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Food and nutrition security:
why food production matters

FOOD SECURITY AND NUTRITION IN THE LAST 50 YEARS

The years 1945 to 1952 saw Europe struggling to restore pre-war food production, consumption and security. Even in the mid-1960s, former levels still had not been reattained in Asia - rightly seen as the highest-risk area, where chronic undernourishment left people extremely vulnerable. Between 23 million and 30 million lives were lost in the Chinese famine of 1960-1962. In 1965 and 1966, famine was barely avoided in South Asia. More than 75 percent of Asians (and probably 90 percent of undernourishment victims) depended on food production for their income.

Then, in much of the world came rapid growth, green revolutions, land reform and poverty reduction. The proportion of chronically underfed persons fell in developing countries from 36 percent in 1970 to 20 percent in 1990. The proportion of underweight children under five years of age fell globally from 42 percent in 1975 to about 32 percent in the late 1990s. The reduction in undernutrition was rapid in East Asia, substantial in South Asia and Latin America but very slight in Africa, and it recently reversed in the republics of the former USSR. In these last two regions, related death rates are rising. Moreover, globally, progress in combating poverty and undernutrition was slower between 1987 and 2000 than between 1970 and 1985, corresponding to slowdowns in the yield growth of food staples, in land redistribution and, hence, in rural employment. Despite past progress, during the 1990s one in five people in developing countries ate less than the caloric minima for metabolic, work and other functions. Worldwide, there are still more than 150 million children under five who are underweight; more than 200 million - more than one in four - are stunted. These conditions appear to be implicated in about half of the 12 million deaths annually of children under five and, for some of the more damaged survivors, in physical and even mental retardation.

Notwithstanding the slowdown in the progress against poverty and undernutrition, governments were increasingly given credit for such a large fall in food insecurity. At the national level, overt colonialism retreated massively twice, between 1947 and 1965 and in the early 1990s, leaving the state formally accountable to its own nationals. In both periods, many countries (not only former colonies) moved towards democracy. Moreover, national populations were becoming more organized in effective "civil societies" with more literacy, information, communication and power to put pressure on their governments for adequate food access. At the international level, food security was advanced by parallel changes in institutions and public awareness. Institutionally, the process began when the 1943 Hot Springs Conference (in part responding to President Roosevelt's 1941 designation of "freedom from want" as a human right) wrote the blueprint for FAO. For the rest of the century, international agencies obtained money and support, from taxpayers of almost all nations, to underpin major components of food and nutrition security.

At the 1943 Hot Springs Conference, which set the blueprint for FAO, countries accepted responsibility for ensuring food and nutrition security.

IFAD, with a mandate to emphasize nutrition and food production for the poorest, was the harbinger of a growing focus on poverty as the main cause of food insecurity. In 1973, the World Bank began to express its increasing concern about the impact of poverty; but in the 1980s the focus shifted to country lending strategies. These initially emphasized stabilization but, increasingly in the 1990s, poverty impact also. The current World Bank President, James Wolfensohn, asks that the Bank be judged by its impact on poverty. Despite small (but significant) lending for nutrition as such, the Bank's approach implies that poverty reduction, together with increased agricultural output, is the main route to food and nutrition security. Yet the share of Bank lending (and of total aid) going to agriculture has fallen since the early 1980s, as have yield growth in food staples and the speed of poverty reduction and improvement in household food security.

A series of international conferences, most notably the World Food Conference of 1974, clarified the issues but led to sarcasm about "resolutions without resolution". Yet, in 1996, the Copenhagen World Summit for Social Development (the Social Summit) and the Rome World Food Summit culminated in targets to halve world poverty and undernutrition by 2015, and the Organisation for Economic Co-operation and Development (OECD) has supported moves to make this target country-specific, monitored and backed by aid.

The targets for reducing poverty and food insecurity can be met. In East Asia the number of food-insecure fell faster between 1970 and 1985, owing in part to fertility transitions and bringing sharp falls in child-adult ratios as well as a rising ratio of workers to dependants (see the section Demographic transitions and food security, p. 203). Even larger shifts are now under way in Africa and South Asia. Can these heartlands of poverty and food insecurity expel them through this demographic "window of opportunity"?

Increased food production is necessary but not sufficient to improve food security - entitlements must also grow.

Past and current trends and issues: implications for the early 2000s

Postwar experience suggests that, for rapid falls in undernutrition to continue in the low-income African and Asian countries where it remains worst, yield growth in main food staples will need to recover to the 3 percent level achieved in the 1970s - in the 1990s, as in 1950-65, it was barely 1 percent per year in developing countries. Growth in yields will also need to spread to some of the neglected staple crops and poorly watered lands, especially in Africa, that were bypassed by the green revolution. However, in real terms, funding for public agricultural research has been stagnant in international centres since the mid-1980s and has fallen in Africa and Latin America. Threatened water scarcities and the overfarming of marginal lands, although sometimes seen as reasons for not aiming at higher yields of food staples, are partly due to inadequate funds for research.

In the 1940s and 1950s, the founders of FAO saw such needs clearly. So, in the 1960s, did the creators of the green revolution. Such production-oriented approaches are not sufficient to improve food security and health environments, but they are necessary.

Since 1945, the following global trends affecting food security and nutrition have emerged:

Consequently, attention is increasingly focused on the food-health-nutrient-activity balance and safety, involving micronutrients as well as calories; health (including bioabsorption and biodiversion), work and child care as well as food intake; and overnutrition as well as undernutrition.

Linked to the above, staples production for local employment and consumption has been downgraded since the early 1980s. This is also due to expanding European and Asian staples output and yields; falling real prices of staples; environmental concerns; failure to appreciate that many low-income people require extra staples production to obtain employment-based entitlements to food staples; and reliance on comparative advantages and trade options to permit a "switch" to cutting undernutrition mainly by non-food employment. Growth in such employment opportunities has seldom been substantial or nationwide until late in the development stage, even in East and Southeast Asia.

Staples yield growth, which was 3 percent per year in the developing world in the 1970s, fell to just above 1 percent in the 1990s. The need to raise yields, and thereby staples-related employment and entitlements, in poor areas will increase as workforces grow by 2 to 2.5 percent per year in much of Asia and Africa up to 2025.

The yield potential for tropical and subtropical staples surged for maize in the 1950s, and for rice and wheat in the 1960s, but has subsequently slowed down. In most countries with widespread undernutrition, contrary to general belief, rapid progress in food staples production implies renewal of growth in yield potential. The shift from states and international public action towards markets must be modified in at least one key area, biotechnology, if research is to be reoriented to the still pressing requirements for reduced undernutrition.

Three themes underly the trends described above:

i) The end of the dichotomy between "productionist" and "distributivist" approaches to individual food security - between failures of "food availability" and "food entitlements" as causes of famine (and chronic hunger). For most of the undernourished, extra employment income from local staples production has been the key to enhanced food entitlements in the period from 1950 to 2000, as discussed below. This will remain so until 2025, given the continued rapid growth of workforces and the need to restrain and stabilize local staples prices. Such employment is generated as a result of higher yields of food staples and better access to land, credit and institutions. The slowdown in food staples yield growth since the 1970s, and in its employment impact, offers new challenges. The experience of the green revolution shows how to address them in ways that enhance food entitlements and household food security. So far, however, the promising new tools of biotechnology have not been applied for the purpose of raising staples yields for poor smallholders.

ii) Increased policy focus on nutrition security (see the section From energy adequacy to nutrition security, p. 231) in response to new knowledge and new problems and in recognition of the fact that nutrition encompasses aspects such as nutritional quality and balance, food safety and physical activities that prevent obesity.

iii) The need for people and organizations wishing to improve food and nutrition security to respond correctly to changes in the role of the state vis-à-vis markets. This theme includes the joint action of these groups towards, and possible biases against, weaker or less politically active groups at special nutritional risk (e.g. rural or remote groups, children, females, minorities and refugees). The role of states and markets is crucial in determining whether such groups gain income, access to food and information to permit nutrition security. Many opponents of "free" or globalized markets fear that, as a result of perverse interactions between states and monopoly-like corporations, such markets do not help, and may harm, some of these vulnerable groups in their progress towards nutrition security. Even though competition can make some poor groups poorer still, there is much evidence to suggest that countries that liberalize their markets are generally those that are most likely to raise incomes, and this tends to reduce poverty faster.

FOOD SECURITY AS ENERGY ADEQUACY

For most of the world's poor, "food security" is knowing that future meals will provide enough dietary energy to meet their requirements. Box 18 reviews the concepts of food adequacy and security that are used in the text.

THE FRAMING CONDITIONS: PEOPLE, FOOD AND ENTITLEMENTS

Demographic transitions and food security

The past 50 years have seen an astonishing demographic transformation. Population growth accelerated between 1940 and 1960 in Asia and Latin America, and ten years later in Africa. The really massive improvement was among children under five, which raised the ratio of children to adults. Some 10 to 20 years later, the age groups that had been saved from child death increasingly entered the workforce, and parents, now more confident that their children would survive, began to reduce their fertility rates. As population growth slowed down, the ratio of adults - savers and workers - to children began to climb steeply.

Just as the early phase of demographic transition, with its rapid growth in child numbers, had harmed economic growth, income distribution and, hence, the reduction of poverty and PEM, so the later stage - with children reaching working age, and fertility falling - helped all these factors. The effects on food security are considerable. Directly, smaller families are less likely to be poor and, given their poverty level, less likely to suffer PEM. Indirectly, about one third of East Asia's growth in real income per person from 1965 to 1992 can be accounted for by rising adult-child ratios; across more than 50 developing and transitional countries for which adequate poverty data are available, the poverty-reducing impact of lower fertility rates is about as strong via better income distribution as via faster economic growth.1

Box 18

FOOD ADEQUACY, FOOD SECURITY AND PROTEIN-ENERGY MALNUTRITION

Individual food adequacy (IFA) is shown, in the short term, by calorie intakes that are sufficient for needs, varying with age, health, work and adult height; in the medium term, by the absence of acute protein-energy malnutrition (PEM),1 for example low child weight for age (WA) or low adult weight for height (WH)); and in the long term by the absence of chronic PEM in children under five, of low height for age (HA). Inadequate HA (stunting), WA (underweight) or WH (wasting) are often equated with shortfalls of more than two standard deviations below the United States median (>2 SD).

Individual food security (IFS) refers to "access to adequate safe and nutritious food to maintain a healthy life ... without undue risk of losing such access"2, i.e. IFA as well as the confidence that it can be maintained. Without such confidence, people take hypercautious decisions that forfeit their chances to escape from chronic hunger.

A poor person usually obtains 70 to 80 percent of his or her calories (and most other nutritional requirements) from one or two of the world's seven main food staples. These are by far the cheapest sources of energy, and of most other nutrients. For the poor, access to these staples is the key to achieving IFS.

Household food adequacy/security (HFA/HFS) is necessary for IFA/IFS, but not sufficient, because food may be distributed among household members disproportionately to their individual needs.

National food security (NFS) refers to a nation's capacity to ensure HFS/IFS without undue departure from other policy goals. NFS in a given year is often measured by: dietary energy supplies (DES) per person, allowing for the distribution of food and needs among individuals and times; or the ratio of food imports to total exports, although food aid must be allowed for; or staples stocks (publicly controlled or likely to be marketed if prices rise) as a share of normal consumption.

1 The proximate cause of PEM appears to be energy deficiency relative to requirements and infection burdens. Although protein deficiency causes widespread and serious damage, most nutritionists now reject the earlier view that protein deficiency, let alone specific amino acid deficiency, is an independent problem requiring special protein-rich foods, supplements or cereal varieties. Only exceptionally is a protein problem not curable simply by providing "more calories".
2
FAO. 1996. The Sixth World Food Survey. Rome.

The "demographic gift" of an increased worker-dependant ratio may help sub-Saharan Africa and South Asia to reduce food insecurity, as occurred earlier in East Asia.

The heartlands of world poverty, South Asia and sub-Saharan Africa, have entered their fertility transition and will face a very rapid rise in their ratios of workers and savers to dependants in the next two decades. For example, in Kenya, on the UN "medium variant" projection, the ratio of prime-age adults - the main workers and savers - to children under 15 years of age will rise from only 1:24 in 2000 to 1:87 in 2020. Will this "demographic gift" sharply cut poverty and, hence, PEM in Africa and South Asia - as it did in East Asia? This depends on whether extra workplaces offering rising incomes become attractive for the growing workforce and their employers - as was the case in East Asia - and whether extra investment opportunities, with a high impact on growth and poverty, attract the new savers. In East Asia this was achieved through a first phase of growth in staples yields and employment as a result of the green revolution between the mid-1960s and late 1980s; those countries that successfully continued the struggle to reduce poverty and malnutrition then moved into a second phase of rising non-farm employment, both urban and rural.

Sharp rises in adult-child ratios and thus in worker-dependant ratios and in savings, which were experienced in South Asia and Africa, are a "window of opportunity" for these regions to slash remaining poverty and PEM, as was done in East Asia. It has been proved that farm intensification through methods suited to local conditions can achieve similar results on a sustainable basis in large parts of South Asia and Africa. But the window is now curtained by threats to the growth in yields of, and employment-based entitlements to, main food staples and, in some cases, by severe land inequality.

FAO/20729/A.Proto

Rural poverty in Honduras Poverty does not completely
explain undernourishment - FAO/20729/A. Proto

Poverty and entitlements to food

Hunger, not just famine, mainly afflicts people who have insufficient "food entitlements".2 As Sen emphasized, food production still matters: the poor rely on it for most of their food entitlements, whether based on small-scale farming or employment.

However, one would expect postwar improvement in food security to be associated with a substantial retreat of poverty (used here in the limited sense of "low real private consumption per equivalent adult"). Broadly speaking, this is correct. Poverty declined (and nourishment and DES improved) little in sub-Saharan Africa, in Latin America mainly in 1965-78, and in Asia mainly in 1975-90.3 Recent resurgences of poverty and undernourishment in the transitional countries are clearly linked.4

Yet, many poor households do not suffer undernourishment, owing to "positive deviance" in child care, low energy requirements or other behavioural adaptations. Many non-poor households, for opposite reasons, do suffer undernourishment. And, although the poorest show much higher responsiveness of calorie intake to extra income than others, the short-term responsiveness of the average household, even in quite poor communities, is often rather slight; poverty does not completely explain current household caloric inadequacy or PEM.

Nevertheless, poverty - and its main proximate cause, inadequacy of income from paid or self-employment and, hence, inadequacy of food entitlements - substantially "explains" long-term group undernourishment risk. Among and within countries, differences in the decline in poverty help to predict the improvements in both caloric underfeeding and anthropometric undernutrition. For several reasons, the relationship between poverty reduction and increased DES is imperfect:

However, these and other qualifications do not negate the strong causation between poverty and DES shortfall, food insecurity and PEM.

Self-sufficiency in staples is not an indication of national food security.

ENERGY ADEQUACY AND INADEQUACY: LEVELS AND TRENDS

Self-sufficiency in food staples and national food security

National food security (see Box 19) may be sought by increasing national staples self-sufficiency (NSSS), capacity to pay for staples imports, or stocks. A country's NSSS trends do not reveal trends in food security, although they help our understanding of its causes:

Box 19

NATIONAL STAPLES SELF-SUFFICIENCY: IS IT GOOD FOR FOOD SECURITY?

National staples self-sufficiency (NSSS) may or may not advance food security. India has attained NSSS, yet mass malnutrition remains. Indeed, NSSS in India is due not only to the green revolution's success in raising yields and output of rice and wheat, but also to persistent (albeit declining) poverty: staples output is "sufficient" for NSSS partly because the poor cannot afford adequate staples, i.e. they lack household food security (HFS).

As they develop, many countries shift production away from food staples, instead exploiting comparative advantages by increasing cash crop and/or industrial production, which is exported to buy more food. If these exports - as in Malaysia - raise employment incomes for the poor, the loss of NSSS can improve HFS. In Latin America and the Caribbean, staples imports rose from 0.9 percent of world food staples trade in 1962-70, to 5.7 percent in 1989-97, alongside big advances in nutrition. However, the rise during the same period in sub-Saharan Africa, from 2.7 to 4.7 percent, is less benign, since few countries achieved much expansion in non-staples employment or exports or, respectively, private or national capacity to buy staples imports.

Successful development usually involves two stages as regards NSSS. Stage one shows falling net staples imports as domestic staples production expands and is absorbed by people whose nutrition is thereby improved. Stage two shows rising net staples imports as later development shifts workers out of agriculture and then shifts food consumption, as consumers become better fed and less poor, towards animal products - which require two to six times more grain per 1 000 human calories than direct cereals or bread consumption. The Far East's staples deficit as a share of world staples trade fell in stage one from 8.4 percent in 1962-70, to 4.7 percent in 1983-88. It then rose in stage two to 10.3 percent in 1995-97. Both stages saw big falls in PEM.

Can a greater degree of NSSS help HFS cost-effectively, given its comparative advantage in:

  • appropriate agro-ecologies;

  • early development, where poverty reduction depends mainly on affordable rural workplaces; and

  • countries or remote areas facing high risks or food transport costs?

A second indicator of NFS is the ratio of food imports to total exports. Given sufficient political will and functioning market and transport systems, countries with low ratios can respond adequately to poor harvests or sharp rises in food import prices. In 1988-90, 11 countries in Africa (including Ethiopia, Egypt and Mozambique) had food imports-total exports ratios of above 55 percent - levels that were seen elsewhere in the developing world only in Haiti, Samoa and Yemen. Such countries tend to rely heavily on food aid. Table 10 tracks an even more relevant ratio, that of imports minus exports of food staples to non-staples exports, for some large countries.

Table 10

STAPLES IMBALANCES

 

1961-63

1965-67

1975-77

(Million $)

1985-87

1995-97

Brazil

1. Net staples imports

2. Non-staples exports

3. 1 as a percentage of 2



168.5

1 323.8

12.7



138.7

1 613.8

8.6



310.0

10 101.5

3.1



770.2

21 752.4

3.5



1 933.1

33 079.7

5.8

China

1. Net staples imports

2. Non-staples exports

3. 1 as a percentage of 2



330.3

1 467.5

22.9



245.9

2 036.1

12.1



260.4

6 721.7

3.8



360.9

32 556.4

1.1



1 601.4

160 073.2

1.0

India

1. Net staples imports

2. Non-staples exports

3. 1 as a percentage of 2



367.0

1 466.5

25.0



797.7

1 659.1

48.1



1 019.3

5 301.1

19.2



-175.3

9 862.0

-1.8



-1 162.9

32 041.0

-3.6

Indonesia

1. Net staples imports

2. Non-staples exports

3. 1 as a percentage of 2



123.3

720.5

17.1



68.3

681.6

10.0



555.0

8 828.9

6.3



258.6

18 380.9

1.4



1 609.7

49 525.0

3.2

Kenya

1. Net staples imports

2. Non-staples exports

3. 1 as a percentage of 2



-1.0

169.6

-0.6



-1.3

234.7

-0.6



-4.9

810.5

-0.6



+17.1

1 041.9

1.6



112.4

2 074.3

5.4

Mexico

1. Net staples imports

2. Non-staples exports

3. 1 as a percentage of 2



19.6

840.9

2.3



74.6

1 036.7

7.2



329.4

3 382.2

9.7



434.0

20 332.7

2.1



1 397.2

57 340.6

2.4

Nigeria

1. Net staples imports

2. Non-staples exports

3. 1 as a percentage of 2



18.6

496.3

3.7



21.0

741.1

2.8



296.5

10 102.1

2.9



378.5

9 045.4

4.2



422.0

16 246.5

2.6

Sudan

1. Net staples imports

2. Non-staples exports

3. 1 as a percentage of 2



10.4

199.6

5.2



9.6

200.4

4.8



10.7

538.6

2.1



1 308.3

383.5

34.1



1 092.0

554.1

19.7

Former USSR

1. Net staples imports

2. Non-staples exports

3. 1 as a percentage of 2



-378.3

6 263.7

-6.0



69.3

8 444.8

0.8



2 138.0

37 943.5

5.6



3 612.0

96 580.4

3.8



1 906.7*

64 766.5*

3.0*

* 1995 only.
Source: FAO.

This indicator gives a rather better guide to NFS than self-sufficiency. It does suggest the precarious food security situation in China in the early 1960s, in India when landless labourers' employment income was slashed by the successive disastrous monsoons of 1965 and 1966, and in the Sudan during episodes of civil war. However, the ratio must be used with care. Net staples imports can fall, not only because domestic supply is rising, but because people are becoming poorer and less able to afford sufficient staples. A rise in non-staples exports, as with petroleum in Nigeria, the former USSR and Indonesia, may do surprisingly little to improve staples availability via imports. If such export income accrues largely to owners of capital and/or governments who receive royalties but have other priorities than food security, little employment income is created for the poor and the income will not be used to buy food staples.

The ratio of stocks in public hands to normal consumption is also an indication of a country's NFS. In years of dearth, states can undertake large releases of staples. This helps the poor by suppressing the rise in prices. It also encourages the timely release of traders' hoards when prices start to rise; public capacity to act in this way in Bangladesh in 1984, but not in 1974, probably made the difference between famine and non-famine.6

Underfeeding: potential and actual DES

For the First and Second World Food Surveys,7 FAO had measured potential underfeeding by setting national and regional mean daily "dietary energy supplies" (DES) per person against average requirements. Since the Third and, especially, the Fourth World Food Surveys, estimates of distribution of supplies were also taken into account. Supply estimates often depend on questionable output data, and requirements are controversial. However, sharp trends and major turning points in DES are usually significant, relating strongly to PEM outcomes and, hence, to HFS. Table 11, p. 212, provides summary DES data for a longer period.

Before 1939, "in areas containing over half the world's population, food supplies at the retail level [provided] less than 2 250 calories per caput daily.... Average total calorie supplies were around 2 000 or less in many large countries...".8 Europe recovered rapidly from wartime shortages but the proportion of the world's people in countries with DES below 2 200 kcal per day rose from about 40 percent just before the Second World War to about 60 percent in the late 1940s. "Over most of the Far East, where nearly one half of the world's population is concentrated, the declines [in DES] were about 10 percent." Average DES soon after the Second World War was 24 percent below requirements in India, 21 percent in French North Africa and 18 percent in Mexico. 9 Work effort, and to some extent basal metabolic rate and body size, "adapted" to such low intakes or requirements, fell but such adaptation was often harmful, resulting in widespread mortality, illness and mental and physical underperformance.

Table 11

PER CAPUT DES IN SELECTED AREAS AND COUNTRIES, 1934-1997

 

1934-381

1946-492

1961-63

1976-78

1988-90

1995-97

 

 

 

(kcal/day)

 

 

Africa

 

 

2 100

2 220

2 320

2 415

Sub-Saharan

 

 

2 040

2 060

2 080

2 190

Central3

2 060

2 080

2 150

2 150

2 050

2 080

East

 

 

1 980

2 040

1 960

2 010

West

 

 

2 090

2 030

2 200

2 400

Ghana

 

 

2 020

2 020

2 090

2 620

Uganda

 

2 100

2 240

2 250

2 170

 

Kenya

2 2304

 

2 130

2 260

1 950

1 980

Mozambique

 

 

1 950

1 950

1 830

1 780

Nigeria

 

 

2 160

1 970

2 190

2 750

Asia

 

 

1 920

2 170

2 520

2 660

South

1 970

1 770

2 020

2 040

2 270

2 350

Bangladesh

 

 

2 090

2 040

2 050

2 080

Cambodia

1 8505

1 560

2 020

1 620

1 920

2 050

China

2 230

2 030

1 710

2 120

2 640

2 840

India

1 9706

1 700

2 040

2 040

2 290

2 470

Latin America/Caribbean

 

 

2 340

2 600

2 710

2 770

Central America

 

 

2 390

2 720

2 910

2 924

South America

 

 

2 350

2 570

2 650

2 790

Brazil

2 150

2 340

2 250

2 550

2 760

2 930

Mexico

1 800

2 050

2 530

2 880

3 080

3 110

Peru

1 860

1 920

2 170

2 120

2 120

2 360

Transitional countries

 

 

3 150

3 410

3 380

2 780

Eastern Europe

3 160

3 470

3 420

2 950

 

 

Developing countries

 

 

1 960

2 200

2 490

2 627

Developed countries

 

 

2 970

3 190

3 300

3 220

1 1931-37 for China; 1935-39 for Brazil.
2 1949-50 for India and China.
3 Central and Tropical for 1934-38 and 1946-49.
4 Includes Uganda.
5 French Indochina.
6 Includes Pakistan.

Note: For this table, three-year averages were estimated from 1961-63 to 1995-97. Periods were chosen after 1961-63 to correspond to apparent "periods of change" in DES trends for several regions. FAO data are based on food balance sheets, i.e. they depend on the reliability of food production data which, for smallholder root crops and cereals in sub-Saharan Africa, are known to be weak. Small changes in short periods should be ignored. All data are rounded.

Sources: FAOSTAT; FAO. 1946. The First World Food Survey. Washington, DC; FAO. 1953. The Second World Food Survey. Rome.

Table 11 suggests that DES in China, India and Kenya had, even by 1976-78, no more than recovered to the inadequate 1934-38 level, although DES in Latin America had improved sharply. The set of three-year averages confirms that 1976-78 was a turning point. India, China and some other Asian countries shifted from no change to rapid improvements in DES. In Central and East Africa, DES shifted from stagnation to steady decline. Interestingly, DES in West Africa showed no trend between 1961-63 (2 090 kcal) and 1982-84 (1 990 kcal), but then rose steadily to 2 400 kcal in 1995-97.

DES per caput in Asia and West Africa is now about 20 percent higher than in the mid-1970s, and in Latin America (from a much higher base) about 7 percent higher. In the same period, in East and Central Africa, DES appears to have fallen slightly by about 2 to 3 percent from already low levels. However, these DES estimates show that the national potential to reduce underfeeding has risen fast and far for the vast majority of inhabitants of at-risk countries - dramatically so in East Asia and Latin America. The fact that potential improvements in underfeeding (increases in average daily DES based on food balance sheets) do translate into actual improvements in the proportions of underfed people can be shown in two ways:

Box 20

CALORIC AND ANTHROPOMETRIC UNDERNUTRITION BY REGION

Region

Years

Undernourished population

 

 

Caloric1

Anthropometric status of children under five years

 

 

Population below 1.54 BMR

Wasted2

Stunted2

Underweight3

   

(Millions)

(%)

(Millions)

(%)

(Millions)

(%)

(Millions)

(%)

All developing countries

1969-71

918

35

 

 

 

 

 

 

 

1979-81

906

28

 

 

 

 

164.0

37.8

 

1990-92

841

20

47.9

9.1

215.2

40.7

183.5

34.3

East and Southeast Asia4

1969-71

476

41

 

 

 

 

 

 

 

1979-81

379

27

 

 

 

 

22.8

39.1

 

1990-92

269

16

9.4

5.2

59.8

33.3

19.9

31.3

- China

1980

 

 

 

 

 

 

20.5

23.8

 

1990

 

 

 

 

 

 

23.6

21.8

South Asia

1969-71

238

33

 

 

 

 

 

 

 

1979-81

303

34

 

 

 

 

89.9

63.7

 

1990-92

255

22

26.6

17.1

92.7

59.5

101.2

58.5

Sub-Saharan Africa

1969-71

103

38

 

 

 

 

 

 

 

1979-81

148

41

 

 

 

 

19.9

28.9

 

1990-92

215

43

6.1

7

33.7

38.8

28.2

29.9

Near East and North Africa

1969-71

48

27

 

 

 

 

 

 

 

1979-81

27

12

 

 

 

 

 

17.2

 

1990-92

37

12

4.4

8.8

16

32.4

6.8

13.4

Latin America and Caribbean

1969-71

53

19

 

 

 

 

 

 

 

1979-81

48

14

 

 

 

 

 

 

 

1990-92

64

15

1.5

2.6

12.7

22.7

11.7

20.4

-Central America/Caribbean

1980

 

 

 

 

 

 

3.1

17.7

 

1990

 

 

 

 

 

 

3.0

15.4

- South America

1980

 

 

 

 

 

 

3.1

9.3

 

1990

 

 

 

 

 

 

2.8

7.7

Sources:

1 FAO. 1996. The Sixth World Food Survey, Rome. More recent estimates of numbers of undernourished can be found in FAO. 1999. The State of Food Insecurity in the World 1999. Rome.

2 FAO. 1996. The Sixth World Food Survey. Rome.

3 UN ACC/SCN. 1992. Second Report on the World Nutrition Situation, Vol. 1, p. 67. Washington, DC; 2020 projections from M. Rosegrant,
M. Agcaioli-Sombilla and D. Perez. 1995. Global food projections to 2020: implications for investment. Food, Agriculture and Environment Discussion Paper No. 5. Washington, DC, IFPRI.

4 Southeast Asia only for "underweight", as separate data are given for China.

Definitions:

BMR: Basal metabolic rate.

Wasted: Wasting is a measure of a child's weight for height in relation to the median value of the US (NCHS) reference population. The cutoff point used here is -2 SD from the median. The figures in the table indicate the prevalence of total wasting (moderate and severe).

Stunted: Stunting is a measure of a child's height for age in relation to the median value of a standard reference population. The cutoff point
is -2 SD from the median.

Underweight: Underweight is a measure of a child's weight for age in relation to the median value of a standard reference population. The cutoff point is -2 SD from the median.

(UNICEF. 1993. Child malnutrition: country profiles. New York.)

Higher food availability translates into reductions in undernourishment.

The recognized weakness of national food production estimates for most of Africa may suggest that estimates of mean DES in Africa are much too low - and, hence, the estimates of underfeeding, and implied lack of HFS, are much too high. But there is no evidence of a continentwide bias in that direction. Another explanation of the HFS discrepancy, which is borne out by mortality, famine prevalence and other evidence, is that smallness of body size, except at extremes, is less harmful in South Asia than in Africa. If this is so, South Asia's much more widespread smallness gives a less reliable guide to IFS than does Africa's much more widespread DES shortfall. In any case, countries and regions tend to show similar trends in stunting and DES (Box 20).

The huge improvement in DES, and also in PEM, is not a cause globally for easy optimism about food security. More than 800 million people are still seriously underfed in DES terms. Africa has not seen a secular improvement; and in the transitional economies, real DES may be declining. Above all, despite favourable signs in the heartlands of DES shortfall and of PEM (e.g. the spread of the fertility transition to Africa and the acceleration of growth in South Asia) the production and employment conditions for continuing rises in food entitlements may be fading, together with growth of employment and yields in food staples.

Table 12

DEVELOPING COUNTRY TRENDS IN PEM: PROPORTION OF CHILDREN UNDER FIVE WITH <2 SD BELOW US MEDIAN

UN region

Stunting

Underweight

Wasting

 

1980

1990

1995

2000

1980

1990

1995

2000

1995

Africa

Eastern

Northern

Western

40.5

46.5

32.7

36.2

37.8

47.3

26.5

35.5

36.5

47.7

23.3

35.2

35.2

48.1

20.2

34.9

26.2

24.9

17.5

30.1

27.3

30.4

15.6

33.3

27.9

33.2

14.8

34.9

28.5

35.9

14.0

36.5

9.6

7.0

7.2

15.6

Asia

South and Central

Southeast

52.2

60.8

52.4

43.3

52.2

42.6

38.8

48.0

37.7

34.4

43.7

32.8

43.9

58.1

43.5

36.5

50.9

39.9

32.8

47.3

32.6

29.0

43.6

28.9

10.4

15.4

10.4

Latin America/ Caribbean

Caribbean

Central America

South America

25.6

27.1

26.1

25.1

19.1

21.7

25.0

17.2

15.8

19.0

24.5

13.2

12.6

16.3

24.0

9.3

14.2

22.9

15.1

13.2

10.2

17.2

15.2

8.2

8.3

14.4

15.3

5.7

6.3

11.5

15.4

3.2

2.9

n.a.

4.9

1.8

DEVELOPING COUNTRIES

47.1

39.8

36.0

32.5

37.4

32.1

29.2

26.7

9.4

Sources: ACC/SCN. 2000. Fourth Report on the World Nutrition Situation. Geneva; and WHO Global Database on Child Growth, 1990.

Household food security against PEM

The incidence of child PEM, measured as weight for height (wasting), height for age (stunting) or weight for age (underweight) is still shockingly high, even though it is falling. About 36 percent of children under five in the developing world - 197 million - were stunted in 1995, 29 percent were underweight and 9 percent were wasted, a condition that usually leads to hospitalization in rich countries. PEM is associated with the deaths of some 6 million children each year, and with persistence into adulthood of incomplete mental development, reduced physical work capacity and damaged immune response for many millions more.

FAO/11231/Y.MULLR

Food insecurity as a result of natural disasters
A malnourished child is dwarfed by a ruined cereal crop
in the Navrongo district of the Gambia, where two thirds of
the crops were destroyed by drought

- FAO/11231/Y. MULLER

In terms of measurement, it is less problematic to assess PEM trends than levels. Table 12 shows a slow but consistent improvement in PEM indicators and, hence, in individual food adequacy outside sub-Saharan Africa. The pattern is confirmed by national surveys of children under five for stunting for 1980-199511 and low weight for age for 1976-1995.12

If we could compare all the 50-year periods in human history, 1950-2000 would almost certainly win first prize for speed, scale and spread of nutritional improvement. The falls in underfeeding came first in Europe; indeed, underfeeding (and probably PEM) rose in much of the developing world in 1945-60. The fall in PEM was most dramatic in East Asia, but it was also large in Latin America and South Asia. Only sub-Saharan Africa saw no improvement in DES and no fall in PEM. In 1985-2000, the decline in PEM slowed globally and reversed in transitional countries.

SECURITY AND INSECURITY: SPATIAL AND TEMPORAL VARIATIONS

Seasons, years and famines

Apart from inadequate "normal" energy supplies, vulnerable people are faced with the risk of sharp downturns - poor seasons and poor years. Improved average DES reduces food insecurity linked to poor seasons and poor years. So do the greater integration of food markets and public action to reduce nutritional and food price instability. Therefore, famines have been much rarer since 1945; since 1963 they have shifted almost wholly from Asia to Africa, and since the 1970s they have been largely confined to cases of war, civil war or the breakdown of a state. One reason for the retreat and relocation of famines has been the spread of political pluralism and openness; with rapid global communication technologies, including television, it is almost impossible for famine (as opposed to chronic, even fatal, undernourishment) to persist in an open and democratic society.13 The risks of large famines have also been reduced by better early warning and response systems.

Table 13

DROUGHTS AND FAMINES, 1972-1996

Years

Average number of people killed by famine and drought

Average number affected

Average number made homeless

 

 

(Thousands)

 

1972-76

1977-81

1982-86

1987-91

1992-96

254

0

112

2

0.5

43 563

52 123

103 247

75 852

21 480

0

0

100

10

0

Source: International Federation of Red Cross and Red Crescent Societies. 1998. World Disasters Report. Oxford, UK, Oxford University Press.
Note: Entries of 0 and 0.5 obviously indicate very substantial underreporting.

Famines causing more than 500 000 deaths in Asia have been virtually absent - in sharp contrast to the historical record - since the disaster in China in 1959-61. The worst subsequent Asian experience, in Bangladesh in 1974-75, cost fewer than 500 000 lives. Most deaths have been in sub-Saharan Africa, but only in Ethiopia (1984-85) did they approach 1 million.14 Globally, there have been big swings in deaths resulting from famine or drought; periods such as 1982-86 saw "clusters" of war or civil breakdown in several drought-affected countries (Table 13). Seriously affecting 800 million people and causing 6 million deaths per year among children under five alone, since the mid-1960s chronic PEM has damaged far more people than have famines.

Seasonal undernutrition has enduring consequences for physical and economic health.

The incidence of severe seasonal worsening of nutrition has also almost certainly lessened, but there is much more evidence of the great harm that it does. In areas with fluctuations, people adapt to reduce stress, both behaviourally (storage, borrowing) and biologically (tending to deposit and release fat rather than lean).15 However, some bad seasons are worse than normal, or follow previous bad harvests or economic downturns. And poor people, especially if they suffer low average DES and hence body size, face greater problems from seasonal stress and greater difficulties in coping with it. Human action makes a big difference: around 1994, some 370 million rural Asians and "only" 33 million Africans lived in areas that put them at nutritional risk from the effects of severe agricultural seasonality. However, the fact that irrigation and food entitlements are more widespread in Asia probably meant that more Africans than Asians were harmed by seasonal nutrition stress.

Seasonality especially harms food adequacy for three groups. Stillbirth rates increase if the hungry season occurs in the second trimester of pregnancy, and there is a higher mortality rate if it occurs at ages 6 to 12 months (as passive immunity is lost before it is fully replaced by active immunity).16 Furthermore, children born in the hungry season face a sharply raised risk of age-specific death in adulthood. In the Gambia, the survival chances of more than 3 000 babies, born in different seasons, have been documented for more than 50 years, revealing "very marked ... raised mortality among adults born during the hungry season.... Infectious deaths [and their secondary effects] were the largest single [cause, suggesting] that early life events have caused permanent damage to the immune system".17

GROUP DISTRIBUTION AND FOOD SECURITY

Food and nutrition security is harmed for the rural, the remote, females, refugees and displaced persons, as well as for ethnic minorities and children,18 by reinforcing disadvantages in three ways:

Each of the following is normally more prevalent with than without each of the others: remoteness, rurality, discrimination against females, inadequate schooling, bad sanitation, absent or distant health care, poverty, heavy and seasonally peaked work even in pregnancy, and low calorie consumption per person.20 In most developing countries, those in the "worst" quintile for all of these characteristics are likely to have 50 to 65 percent of the national average life expectancy and years of education, and double the age-specific death rate and periods of illness.

Rurality

Average energy consumption is usually somewhat higher in rural areas, but not among the poorest. In rural India, the poorest decile received only 1 212 kcal/person/day in 1972-73 (despite using 82 percent of consumption for food), as against a still shocking 1 316 (79 percent) in urban areas. Especially for employee households, work tends to be harder and infection more frequent and there are more pregnancies per woman in rural areas, so more food is needed. Confirming this, at the same level of income per equivalent adult, an increase leads to a larger rise in calorie consumption in rural than in urban areas. A greater food shortfall relative to requirements means that in rural areas stunting and wasting are typically at least 1.5 times more common than in urban areas.21

Since about 1980, owing to a reclassification of rural areas and to migration, the proportions of urban people suffering from PEM (and usually absolute urban numbers affected) increased. However, the already larger rural incidence of undernourishment usually diverged further from the urban incidence. The ratio of rural to urban incidence of stunting and wasting - as of poverty and early death - tended to rise, except in Africa, where the disparities had been greatest initially. The 60 percent of the world's population who live in Asia have seen big falls in undernourishment, child mortality and poverty risk, but mostly alongside some rise in rural-urban and regional divergence within nations.22

An aspect of the "reinforcing disadvantage" is that, even if both rural women and rural men fall behind their urban counterparts by the same proportion in nutrition indicators, rural women suffer more. Compared with urban women, their risk from low food consumption is worsened by less chance of trained attendance at childbirth and by a greater lag in education. To compound the damage in Asia and Africa, where undernourishment is worst, there is a larger proportion of rural women than rural men.

Region

In China, much of the rest of Asia and Latin America, remote, marginal, poorly watered or mountainous regions are the most liable to caloric undernutrition and to the other disadvantages that have an impact on death rates and on the development of those who survive: undersupply of health care, schools and roads, as well as a high proportion of residents suffering language or other discrimination, for example ethnic minorities. In Brazil, poverty explains only part of the much worse nutrition status in the north and northeast of the country than elsewhere; much of the rest is probably due to less access to health services.23

Assets

In some places (rural South Africa, northeastern Brazil) income is so unequal that even rapid growth has little impact on PEM or poverty. This is usually due in substantial part to extreme inequality of assets, especially land and education. Infant and child mortality, strongly linked to PEM, are often higher among landless labourers than among small farmers. Distributive land reforms have been linked with sharp falls in undernutrition and poverty.

There is ample evidence that households with an educated adult - especially a woman - have a higher standard of living and, even at a given level, have less PEM. Educated women marry later and have lower marital fertility. Their households are better nourished owing to more knowledge of food and farming and to higher worker-dependant ratios and less sibling competition.24 Less widely recognized is the implication that, where education is especially unequally distributed (by region, gender or income group), PEM is higher than elsewhere - particularly among the most vulnerable (small children) owing to high fertility in uneducated households.

Gender

What is the role of gender in reducing PEM and/or overnutrition? In some countries, tests showed that stunting or low weight was much more prevalent than predicted from average DES. This is partly because of adaptation, but also partly because the gender distribution of DES and health care (and hence treatment of infections, which alters the efficiency of DES use) is especially unequal in some countries. This contributes to the unfavourable stunting and wasting status of India - North India, like Bangladesh and Pakistan, shows strong food discrimination against girls aged two to five years, with known harmful outcomes.25 The same is probably true of Mauritania. The nutritional ill-effects of gender discrimination may rise even where nutrition is generally improving; in India, the incidence of adult body mass index (BMI) below 16 (third degree chronic energy deficiency) was 11.4 percent of men in 1975-79 but 8.8 percent in 1988-90, while for women the incidence only fell from 12.7 percent to 11.3 percent.26

Girls aged two to four years suffer serious disadvantages compared with boys in DES (relative to need) and/or access to health care - and as a result worse PEM - in many parts of Asia, but not in sub-Saharan Africa or Latin America.27 Furthermore, girls almost everywhere have fewer chances of education than boys, so that women have less access to skilled work. Women also suffer discrimination in pay even for the same job or task, and more severely in access to land, legacies and credit. Although the evidence (especially in Asia) does not suggest a much greater poverty risk for women, their control over income is certainly less.

Apart from directly damaging the food security of women, these gender disparities harm children's food security, in two ways. First, income - including extra income - is more likely to be spent on improving the nutritional status of children under five if it accrues to women. Second, discrimination against small girls in feeding or health care not only cuts female life expectancy to the levels of males - elsewhere it is three to six years more - but is transmitted to later generations. Difficult pregnancies due to small womb size induce low birthweight, imperilling infant life and development. This helps explain why, for example, several South Asian regions suffer more frequent stunting and wasting than many African countries with lower calorie intakes and similar interhousehold distribution.28

International refugees and internally displaced persons

International refugees were estimated to total 1.8 million in 1960 and remained around 1.5 million to 2.5 million until 1976. They rose to a peak of 18 million to 19 million in 1991-92, then fell to about 12 million at the end of 1998. In sub-Saharan Africa, refugees and internally displaced persons (IDPs) fell from the 1995 peak of 16 million to 12 million in 1997; in Asia, the number of refugees fell from 5.8 million at end-1993 to 4.5 million at the end of 1995, plus more than 1.7 million IDPs.

However, IDPs often suffer extreme hunger or worse, especially when displacement is: sudden; results from violence, drought or natural disaster; is prolonged; separates victims from land or other means of production; or concentrates on women, children or the elderly. These victims, often without male heads of family (who are away fighting), face multiple threats to food entitlements, health and hence nutrition, especially among children. Well-funded refugee camps can substantially reduce PEM, as was the case for Afghan refugees to Pakistan and Kosovar refugees to nearby areas, or can achieve less (as in Angola and the Sudan) owing to underfunding, exacerbated by repeated bouts of civil violence, inducing inflows of refugees who are underfed even in normal times, disrupting food access, or obstructing food flows.

STAPLES PRODUCTION AND ACCESS TO FOOD

Changing perceptions of availability, entitlements and production, 1945-2000

This section shows that the conventional wisdom of postwar years - that very poor, mainly farming populations first escape poverty mainly by increasing their output of food staples - was quite wise after all, despite later swings of "development fashions". Between 1945 and 1965, emerging nations, which were accountable for food security but seeking to conserve foreign exchange for industrialization, emphasized self-sufficiency in food staples. Few analysts questioned tropical countries' comparative advantage in domestic staples production. This was therefore seen during this period as the key to availability, which was expected to ensure HFA/HFS. However, as land shortages began to be felt, price and allocation bias against agriculture, as well as distortions of farm markets, made it harder to attain food production goals.

Three changes occurred after the mid-1960s:

The resulting upsurge in smallholders' employment and staples production provided a local source of food, together with employment-based income entitlements to it, thereby slashing poverty and PEM in much of Asia and Latin America between 1965 and 1988. Since the early 1980s, the following factors have weakened the emphasis on expanding staples production in areas where PEM remains:

However, expanded local food production must still be seen as part of the cure for nutrition problems. PEM remains the world's main cause of death and misery. The great majority of its 800 million victims are afflicted mainly because they (or their working parents or children) lack employment-based entitlements to food, i.e. they cannot produce, or earn enough to afford, sufficient food. Extra food entitlements to reduce PEM and to accommodate the expected 50 percent increase in working-age populations in Africa and South Asia by 2020 to 2025 will continue to depend on rising employment or self-employment in farming, mainly food production.

Food staples production, yields and income from employment

In the developing world, falls in poverty, caloric underfeeding and PEM have generally accompanied rapidly increasing food staples output. Table 14 shows why. People in these areas still depend mainly on farming and farm labour for employment income. For the poor, such income is overwhelmingly the main source of food entitlements. For the most food-insecure - the poorest, the rural, the remote - farm dependence is still
higher. Increased staples production nearby, generating
more employment and self-employment income to
ensure entitlements to reliable supplies, is usually the key to food security, until enhanced farm growth followed by
successful diversification has reduced employment
dependence on farming towards current East Asian and Latin American levels.

Those who are most food-insecure rely on nearby staple food production until they can diversify their income sources.

The years 1945 to 1959 saw some acceleration of staples growth, based mainly on land area expansion and (in Asia) irrigation. From the late 1950s, with population growth and urban expansion, more and more prime agricultural regions ran out of quality spare arable land, while the number of people seeking work grew faster than ever, and industrialization proved either slower, or much less job-rich, than had been expected by the planners. Fortunately, 1965 to 1985 were golden years for yield growth of main staples in Asia and Latin America, as the green revolution increasingly provided varieties that were friendly to employment-intensive small farmers. Table 15 summarizes the outcomes since 1961.

As is shown in Table 15, yield growth in Asia and Africa shows a downward turning point around the mid-1980s, although timing varies among crops and regions. Moreover, although staples yield growth still generates much more employment per unit of extra GDP than, say, grazing, industry or construction (and than most urban activity), the employment effect declined: a 20 percent rise in wheat or rice yield in Asia led to about 8 percent more employment in the mid-1970s, but only 3 to 5 percent by the late 1980s. It is not surprising that the regional and temporal distribution of staples yield growth matches that of reduced poverty, underfeeding and PEM.

Table 14

PERCENTAGE OF WORKERS MAINLY DEPENDENT ON AGRICULTURAL INCOME

Region

1950

1960

1970

1980

1990

2000 1

East/Southeast Asia

South Asia

Sub-Saharan Africa

Latin America/Caribbean

All developing countries

76

76

87

55

79

71

71

84

50

74

64

69

81

43

69

56

66

74

35

63

51

60

69

26

58

41

55

64

21

52

1 Estimate.
Source: FAOSTAT.

Table 15

RATE OF STAPLES YIELD GROWTH, 1961-1998

 

Developing countries

East/ Southeast Asia

Latin America/ Caribbean

South Asia

Sub-Saharan Africa

All Africa

 

   

(Percentage per year)

 

 

Cereals

           

1961-71

1971-81

1981-91

1991-98

1966-82

1982-98

2.76

2.76

1.86

1.55

2.7

1.67

1.96

2.03

1.67

0.86

2.36

1.35

1.43

2.38

0.74

2.72

2.23

2.05

1.88

2.33

3.09

1.7

2.3

2.69

(0.29)

2.04

(-0.07)

(0.97)

1.76

(0.06)

1.03*

1.98

(0.75)

(1.13)

1.94

0.75

Roots and tubers

           

1961-71

1971-81

1981-91

1991-98

1966-82

1982-98

2.95

1.19

0.73

0.99

1.12

0.7

(0.4)

2.92

1.06

(0.09)

2.38

(0.21)

1.57

-0.77

1.07

1.02

-0.56

0.87

4.13

1.73

1.62

1.09

2.04

1.5

0.65

1.44

1.91

(0.25)

0.52

1.42

0.65

1.52

1.95

(0.34)

0.61

1.42

Sources: FAOSTAT. Author's regression data. Best-fit linear trend growth rates over each period.
Note: Numbers in parentheses mean trend is not significant; * significant at 10 percent; others significant at 5 percent.
employment and yields. This is not because more global food availability will cure hunger. It is because entitlements to more, nearby and reliable staples, generated mainly by work in producing them, remain for most of the world's at-risk people the initial escape route from both poverty and PEM; and because countries that industrialize almost always do so after successful staples yield growth.

The poor and malnourished obtain their claims to food largely from income, their own or that of parents or offspring, which almost always derives from work. The large majority of such income and work, as of the poor and malnourished themselves, is rural, and still will be in 2025.30 Hence, the food entitlements of the poor and near-poor, who will remain mainly rural, will continue to depend largely on rural paid or self-employment income.

Growth in these rural work-based food entitlements can come from growth in farming and growth in the rural non-farm sector (RNFS). RNFS growth, at least in low-income countries, usually depends on prior demand from a growing local agriculture, to which RNFS provides farm tools and inputs; processing and transport of farm outputs; and, above all, "consumption linkages" as rising farm incomes, especially among less well-off farmers and farm workers, are spent on local construction, trade, transport and other services.

Therefore, growth of rural employment income, and hence better food security for those at risk, will continue to depend mainly on nearby agricultural employment and income growth. Increasing migration to the cities does not invalidate this logic, for several reasons.

FAO/19710/G.BIZZARRI

Employment in staple food production Rural peasants
in Myanmar use the land extensively for wheat production

- FAO/19710/G. BIZZARRI

In most of Asia and Africa, where the majority of the food-insecure live and work, extension of farming into new lands is becoming, or is already, prohibitively costly (or even infeasible). Hence, expanded employment and self-employment income in agriculture is usually feasible only to the extent that:

These three conditions usually stimulate each other, but agricultural productivity growth is the main source of extra demand for hired and self-employment on farms, and of better food security,31 and it is mainly and increasingly constrained by land or water shortages. Therefore, agricultural employment and income growth, the main source of reduced food insecurity, will depend mainly on growth of farm output, usually implying higher yields per hectare or per litre.

Staple food production is a labour-intensive means of generating income.

Reducing food insecurity via farm employment: staples yield growth

Staples production is usually the main land use, employment source and output component of agriculture in most areas with serious food insecurity (i.e. in early development in low-income countries). Small farmers and landless labourers, the people most likely to be food-insecure, tend especially to concentrate on food staples production. This generates more employment per extra unit of land or of output than most alternative land uses. After successful early development in which extra employment and food security depend mainly on extra food staples production, land-scarce countries increasingly find that the comparative advantage shifts away from agriculture, and within agriculture away from food staples. But for food-insecure low-income populations, higher yields (per hectare and per litre) for food staples, and therefore extra employment and self-employment income in growing them, will be the main source of enhanced food security, at least until 2020.

Higher yields from staples production will be the main source of enhanced food security until at least 2020.

Three factors pose a threat to food security based on staples production: animal products, water availability and yield potential.

As incomes rise for the more affluent groups in the developing world, so more income is diverted from grains to animal products and total calorie intake is raised. Calories produced from meat or milk require three to seven times more cereal than grain. This may put upward pressure on staples prices and downward pressure on local availability, adversely affecting the poor. On the other hand, increased demand and prices for feedgrains may benefit farmers' incomes.

With urbanization and industrialization, both the demand and the need for water increase. There is considerable economic, ecological and political pressure to divert water away from agriculture. It will be difficult to obtain the increases in water-use efficiency needed to maintain, let alone increase, staples output in the irrigated heartlands of the green revolution in Asia and Central America. There will be increasing pressure to divert land to activities with more output per litre than staples production (and sometimes, although not always, lower employment). These problems will especially constrain output, yield and employment growth in rice, the thirstiest staple.

Cereal yield growth in developing countries has declined from an annual rate of almost 3 percent for 1967-82 to just above 1 percent in the 1990s. Yield potential, the best obtainable yield under trial plot conditions, with no limits on water, labour or agrochemical inputs, grew only very slowly for millets and sorghum in most semi-arid areas, including most of Africa. It was more rapid for maize, wheat and rice, as higher-yielding varieties became available in the early years of the green revolution in most of Asia and Central America. Farmers normally find it economically advantageous to achieve only 10 to 40 percent of yield potential, depending on agro-ecology, costs, risks and infrastructure for buying inputs and selling outputs. After a major improvement in yield potential, farmers normally move up to the new 10 to 40 percent economic "limit" in 10 to 15 years. After the early 1970s, yield potential rises resulting from the green revolution inevitably slowed down and shifted to improved defence against new pest biotypes. The slowdown in field yields in green revolution areas followed in the mid-1980s (in many areas no such improvement had taken place). The decline of real spending on agricultural research in Africa and Latin America, and its stagnation (and decline in 1999-2000) in the international system, signify a bleak future for yield potential and thus field yields in main staples.

Reducing food insecurity via distributive access: land, gender rights and food

It is sometimes said that no additional staples production is required to end PEM, given that it burgeons alongside vast unused grain stocks, not just globally or in rich countries, but even in India, because distribution is so unequal that the undernourished lack sufficient food entitlements. This lack is indeed the main cause of PEM. However, to rely solely on major, direct redistribution is to forget the slowness and/or rarity of this process and the political difficulties encountered. Yet better distributive access can greatly help to get adequate food to the initially poor - via efficiency as well as via equity.

This is partly because small farms usually have higher yields and agricultural productivity, although not for all crops and conditions. Theory and (limited) evidence suggest that small farms do not usually lose their competitive edge following technical progress such as the green revolution, or most styles of liberalization and globalization. In addition to these efficiency arguments for land redistribution as a source of employment, and thus food security, there are equity arguments. Some countries and regions, despite upper-middle average real incomes, feature extreme inequality of landholding and income, resulting in widespread poverty and significant PEM; it is difficult to envisage their substantial reduction in, for example, South Africa or northeastern Brazil without land redistribution.

Even there, however, many of the poorest would not receive land from politically plausible redistribution. This is especially the case in countries such as Bangladesh, where some 25 percent of the farm population is functionally landless and where a 2 ha holding is large and a 10 ha holding exceptional. It is a mistake, however, to denigrate the contribution of land distribution to lowered PEM on these grounds. This contribution does not depend mainly on income from land, but on employment effects. The smaller the farm, and the larger the proportion of family workers, the lower the costs of screening, seeking and supervising labour, and the smaller the benefits of "shirking". Therefore, small farms normally use more hired labour per unit of land and much more family labour than large farms.

More equal access to resources can improve the efficiency of farm production for some crops and in certain conditions.

FROM ENERGY ADEQUACY TO NUTRITION SECURITY

Agriculture and health - combining food security and nutrition security

Over the last 50 years, the main global food issues have been famine, chronic hunger and PEM. These problems interact with other problems and, as they retreat, expose new problems. Hence, attention is paid increasingly to nutrition security. Although undernourishment still contributes to the deaths of 6 million children each year, other goals cannot be brushed aside: anaemia increases the mortality risk for more than 1.5 billion people worldwide; obesity (BMI >27.5) affects about a third of adults in the United States and will help kill at least another third. Yet, paradoxically, nutrition problems of late development, such as obesity, are genetically and behaviourally rooted in those of underdevelopment, such as PEM. Moreover, a growing majority of countries are seriously affected by both sets of problems.

Moreover, in poor countries, adequate nutrition depends jointly on health and food. The huge fall in infant and child mortality is linked to the interaction between more (and more stable) food consumption and improved sanitation, immunization and health care. A classic study32 proved this synergism in the poor villages of the Indian Punjab. A much larger fall in mortality and undernutrition was achieved when a fixed cash sum was divided between health care and nutrition supplementation, than when it was concentrated on one or the other.

Under- and overnourishment can exist simultaneously within countries.

Micronutrients - beyond food security in energy terms

Nutrition security requires overcoming key mineral and vitamin deficiencies, which often overlap and interact.

Iron deficiency anaemia (IDA) affects about one in three people worldwide and 43 percent of developing country populations. "All recent estimates of trends ... have failed to show significant improvement".33 Global prevalence has risen since 1980 and increases among adult men have outweighed falls among women and children under five.

Severe IDA is the cause of one in five maternal deaths worldwide and is transmissible to children, causing stunting and vulnerability to infection. Even modest preschool IDA permanently reduces learning capacity and manual dexterity. A 10 percent rise in haemoglobin in a moderately anaemic person raises work capacity by 20 percent.34

Iron can be obtained from cereals, some vegetables and pulses, dairy products and meat - in sharply rising order of both iron content and bio-availability. As incomes rise, people turn from cereals to pulses and vegetables, and later to meat. Therefore, income growth should have reduced iron deficiency in Asia, where it is most serious. However, production changes have offset this: cereals showed more buoyant yields than pulses and displaced them, making pulse sources of iron scarce before most people could afford much meat.35

The risk of iodine deficiency diseases (IDD) in the 1990s affected some 2.2 billion people worldwide, of whom 740 million suffered from goitre. Estimates in about 1994 indicated 11 million people with cretinism and a further 43 million with mental impairment. IDD has declined dramatically: a great success story for nutrition security policy. Following the iodization of salt, the proportion of people at IDD risk fell between 1994 and 1997 from 33 to 23 percent in Africa, from 23 to 7 percent in the Americas, from 43 to 30 percent in the eastern Mediterranean area, and from 29 to 14 percent globally.

FAO/20216/L.DEMATTEIS

Nutrition security Adequate nutrition requires a diet that
is both adequate and balanced, including essential
micronutrients

- FAO/20216/L. DEMATTEIS

Vitamin A deficiency (VAD) affects fewer people than iron or iodine deficiency. However, clinical (ocular) VAD can irreversibly harm children, while subclinical VAD raises mortality risk in pregnancy and impairs child development and iron utilization. Vitamin A is obtained largely from animal sources in high-income countries and Latin America, but elsewhere from green leafy vegetables, sweet potatoes and palm oil. The number of children under five in developing countries with clinical VAD fell from 5 million (1.1 percent incidence) in 1985 to 3.3 million (0.6 percent) in 1995. Subclinical VAD is much more prevalent, affecting an estimated 75 million to 250 million children under five.36

Other deficiencies, such as zinc, calcium and dietary fibre deficiency as well as excess sodium, are also probably widespread and are increasingly receiving attention. As people become richer, they diversify their diets and raise their consumption of animal products, fruit and vegetables. This reduces the risk of iron, zinc and Vitamin A deficiency substantially. These changes help the poor mostly in middle-to-late economic development. The very poor cannot afford to use income gains, if any, to buy micronutrient-rich fruit, vegetables or animal products. Yet these people are the ones most likely to be nutrient-deficient and untreated. Therefore, it is important to increase key micronutrient levels in their main cheap foods: staples. In 1999, much higher levels of iron and Vitamin A were introduced by transferring genes from other plants into rice. This indicates a vital line of research.

Overnutrition, diet-related diseases, development
and diet composition

Overnutrition relative to reduced activity levels (and linked with diets containing excessive animal fats, salt and sugar, and deficient fibre) is a major cause of obesity, high blood pressure, coronary heart disease, diabetes and some cancers, leading to premature adult death and disability in old age - in developed countries.

Prevalence data show that nutritional diseases of "affluence" are already significant, not only among the poor in rich countries, but even (spreading down the income scale) in countries with widespread PEM. By 1995, 3.3 percent of children under five (18 million) were overweight in the developing world; in North Africa the proportion was higher than 8 percent (in the United States it was 7.4 percent). Obesity in urban areas far exceeds that in rural areas in a range of developing countries. By being obese, children under five more than double the risk of obesity in adult life.37

Lower-income groups are "differently food-insecure". In poor countries they are the most prone to PEM and deficiency conditions, eating too little food of which too small a proportion is from animal sources, which provide concentrated and accessible vitamins, iron and zinc as well as energy. In rich countries, they are the most prone to obesity and resulting disease and death and, often with low energy use, eat too many calories - and too many from fat and animal sources.

Food diversity is a main source of food security (against diseases of affluence as well as poverty, and to permit full discharge of "capabilities and functionings"). It is the indicated weapon against overnutrition and undernutrition alike, although that does not contradict the priority for increased income-based entitlements to cheap energy sources for sufferers from PEM. Food diversity improved between 1969-71 and 1990-92 in all regions and all types of economies, as is indicated by a falling proportion of calories derived from a country's main food group. Increasing trade, travel and urbanization have diversified food baskets in a large number of countries. Static health gains apart, this reduces the dynamic risk from crop failure or price rises for a single food source. Pressures towards diversity, except in the remotest areas and for some of the many people who are still too poor to consume enough calories, have more than offset "homogenization". In addition, globalizing shifts in local staples consumption have generally not damaged, but have rather been led by, or are conducive to, local staples production.38

POLICY IMPLICATIONS AND CONCLUSIONS

This review points to a number of areas for policy action to significantly reducing poverty and undernutrition. These areas concern smallholder staple food production, equity and redistribution, disadvantaged and vulnerable groups and nutrition security. Policy decisions relating to trade, market liberalization and the environment will also play a determining role in achieving food security on a sustainable basis.

Reducing poverty and improving nutrition through staples production

A first policy priority emerges from the fact that staples yield growth, which is a key factor for poverty reduction and food security in the early stages of development, has been on the decline since the mid-1970s. This requires renewing progress in staple yield potential.

Researchers and policy-makers must address the reasons why the green revolution:

A second labour-intensive, nutrition-improving green revolution requires more funds for public sector agricultural research; a renewed focus on plant breeding; buying in biotechnology skills from the private firms that now control them; and stress on less-favoured regions, sustainable water use and labour-intensive cultivation of staples on smallholdings.

The need to expand local food employment for individual food security, while mainly a national issue, validates international concern with agricultural, land-water environmental research and institutional prerequisites for rising smallholder food yields in developing countries.

The role of redistribution in achieving staples-based household food security

Household food security is assisted by higher yields of food staples, which in turn are facilitated by better access to land, credit and institutions. Land redistribution is particularly important given the extremely unequal landholding and farm income situation, resulting in widespread poverty and food insecurity in some countries and regions. Land redistribution (not tenancy reform, which has the opposite effect - encouraging landlords to evict and consolidate into bigger, less labour-using owner-farms) is a powerful source of employment-based entitlements to food, and also means more land sown to staples, as small farmers reduce the risk posed by price rises in retail food markets.

Land reforms between 1950 and 1980 achieved far more than fashionable scepticism suggests. But, as with the green revolution, revival requires awareness of why progress slowed (many countries have little land left in large holdings; political conditions, global and local, for old-style land reform are less favourable). Yet, in labour-surplus economies (where widespread undernutrition is found), market advantages favour labour-intensive small farms. It is therefore worth exploring land reform "with the grain of the market". A second wave of nutrition-improving land reforms might result in making farm units smaller and more equal voluntarily by: i) removing selective support from rich farmers' inputs (especially water); ii) focusing water, market-access facilities, training, credit and research on small farms (and on the poor people trying to buy them); and iii) assisted or voucher-based schemes for poor farmers to obtain farmland.

National staples self-sufficiency and food security

More food self-sufficiency may imply better or worse food security conditions for a country. It can be sought by "flexible", good policies such as irrigation programmes or agricultural research. But quests for self-sufficiency may turn to extracting rural produce cheaply to feed cities, creating perverse incentives, harming food output and employment and worsening undernutrition.

Development typically involves two stages with regard to food imports (see Box 19, p. 208), and policies need to work with the sequence: in the phase of declining recourse to food imports, sound food self-sufficiency policies (that take into account comparative advantage, logistic and agro-ecological conditions), achieved through labour-intensive activities (especially in smallholdings), can reduce undernutrition. In the later development phase, when net staples imports increase (financed by exported manufactures and services, which themselves employ the poor and give them more food entitlements), policy action will further contribute to reducing undernutrition by promoting labour-intensive shifts out of staples production.

It must be stressed, however, that stage two is a viable option only after the phase of staples employment and output growth. China's famine of 1960 and India's near-famine of 1965-66 show that sidelining local growth of food staples yields before non-farm employment takes off has disastrous results for food security.

Subsidized food distribution must be limited and well targeted.

Coping with fluctuations in food supply and access

Poor people, with a low calorie intake and, hence, body size, face greater problems from seasonal stress and greater difficulties in dealing with it. Policy options can help households' seasonal stress management. Fluctuations in employment income can be reduced by appropriate policies for robust and peak-spreading farming via irrigation, pest management and appropriate new varieties. A higher proportion of Asians than Africans is affected by severe agroclimatic seasonality, but a lower proportion is harmed. The difference is made by the existence in Asia of more widespread irrigation, public works and transport options.

Subsidized food distribution from public stocks is usually not directly targeted at the poor but helps them in years of dearth by encouraging the earlier release of traders' hoards, thereby limiting price rises. It is crucial to ensure that public stock releases reach needy, drought-affected and remote regions. No large country with undernutrition problems can sensibly dispense with public grain stocks, but their size in some countries such as India - often representing 10 percent and sometimes even 20 percent of domestic staples production - involves huge costs in forgone public investment. Accordingly, policy managers should explore alternative methods (such as purchased liens on farmers' stores, or forward or options contracts in international markets) that might achieve more household food security at less cost. International agency guarantees for such market-friendly and cost-cutting national food security policies would be needed; they could feasibly be provided on a trial basis for small countries.

Household coping mechanisms that reduce vulnerability to shocks include credit and other arrangements for smoothing consumption; policy can support these, for example, by encouraging consumption microfinance for the poor where sustainable.

Focusing on vulnerable and disadvantaged groups

Household food security can be improved in these groups by direct food distribution, food-for-work, food subsidy or emergency relief schemes. Again, the employment link should be stressed: food-for-work can enhance working capacity, productivity and incentive; the work can produce further food and/or entitlements to it. Including the needy, excluding the greedy, cost containment and appropriate incentives are difficult issues. However, examples exist of strikingly cost-effective and well-targeted interventions that have accelerated nutritional improvement and avoided serious disincentive effects.

In a long-term perspective, basic education constitutes the best investment in favour of the most disadvantaged groups. Education improves farm productivity and income, among labourers as well as farmers. Educated women marry later, and have lower marital fertility. Their households are better nourished as a result of more knowledge of food and farming and of higher worker-dependant ratios and less sibling competition. Where education is very unequal (by region, gender or income group), undernourishment is higher than elsewhere - especially among the most vulnerable (small children), owing to high fertility in uneducated households.

In some areas, energy adequacy and household food security would be improved by redistributing control over income and assets towards women, for instance by reducing educational discrimination against girls and creating or enforcing women's legal rights to inherit land.

The environment and food security

Both food security and the environment can gain from better policies. Trade-offs exist but they are often a result of the wrong incentives or institutions: "thirsty" food crops, notably rice, imperil sustainable water use where rice is subsidized relative to other crops, water relative to other inputs and urban relative to (potentially water-economizing) rural investment.

The environment and household food security gain from: correcting anti-employment and anti-environment incentives; and building on the key role of employment income for food entitlements, especially in periods of slack season and "off-year" employment. Schemes can be designed to substitute employment for environment, for example by using, or designing, soil- or water-saving public works.

From household food security to nutrition security: combined policy

Developing countries must tackle nutrition problems of late development, such as obesity, jointly with those of undernourishment, because: i) they have both already;

ii) resource allocation between them is biased by political structures; and iii) mishandling present PEM and micronutrient deficiencies greatly increases death and illness from overnutrition 20 to 50 years later. Policy action is thus required in the form of incentives and public sector allocations. Two other problems, micronutrient deficiencies and food safety, which are shared in different forms by the wasted and the obese, underline the need for a combined nutrition security policy for agriculture, nutrition, health and the environment.

As the benefits of economic advances, and subsequent ageing of the population, spread from the better off to others, it is important that changes in diet and activity patterns spread too. This involves timely changes in incentives and institutions in agriculture, food markets, medical systems and education.

NOTES

1 R. Eastwood and M. Lipton. 1999. The impact of changes in human fertility on poverty. Journal of Development Studies, 36(1): 1-30.

2 A.K. Sen. 1981. Poverty and famines: an essay on entitlement and deprivation. Oxford, UK, Clarendon Press.

3 World Bank. 2000. World Development Report 2000/2001. New York, Oxford University Press.

4 S. Yaqub. 1999. Poverty in transition countries: what picture emerges from UNDP's National Human Development Reports? Working Paper No. 4. Brighton, UK, Poverty Research Unit, Sussex University.

5 A. Krueger, A. Valdes and M. Schiff. 1996. The mulcting of agriculture in developing countries. Washington, DC, World Bank.

6 M. Ravallion. 1997. Famines and economics. Journal of Economic Literature, 3: 1205-1243.

7 FAO. 1946. The First World Food Survey. Washington, DC. (5 July)

8 Ibid.

9 FAO. 1953. The Second World Food Survey. Rome.

10 K. Bagchi. 1992. Impact of four decades of development on nutrition and health status in India. Rome, FAO/WHO Joint Secretariat of the International Conference on Nutrition.

11 ACC/SCN. 1997. Third Report on the World Nutrition Situation. Geneva.

12 FAO. 1996. The Sixth World Food Survey. Rome.

13 Sen, op. cit., note 2.

14 Ravallion, op. cit., note 6.

15 P. Payne and M. Lipton. 1994. How third world rural households adapt to dietary energy stress: the evidence and the issues. Food Policy Review No. 2. Washington, DC, International Food Policy Research Institute; A.E. Dugdale and P.R. Payne. 1987. A model of seasonal changes in energy balance. Ecology of Food and Nutrition, 19: 231-245.

16 S. Schofield. 1974. Seasonal factors affecting nutrition in different age-groups and especially pre-school children. Journal of Development Studies, 11(1): 22-40.

17 A.M. Prentice. 1999. Early nutritional programming of human immunity. Annual Report 1998. Lausanne, Switzerland, Nestlé Foundation.

18 Children are disadvantaged indirectly, because concentrated where PEM is especially prevalent: the households of the poor, large families, rural and remote areas with delayed fertility transitions.

19 M. Lipton, S, Osmani and A. de Haan. 1997. Quality of life in emerging Asia. Background paper for Emerging Asia: changes and challenges. Manila, Asian Development Bank.

20 A household tends to have higher child-adult ratios, and hence reduced caloric requirements, if (other things being equal) it is: in the poorest decile; rural; remote; poorly educated. However, many indicators, for example differential mortality, show that requirements are reduced less than consumption.

21 J. von Braun, J. McComb, B. Fred-Mensah and R. Pandya-Lorch. 1993. Urban food insecurity and malnutrition in developing countries: trends, policies and research implications. Washington, DC, IFPRI.

22 Among the Chinese poor, however, rural and urban calorie consumption converged in the 1980s, probably because many hungry rural migrants moved to cities, where they seldom obtain either urban or rural social security benefits. See R. Eastwood and M. Lipton. 2000. Changes in rural-urban inequality and urban bias. In G. Cornia, ed. The upturn in inequality within nations since 1980; and M. Lipton, A. de Haan and S. Yaqub. 2000. Poverty in emerging Asia. Asian Development Review (March).

23 WHO. 1991. Country studies in nutritional anthropometry: Brazil. Geneva.

24 M. Livi-Bacci and G. de Santis, eds. 1998. Population and poverty in developing countries. Oxford, UK, Clarendon Press.

25 A. Bhargava and S. Osmani. 1997. Health and nutrition in emerging Asia. Background paper for Emerging Asia: changes and challenges. Manila, AsDB.

26 Bagchi, op. cit., note 10.

27 B. Harriss. 1986. The intra-family distribution of hunger in South Asia. Helsinki, World Institute for Development Economics Research; M. Lipton. 1983. Poverty, undernutrition and hunger. Staff Working Paper No. 597. Washington, DC, World Bank; P. Svedberg. 1989. Undernutrition in Africa: is there a sex bias? Stockholm, Institute for International Economic Studies.

28 Bhargava and Osmani, op. cit., note 25.

29 M. Lipton. 1993. Land reform as commenced business: the evidence against stopping. World Development, 21(4): 641-57.

30 Net remittances of urban incomes to the rural poor are important in a small, although growing, number of exceptional areas, but the cost of an urban workplace - capital, infrastructure and congestion - is much higher, even in the informal sector, than in rural areas.

31 Unless such growth is induced by a labour-displacing technology.

32 C. Taylor et al. 1978. The Narangwal project on interactions of nutrition and infections: 1. Project design and effects upon growth. Indian Journal of Medical Research, 68 (Suppl.) (December).

33 ACC/SCN. 2000. Fourth Report on the World Nutrition Situation. Geneva.

34 ACC/SCN, op. cit., note 11.

35 ACC/SCN. 1992. Second Report on the World Nutrition Situation. Geneva.

36 ACC/SCN, op. cit., note 33.

37 Ibid.

38 M. Lipton, A. de Haan and E. Darbellay. 1999. Food security, food consumption patterns and human development. In Human Development Papers 1998: consumption and human development. New York, UN, Human Development Office.


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