Position Statement
It is the position of The American Dietetic Association that access to adequate food is a fundamental human right. Hunger continues to be a worldwide problem of staggering proportions. The Association supports programs that combat hunger, allow for self-sufficiency, and are environmentally and economically sustainable.
Sustainability
Society's ability to shape its economic and social systems so as
to maintain both natural resources and human life. Sustainable
development includes the reduction of poverty and hunger in
environmentally sound ways. It also embraces the following
broader objectives that are interrelated and mutually
reinforcing:
Hunger A condition in which people lack the basic food intake to provide them with the energy and nutrients for fully productive, active lives (13). Malnutrition Failure to achieve nutrient requirements, which can impair physical and/or mental health. It may result from consuming too little food or a shortage or imbalance of key nutrients (eg, micronutrient deficiencies or excess consumption of refined sugar and fat) (13). Food security Access at all times by all people to adequate food for an active and healthy life (1). |
Food security means access at all times by all people to adequate food for an active and healthful life (1). Worldwide, a substantial number of people remain food insecure or hungry. (See hunger-related terms in box at right.) Data indicate that approximately 20% of the world's population, or 1 billion people, are energy deficient (2). Micronutrient deficiencies are even more widespread: according to the World Health Organization, more than 2 billion people suffer from an inadequate intake of iodine, iron, and vitamin A (3).
Famine the image many people have of hunger affects relatively few people, and the amount of food needed to prevent it is relatively small. Famines can be caused by natural disasters or by war and civil strife. Early warning systems and humanitarian responses have virtually eliminated famine deaths due to natural disasters. In 1992, 157 million people, or 3% of the world's population, lived in countries affected by famine or severe food shortage (not everyone in these countries actually suffered from hunger) (3).
Chronic hunger due to poverty is much more widespread than acute hunger due to famine. About 36% of preschool-aged children in developing countries are moderately or severely malnourished based on weight-for-age (4). Each day, an estimated 35,000 (14 million per year) die of malnutrition and related preventable disease (5). An overview of the current status of hunger in various regions of the world follows (3).
Sub-Saharan Africa Hunger is widespread and worsening. Long-term economic decline, international debt, low commodity prices, poor results from structural adjustment policies supported by the World Bank and International Monetary Fund, and violent conflicts contribute to increased hunger.
Asia-Pacific region Although hunger has declined in the past 20 years because of economic growth and large-scale pub-lic investments in nutrition, health, and education, the region is home to most of the world's hungry people. Incidence of un-dernutrition among preschool children is higher than in Africa.
Middle East Hunger declined between 1970 and 1990 as higher oil prices permitted increased food imports.
Latin America Debt and austerity policies led to increased hunger during the 1980s. No total regional change occurred in the 1990s.
Europe Structural unemployment in the 1980s and early 1990s led to increased poverty and homelessness and the proliferation of food banks. In formerly communist countries, violent conflicts and massive economic transition have created hunger and food insecurity for many people.
United States Hunger has increased since 1985 because of underfunding of government antihunger programs, long-term decline in the average worker's real wages, and increased poverty, especially among children.
The magnitude of hunger is intolerable in a world of plenty. In addition to human suffering, hunger and malnutrition have negative effects on labor productivity, cognitive development, and health. Hence, hunger eradication is in the world community's interest. Because hunger causes are typically a combination of individual, household, community, national, and international factors, however, simplistic solutions are inadequate.
In the 1950s and 1960s, emphasis was placed on increasing national food supplies to deal with hunger. Such an approach is necessary, but insufficient. In many countries where food availability is at or greater than 100% at the national level, 20% to 30% of the population consumes less than 80% of their energy needs (1). National data on food supplies mask regional differences. In China, Thailand, and Indonesia, for example, high rates of undernutrition persist in certain regions despite generally effective national commitments to reducing hunger.
Furthermore, for those without control over land to produce their own food, increased food output does not ensure access to food in the absence of secure and adequate incomes (6). Poor and hungry people may lack the political clout to command public services, and more affluent people outbid them in the marketplace. To the extent that government policies increase a household's access to food (because these policies result in higher incomes or lower food prices, or because the government supports direct interventions such as feeding programs), household food security improves.
In many countries there are problems of access to food within households. Individual food intake within the household is affected by sex, control of income, education, age, birth order, and genetic endowments. For example, women and girls may receive less food than men and boys. In some cultures, women are more likely than men to allocate income to food; thus, to the extent that women control income, they are more likely to use it to ensure household members' food consumption (7,8).
Most malnourished children live in homes that have access to adequate quantities of food. Malnutrition can result from low birth weight (which may stem from poor nutrition during pregnancy) and bottle-feeding in inappropriate circumstances, such as the absence of clean water or the income to afford formula. But the main cause of malnutrition is illness, especially diarrhea and infectious diseases, which thrives in poor communities lacking clean water and sanitation. Chronic poor health saps children of nutrients and leaves them with poor appetites, while malnutrition can cause permanent mental and physical damage (9-11). Environmental sanitation and immunization are essential for combating childhood malnutrition.
Racism and ethnocentrism underlie much of the world's hunger (12). In Sudan, for example, racial and ethnic competition for resources has led to violent conflict and the world's highest rates of undernutrition. Globally, ethnic and political conflicts contribute to the hunger problem by diverting resources that could be used to meet basic human needs. In 1994, global military expenditures were estimated at $767 billionmore than the total income of the poorest 45% of the world's population (13). Conflicts also disrupt food production, markets, and transportation and displace workers from their livelihood. Warring parties may deliberately use hunger as a weapon.
Policy makers debate whether to tackle hunger primarily through broad-based economic policies that alleviate poverty or through targeted food and nutrition interventions. Often no single approach suffices. Particularly troublesome are obstacles to reducing hunger in rural areas, where food insecurity affects the most people.
Policies that promote long-term, sustained increases in poor people's incomes provide the most viable strategy for permanently eradicating hunger. In the short to medium term, complementary targeted programs are needed to provide a nutritional safety net for vulnerable households.
Labor-intensive public works programs have been successful in increasing the income and, thus, the food consumption of very poor people in a number of developing countries (14). Targeted feeding programs, most commonly supplementary food programs for preschool-aged children and pregnant women, can also be an effective part of the social safety net.
Because the economies of many developing countries are based on agriculture, growth in that sector, primarily through technological change, is critical for general economic growth, poverty reduction, and elimination of hunger. The agricultural technologies of the 1960s and 1970s that relied heavily on modern seed varieties had dramatic effects on food production, most notably in Asia and some parts of Latin America (15). These technologies led to lower food prices, benefiting urban consumers, landless rural people, and small farmers who were net purchasers of food (16). As production increased, rural incomes increased. For example, in North Arcot, India, households that adopted new rice varieties more than doubled the real value of consumption of food and other goods between 1973 and 1984 (17), and diets became more varied. Demand for hired agricultural labor increased, boosting the incomes of rural poor people. But many poor farmers could not use these technologies because they relied on costly patterns of irrigation, fertilizer application, and pesticide use. Such technologies can also contribute to the problems of land degradation, which are already severe where growing poor populations have no choice but to intensively farm marginal land.
In much of the developing world, control over land and other assets is highly inequitable. Increasing poor people's access to assets, including credit, is essential to ending hunger. The Grameen Bank in Bangladesh, which offers microenterprise loans to very poor people, is a model of how poor people may access bank credit (18).
The end of the Cold War provides new opportunities for creating a hunger-free world, but also heightens the danger of new hunger crises. Resources previously devoted to arms races and ideological struggle can now go toward ending hunger and poverty. At the same time, the world faces an unprecedented explosion of regional conflicts, many of them based on long-standing ethnic grievances and struggles over control of resources. This has caused serious increases in short-term hunger and created relief needs that have overwhelmed long-term development efforts.
The global shift away from authoritarian government provides openings for disenfranchised groups to shape policies and programs (19). In this changing world order, many institutions are being pressed to change their roles. The United Nations faces new challenges to make and keep peace, meet humanitarian assistance needs, and uphold the right to food.
The long-term solution to hunger is sustainable development. This includes meeting basic human needs (basic health, nutrition, and education for all); expanding economic opportunities, especially for poor people; protecting and enhancing the environment so that progress can be sustained; and promoting pluralism and democratic participation.
Presently, global grain supplies are adequate to provide every person on earth with their minimum energy requirements. Supplies are likely to remain adequate in the short-term future. For developing countries as a whole, food supplies increased more rapidly than population in the 1970s and 1980s, but in sub-Saharan Africa, where population is growing 3% annually unprecedented in history for an entire continent, and in contrast to a 1% growth rate in the United States per capita food production has declined. If current population growth trends continue, food output could fall short of projected demand by 50 million metric tons by the year 2000.
Globally, growth rates in crop yields are declining, but even optimistic scenarios require a doubling of food production within the next generation to keep up with projected population growth. Efforts to overcome these constraints often degrade the environment and conflict with the longer-term sustainability of agriculture (20). Increased subdivision of land among successive generations and expansion of farms into ecologically fragile areas add to environmental destruction caused by the flight of hungry people from rural areas to cities and deforestation of adjoining areas. Some 1.5 to 1.7 million acres of agricultural land in developing countries are lost each year to soil erosion. Overconsumption by affluent people diverts resources that could meet basic human needs and adds considerably to the strain on the environment.
Maintaining the balance among people, food, and the environment requires a reversal in the declining trend in global funding for agricultural research. Current research should give priority to environment-friendly technologies and improvements adapted for poor farmers.
Reducing population growth is also part of the equation. Some evidence suggests that the most effective way to reduce population growth is to improve the lot of women, especially through education for girls (Matthews J. Population control that really works. Washington Post. April 1, 1994: 21).
The world has both the food and the technical expertise to end hunger (3). What is lacking is the political will. The changes needed to overcome hunger will only occur if concerned citizens worldwide seek to change public policies. Past efforts of US antihunger activists led, for example, to increased funding for child survival programs, which are now saving the lives of some 5,000 children each day. In developing countries such as Zimbabwe, Brazil, and the Indian state of Kerala, popular organizations have pressed governments to give greater priority to reducing hunger and poverty (12).
Declarations upholding the right to food security, such as those issued at the International Conference on Nutrition in 1992 and the World Summit for Children in 1990, help create the environment for the needed shift in priorities. But reducing hunger will also require tangible resources. The costs are real, but so are the costs of failing to act. In most cases, micronutrient deficiencies can be ended with low-cost, readily available nutrition interventions (eg, salt iodization and vitamin A capsules). Sustainable development to overcome chronic undernutrition is more difficult, economically and politically, but the payoff is high: more people contributing to the economic, social, and cultural life of their communities, nations, and the world.
Presently, governments of most foreign aid donors and developing countries do not give high priority to reducing poverty and hunger. The quantity and quality of aid falls short of its hunger-reducing potential. Foreign aid amounts to about 1% of the US federal budget; no more than 35% of US foreign aid is focused on sustainable development (21).
Industrialized countries need to adapt the rules of the global economy to encourage development in poor countries. The 1994 General Agreement on Tariffs and Trade (GATT) will cost Africa an estimated $2.6 billion by the year 2000 because of lost trade advantages and food aid (21,22), but Africa's needs barely figured in the negotiations. Barriers against exports from developing countries cost them an estimated $100 billion each year, double what they receive in aid. Further, the international debt crisis of the 1980s left many developing countries with a heavy burden of unpayable debt, and the macroeconomic reforms that international financial institutions pushed them to adopt have often been unnecessarily harsh on poor and hungry people (23).
Long-term solutions to hunger must address the root causes. Sustainable development requires political, economic, and social changes: empowering the disenfranchised, widening access to assets and other resources, narrowing the gap between rich and poor, and adjusting consumption patterns so as to foster good stewardship of nature (13). Without these changes, hunger will continue to plague humanity. Ending hunger is not only a moral question, but a practical concern for all of us and for future generations. It means not only upholding the rights and dignity of all human beings, but also maintaining the security and integrity of the planet on which we all live.
Hunger is a massive, but solvable problem. Nutrition professionals are uniquely qualified to educate elected officials and voters about the nutritional impact of policies and programs. There is an urgent need for nutrition professionals to become actively involved in seeing that the food assistance programs that support sustainable development are protected, improved, and expanded. When possible, nutrition professionals should get involved, on a long-term and short-term basis, in relief, development, and education activities in the developing world.
References
1.Poverty and Hunger: Issues and Options for Food Security. A World Bank Policy Study. Washington, DC: World Bank; 1986.
2.Sixth World Food Survey. Rome, Italy: Food and Agriculture Organization of the United Nations; 1992.
3.Uvin P. The state of world hunger. In: Uvin P, ed. The Hunger Report 1993. Langhorne, Pa: Gordon and Breach for the Alan Shawn Feinstein World Hunger Program, Brown University;1994:1-42.
4.Carlson BA, Warlow TM. A Global, Regional, and Country Assessment of Child Malnutrition. New York, NY: UNICEF; 1990. UNICEF staff working paper 7.
5.United Nations Children's Fund. The State of the World's Children 1993. New York, NY: Oxford University Press; 1993.
6.Dreze J, Sen A. Hunger and Public Action. Oxford, England: Clarendon Press; 1989.
7.Piwoz EG, Viteri F. Studying health and nutrition behavior by examining intrahousehold resources distribution and the role of women in these processes. Food Nutr Bull. 1985;7(4):1-35.
8.Garcia M, Pinstrup-Andersen P. The Pilot Food Subsidy Scheme in the Philippines: Its Impact on Income, Food Consumption and Nutritional Status. Washington, DC: International Food Policy Research Institute; 1987. Research Report 61.
9.United Nations Children's Fund. Progress of Nations 1994. New York, NY: UNICEF; 1994.
10.United Nations Children's Fund. The State of the World's Children 1994. New York, NY: Oxford University Press; 1994.
11.United Nations Children's Fund. The State of the World's Children 1995. New York, NY: Oxford University Press; 1995.
12.Twose N, Pogrund B. War Wounds: Development Costs of Conflict in Southern Sudan-Sudanese People Report on Their War. London, England: Panos Institute; 1988.
13.Cohen MJ, ed. Causes of Hunger: Hunger 1995. Fifth Annual Report on the State of World Hunger. Silver Spring, Md: Bread for the World Institute; 1994.
14.Kennedy E, Pinstrup-Andersen P. Nutrition-Related Policies and Programs: Past Performances and Research Needs. Washington, DC: International Food Policy; 1983.
15.Pinstrup-Andersen P, Hazel PBR. The impact of the green revolution and prospects for the future. Food Rev Int. 1985;1(1):1-25.
16.Kennedy E, Bouis H. Linkages between Agriculture and Nutrition: Implications for Policy and Research. Washington, DC: International Food Policy Research Institute; 1993.
17.Hazel PBR. Changing patterns of variability in cereal prices and production. In: Mellor JW, Ahmed R, eds. Agriculture Price Policy for Developing Countries. Baltimore, Md: Johns Hopkins University Press; 1987: 27-52.
18.Barraclough SL. An End to Hunger? The Social Origins of Food Strategies. Atlantic Highlands, NJ: Zed Press for the United Nations Institute on Social Development and the South Centre; 1991.
19.United Nations Development Program. Human Development Report 1993. New York, NY: Oxford University Press; 1993.
20.Vosti SA, Reardon T, von Urff W. Agriculture Sustainability, Growth and Poverty alleviation. Issues and Policies. Proceedings of an International Conference, Sept 23-27, 1991. Feldafing, Germany. Washington, DC: International Policy Research Institute; 1992.
21.Cohen MJ. The uses of aid: the United States of America. In: Randel J, ed. The Reality of Aid: An Independent Review of International Aid. London, England: Actionaid; 1994: 122-131.
22.Foreign Aid: What Counts Toward Sustainable for Sustainable Development and Humanitarian Relief. Silver Spring, Md: Bread for the World Institute. Occasional paper No. 4. In press.
23.Cornia GA, Jolly R, Stewart F, eds. Adjustment with a Human Face: Protecting the Vulnerable and Promoting Growth. Vol 1. Oxford, England: Oxford University Press; 1987.
24.Assessing the Impact of the Uruguay Round. Paris, France: Organization for Economic Cooperation and Development; 1993.
ADA Position adopted by House of Delegates on April 16, 1995. This position is in effect until December 2000. ADA authorizes republication of the position statement/support paper, in its entirety, provided full and proper credit is given. Requests to use portions of the position must be directed to ADA Headquarters at 800/877-1600, ext 4896 or ppapers@eatright.org.
Recognition is given to the following for their contributions:
Authors:
David Beckman; Marc J. Cohen, PhD; and Eileen Kennedy, PhD, RD
Reviewers:
American Institute of Nutrition (Benjamin Caballero, MD, PhD; B. J. Friedman, PhD, RD); Hunger and Malnutrition dietetic practice group (Diane Veal Jones, MS, RD; Minkie Medora, MS, RD); Rena M. Labosco, MS, RD; Rina Rosenberg, RD; and Barbara J. Scott, PhD, RD
source: http://www.eatright.org/aworldhunger.html 25jan01
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