated program implementation, it became dear, at least in hindsight, that the criteria may have restricted the flow of benefits to the poorest.

The concept of integrating multisectoral public services under the umbrella of a single rural development project turned out to be organizationally unworkable The activities intended to enhance human capital were frequently foregone when line ministries of education, health, and so on were reluctant to be "integrated" into predominately agricultural projects. Hence, the contribution of integrated rural development to the alleviation of hunger, even in rural areas, remained at best modest.

Another reason for the early demise of rural development projects was the growing realization that development generally was not well served by a complex, centralized planning approach that relied for its implementation on a smoothly functioning bureaucracy and large public investments. This skepticism, which coincided with worsening economic conditions in the industrial countries and hence reduced growth in the Bank's resources, sharply decreased further funding for integrated agricultural projects.

In the 1980s development theories tended to advocate greater reliance on market forces and less on planning and government interventions. As for agriculture, development experts recognized that reducing the implicit and explicit taxation on the sector practiced in many countries could be far more beneficial to the sector than large public investments. Bolstered by the success stories of a few (small) countries in East Asia, the decade opened with renewed optimism about the potential for rapid growth that would sweep away poverty and food shortages.
Some in the Bank were less optimistic about the rapid transformation of countries into well functioning market economies and the unfolding, of unprecedented, high growth rates. In addition, there was evidence that economic growth trickles down so slowly that even under the most optimistic assumptions of growth in national income and food production, poverty and hunger would not be swept away for a long fume. These concerns, reflected in a 1986 Bank policy paper, that neither increased national economic growth nor ample food supplies at the global or national levels would eliminate poverty, were not new. As early as 1956, an economist with the FAO wrote in a paper discussing food stocks: "Malnutrition is a chronic problem. The main cause of undernutrition and malnutrition is poverty, lack of consumers' purchasing power."

Amartya Sen captured most eloquently the dichotomy between the same emerging perspectives and those perceptions to which many international organization continued to ad here: "The relentless persistence of famines and the enormous reach of world hunger, despite a steady and substantial increase in food availability, makes it imperative for us to reorient our approach away from food availability and towards the ability to command food.

Reutlinger and Selowsky had also previously drawn attention to the relationship between malnutrition and poverty in preparing quantitative estimates of the extent of hunger "That undernutrition is a function of absolute poverty is self-evident But estimates of the global magnitude of calorie deficiency in the developing countries have usually been made by reference to highly aggregated per capita data."

In its policy paper on poverty and hunger, not only did the Bank demonstrate unequivocally the relationship between hunger and the lack of adequate purchasing power, but it also asserted emphatically that the long-held belief that increased domestic production would lead to greater food security had to be discarded and replaced by policies that addressed the plight of the poor. The document states:

Although far too many people eat too little, the energy deficit in their diets represents only a small portion of the food energy consumed in most countries. Increasing the food supply would not eliminate this problem, since it would not necessarily improve the incomes and the purchasing power of the poor. This is why international support should focus on policies and investments that would improve the distribution of benefits by raising the real income of people facing chronic food insecurity and stabilizing access to food for people facing transitory food insecurity.

The document concludes that the lack of food security is a lack of purchasing power that is not necessarily eliminated with food self-sufficiency. In the long run chronic food insecurity is eliminated through economic growth, and in the short run through measures to redistribute purchasing power to those who are undernourished The document stresses that searching out only the most cost effective measures for implementation is essential.

Consistent with the view expressed in the policy paper on poverty and hunger, the World Bank's World Development Report 1990 and Poverty Reduction Handbook emphasized the need to maintain macroeconomic policies that placed a high priority on creating employment, introducing measures to increase the participation of the poor in growth and to reach resource-poor areas, delivering social services to the poor, and providing special income transfers and safety nets. The Bank present lending portfolio and economic and sector work are beginning to reflect these perceptions.

The Bank's focus on Africa in the late 1980s confronted it with the hunger problem particularly forcefully. Here was a continent in which population growth exceeded the growth in food production without compensating growth in the purchasing power of people and nations For a while some of the food deficit was made up by food aid, but it became clear to all that the growing dependency of countries for their physical survival needed to be addressed with urgency.

The Bank's prognosis and prescriptions, written up in a special report, The Challenge of Hunger in Africa: A Call to Action, were discussed prior to and during publication in several ad hoc international meetings hosted by the Dutch government. The recommendations for specific actions included the following:

· 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 the fluctuations in food prices and supplies · Strengthening the institutional capabilities of.

African governments to manage food security programs

· Increasing the effectiveness of food aid, including improving preparation and coordination of responses to emergency food situations

· Making more systematic efforts to identify the people at high risk of food insecurity.

The Bank is now putting these recommendations into practice, but with far fewer resources than are required A particularly noteworthy feature of this initiative was the active dialogue between the Bank, other international organizations and government-to-government aid programs, and NGOs. The positive outcome was to demonstrate that such meetings, held in an informal atmosphere, can establish a useful encounter between people working on hunger in widely different institutional settings.

Implementation of the envisioned active collaboration among the many agencies concerned with hunger in Africa fell short of expectations The lesson might be that expecting too much collaboration is unrealistic. Work on hunger ties in with a host of other agendas that are quite different for each organization. It is perhaps natural that each organization should pursue, and be seen to pursue, those strategies that appeal to their own particular constituencies.

Nongovernment Organization

Apart from their invaluable role in international feeding programs (involving approximately US$25 billion of food annually), the NGOs, because of their on-the-ground presence and first-hand knowledge of the needs and the interests of the poor, have been extremely important in keeping the focus of development on the hungry. NGOs demonstrate a variety of approaches to addressing hunger and poverty The administration of food aid programs, including food-for work and nutrition programs, continues to be the primary commitment of some of the largest NGOs, such as CARE and Catholic Relief Services Others provide services for developing small and micro enterprises Inspired by the Grameen Bank of Bangladesh, small scale credit programs have become popular among NGOs end their donors Still others are heavily involved in advocacy and education, and are directing their attention more toward policy and macroeconomic issues.

In addition to channeling sizable voluntary contributions (about US$2 billion each year), the NGOs' advocacy work has been important in increasing foreign assistance flows to the poorest of the poor. The NGOs have learned from field experience that food relief is not the answer to chronic food insecurity. As a consequence, Bread for the World and other NGOs have become champions of assistance targeted directly to the poor Their strong advocacy of peasant agriculture has at times obscured their appreciation of the role that domestic and international markets could play in efficiently providing and stabilizing food supplies. Today awareness is growing that national food self-sufficiency may not, in all cases, be a reasonable goal.

Major Conferences of the 1990s

Recent conferences, including the UNICEF Children's Summit (1990), the Rio Conference on Environment and Development (1992), and the International Conference on Nutrition (1992), all addressed hunger and endorsed recommendations and targets for its elimination or reduction The UNICEF summit introduced new concepts to the dialogue on hunger that included (a) providing services to the very poor, (b) building capacity, and (c) empowering the poor. In particular, the summit recommended disseminating knowledge and support services to increase food production so as to ensure household food security.

The World Declaration on Nutrition, adopted by 159 participating countries at the FAD/WHO International Conference on Nutrition in December 1992, stated that "there is enough food for all and that inequitable access is the main cause [of hunger and malnutrition". Poverty and the lack of education, which are often the effects of underdevelopment, are the primary causes of hunger and malnutrition".

In the opening address of the conference, the secretary-general of the United Nations judged food and nutritional security to be the most crucial issues for world peace and security. He placed nutrition in the forefront of national strategies that put human beings as individuals at the center of the development process The UN's role would be to mobilize international awareness and concern and contribute to technical efforts.

The UN Conference on environment end Development, held in Rio de Janeiro m 1992, highlighted the international concern for sustainable development and environmentally sound management of natural resources According to Agenda 21," which sets out the aims of the conference, sustainable agriculture, characterized by political will; proper economic analysis of environmental impacts; appropriate incentives, such as prices, share rights, and effective participation; Institutional flexibility, and complementary infrastructure, such as transport, storage, credit, and research, are needed to address world hunger.

Chapter 14 of the agenda, which concerns food security, states that increases in food production improve food security only if they are sustainable. Policies to foster sustainable agricultural growth should include provisions that avoid fragmentation of landholdings; develop and transfer appropriate technologies; and improve harvesting, storage, processing, distribution, and marketing Voicing a concern frequently raised by the NGOs, the agenda called for strengthening rural organizations to decentralize decisionmaking Chapter 32 maintains that a farmer-centered approach is key to attaining sustainable agriculture in the developing and industrial countries.

Concluding Remarks

Starvation from natural disasters has virtually disappeared from the face of the earth, although in some countries people still die from hunger because of the actions of ruthless governments. International awareness and efforts have been responsible for the progress made in eliminating outright starvation. Advances in transportation, communications, and mass media have facilitated international responses to famine.

Modern medicine and the effective, hard work of a dedicated cadre of international civil servants and other professionals have made some progress in reducing the prevalence of malnutrition caused by micronutrient insufficiencies, lack of awareness about nutrition, and poor public services and social infrastructure.

However, not enough has been accomplished to reduce undernutrition or chronic hunger. This is not because of a lack of growth in national products or food production In most countries these have grown at the same or higher rates than population, in themselves laudable accomplishments Chronic hunger persists for two reasons Some would place all the blame on lack of political will. Measures to overcome poverty do fail m part because of the inherent resistance to dismantling and rearranging the prevailing legal and economic power structures within a country. But we believe that another important reason for the failure has been the dearth of workable and cost effective ways to reach the poor. Many of the past hunger initiatives failed to confort the problems poor people face with practical and realistic solutions.

Consensus is growing that poverty is hunger's root cause and that governments need to deliver social services to the poor, not only to improve their present Living conditions, but also to empower them to shed their poverty. However, there is much less agreement on the appropriate mix of resources—food, water; land, credit, improved technology, training, markets, and so on-and on how to transfer these resources to enable the poor to augment their ability to acquire or grow the food they need.

The challenge for the international community is to learn new ways of providing assistance, consonant with the decentralization process many countries are undergoing, directly to the very poor. International assistance should be sufficient to combat chronic hunger effectively without waiting for economic development to eradicate poverty.

Notes.

1. Robert Chen and Robert Kates, "World Food Security: Prospects and Trends, Climate Changes and World Food Security" (Unpublished manuscript, July 1993).

2. Edward Clay and John Borton, "Food Security and Disasters in Africa: A Framework for Action" (Unpublished paper written for the World Bank, June 1991).

3. Clay and Borton, "Food Security and Disasters in Africa.

4. Alan Berg, Malnutrition: What Can Be Done? (Baltimore: Johns Hopkins University Press, 1987), 4.

5. Berg, Malnutrition.

6. Nevin Scrimshaw, Effects of Food and Nutrition Assistance to Developing Countries (Ithaca: Cornell Food and Nutrition Policy Program, 1991).

7. Robert Chen, I. Datt, and Martin Ravallion, Is Poverty Increasing in the Developing World? Policy Research Working Paper no. 1146 (Washington, D C: World Bank). Strictly speaking, the estimates refer to an income criterion. Yet, if income properly reflects changes in real income, these poverty measures are a good estimate of the chronically hungry, because food represents a high share of expenditures.

8. Thomas Weiss and Robert Jordan, The Global Food Conference and Global Problem Soloing (London Praeger Publishers, 1976).

9. Conference Report Resolution XVIII. For most of the decade, the 10 million-ton goal was not achieved, but since 1984 food aid has exceeded the target, reaching nearly 12 million torts in 1992 However, under the Food Aid Convention, donors remained committed to 7.6 million tons.

10 FAO, Report of the Conference of Council of FAO, Twenty-Third Session, November 9-28, 1985 (Rome: TAO, 1985), 35-39.

11. FAO, Report of die Council of FAO, Ninety-Ninth Session, (FAO: Rome, 1991), 21.

12. Shlomo Reutlinger, "Food Insecurity Magnitude and Remedies," World Development 6 (1978): 797-811.

13. World. Food Council, National Food Strategies: To Eradicate Hunger (Rome World Food Council, 1982), .

14. World Food Council, The Cyprus, Initiative against Hunger in the World, WFC19892 (World Food Council: Rome, 1989), 2.

15. Resolution XIII of the conference report.

16. Idriss Jazairy, M. Alamgir, and T. Panuccio, The State of world Rural Poverty (New York: New York Press, 1992).

17. Operations Evaluation Department, Rural Development: World Bank Experience, 1965-86 (Washington D.C.: World Bank, 1988).

18. World Bank, World Development Report 1986 (Washington D.C.: World Bank, 1986).

19. World Bank, Poverty and Hunger: Issues and Options for Food Security in Developing Countries (Washington, D.C.: World Bank, 1986).

20. Gerda Blau, Functions of a World Food Reserve: Scope and Limitations (Rome: FAO, 1956), 5.

21. Amartya Sen, Hunger and Entitlement (Forssa: United Nations University, World institute for Development Economics Research, 1987), 17.

22. Shlomo Reutlinger and Marcelo Selowsky: Malnutrition and Poverty: Magnitude and Policy Options. (Baltimore Johns Hopkins University Press, 1976), 3.

23. World Sank, Poverty and Hunger, 17.

24. World Bank, World Development Report 1990 (Washington, D.C: World Bank, 1990); World Bank, Poverty Reduction Handbook (Washington, D.C: World Bank, 1993).

25. World Bank, The Challenge of Hunger in Africa. A Call to Action (Washington, D.C: World Bank, 1988),.

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Brown, Lester 1991. Saving the Planet.- How to Shape an Environmentally Sustainable Global Economy New York: Norton Publishers.

Cohen, Mark, ed 1993 Hunger 1994: Transformating the Politics of Hunger. Silver Spring, Md.: Bread for the World.

FAO. 1973 World Food Programme, A Story of Multilateral Aid, 3rd ed. Rome.

FAO. 1979 FAO Principles of Surplus Disposal and Consultative Obligations of Member Nations. Rome.

FAO. 1985 Food Aid for Development: Three Studies Rome.

FAO. 1990. Towards Better Nutrition for All: Preparing for the International Conference on Nutrition Rome.

FAO Committee on World Food Security 1974. "Draft Evaluation of World Cereal Stock Situation." CCCP:GR 74/11. Rome.

FAO Committee on World Food Security 1979 Outcome of the Negotiating Conference for a New International Grains Arrangement: Implications for World Food Security and Proposals for Implementing the International Undertaking CFS: 79/8. Rome.

FAO Committee on World Food Security 1979 Action Taken to Adopt a National Cereal Strategy CFS:79/4 Rome.

FAO Committee on World Food Security 1983. Assessment on the World Food Security Situation and Stock Situation and the Short-Term Outlook CFS 83/2 Rome.

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Islam, Nurul 1989 "Undernutrition and Poverty: Magnitude, Pattern and Measures " Paper presented at the World Food Conference, Iowa State University, Ames.

McNerney, J.J. 1978. Developments in International Food Policy. Commonwealth Paper no 9. London: Commonwealth Publishers.

Ravallion, Martin. 1987. Markets and Famines. Oxford: Clarendon Press.

Ravallion, Martin. 1987. 1989 Is undernutrition Responsive to Changes in Incomes? World Bank Working Papers WPS 303. Washington D.C.: World Bank.

Reutlinger, Shlomo, and Pellekaan van Holst 1986. Poverty and Hunger: Issues and Options for Food Security in Developing Countries. Washington D.C: World Bank.

Schiff, Maurice, and Alberto Vald 1990. The Link between Poverty and Malnutrition: A Household Theoretic Approach. World Bank Working Papers WPS 536. Washington, D.C: World Bank.

Sen, Amartya 1977 "Starvation and Exchange Entitlement A General Equilibrium Approach and Its Application to the Great Bengal Famine." Cambridge Journal of Economics 1:33-60.

Sen, Amartya 1977 1981 Poverty and Famines An Essay on Entitlement and Deprivation Oxford: Oxford University Press.

Sen, Amartya 1977 1985. Poverty and Hunger Research Memorandum, no RM-102:1-31. New York: Williams College, Center for Development Economics.

Simon, Arthur 1975. Bread for the World New York: Paulist.

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World Food Council 1989 The Cyprus Initiative against Hunger in the World WFC19892. Rome.

World Food Council 1989. The Views of the Non Governmental Organizations as Presented to the World Food Council.

WFC/1989/2(Part II/Add.3) Rome.

WFC 1991. Focusing Development Assistance on Hunger and Poverty Alleviation. Rome.

World Food Programme. 1977. Assessment of Food Aid Requirements and of Food Aid Targets for Cereals Possible Approaches WFP/CFA:3/7-B Rome.

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