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Undernourishment around the world

Counting the hungry: latest estimates

FAO’S LATEST ESTIMATES signal a setback in the war against hunger. The number of chronically hungry people in developing countries declined by only 19 million between the World Food Summit (WFS) baseline period of 1990–1992 and 1999–2001. This means that the WFS goal of reducing the number of undernourished people by half by the year 2015 can now be reached only if annual reductions can be accelerated to 26 million per year, more than 12 times the pace of 2.1 million per year achieved to date.

Analysis of more recent trends makes the prospects look even bleaker. From 1995–1997 to 1999–2001 the number of undernourished actually increased by 18 million (see page 8 for details and analysis).

Improving the FAO estimate of prevalence of undernourishment

In estimating the prevalence of undernourishment FAO takes into account the amount of food available per person nationally and the extent of inequality in access to food.

An International Scientific Symposium on Measurement of Food Deprivation and Undernutrition held in 2002 concluded that the method used by FAO is the only way currently available to arrive at global and regional estimates of the prevalence of undernourishment. The Symposium also called for efforts to improve both the data and the analytical approach used to derive these estimates.

In response to the Symposium’s recommendations, FAO’s Statistics Division has reinforced its activities in several areas, including:

• expanding use of the FAO methodology to measure the extent of food deprivation at subnational levels, such as urban and rural areas;

• reconciling estimates of national food consumption from food balance sheets and household surveys;

• analysing trends in the inequality of access to food;

• reviewing the minimum energy requirements used to define food deprivation in light of new recommendations from an FAO/WHO/UNU Expert consultation; and

• integrating analysis of trends in food deprivation and nutritional status.

Worldwide, FAO estimates that 842 million people were undernourished in 1999–2001. This includes 10 million in the industrialized countries, 34 million in countries in transition and 798 million in developing countries. At the regional level, the numbers of undernourished were reduced in Asia and the Pacific and in Latin America and the Caribbean. In contrast, the numbers continue to rise in Sub-Saharan Africa and in the Near East and North Africa.

These numbers and trends are dominated by progress and setbacks in a few large countries. China alone has reduced the number of hungry people by 58 million since the World Food Summit baseline period. But progress in China has slowed as the prevalence of undernourishment has been reduced. At the same time, India has shifted into reverse. After seeing a decline of 20 million in the number of undernourished between 1990–1992 and 1995–1997, the number of hungry people in India increased by 19 million over the following four years.

Proportion of undernourished in developing countries, 1990-1992 and 1999-2001

Grey bars: 1990-1992
Coloured bars: 1999-2001
Countries grouped by prevalence of undernourishment in 1999-2001

Counting the hungry: recent trends in developing countries and countries in transition

WITH THE SLOW PACE of progress achieved since 1990- 1992, prospects for reaching the world food summit goal of halving the number of hungry people by 2015 appear increasingly remote. Closer analysis reveals that these numbers mask an even more alarming trend. If the nine-year period is divided in half, figures for the developing countries as a whole indicate that the number of undernourished people has actually increased by 4.5 million per year during the most recent subperiod from 1995- 1997 to 1999-2001.

Data from individual countries show that only 19 countries succeeded in reducing the number of undernourished during both subperiods. In these successful countries, the total number of hungry people fell by over 80 million over the full nine-year period (see graph below).

At the other end of the scale are 26 countries where the number of undernourished increased in both subperiods. In most of these countries, the prevalence of undernourishment was already high (greater than 20 percent) in 1990–1992. Over the next nine years, the number of hungry people in these countries increased by almost 60 million.

Analysing the keys to progress and reversals in reducing hunger

In attempting to analyse the factors that fuel progress in reducing hunger, a combination of six indicators proved most successful at differentiating among countries grouped according to their performance between 1990–1992 and 1999–2001. These indicators include population growth, GDP growth per person, health expenditure as a proportion of GDP, the proportion of adults infected with HIV, the number of food emergencies and the UNDP’s Human Development Index (itself a composite of many economic and social indicators).

In the countries that succeeded in reducing hunger throughout the nineyear period, GDP per capita grew at an annual rate of 2.6 percent – more than five times higher than the rate in countries where undernourishment increased in both subperiods (0.5 percent). The most successful countries also exhibited more rapid agricultural growth (3.3 percent per year compared to only 1.4 percent for the countries where hunger increased throughout the decade), lower rates of HIV infection, slower population growth and far fewer food emergencies.

Preliminary analysis (see box) suggests a number of factors that may have contributed to success in some countries and setbacks in others. Not surprisingly, the countries that succeeded in reducing hunger in both subperiods also exhibited significantly higher economic growth. Countries where the number of hungry people increased, on the other hand, experienced more food emergencies and higher rates of HIV infection.

Not all of the news that emerges from this analysis is bad. Twenty-two countries, including Bangladesh, Haiti and Mozambique, succeeded in turning the tide against hunger, at least temporarily. In these countries, the number of undernourished declined during the second half of the decade after rising through the first five years.

In 17 other countries, however, the trend shifted in the opposite direction and the number of undernourished people, which had been falling, began to rise. This group includes a number of countries with large populations, among them India, Indonesia, Nigeria, Pakistan and Sudan.

At the same time, progress has slowed in many of the countries that had scored dramatic gains during the first five-year subperiod, including China. Having reduced the prevalence of undernourishment to moderate levels (below 20 percent), these countries can no longer be expected to propel progress for the developing world.

With reversals in many large countries and progress slowing in others, the pattern of change in the developing countries as a whole shifted from a declining to a rising trend. Between 1995–1997 and 1999–2001, the number of hungry people in the developing countries increased by 18 million, wiping out almost half the decrease of 37 million achieved during the previous five years. Unless significant gains are made in large countries where progress has stalled, it will be difficult to reverse this negative trend.

Undernourishment rising in many countries in transition

FAO’s first analysis of the changes that have occurred since the break-up of the Soviet Union and Yugoslavia shows that hunger is increasing in many of the countries in transition. Overall, the number of undernourished people in the countries in transition grew from 25 to 34 million between 1993–1995 and 1999–2001. These estimates must be regarded as provisional, as implementation of household sample surveys to replace the data obtained from administrative records in the centrally planned system is still at an early stage.

Nearly all of the increases in undernourishment took place in the Commonwealth of Independent States (CIS), where the number of hungry people rose from 20.6 to 28.8 million and the proportion increased from 7 to 10 percent. Economic transition has been accompanied by far-reaching political and administrative changes that have disrupted trade and exchange relations and led to severe foreign exchange shortages. In addition, agricultural production and marketing systems have broken down.

The Baltic States and East European countries have largely avoided these problems. In most of these countries, the prevalence of undernourishment has decreased or remained stable. This has not been the case, however, in Bosnia and Herzegovina, Bulgaria, Latvia, the Former Yugoslav Republic of Macedonia, and Serbia and Montenegro, where the prevalence of undernourishment either rose or was still significant in 1999–2001.


Food insecurity and HIV/AIDS: when short-term emergencies intersect a long-wave crisis

SINCE THE HIV/AIDS EPIDEMIC began, 25 million people have died of the disease. Another 42 million are now infected with HIV. During this decade, AIDS is expected to claim more lives than all the wars and disasters of the past 50 years.

The food crisis that threatened more than 14 million people in southern Africa in 2002–2003 brought into sharp focus the interactions between HIV/AIDS and food security. It demonstrated that hunger cannot be combated effectively in regions ravaged by AIDS, unless interventions address the particular needs of AIDS-affected households and incorporate measures both to prevent and to mitigate the spread of HIV/AIDS.

HIV/AIDS and food crises: a chronic double emergency?

The southern African food crisis was triggered by a combination of recurring droughts, failed economic policies and civil strife. Its impact was compounded by the devastating AIDS epidemic that had already shattered millions of families, undermined the food sector and weakened the capacity of governments to respond. In 2001 alone, the year before the crisis hit, nearly half a million people in the affected countries died of AIDS, orphaning an estimated 2.5 million children.

Governments and international organizations responded quickly to deploy emergency food aid. But reports from the field warned that they were facing a new kind of emergency, in which severe short-term food shortages overlap an unprecedented collapse of health, agricultural production and food security that will endure for decades. The AIDS epidemic is driven by a slow-acting virus, with an epidemic curve that stretches well into the century (see graph).

AIDS erodes food security

HIV/AIDS causes and exacerbates food insecurity in many ways. Most of its victims are young adults who fall ill and die during what should be their peak productive years. They leave behind a population overbalanced with the elderly and young, many of them orphans (see graph). The impact on farm production and food security is often devastating.

By the year 2020, the epidemic will have claimed one-fifth or more of the agricultural labour force in most southern African countries (see graph). Already, in several affected countries, 60 to 70 percent of farms have suffered labour losses as a result of HIV/AIDS. In some severely affected areas, studies have found that more than half of all households are headed by women (30 percent, mostly widows), grandparents (nearly 20 percent) and orphaned children (almost 5 percent). Lacking the labour, resources and know-how to grow staple and commercial crops, many households have shifted to cultivating survival foods. Others have abandoned their fields entirely. A study of communal agriculture in Zimbabwe found that maize production fell by 61 percent in households that suffered an AIDS-related death (see graph).

And the impact will continue to be felt for generations to come. AIDS diminishes investment in agriculture. It strips households of assets as they are forced to sell off what little they have to pay for medical and funeral expenses, or simply to survive. It forces children, particularly girls, to withdraw from school to work or care for ill parents, and it cuts off the transfer of essential skills and knowledge from one generation to the next. In two districts in Kenya affected by AIDS, a study found that only 7 percent of orphans heading farm households had adequate agricultural knowledge.

UNAIDS projects that between 2000 and 2020, 55 million Africans will die earlier than they would have in the absence of AIDS – a total equivalent to the entire population of Italy. This unprecedented human catastrophe will seriously hamper economic and social development. Recent estimates indicate that the pandemic has already reduced national economic growth rates across Africa by 2 to 4 percent a year. Data also suggest that undernourishment has continued to climb in countries where HIV/AIDS was already widespread in 1991, while declining elsewhere in sub-Saharan Africa (see graph).

Hunger fuels AIDS epidemic

While HIV/AIDS has become a major cause of hunger, the reverse is also true. Hunger accelerates both the spread of the virus and the course of the disease. Hungry people are driven to adopt risky strategies to survive. Frequently they are forced to migrate, often to urban slums where HIV infection rates are high. In desperation, women and children barter sex for money and food, exposing themselves to the risk of infection.

For people who have already been infected with HIV, hunger and malnutrition increase susceptibility to opportunistic infections, leading to an earlier onset of full-blown AIDS. Once the disease takes hold, nutrient absorption is reduced, appetite and metabolism are disrupted and muscles, organs and other tissues waste away. People living with HIV/AIDS need to eat considerably more food to fight the illness, counteract weight loss and extend a productive life.

Food security helps prevent AIDS

As the crisis in southern Africa has shown, food security interventions must be planned with an “HIV/AIDS lens”. Traditional food aid safety nets are not sufficient and may prove ineffective.

Families that have lost key productive members may not be able to participate in “food for work” projects, commonly used as a way to provide emergency food in exchange for labour on public works projects. To recover and achieve a degree of self-sufficiency, they need both food assistance and agricultural development programmes that address their needs by emphasizing nutritious crops that require less labour, diversification that spreads labour requirements and harvests more evenly throughout the year, and education and training for orphaned children and adolescents.

Incorporating HIV prevention, nutritional care for people living with HIV/ AIDS and AIDS mitigation measures into food security and nutrition programmes can help reduce the spread and impact of HIV/AIDS. Indeed, when short-term food emergencies intersect the long-wave HIV/AIDS crisis, household food security is likely to be the single most important HIV prevention strategy and AIDS mitigation response.

Water and food security

WATER AND FOOD SECURITY are closely related. Agriculture is by far the biggest user of water, accounting for about 69 percent of all withdrawals worldwide and over 80 percent in developing countries. Reliable access to adequate water increases agricultural yields, providing more food and higher incomes in the rural areas that are home to three-quarters of the world’s hungry people. Not surprisingly, countries with better access to water also tend to have lower levels of undernourishment (see graph).

If water is a key ingredient in food security, lack of it can be a major cause of famine and undernourishment, particularly in food-insecure rural areas where people depend on local agriculture for both food and income. Drought ranks as the single most common cause of severe food shortages in developing countries. For the three most recent years for which data are available, drought was listed as a cause in 60 percent of food emergencies (see graph).

Africa is both the driest continent (other than Oceania) and the region where hunger is most prevalent. Within Africa, undernourishment and periodic famines have afflicted semi-arid and drought-prone areas (see map).

Even where overall water availability is adequate, erratic rainfall and access to water can cause both short-term food shortages and long-term food insecurity. Floods are another major cause of food emergencies. Sharp seasonal differences in water availability can also increase food insecurity. In India, for example, more than 70 percent of annual rainfall occurs during the three months of the monsoon, when most of it floods out to sea. Farmers who lack irrigation facilities must contend with water scarcity through much of the year and with the threat of crop failures when the monsoons fail.

Irrigation increases yields while reducing hunger and poverty

By ensuring an adequate and reliable supply of water, irrigation increases yields of most crops by 100 to 400 percent (see graph). Although only 17 percent of global cropland is irrigated, that 17 percent produces 40 percent of the world’s food.

Along with higher yields, irrigation increases incomes and reduces hunger and poverty. Data show that where irrigation is widely available, undernourishment and poverty are less prevalent (see graph).

Ongoing studies in Asian countries provide evidence that irrigation alleviates both permanent and temporary poverty. In India, for example, a World Bank study found that 69 percent of people in non-irrigated districts are poor, but only 26 percent in irrigated districts.

Farmers benefit directly from irrigation through increased and more stable incomes and the higher value of irrigated land. Even landless labourers and small farmers who lack the resources to employ irrigation themselves often benefit through higher wages, lower food prices and a more varied diet. Studies in Bangladesh and India have shown that every job created in irrigated agriculture yields another job in agricultural services and the processing industry. Irrigation has the greatest impact on reducing hunger when it is labour-intensive, employs affordable, small-scale techniques and is combined with access to credit, marketing and agricultural extension services.

Looking to the future

Over the next 30 years, the world’s population is expected to grow by 2 billion people. Feeding this growing population and reducing hunger will only be possible if agricultural yields can be increased significantly and sustainably. That, in turn, will depend on increased use of irrigation and improved water management, even as a growing number of countries face water shortages.

FAO expects the irrigated area in developing countries as a whole to expand by almost 20 percent by the year 2030. By using irrigation water more efficiently and taking advantage of opportunities to grow several crops a year on irrigated land, FAO estimates that the effective irrigated area can be increased by 34 percent while using only 14 percent more water. The largest increase (44 percent) is expected in sub-Saharan Africa, where only 4 percent of arable land is irrigated today.

Large-scale irrigation is not always a viable or desirable option. In some areas, including much of Africa, rainfall patterns and the geology of river basins preclude cost-effective irrigation. In others, poorly managed irrigation and overextraction of groundwater threaten sustainability and food security. An estimated 7 to 10 percent of the world’s 270 million hectares of irrigated land have been degraded by the accumulation of salts. In many areas, water is being pumped out of the ground for irrigation far faster than it can be replenished by rainwater percolating through the soil. In China, where more than half of the irrigated lands rely on tubewells, water tables have fallen by up to 50 metres over the past 30 years.

Where water is scarce and the environment fragile, achieving food security may depend on what has been called “virtual water” – foods imported from countries with an abundance of water. It takes 1 cubic metre of water to produce 1 kilogram of wheat. Extrapolating from those numbers, FAO calculated that to grow the amount of food imported by Near Eastern countries in 1994 would have required as much water as the total annual flow of the Nile at Aswan. In such conditions, it may make sense to import food and use limited water resources for other purposes, including growing high-value crops for export.

Hunger hotspots

AS OF JULY 2003, 36 countries around the world faced serious food emergencies requiring international food assistance. The causes of these food shortages are varied and complex. The locations, as indicated on the map, are painfully familiar. All the countries affected in 2003 had experienced food emergencies for at least two consecutive years. Many had been plagued by severe food shortages for a decade or longer.

In southern Africa, food production has started to recover from the severe drought that reduced harvests by as much as 50 percent in 2001/2002. But several countries in the region still face severe shortages and all must contend with the long-term impact of the HIV/ AIDS pandemic (see pages 10–11).

Further to the north, pre-famine conditions have been reported in Eritrea and parts of Ethiopia, where crops have withered, livestock are dying from lack of water and grazing, and millions of people need emergency food aid.

Several Asian countries have also been facing the effects of harsh weather, including drought and unusually cold, snowy winters in Mongolia.

Although drought and other natural disasters remain the most common causes of food emergencies, an increasing proportion are now human-induced. In several countries in Central and West Africa, civil strife has disrupted both food production and access to food.

Even developments in international commodity markets can trigger food crises in countries that depend heavily on agricultural exports or food imports. The collapse of coffee prices has been a major cause of increased food insecurity in Central America.

Overall, conflict and economic problems were cited as the main cause of more than 35 percent of food emergencies during 1992–2003 (see graph).

The recurrence and persistence of emergencies highlights a number of countries that could be considered as “food emergency hotspots”. Thirty-three countries experienced food emergencies during more than half the years of the 17-year period between 1986 and 2003. Many conflict-induced complex emergencies are persistent and turn into long-term crises. Eight countries suffered emergencies during 15 or more years during 1986–2003. War or civil strife was a major factor in all eight.

Droughts take heavy toll on livestock herding communities

Two consecutive years of severe drought have decimated both crop and livestock production in Mauritania, triggering a food emergency. In a country where less than 1 percent of the land can sustain crops, livestock accounts for 70 percent of agricultural production and 15 percent of national GDP. But lack of water has forced herders to sell or slaughter many of their animals. Distress sales sent prices plummeting by more than 50 percent in one year.

On the other side of the globe, several years of drought and harsh winters have devastated livestock production in Mongolia. Unusually heavy snowfall in 2003 killed up to 2.5 million animals, undermining the livelihood of nearly a quarter of the country’s population. An estimated 80 percent of Mongolians, many of them nomadic herders, raise livestock, accounting for almost 90 percent of agricultural output.

The food crises in Mauritania and Mongolia highlight the vulnerability of traditional pastoral production systems, particularly nomadic systems that are the main source of food and income in semi-arid rangelands ill suited to growing crops.

Globally, an estimated 675 million rural poor people depend on livestock for some or all of their subsistence. Other estimates suggest that as many as 70 percent of the rural poor are livestock owners. That figure includes nearly 200 million pastoralists and more than 100 million landless livestock keepers in mixed farming regions who depend almost exclusively on livestock.

Their animals and livelihoods are highly vulnerable to droughts and floods, resource degradation and outbreaks of disease. And they are coming under increasing pressure as human populations increase and grazing areas shrink.

In Afghanistan, three consecutive years of severe drought (1999–2001) led to massive distress sales and deaths of animals that reduced the livestock population by nearly 60 percent. Most nomadic Kuchis lost almost their entire herds.

In Eritrea, the worst drought in decades caused livestock losses as high as 10 to 20 percent in some areas in 2002.

The same drought also struck neighbouring Ethiopia, which has one of the largest livestock populations in Africa. The eastern pastoral areas of Afar and Somali were hardest hit. Acute shortages of water and fodder caused losses of up to 40 percent for cattle and 10 to 15 percent for goats and sheep. Livestock prices fell by up to 50 percent.

These emergencies underline the fact that traditional livestock production systems sustain some of the world’s most vulnerable communities in some of its harshest environments. They also highlight the need for emergency prevention and rehabilitation programmes to respond to the particular needs of livestock owners.

Early warning systems have had difficulties detecting the impact of drought on pastoralists and providing the information needed to help them cope and recover. Pastoral communities typically need different kinds of aid over longer periods than farmers who rely mainly on crops. When rains return after a drought, for example, farmers may require little more than seeds, fertilizer and one successful cropping season to get back on their feet. But pastoralists may need several years of assistance to weather the crisis, replenish their breeding stock and rebuild the herds that represent both their livelihoods and their life savings. In the long term, alternatives must be found for those whose livelihoods can no longer be sustained by nomadic herding.


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