Famine and Feast Life on the margins: the inequality of food and nutrition security RESPONSE AND MANAGEMENT: FOOD AID AND ASSISTANCE PowerPoint presentation by Médecins Sans Frontières / Doctors Without Borders (MSF) UK Schools Team: Mary Doherty and Severa von Wentzel March 2014
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Famine and FeastLife on the margins: the inequality of food and nutrition security
RESPONSE AND MANAGEMENT:FOOD AID AND ASSISTANCE
PowerPoint presentation by Médecins Sans Frontières / Doctors Without
Borders (MSF) UKSchools Team: Mary Doherty and Severa von Wentzel
March 2014
INTERNATIONALRESPONSE AND MANAGEMENT:
Management of food security and supply
Management of food security and supply, an age-old topic, became very topical in the 2000s because of:
• Economic concerns following food price shocks of 2006-2008
• Environmental concerns such as climate change, soil degradation and water
• Health, particularly growing malnutrition including obesity epidemic and related non-communicable diseases
• Concerns with resilience of food supply; for instance, in the UK after the lorry strike that brought the country to 5 days from shortages
Source: “Food Security and Sustainability: One Can’t Make an Omelette Without Cracking Some Eggs” http://vimeo.com/24914046
Actors in the international response
International food aid and assistance is driven in large part by: • Donors and international institutions• UN institutions such as World Food Program• NGOs (non-governmental organisation) actors are
independent of national governments such as MSF, World Vision, CARE and Catholic Relief Service
• World bank Formed at Bretton Woods in 1944,its remit is to support developing countries.
• IMF Formed at Bretton Woods in 1944, it is in charge of stabilising currencies and supporting weak economies
Further Info Critical view on the actors, politics and economics of Food Aid:http://www.globalissues.org/article/748/food-aidGreeley et al Effect of mass supplementation http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0044549URBAN SETTING RESPONSE http://www.cmamforum.org/Pool/Resources/Humanitarian-resp-in-urban-settings-Disasters-Lucchi-2012.pdf
After the global food price hikes, there was a call to increase the coordination of the Rome-based agencies and the focus on improving the link between food assistance and food security.
Rome-based agencies is a short-hand for three United Nations’ agencies based in Rome:• World Food Programme (WFP): http://www.wfp.org/
Largest humanitarian organisation in the world that handles most of the multi-lateral (involving more than 2 donors) food aid
• Food and Agriculture Organization (FAO): http://www.fao.org/home/en/
• International Fund for Agricultural Development (IFAD): http://www.ifad.org/
• EU and its member states• Canada• Japan• Non-DAC donors such as Kuwait, Saudi
Arabia and United Arab Emerites becoming more significant. China and South Korea started making substantial provisions of in-kind food aid largely directed at North Korea in the 1990s. contents
Source: www.odi.org.uk/resources/docs/6038.pdf
DAC and non-DACdonors
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The Organisation for Economic Co-Operation and Development’s (OECD) Development Assistance Committee (DAC) serves as a discussion forum on issues surrounding aid, poverty reduction and development. Member states marked in yellow.
• The focus is still largely on addressing undernutrition, not the double burden of malnutrition.•Food aid represents the majority of humanitarian appeals.
• Constantly shifting contexts and needs in emergency and transitional settings and growing funding requirements.
Further info• CAFOD Aid Factsheet http://www.cafod.org.uk/Media/Files/Resources/Secondary/resource-
pages/Factsheets Humanitarian Policy Group Food aid and food assistance in emergency and transitional contexts: a review of current thinking – shift to food assistance and trends http://www.odi.org.uk/sites/odi.org.uk/files/odi-assets/publications-opinion-files/6038.pdf
• Case study success stories Nutrition report 2013. UN childhood nutrition report on 11 countries with success in their childhood feeding programmes http://www.unicef.org/media/files/nutrition_report_2013.pdf
• On “The future of food aid” http://www.irinnews.org/report/98469/analysis-the-future-of-food-aid
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Source: http://www.globalissues.org/article/748/food-aid; http://www.odi.org.uk/sites/odi.org.uk/files/odi-assets/publications-opinion-files/6038.pdf; Levine and Chastre et al “Missing the Point” http://www.odi.org.uk/sites/odi.org.uk/files/odi-assets/events-presentations/1422.pdf; HPG report
Food aid and assistance: The terms and definitions used around food aid and food assistance are not very clear and changing - clarity needs to be greater. The have changed, in particular, to allow for the inclusion of the provision of cash for food-related purposes. The use of cash-based transfers and vouchers has increased.Programme Food Aid is almost always made up of in-kind direct transfers (see next slide) and makes up the majority of US food aid.Relief, or Emergency Food Aid Usually free food distribution during emergency situations as a result of natural or man-made disasters. Not necessarily short-term, as countries can suffer chronic food insecurity for long periods. It may include food, water, tents, clothing or rescue and medical teams.Project Food Aid This is food aid delivered as part of a specific project related to promoting agricultural or economic development, nutrition and food security, such as food for work and school feeding programmes. Relief aid and project food aid are usually distributed by the World Food Programme (WFP), Non-governmental organizations (NGOs), and occasionally by government institutions.Development aid: Given to benefit the people and economy of a country, money is given to a wide range or programmes and projects such as infrastructure and education.
In-kind aid: Food grown in the donor country is distributed or sold abroad. Usually it is a government to government transfer, where the recipient countries purchases the food with money borrowed at lower than market interest rates. Local and regional procurement: Purchases in and around the countries that need it.Tied aid: Money that comes with strings - a requirement to spend it a certain way or to follow a particular policy. What is monetization of food aid? http://www.careinternational.org.uk/news-and-press/latest-news-features/2388-what-is-monetization-of-food-aid-five-questions-on-food-aid-qmonetizationq-in-the-us-answered
Untied aid: No spending or policy proviso attached to money given.SAPs (Structural adjustment programmes) Implemented by the IMF, aid or loans given if a country followed SAPs. Aimed at boosting development and reducing corruption, they were criticised for benefiting rich countries and corporations.Multilateral aid: Given by multiple donors to a specific country, it may be collected by an UN organisation or an NGOBilateral aid: Given by one country directly to another. Most non-DAC donors provide assistance bilaterally from government to government assistance, but there is a paucity of information on this. contents
Short-term actions and supply-led strategies prevail over long-term policies as most political attention is short-term. The wide spectrum of strategies includes:• Fairer trade• Reduced debt servicing• Reduced subsidies to richer economies • Less tied aid• More community involvement• Appropriate technology • Infrastructure building
Action for students: 1. Discuss in pairs and make notes in your folder about what each
of the different strategies above entails refer to concrete examples and highlight the desired outcomes.
2. Identify the strategies which are long term, short term3. Watch the Fairfood international clip “A Fair Future for food chain
• Shift away from in-kind food aid to many new response options and more flexible donor resources such as local and regional procurement away from aid sourced internally in a donor country (except for USA). “People need different kinds of aid in different situations. If food is not
available in a flooded area, actual food supplies are the answer. In the case of chronic shortages, experts suggest cash or vouchers, integrated into a broader social protection system, might be the answer.” http://www.irinnews.org/report/97576/getting-food-aid-right
• More emergency and less programme and project aid. They can help build the basis for long-term food security and can be particularly important in countries in protracted crisis. An emergency response is not designed to be sustainable, but rather to keep people alive.
• Major efforts to improve food security analysis, early warning, response analysis
However, there “remains little in the way of an evidence base about what works best under what circumstances.” and little on recipient preference http://www.irinnews.org/report/97576/getting-food-aid-right
• Growing focus on nutrition programming and on the nutritional outcomes of food assistance and linking of food assistance to nutritional outcomes. Growing scientific and political consensus on the need to focus on children under two.
• “Depression of food prices in local markets, affecting local livelihoods: Buy food for distribution from local markets.
• Intercommunity conflict when food aid is targeted; friction between the agency and the community: Involve communities in the selection of targeting methods and other aspects of food distribution.
• Hijacking of food for political purposes (e.g. feeding armies): Use a food commodity that only the most needy will find desirable.
• Households outside the immediate area leave their homes in order to be close to sources of aid: Spread information about targeting criteria before aid distribution starts.
• Change of attitudes and creation of unrealistic expectations; hindrance of traditional coping strategies: Limit to the absolute minimum the time that free food aid is distributed, and replace it with other forms of aid if necessary.
• Friction between refugees or IDPs and local populations: Make sure that local leaders are informed at all stages about the aid, and include the most vulnerable of the host population in assistance interventions.
• The market becomes flooded with food aid commodities, prices tumble and the food loses its economic value: Target food aid as much as possible.
• Reduced demand for local farmers' produce: Choose commodities that will not compete directly with local production, or else purchase commodities in local markets.” (Source: http://www.fao.org/docrep/008/y5815e/y5815e0a.htm)
Multi-sectoral approach
“Malnutrition is often misunderstood by policymakers as simply a ‘lack of food’ problem. It is not. Rather, it is a complex multidimensional and intergenerational problem and needs a multi-sectoral as well as direct and specific interventions.” (http://www.financialexpress.com/news/tackling-undernutrition-challenges/1154970/0 )
• As malnutrition and its causes are complex, a multi-stake holder and multi-sectoral approach underpinned with better governance is required. Such an approach can meet multiple objectives such as nutrition, gender equality and sustainability.
• Most current policy responses focus on supply side (producing more), but given global numbers of hungry this is not working on its own. Consumerism and markets need to be accompanied by policies that help rebalance power.
International management is increasingly needed to ensure food supply and security.
A multi-sectoral approach includes interventions in food systems, public health and education and needs to create an enabling environment through broader interventions and direct nutrition-specific ones. Action is urgent for both types of interventions.
Challenges are to • To sustain global commitment• To boost country-level commitment• To translate commitment into action• To boost improvements in nutritional status and livelihoods
Linkages in the food security architecture can be further improved.
Governance:coordination and coherence
In an effective, timely and comprehensive mechanism for governing and coordinating food and nutrition security and sustainability, including food aid, key stakeholders could:• Address complex and interrelated issues and deeper underlying
determinants such as the quality of governance and institutions as well as issues relating to peace and security. Fragile states have special needs.
• Garner high-level support and political partnerships as a foundation for an “whole of society” approach with “ownership” led by the governments, but including civil society, parliaments and the private sector. Country-owned strategies may not be possible in fragile states, so other actors must assume a more activist role based on interim strategies.
• Build a mechanism for “policy coherence”, timely policy co-ordination through government-wide attention to unintended negative consequences on nutrition of donor and recipient countries’ policies and interventions; for example, subsidies for biofuels and food exports.
Initiatives such the UN REACH and the Millennium Development Goals have been followed by the L’Aquila initiative and New Alliance for Food Security and Nutrition and US Feed the Future, "1,000 days" campaign and “Scaling Up Nutrition” (SUN).
The Committee on Food Security, UN High Level Task Force, New Food Security Cluster and Food Assistance Convention have been active.
These are developed by government, academic, research institution, civil society, private company, development agency, UN organisations and the World Bank specialists and bring together countries suffering high levels of malnutrition with major international food donors.
Further info:
“Aid policy: New mechanism to boost food security” http://www.irinnews.org/report/92846/aid-policy-new-mechanism-to-boost-food-security
Source: MSF “Food Aid System continues to fail malnourished children” http://www.msf.org/article/food-aid-system-continues-fail-malnourished-children
First Millennium Development Goal: reduceby half the proportion of people who sufferfrom hunger between 1990 and 2015.(ftp://ftp.fao.org/docrep/fao/012/i0876e/i0876e02.pdf ).
Based on the latest FAO undernourishmentestimates, this can be met if appropriate actions are taken to reverse the slow down since 2007/2008.
Further info: Save the children, Ending poverty in our generation. https://www.securenutritionplatform.org/Pages/DisplayResources.aspx?RID=143MDG, Food and Agriculture: http://www.mdg-review.org/index.php/sections/38-food-aagriculture/56-mdg-food-and-agricultureFarming is key to Africa’s prosperity (supporting women farmers)http://www.irishexaminer.com/analysis/farming-is-the-key-to-africas-prosperity-262936.html
In Sub-Saharan African countries levels of malnutrition are declining very slowly, remain very high or are growing, while there are have been large declines across Asia, Latin America and the Caribbean.
“We have learned from the experience of the MDGs. There have been huge successes, but also gaps. I believe the new goals need specific targets on hunger and nutrition. I believe we need a strong emphasis on agriculture, and in particular climate-sensitive agriculture. I believe we need a stronger, more specific approach on the rights of women and girls.” - Irish Minister for Foreign Affairs and Trade Eamon Gilmore
Environmental sustainability and gender equality are key to meeting Millennium Development Goals.
“Conserving the agricultural resource base and livelihood security of the poor can be mutually supportive in three ways. First, secure resources and adequate livelihoods lead to good husbandry and sustainable management. Second, they ease rural-to-urban migration, stimulate agricultural production from resources that otherwise would be underused, and reduce the need for food to be produced elsewhere. Third, by combating poverty, they help to slow population growth.” (UN Documents, Our Common Future - http://www.un-documents.net/ocf-05.htm)
The report on the 2009 G8 Summit in L’Aquila, Italy recognised the “the
combined effect of long standing under investment in agriculture and food
security, price trends and the economic crisis have led to increased hunger and
poverty in developing countries, . . . jeopardizing the progress achieved so far
in meeting the Millennium Development Goals.” (Joint Statement)
Leaders launched the L’Aquila Food Security Initiative (AFSI), which follows the five Rome principles on sustainable food security. It call on donors to draw up and implement development plans that respond to the needs of developing countries and ensure that all actors are cooperate in their work to achieve sustainable outcomes:
Rome principles: 1. Country Ownership; 2. Strategic coordination; 3. Comprehensive approach; 4. Multilateral support and improvement; 5: Sustained financial commitment
Other core commitments: gender, environmental sustainability, transparency
The G-8 group of powerful nations made a L’Aquila commitment
signed by over 20 countries in 2009 in Italy to "take urgent action
to eradicate hunger from the world." It set out to invest $22 billion
in agriculture over three years based on the Rome Principles. This reversed two decades of aid policies that neglected developing country agriculture to invest in country-led
programmes.
Instead of renewing the L’Aquila 2009, which was up in May 2012, the New Alliance for Food Security and Nutrition and US Feed the Future and was rolled out. • Video and article on food security policy and trade:
• International Food Policy research Institute (IFPRI) Global Food policy Report 2012 https://www.securenutritionplatform.org/Pages/DisplayResources.aspx?RID=179
• “At the G-8 Summit hosted by President Obama at Camp David, African heads of state, corporate leaders and G-8 members pledged to partner through the New Alliance and, working with the African Union and Grow Africa, lift 50 million people out of poverty in sub-Saharan Africa by 2022.”(http://feedthefuture.gov/article/fact-sheet-new-alliance-food-
security-and-nutrition) • The New Alliance for Food Security and Nutrition private-
sector-led affords a lot more power to partnerships with the private sector, multinationals like Monsanto and Yara.
• Conditions imposed by donors give foreign firms greater access to Africa's markets.
Feeding Practices & Behaviors: Encouraging exclusive breastfeeding up to 6 months of age and continued breastfeeding together with appropriate and nutritious food up to 2 years of age and beyond
Fortification of foods: Enabling access to nutrients through incorporating them into foods
Micronutrient supplementation:Direct provision of extra nutrients
Treatment of acute malnutrition:Enabling persons with moderate and severe malnutrition to access effective treatment
Agriculture: Making nutritious food more accessible to everyone, and supporting small farms as a source of income for women and families
Clean Water & Sanitation: Improving access to reduce infection and disease
Education & Employment: Making sure children have the nutrition needed to learn and earn a decent income as adults
Health Care: Access to services that enable women & children to be healthy
Support for Resilience: Establishing a stronger, healthier population and sustained prosperity to better endure emergencies and conflicts
Nutrition-Sensitive Strategies Specific Actions for Nutrition
Nutrition-sensitive strategies increase the impact ofspecific actions for nutrition
International agencies
Action for students: Discuss in a group of four, elaborating on your answers:
1. Why is it necessary for international agencies to be increasingly involved in ensuring food security?
2. What makes an approach purely evidence-based* as opposed to practice- or opinion-based? What evidence matters (e.g., best evidence such as RCT* versus best available evidence)? How do you get it? Why is there a classic policy problem of gap between evidence and policy?
3. What makes an approach sustainable? Are there situations that call for an approach that is not sustaianable?
4. Why does cost-effectiveness matter?
• Randomised-control trial: specific type of experiment that is the gold standard for a clinical trial
• More on evidenced based versus opinion based policy making: http://www.unece.org/fileadmin/DAM/stats/documents/2008/05/dissemination/wp.10.e.pdf
FOOD AID AND ASSISTANCENUTRITIONAL EMERGENCIES
Nexus of strategiesand scales (1)
• There are no one-size fit all scaling up nutrition programmes.
• The risks and vulnerabilities of a particular context need to be assessed in order to devise policies and implement interventions.
• Adequate food and nutrition policies are essential to guarantee the effectiveness of programmes and ensure sustainability. The link between national and district, municipal and community policies is crucial.
• The combination of interventions needs to be put in place in a number of scales. Apart from nutrition intervention, others may focus on addressing inequities and strengthening legal commitments and health systems, for example.
• Successful ones addressing the particular vulnerabilities and needs have secured:
• Political commitment, • Evidence-based national policies and
programmes • Trained and skilled community workers
cooperating with communities• Effective communication and advocacy• Integrated service delivery across multiple
seccontents
Nexus of strategiesand scales (2)
What works in nutritional emergencies
“Proven solutions exist that can end the preventable child deaths and damage caused by malnutrition. Investing in improved nutrition during the critical 1,000 day window can:
• Save more than 1 million lives each year; • Boost a country’s GDP by as much as 11% annually; • Build self-sufficiency--well-nourished children are more likely to
continue their education, have higher IQs, and earn up to 46% more over their lifetimes;
• Significantly reduce the human and economic burden of infectious diseases such as malaria and HIV/AIDS, and chronic diseases such as diabetes; and
• Help end hunger and break the cycle of poverty.”
Source: 1000 days.org “Nutrition – An Investment in Growth” http://thousanddays.org/wp-content/uploads/2012/05/1000-Days-June-2013-Investment-in-Growth-Policy-Brief.pdf
What does not
Factors behind low effectiveness of interventions can include:
•Inadequate targeting;• Lack of coordination and integration of
interventions;• Distributed foods not appropriate in terms
of nutritional and micronutrient content;• Weak education component.
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Afar, Ethiopia – Nutritional intervention
Further info: http://www.msf.org.uk/article/ethiopia-isolated-and-malnourished-msf-treats-malnutrition-rural-afar
“When I see this child I feel very happy because the grandmother and the rest of the community thought she was going to die, but we saved her life and she is still alive,” says Nabiyu Ayalew, MSF’s outreach nurse.
Nutrition interventionsare cost-effective
“Evidence shows that nutrition interventions are some of the most cost effective of any development intervention, saving lives and investing in the future potential of children. Scaling up coverage of a minimum package of direct nutrition interventions, identified by the Lancet medical journal in 2008, could prevent a quarter of child deaths and lower the prevalence of stunting —a condition limiting physical and cognitive development caused by chronic malnutrition—by a third.” Enough Food If Campaign “G8 Summit Briefing” http://www.bond.org.uk/data/files/G8-summit-briefing.pdf
Action for students: Watch “MSF Campaign for Effective Treatment” on therapeutic foods
and theiruse in Niger, Sahel http://www.youtube.com/watch?v=e-XMu1YzLsU
improve nutrition outcomes and protect human capital
Behaviour change interventions usually delivered on-on-one at the community through community nutrition programmes and such level,Including:
•Promotion of breastfeeding• Appropriate complementary feeding
practices (but not provision of food)• Proper hygiene notably hand
washing (Mason et al. 2006).
Micronutrient and deworming interventions that provide a range of supplements for:
• Children under the age of five (periodic vitamin A supplements, therapeutic zinc supplements to manage diarrhoea, multiple micronutrient powders, and deworming drugs)
• Pregnant women (iron-folic acid supplements, as well as iodized oil capsules where iodized salt is not available)
• General population(iron fortification of staple foods and salt iodization).
Complementary and therapeutic feeding interventions that provide:
• micronutrient-fortified and/or -enhanced complementary foods to prevent and treat moderate malnutrition among children 6–23 months of age
• community-based management of severe acute malnutrition among children under five years of age.
Source: Nutrition programmes as an investment and Source on Lancet study:http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources/Peer-Reviewed-Publications/ScalingUpNutrition.pdf
Prevention is much better than treatment – not to get sick in the first place.
Preventative measures such as cash transfers and supplementary feeding are far more cost efficient than treating a malnourished child and the loss inherent in its curtailed future.
Types of feeding programmes: General food distribution
General food distribution (GFD) is typically used in large-scale emergencies, where there is an acute food shortage and / or food prices hikes. GFD is usually not targeted.
Examples:•GFD in Haiti after the earthquake in 2010
• GFD in typhoon affected areas in the Phillippines 2013. In such an acute onset emergency, high energy biscuits are used.
General food distributions can become part of a country’s anti-poverty programme in which case they are targeted to the poorest segments of the population. Examples of ‘targeted’ GFD:
Blanket feeding This is deployed normally during a severe food crisis and also targets specific populations, normally extending non-discriminatory feeding programmes for pregnant mothers, under-5 children, elderly, and the sick, whether they are facing malnourishment or not.
Often in conjunction with general food distribution, blanket feeding can also exist independently. It targets the members of a population who are at the highest risk of malnutrition (pregnant and breast feeding women, children under 5, elderly, chronically ill) with foods that are designed to meet their specific nutritional needs.
PlumpyDoz is used for blanket feeding.
Further Info: Alertnet “Milk in the Sahel; making a real impact on malnutrition” http://www.trust.org/item/20140109120020-yg42e/?source=hpeditorial
Supplementary feeding program (SFP) When malnutrition rates extend over 15 percent and populations still need assistance to fill gaps and in treating specific target groups, NGOs will provide SFPs during the day to provide warm meals, appropriate nutrients, and special foods for various parts of the affected population. It provides supplemental foods to members of the population who exhibit moderate levels of malnutrition (defined by low middle arm circumference or low weight for height) and are at risk for developing severe malnutrition. Most SFP target pregnant and lactating women and children under 5 with energy dense fortified foods.
Therapeutic feeding program (TFP) TFPs are established to treat severely malnourished people, and to provide immediate relief to those of an emergency-affected population in danger of dying because of lack of food. Ideally, TFPs are 24-hour stations. In emergency settings, though, staff and supply limitations will often prevent 24-hour operation.” (http://www.cdham.org/wp-content/uploads/2011/11/Chapter-12.-NGOs-and-Food-and-Nutrition.pdf)
The vast majority of TFPs are run in regions where food availability is not the predominant concern (e.g., Niger, Burkina Faso, Ethiopia, Democratic Republic of Congo). TFPs are established in in out-patient clinics and in-patient hospitals areas where childhood malnutrition is endemic due to a high burden of infectious disease combined with poor diets that fail to meet young children’s specific nutritional needs. TFPs may also be set up in emergency-affected populations where there is a background level of endemic malnutrition that will get worse or where there is reason to believe that the number of severely malnourished children will increase.
Commercialised therapeutic RUF typically takes the form of a peanut/milk-based paste with all nutrients essential to treat severe acute malnutrition. It comes in individually wrapped airtight foil packets that are resistant to bacterial infection and easy to distribute. The product has a long shelf life, making it easy to store, transport and to use in hot climates as an efficient way to provide milk to children under three.
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MUAC
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The nutritional status of a child is checked by using the MUAC (Middle-Upper-Arm Circumference) bracelet at an MSF therapeutic feeding centre. The indicator gives rough estimates of protein (muscle) and energy (subcutaneous fat stores) that correlate with changes in body weight in malnourished children.
contentsImage: Harvaar Karlsen
contentsImage: Stefan Pleger
NUTRITIONAL INTERVENTIONUK AND US
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‘Food stamps’ in the UK
Food stamps were last issued during the Second World War to address food insecurity.
Right: a woman is handed food stamps in office in Elephant and Castle in south London in 1944Top right corner: a shopkeeper cuts out a coupon in a shop in 1940 Images: AP Photo http://news.uk.msn.com/uk/food-stamps-in-the-uk-613888
Action for students: What are some of the issues raised against moving to payment cards? What are the issues with Foodbanks? • Read the BBC article “Numbers relying on food banks triple in a year ”
http://www.bbc.co.uk/news/business-24536817• Watch the clip on UK Foodbanks and explain how these help address food insecurity. http://www.trusselltrust.org/foodbank-
• Programmes such as Healthystart (UK) or WIC (USA) address the problem of nutrition security by providing a limited number of highly nutritious foods, dairy, fruits, vegetables, fish, fortified foods for children.
• They intend to target the population subgroups most at risk of malnutrition such as pregnant and breast feeding women and young children.
• Risk of malnutrition has increased with the economic downturn and the rise in food prices in the UK.
Action for students: 1. Read about Healthystart vouchers http://www.healthystart.nhs.uk/
2. the Guardian’s “Food vouchers to provide emergency help but prevent spending on alcohol” http://www.theguardian.com/politics/2013/mar/26/payment-cards-emergency-assistance-food-stamps
2. MSN News 'Food stamps' to be issued in the UK: Q&Ahttp://news.uk.msn.com/uk/food-stamps-in-the-uk-613888
“The United States is sending food overseas to children that it would not feed to its own citizens. This double standard needs to end.”
- STARVED FOR ATTENTIONhttp://www.starvedforattention.org/_inc/en/press/Malnutrition-Fact-Sheet.pdf
US on the edge of poverty
Action for students: 1. View Video on food stamps in the US by Center on Budget and Policy Priorities:
off the charts (Warning: video contains some graphic images of the effects of malnutrition and hunger on children) http://www.offthechartsblog.org/round-up-everything-you-need-to-know-about-snap/
2. Look at the slide show “On the Edge of Poverty, at the Center of a Debate on Food Stamps”
3. Read the article with a partner and argue for or against the programme being scaled down.Image: SNAP Hotline http://www.hungercoalition.org/snap-campaign;
“People have a lot of misimpressions about hunger in America. People think it’s associated with homelessness when, in fact, it is working poor families, it’s kids, it’s the disabled.” - Maura Daly, a Feeding America spokeswoman
Graph: The Atlantic, Republicans Try to Cut Food Stamps as 15% of U.S. Households Face Hunger http://www.theatlantic.com/business/archive/2013/09/republicans-try-to-cut-food-stamps-as-15-of-us-households-face-hunger/279465/
SNAP image: http://www.fooddemocracynow.org/blog/2012/jun/13/farm_bill_jackpot_how_much_do_corporations_benefit/On SNAP, WIC and EBT http://dcentric.wamu.org/2011/05/snap-wic-ebt-whats-the-difference/Image: Government Issued debit card http://www.nytimes.com/2013/09/05/us/as-debate-reopens-food-stamp-recipients-continue-to-squeeze.html?ref=opinion Image: We accept EBT http://www.republicreport.org/2012/how-big-corporations-cash-in-on-food-assistance-programs/Latest agricultural survey http://www.ers.usda.gov/publications/err-economic-research-report/err155.aspx#.UjGXej-5bcs
Fourteen and half per cent of US population faces chronic hunger according to the US Department of Agriculture’s latest survey.48 million people, nearly one in 7 people in America receive food stamps at a cost of $72 billion.
SNAP - Supplemental Nutritional Assistance program is the official name of food stamps.
WIC - The Special Supplemental Nutrition Program for Women, Infants, and Children
EBT – Electronic Benefits Transfer cards which resemble debit cards, so can be a more discreet way to use food vouchers.
Action for students: • Starved for attention The US standard and a Double
standard – Part I on WIC in US. Food Prescription Programme. ( million on nutrient-dense foods. Part II “Gift of the American People” - corn soy bean meal. http://www.starvedforattention.org/
• What is MSF calling for? Starved for Attention: What is MSF calling for? http://www.doctorswithoutborders.org/publications/reports/2008/Starved-For-Attention.pdf
• Critical view of US food aid - http://www.guardian.co.uk/global-development/2012/jul/18/corporate-agribusiness-us-food-aid
• Horn of Africa, Against Corn Soy Blend, Conflict in Kenya and Somalia MSF Why do we have to wait for a nutritional crisis http://www.starvedforattention.org/
Food aid (in-kind commodities rather than cash), has been misused to dump surplus production and promote donor country exports. Food aid for commercial purposes and national political interests can distort international trade and be destructive to the recipients country’s food security and economic development. It can hurt poor farmers in LDCs by pushing them to become importers for food products that could be locally grown.
Action for students: Why is food aid a trade issue? Why can food dumping (e.g., during the cold war) help donors more than recipients? Read “Food Aid or Hidden dumping?”http://www.oxfam.org/sites/www.oxfam.org/files/bp71_food_aid.pdf
Many countries successfully address malnutrition at home with strategies that target the most vulnerable and make sure they have access to nutrient-dense foods, but send CSB abroad.
In the interventions in nutritional emergencies, MSF, World Food Programme and other key food players use supplementary foods that meet the nutritional needs of children as the cornerstone.
It has been established that most food aid today does not provide appropriate nutrition to young children, and yet the global food aid system largely continues to provide substandard foods to millions of malnourished children every yearSource: MSF “Food Aid System continues to fail malnourished children” http://www.msf.org/article/food-aid-system-continues-fail-malnourished-children
Double standard“There is not enough emphasis on the types of foods included in aid
deliveries, inother words, the quality of food. Most current food aid programs for
developingcountries rely almost exclusively on fortified cereals made of corn and
soy blend(CSB), which may relieve a young child’s hunger, but do not provide proper nourishment.
The US is the world’s largest food aid donor. It produces and ships hundreds of
thousands of tons of CSB and other fortified blended flours for use in nutrition
programs throughout the developing world, even though these foods are recognized
as nutritionally substandard for infants and young children.
CSB and other flours are not promoted in the US Special Supplemental Nutrition
Program for Women, Infants, and Children (WIC) nutrition safety net program in
the US, which provides vouchers to low-income young mothers for the purchase
of nutritious foods like milk, fruits, eggs, etc…
The United States is sending food overseas to children [food with little nutritional value ] that it would not feed to its own citizens. This double standard needs to end.” (Starved for attention, http://www.starvedforattention.org/_inc/en/press/Malnutrition-Fact-Sheet.pdf)
Problems with food aid
Action for students:In pairs, discuss US food in light of the points below. Research US policy and food aid today. Are there any changes?
• “It is a donor-driven system• It promotes domestic interests of donor
countries• It is a foreign policy tool• International institutions are driven by
exporters• Development is not necessarily the objective”
Establishing food as a legal right, the scheme plans to subsidise food for two-thirds of the Indian population. It aims to provide grain to 800 million poor people every month.
Source: WSJ “Food Bill – Contours of debate” http://www.livemint.com/r/LiveMint/Period1/2013/08/22/Photos/g_food-security_web.jpgHindustan Times “Sonia's ambitious food bill wins LS vote; UPA gets its 'game-changer‘”http://www.hindustantimes.com/India-news/NewDelhi/Sonia-s-ambitious-food-bill-wins-LS-vote-UPA-gets-its-game-changer/Article1-1113348.aspx
The right to food, to increase food security is not a new idea and appears in
many international treaties. It is accepted as a framework for global action.
Article 25 of the Universal Declaration of Human Rights, which all United
Nations member states adopted in 1948, lists the right to food among a state’s obligation: "Everyone has the right to a standard of living
adequate for the health and well-being of himself and his family, including food."
India has one of the worst track records in terms of childhood malnutrition, chronic hunger and deprivation in the world, which are even higher than countries with lower economic development.
In the Indian Constitution, Article 21 of the Indian Constitution about a fundamental right to life and personal liberty provides the right to food, as repeatedly interpreted by the Supreme Court. Article 47 holds the Indian state accountable to raise the standard of nutrition of its people.
India has implemented some of the biggest food security schemes in the world during the post-independence decades.
Biraj Patnaik, “The Right to Food” http://infochangeindia.org/agenda/hunger-a-food-security/the-right-to-food.html
The programmes broadly fall into four categories:• “Entitlement feeding (Integrated Child Development Services [ICDS],
Mid-Day Meal Scheme [MDMS])• Food subsidy programmes (targeted Public Distribution System [PDS]
including Antyodaya and Annapurna Yojana)• Employment programmes (National Rural Employment Guarantee Act
[NREGA], Sampoorna Grameen Rozgar Yojana, National Food for Work Programme, Rashtriya Sam Vikas Yojana)
• Social security programmes (National Maternity Benefit Scheme, National Old Age Pension Scheme and National Family Benefit Scheme).”
Photo: Angel Navarrete
Food Security Programmes
While preventing large-scale famines such as Bengal 1943, the programmes “have been
unable to substantively address the problem of chronic hunger. This is not only because of gaps
in implementation, but also because...they do not provide for sustainable andlasting livelihood options....
Concerted efforts have been lacking,(except in a few states ,for example, West Bengal,) to undertake land reforms, give communities rights over natural resources, and address the structural causes of poverty caste and gender discrimination have also been major contributing factors.
On the contrary, the last two decades have witnessed: • an unprecedented alienation of indigenous people and other marginalised
communities from their land and other natural resources; • displacement due to industrial projects and large dams in rural areas; and • fundamental changes in the nature of poverty with unbridled
urbanisation and the disenfranchisement of large sections of urban populations. • global pressures on the Indian economy and the pursuit of deflationary, neo-
liberal policies by successive governments from the early 1990s have abetted in this pauperisation of millions of Indians.”
Biraj Patnaik, “The Right to Food” http://infochangeindia.org/agenda/hunger-a-food-security/the-right-to-food.html
India Right to Food
Action for students: Write a brief report to explain India’s right to food campaign and increasing political will over the last 10 years to address key issues (e.g., access) and objectives. Include lessons India can learn from other countries’ political commitment and convergence. 1. Biraj Patnaik, Principal Advisor Commissioner to India's Supreme
Court MSF Starved for Attention 2008 Preliminary Address http://www.youtube.com/watch?v=An9tNdGaITA
Article on “How to tackle India’s Hunger” http://rtfckarnataka.blogspot.co.uk/2009/07/article-how-to-tackle-indias-hunger-by.html
FAO on work in Brazil, Guatemala, India, Mozambique and Uganda http://www.fao.org/docrep/014/i2250e/i2250e00.htm
3. Clip on the Bihar school lunch poisoning in 2013. What are the risks and what are the controls which should be in place to provide food on this scale? http://online.wsj.com/news/articles/SB10001424052702303448104579149293661052578
Medecins Sans Frontieres is addressing India's unique nutrition issues through mobile clinics, ambulatory therapeutic feeding centres (ATFC’s) and a special emergency clinic to reduce the morbidity and mortality due to severe acute malnutrition (SAM).Photo: Stephanie Sinclair
Bihar State, IndiaAction for students: 1. Watch the Starved for Attention clip on
malnutrition in Bihar State, India. Discuss why has the status quo existed for many generations.http://www.msf.org.uk/starved-attention-retell-story
Bihar is one of the poorest states in India and there are high levels of malnutrition in children aged between six months and five years. In Darbhanga district, MSF operates an inpatient therapeutic feeding centre for children in a critical condition, and several outpatient centres, where those with severe malnutrition come for weekly medical check-ups and receive therapeutic food.
Action for students: Read the articles or research your own on the right to
food debate in India to identify and record the objectives and issues (e.g., corruption) with the bill.• “Food rights and welfare squeezes: how do we free people from
• ”Is India’s food security bill the magic pill?” http://www.bbc.co.uk/news/world-asia-india-23159706
• “In Business – Can India Afford the Food Security Bill?” http://www.youtube.com/watch?v=UnIU0yzOzMY
“India cabinet approves food security bill March 2013”http://www.bbc.co.uk/news/world-asia-india-21840572
• “India upper house passes cheap food plan” http://www.bbc.co.uk/news/world-asia-india-23940298
• Hindustan Times “Sonia's ambitious food bill wins LS vote; UPA gets its 'game-changer‘”http://www.hindustantimes.com/India-news/NewDelhi/Sonia-s-ambitious-food-bill-wins-LS-vote-UPA-gets-its-game-changer/Article1-1113348.aspx
Bangladesh case study. MDG 1: 50% reduction in undernourishment achieved and likely same for underweight; MDG 4 (child mortality) achieved. MDG 5 (maternal health) on track to achieve (SUN 2011)
Progress towards MDGs
Graph: Progress towards meeting the MDG target across regions http://www.fao.org/publications/sofi/en/; http://scalingupnutrition.org/wp-content/uploads/pdf/SUN_Framework.pdf
MDGs cannot be reached without paying urgent attention to nutrition and its determinants.
According to the ONE organisation report on accountability of donors to the l’Aquila pledges, only 22% have been met. And most are not on track to meet them within their pledge period.
motive Role in sustaining life of the margins Examples
Individuals e.g. Farmers
Survival/ profit
Direct producers of food Communities harbour stores of valuable local knowledge, coping strategies and
innovation Their co-operation is critical to ensure environmental sustainability
Fair Trade, substance farming, organic farming
Government
Stability
Funding for agricultural research and development (R & D) Creating political and economic conditions creating stability of food supply Response during times of crisis.
Often techno centric large scale projects e.g. China’s Great Green Wall, or UK overseas aid projects
TNCs
Profit
Research and investment into new farming methods and technologies Resource exploitation and trade in cash crops, fertilizers and farm machinery
for profit
GM Golden Rice Agro-biotech corporations such as
Monsanto (subsidiary of Pharmacia), Syngenta (merger between AstraZeneca and Novartis), Aventis, Dupont and Dow.
NGOs and Foundations
-Philanthropic
Community level support for farmers in the developing world Education, training and skills providers Many promote social equity, for instance female empowerment
Practical Action ,Water Aid Emergency aid eg Medecins Sans
Frontieres The International Alliance Against
Hunger
Research Organisations
Academic
Scientific research on new species and systems Education and skills training of farmers
The development of HYVs by IRRI AGRAs work on a ‘Green Revolution
of Africa’
IGOs
Eg UNEP & FAO
Stability
Promote international co-operation Implementation of global actions such as MDGs Monitoring and research to identify problems and seek solutions Development assistance and aid to the developing world
World Bank’s Global Response Food Programme
1994 UN Convention on Desertification
Watchdog pressure groups
Environment
Research and information gathering and Lobbying of agencies World Resources Institute USA Coalition Food SUSTAIN
MSF: Contact us or find out more
Visit our website: www.msf.org.ukAbout MSF: http://www.msf.org.uk/about.aspxEmail us: [email protected] us on facebook: www.facebook.com/MSF.englishFollow us on Twitter: www.twitter.com/MSF_UKFollow us on You tube: www.youtube.com/user/MSFUK
The MSF movement was awarded the 1999 Nobel Peace Prize.