Do hunger and malnutrition make you want to cry? Time to get your HANCI out

Today sees the launch of the Hunger and Nutrition Commitment Index (HANCI), produced by the Institute of Development Studies (IDS) with funding from Irish Aid and DFID. It looks like it could become one of the more useful annual league tables.

It may not be seen as a progressive view in the UK, but I’m a big league table fan, especially when they’re combined with access to new information. They use political rivalry to motivate politicians, the media love them, they allow good guys to be praised, as well as under-performers to be slapped, and they hand civil society some useful ammunition. The post2015 circus might be well advised to spend more time designing an effective league table, rather than adding yet more issues to its Christmas tree.

The HANCI assesses governments both by intention and action, examining policies and programmes, legal frameworks and public spending in 45 developing countries across 22 indicators (see chart). It uses separate analyses for hunger and undernutrition, and stresses the differences between them.

Guatemala wins the beauty parade, coming ‘a resounding number one’ both on hunger and undernutrition. The report hails ‘a range of efforts by the Government of Guatemala:

• Ensuring high level of access to drinking water (92% of the population)
• Ensuring good levels of access to improved sanitation (78%);
• Promoting complementary feeding practices, and ensuring over nine out of ten pregnant women are visited by a skilled health personnel at least once before delivery;
• Investing substantially in health and having a separate nutrition budget line to make its spending accountable to all;
• Putting in place a Zero Hunger Plan that aims to reduce chronic malnutrition in children less than 5 years of age by 10% in 2016;
• Ensuring that public policy is informed by robust and up to date evidence on nutrition statuses;
• Establishing a multi-sectoral and multi-stakeholder coordination mechanism that is regionally recognised as an example of good practice.’

In contrast Guinea Bissau is at the bottom of the heap. Other findings include:

• Big variation between countries (eg within the BRICS, South Africa is the hero, and India the zero)
• Economic growth has not necessarily led to a commitment from governments to tackle hunger and undernutrition

• Conversely, countries with low per capita GDP and relatively slow growth, like Malawi, can demonstrate commitment (Malawi came second after Guatemala)
• Very low level of correlation between performance on hunger and on nutrition (not clear what to make of that)

Here’s the full index (keep clicking to enlarge a bit):

The HANCI raises lots of questions about the patterns that emerge. All 3 Latin American countries are in the top 5, but the Asian and African countries are much more intermixed. What other features are worth studying? The link to political regimes? Aid dependence? Conflict? It’s a good index and will provide lots of, errm, food for thought.

(And for non-English speakers wondering about the title of this post, it’s a pun on hankie. Geddit?)

Launch of ‘If’ – new megacampaign to tackle global hunger: how does it compare with ‘Make Poverty History’?

Sorry for a second post in one day, but the launch of If is a biggie

Ah the perils of age – am I becoming one of those annoying old guys who greets every new idea (however excellent) with a weary sigh and ‘we already did/discussed all that back in the 19XXs’? I ask because I have a distinct sense of ‘here we go again’ as today, a smorgasbord of 100 NGO logos will adorn the press releases for the launch of ‘If’, a big campaign to tackle global hunger. Logotastic, lots of killer facts, a smart video (below) and, wait for it, white wristbands! Yep, it feels a bit like a rerun of Make Poverty History (2005, for the younger readers). I may blog about this properly when I’ve had time to gauge the debates around the launch, but initial impressions are:

What’s the same as MPH?

Northern focus, pegged to this year’s UK presidency of the G8 (although the G8 is not the global steering committee it was (or at least thought it was) back in 2005).

The wristbands and celebs, which should take development debates outside the usual circuits (a good thing, in case more wonky readers are in any doubt).

The big coalition of NGOs managing the tensions of any alliance in terms of pushing their particular priorities while maintaining a clear enough message to get media ‘cut-through’. More subtly, they also have to balance the dangers of over-hyping impact, ‘make poverty history’ style, with the risks of disappearing into an academically rigorous but entirely incommunicable message of ‘hey everything is context-specific, and there are enormous limits to the efficacy of international action, but we think this would probably help a bit.’

The focus on aid – this is a big year, with UK government becoming the first G8 country to meet the international aid target of 0.7% of national income, even as other governments are tearing up their aid promises under the weight of economic crisis.

What’s different

We didn’t say ‘cut through’ back in the day.

Many more technological options for viral campaigning – twitter (#If) being the most obvious. Linked to that is a much greater focus on transparency (helpfully, if clunkily, translated as ‘seeing clearly’ in the campaign literature). And a seriously funky website (left).

If reflects the shifting development agenda: in come tax dodging, biofuels, agriculture and nutrition, out go trade (Doha round going nowhere) and debt (successful cancellation in dozens of countries). More of a focus on the rich countries putting their houses in order (tax, biofuels etc), which has to be a good thing (its lack was one of the main critiques of MPH by Dani Rodrik and Nancy Birdsall, among others). Climate change is one of If’s core issues, whereas in Gleneagles, it was put on the table by the British government, not MPH.

This one feels more UK-centric (at least for now).

No sign of Bob Geldof so far (but the year is young….)

So what do you think?

One other consequence of age: for my generation ‘If…..’ conjures up images of the 1968 film, which ends with a young Malcolm McDowell on a rooftop machine-gunning the parents and teachers of his posh public school (as we call private schools in the UK). It even has a memorable reference to Oxfam. Trust that’s just a coincidence.

What’s up (or down) with global hunger?

Guest post from Oxfam Research Policy Adviser Richard King (right)

Today the UN’s Food and Agriculture Organisation (FAO) is celebrating World Food Day, and is playing host to the latest Committee on World Food Security meeting. Last week, to warm things up, the FAO, World Food Programme, and International Fund for Agricultural Development launched their joint 2012 ‘State of Food Insecurity in the World’ (SOFI) report, with the FAO’s latest estimates of global hunger. If you’re familiar with oft-cited facts such as ‘nearly one in seven people go to bed hungry’, or ‘nearly a billion people don’t have enough to eat’ reverberating around the echo chamber, they’re based on the calculations in previous editions of this publication.

The annual report has commanded a lot of interest over the past few years, partly because we’re living through a time of extraordinary food price volatility, but also because some of the FAO’s estimates of hunger (or more properly ‘undernourishment’) during the global food and economic crises have raised eyebrows. I won’t rehash here previous critiques of the recent estimates; suffice to say the shortcomings have been increasingly recognised by the FAO itself, and they’ve been beavering away behind the scenes to improve both their calculations and the data that they rely on. So it was with much anticipation that we waited to see what changes last week’s report would bring. And [fanfare!] here they are…

As you can see from the above chart (dotted lines are projections), the major overhaul of the calculations has fundamentally changed our understanding of the trajectory of global hunger over the past two decades. Notably the huge spike previously attributed to food and economic crises in the late 2000s has vanished. That’s not to say these short-term crisis events, particularly the earlier food price shock, didn’t have pernicious consequences for people’s food security, or are without implications for their broader lives over a longer period, it’s just that this particular measure of long-term, absolute, undernourishment isn’t set up to capture the full impact of these acute shocks. For example, very young children are especially vulnerable to short-term disruptions in micro-nutrients (even if calorific intake remains sufficient), which can translate into growth deficiencies and learning difficulties for life. Similarly, families may be forced apart for good when short-term bouts of stress-induced domestic violence have driven women out of their homes in fear of their husbands, and when men abandon their families under the guise of looking for work in the city, some never to return. It’s also true that the latter economic crisis had less of a macro impact on the economies of the most populous developing countries than the guestimated projections originally envisaged.

Cynics might question whether there is also a political motive behind the revisions, less than three years from the 2015 Millennium Development Goal deadline for reducing by half the 1990 proportion of people in the developing world suffering from chronic hunger. After all, recent estimates suggest the allied poverty reduction target for MDG1 has now been met, and criticisms abound. But such scepticism doesn’t stand up to scrutiny once you get under the bonnet of the changes, for at least three reasons.

First, despite the much more positive trajectory than shown in past reports, there is still a long way to go before the MDG target of 11.6 per cent of the developing world’s population would be met. The FAO calculate that “If the average annual decline of the past 20 years continues to 2015, the prevalence of undernourishment in developing countries would reach 12.5 per cent”, still above target. But even this relatively near-miss doesn’t look likely given the flat-lining of progress over the past five years. Political inaction means high and volatile food prices, lack of investment in agriculture, gender inequality, land grabs and climate change are now jeopardising past gains in the fight against hunger.

Second, if you break down the figures by region, the picture is more alarming than at first sight. For sure, there have been significant improvements in Asia and the Pacific, and in Latin America and the Caribbean, both in reducing the proportion of people hungry (the prevalence) and the absolute number of undernourished people, but the picture in the Near East and Africa both north and south of the Sahara is seriously concerning; in sub-Saharan Africa the prevalence was slowly improving, but has slowed, and the absolute number of hungry people in all of Africa and the Near East continues to march relentlessly upwards.

Three, looking at the actual revisions made to the calculations, it’s clear that the main driver of the changes are better (though still far from perfect) data, rather than methodological meddling. Let’s unpack these revisions.

There are essentially five elements that contribute to the significantly different values to those presented in previous reports:

-       Updated estimates of population size and structure

-       Better data on individuals’ heights, and so improved estimates of how much food energy is required

-       Updated estimates of dietary energy supplies available for all countries

-       New estimates of food losses at the retail level (between wholesalers and households)

-       Changes to the underlying methodology (essentially tweaks to statistical distribution models and estimates of coefficients of variation)

Each of these elements has an upward or downward bearing on the previous estimates of undernourishment, but by far the largest marginal factor in each period is the new information available on food losses, which alone adds over 100 million people to the ranks of the hungry previously estimated for each period. In recent years this marginal increase has been more than compensated by downward revisions resulting from dietary energy supply, heights, and methodology changes, but none of these alone accounts for as much as half of the influence of food losses.

Although this leaves us with a better, radically different, impression of what’s likely to have been happening to the prevalence of hunger, it still only paints a partial and conservative picture of food insecurity. Why? Well first, as already alluded to, this is an “indicator of chronic undernourishment based on annual average consumption” so doesn’t fully capture effects of food price and other acute economic shocks. Nor does it capture the longer run impacts of these shocks such as potential job losses, childhood stunting, or the added burdens on women in the care economy.

Second, ‘undernourishment’ is defined “as an extreme form of food insecurity, arising when food energy availability is inadequate to cover even minimum needs for a sedentary lifestyle”. Any woman trying to put food on the table for her family and to deal with the broader repercussions of volatile food prices would be amused by the notion of living a sedentary lifestyle.

Third, the focus on food energy doesn’t tell us about the quality of micronutrients being consumed or whether food preferences are being met. For example, early findings from work undertaken by Oxfam and IDS research partners suggest that as food prices continue to rise children in coastal Kenya have been collecting nutritious (but perhaps not entirely palatable) caterpillars to eat with their starchy staple ugali; whereas in Indonesia, the ‘substitution’ is replacing expensive vegetables with quick and tasty, but less nutritious, instant noodles.

To deal with these shortcomings of the prevalence of undernourishment measure, several responses are in motion. The FAO have for the first time published a wider suite of food security indicators ranging across the determinants of food insecurity, outcomes of food insecurity, and vulnerabilities to food security. And, though it may seem odd that the prevalence of undernourishment indicator itself is not based on asking people if they are hungry, the FAO have also now announced plans to initiate a global poll to monitor food insecurity based on short interviews with people.

This could throw up some interesting results and give us a better indication of the impacts of acute shock events. But in order to understand what it means to live in a time food price volatility, these quantitative indicators and polls need supplementing with rich qualitative information that shed light on how well people are coping with changes to their food security and wellbeing. This is something that Oxfam, IDS, and partners are seeking to do through our Life in a Time of Food Price Volatility project.

Climate Change, the Olympics and Hunger: What’s the link?

This guest post from Tim Gore (right), Oxfam’s climate change policy adviser, explores the parallels between climate change and the Olympics, ahead of tomorrow’s UK-hosted ‘hunger summit’

‘Faster, higher, stronger’ is not just the motto of athletes competing at the London games, it’s also a pretty accurate description of our weather over the past 12 months. And the similarities don’t end there.

In June, the US Government reported that sea ice in the Arctic has melted faster this year than ever recorded before. June also saw another 2 records topple, the highest global average land surface temperature was reached at 1.07°C (1.93°F)  above average, alongside the highest Northern Hemisphere land and ocean average surface temperature ever recorded, at 1.3°C (2.34°F) above average.

Meanwhile, the 2012 Atlantic hurricane season, which officially began on 1 June and ends on 30 November, has seen for the first time ever four tropical storms forming before July – one of which – Tropical Storm Beryl – came ashore in South Florida on 28 May, as the strongest pre-June tropical cyclone to make landfall in the United States.

It’s been a huge record-breaking year for the US overall, and not just in the Olympic swimming pool. The US has won gold for July 2012, as the nation’s hottest month on record, contributing the warmest 12 month period experienced in the country since records began.  Not to be outdone in the medal table, the UK has won gold for the heaviest ever rainfall from April to June, while claiming another record for the highest ever maximum temperature last October and a silver for the second warmest November in 100 years. Throughout the year and around the world, more new records have been set for extreme weather this year than in the London Olympic stadium.

Is this just a coincidence – natural variability – or is it evidence of man-made climate change? Just as the relative performance of athletes will be pored over by their coaches in the coming weeks and months, scientists are now working on analyses that can help answer that question.

Last month, a collection of studies was published which showed that some individual extreme weather events are more likely to have occurred due to greenhouse emissions. For example, they found that the probability of a drought occurring in Texas of the same severity as the state experienced in 2011 has increased twenty times as a result of climate change.

That’s not to say all extreme weather events are made more likely by climate change. New research commissioned by Oxfam into the UK’s record-breaking weather year confirms that the odds of the heavy rainfall of 2012 have not changed under our warmer climate. Although some of the same scientists found that greenhouse gas emissions increased the risk of the destructive UK floods of autumn 2000 substantially, and the chance of a November in the UK as warm as last year’s by around 62 times.

What this means is that greenhouse gas emissions are to our climate what steroids are to an Olympic athlete – they don’t guarantee records will be broken, but they make it much more likely. Just as the doped-up athlete has a better chance of winning an Olympic medal (providing she or he isn’t caught), pumping greenhouse gasses into our atmosphere increases the likelihood of extreme weather.

But that’s where the comparison ends. Because while we celebrate our Olympic successes and hope they inspire a generation, the litany of extreme weather leaves nothing but devastation in its wake, hitting the poorest and most vulnerable amongst us hardest.

Nowhere can this be seen more clearly than in the impact of the current US drought – the worst since the 1950s – on world food prices. As US farmers struggle with crop losses of more than 16%, prices of staples like maize and wheat have rocketed, which is the worst news possible for people in poor countries that spend up to 75% of their incomes on food.

The most vulnerable live in countries reliant on food imports, or that have suffered their own weak harvests. In Yemen, which imports 90% of its wheat, 10 million people are already hungry and 267 000 children at risk of death from malnutrition. An increase in extreme weather, compounded by a flawed global food system, means extreme food prices and rising hunger.

So it is perhaps fitting and very welcome that tomorrow, as the heat and light of the Olympic flame dies down, David Cameron will host a hunger summit for world leaders in London, with Olympic greats Haile Gebrselassie and Mo Farah in attendance. It’s vital they act to reverse decades of under-investment in smallholder farmers, end biofuel programmes that put 40% of US corn into cars not mouths, and redouble efforts to fight climate change. For the close to 1 billion people who will go to bed hungry tonight, what they decide could be the real legacy of London 2012.

You can follow the hunger summit on twitter (#globalhunger) or watch 131 years of global climate change in 26 seconds [h/t Ricardo Fuentes] 

Big Decisions today on Food Crisis in the Sahel: here’s the background

A high level collection of EC and member states officials, UN big cheeses and West African leaders are meeting in Brussels today to discuss the unfolding crisis in the Sahel, where a disaster is looming. Some communities already find themselves in crisis, others see disaster on the horizon as an early lean season approaches and the annual ‘hunger gap’ lengthens. Overall, 18.4 million people are vulnerable to the food crisis, 6 million of whom are ‘severely food insecure’ – in a serious state, but falling short of outright famine (see table for March 2012 figures).

The meeting will focus on the serious funding gap. Only about half the estimated $1.6bn has been committed so far, despite the alarm bell having been rung months ago. The meeting will also launch a ‘partnership for resilience’, which is what I want to focus on here.

It is this focus on resilience, systems and long-term solutions that stands out when reading Oxfam’s most recent briefing on the Sahel crisis and comparing it to our ‘Dangerous Delay’ analysis on the flawed response to the crisis on the other side of the continent, in East Africa. Restrictions on migration and trade, high food prices, a failure to invest in small-holder agriculture and safety nets, and the conflict in Mali and even the international arms trade are significant contributory factors, alongside the failure of the rains.

The Sahel briefing focuses on the need not just to find emergency money, but to treat crises as long-term and cyclical, rather than one-off disasters (300,000 children in the region die of malnutrition, even in a ‘good’ year). The paper’s recommendations for building resilience to such cycles are worth quoting in full:

“Firstly, with food often available on the market but inaccessible due to high prices, developing food reserves in vulnerable regions will be critical not only in enhancing access to affordable stocks in order to rapidly respond to future crises, but also to help governments prevent and manage food price volatility. ECOWAS recently committed to defining a regulatory framework for the development of a regional system of food reserves, a process that should be supported by donors, including at the G20 meeting in June 2012.

Secondly, national policies and programmes promoting social protection measures and social safety nets are needed for the most vulnerable people and communities, especially children, pregnant and breastfeeding women and the elderly. This will increase the long-term resilience of households, improve the nutrition of children, pregnant and breastfeeding women, and lessen the impact of the future droughts. The meeting of the Committee on World Food Security (CFS) in Rome in October 2012 provides a key opportunity to promote and support these investments.

Thirdly, a change is needed to the system of producing and consuming food, moving away from a focus on investing in a limited range of export crops and towards investment in small-scale producers who can increase local food production and break the dependency on fragile and expensive international markets. This should include allocating at least 10 per cent of national budgets to agriculture, as promised in the 2003 African Union Maputo Declaration, but greater attention should also be given to ensure this assistance is targeted to small-scale farmers, particularly women.”

The response to date has in some important ways been better than in previous such crises: the early warning systems functioned relatively well; governments in the region raised the alarm quickly; and some donors mobilised funds more quickly than in the past. Regional governments, Niger in particular, are showing more leadership, as is the regional body, ECOWAS. But such leadership remains largely absent in some of the region’s more fragile, conflict-ridden states. There are some good policies in place, such as an ECOWAS charter for preventing food crises, but implementation is another issue. There is still a long way to go – the cup is perhaps a quarter full.

Despite the funding shortfall, donors are also doing better, with ECHO, the European Union’s humanitarian body, the star of the show in terms of acting early, before the horrifying footage hits the TV screens.

Looking ahead, the peak of the crisis is expected in July/August, with three potential complicating factors:

- A possible African Union or ECOWAS military intervention in Northern Mali to deal with armed groups there (shades of Somalia, in terms of security/anti-terrorism playing havoc with the humanitarian response)
- Predictions of lower than average rainfall (due from now to end August) in Western Sahel, which could tip Western Mali and Senegal into protracted crisis instead of recovery
- A locust epidemic, mainly in Niger and Mali, could be devastating, but is hard to deal with because of restricted access to Mali and Libya.

Such a long term shift in thinking on humanitarian response is vital, but will be of little comfort to the 18 million hungry people in West Africa – they will be looking to the meeting in Brussels today to come up with cash as well as policies. Click on Oxfam’s Sahel campaign to keep up the pressure.

Mouthwash or Global Leadership? What the Hunger Summit will tell us about Britain’s commitment to development

An edited version of this article appeared on the Guardian’s Poverty Matters website yesterday

When it comes to debates about world hunger, mouthwash – more fragrant PR than finding long-term solutions to feeding the planet without destroying it – is just as much of a problem as the greenwash the abounds in environmental fora.  And the Listerine test will be ready and waiting for recently-announced Hunger Summit, to be hosted by Britain during the Olympic Games.

But before we descend into full NGO curmudgeon mode, let’s step back and appreciate the significance of the announcement that David Cameron intends to use the Olympic spotlight to debate world hunger (his spin doctors can’t have been happy at him harshing the national mellow in this way). This is not an isolated gesture – the UK is one of the few European countries to stick to its promises to spend 0.7% of national income on aid from 2013 onwards, and is pushing hard for a tough international treaty to regulate the global arms trade. This kind of leadership earned the Prime Minister an invitation from the UN to chair (along with the presidents of Indonesia and Liberia) a ‘High Level Panel’ to explore how the world can set collective long-term targets for reducing poverty and achieving sustainability.

And leadership is desperately needed. In a world that produces enough food to feed everyone, 1 in 7 of us currently go to bed hungry. In Yemen, the number of food insecure people has doubled since 2009, and Oxfam is about to scale up to reach a million of them. In West Africa, over 18 million people are at risk. The crises are cyclical and deepening – this is a systemic issue, not a one off.

As to why Britain is taking the lead in this way, explanations run the gamut from a continued effort to detox the Tory brand (i.e. mouthwash), to a broader push to use aid to pursue national security goals, to a search for international statesman glory, to (shock) the Government actually understands and is committed to the importance of ending hunger and world poverty.

How will we know which of these is true when the Hunger Summit comes around? By whether it is a one-off event, or the launchpad for a genuine effort to tackle the global perfect storm of climate change, pressures on land and water, high and erratic food prices and rising consumption. Next year, Britain chairs the G8 group of the world’s most powerful economies, providing David Cameron with the chance to repeat the developmental coup of the Gleneagles summit of 2005, when a combination of political leadership and mass campaigning produced breakthroughs on debt and aid. Should he so wish, the G8, along with his membership of the High Level Panel, will provide ample opportunities for British leadership on global development and sustainability.

Early signs also suggest that the Summit will echo the Obama Administration’s reliance on private sector solutions. While some private sector companies are showing a real lead (Unilever  is aiming to involve 500,000 smallholders in its supply chains by 2020), companies can be nasty as well as nice. The state has a crucial role both in regulating private sector behaviour, but also playing a hands-on role in agricultural development (as has been the case in almost every successful agricultural take off to date). Whatever the fiscal temptations, the summit needs to avoid passing the buck.

Beyond the paraphernalia of photo-ops and ‘announceables’, Oxfam, along with many other NGOs, will be looking for concrete commitments in several areas: putting a stop to the spate of land grabs in poor countries by large foreign companies lured by high commodity prices and the prospect of future scarcity; tackling the perverse impact of biofuels, which in the name of rich world energy security, are ousting hundreds of thousands of small farmers from their land, deepening poverty and hunger; greater investment in the 500 million small farms that 2 billion of the world’s more vulnerable people rely on for their sustenance, and reforming an international tax system that allows western tax havens to actively encourage capital flight and tax evasion, sucking  billions of dollars out of poor economies.

Without such progress, the hunger summit will not be nearly enough. Tackling hunger today is welcome, but the prospect of rising hunger for future generations has to be on the table too.

What causes bad nutrition – not enough power or not enough vitamins?

As a general rule, the further The Economist magazine’s subject matter departs from economics, the better it gets, as information and analysis replace the ideological drumbeat of its market fundamentalist ‘priors’. Thanks to its coverage, vital development issues such as gendercide or resource scarcity reach a global mass audience. This week’s issue has an excellent analysis of the rise of the Muslim Brotherhood on the back of the Arab Spring, but the piece that caught my eye was a two page overview on poverty and nutrition, one of those issues that seems to be rising rapidly up the development agenda (see last week’s Save the Children report). Some highlights:

“In the 1960s and 1970s, ending hunger and malnutrition seemed relatively simple: you grew more crops. If the harvest failed, rich countries sent food aid. But the Ethiopian famine of 1984 undermined this approach. Here was a disaster of biblical proportions in a country where food was available. It was a reminder of what an Indian economist, Amartya Sen, had long taught: what really matters with food is not the overall supply, but individual access.

So in the 1990s and early 2000s the emphasis switched to helping people obtain food. This meant reducing poverty and making agricultural markets more efficient. Between 1990 and 2005 the number of people living on less than $1 a day in poor countries (at 2005 purchasing-power parity) fell by a third to 879m, or from 24.9% of the total population to 18.6%.

Yet the food-price spike of 2007-08 showed that this approach also had limitations. Prices of many staple crops doubled in a year; millions went hungry. The world remains bad at fighting hunger. Experts argue about exactly how many people are affected, but the number has probably held flat at just below 1 billion since 1990.

Even where there is enough food, people do not seem healthier. On top of 1 billion without enough calories, another 1 billion are malnourished in the sense that they lack micro-nutrients (this is often called “hidden hunger”). And a further 1 billion are malnourished in the sense that they eat too much and are obese. It is a damning record: out of the world population of 7 billion, 3 billion eat too little, too unhealthily, or too much.

More than 160m children in developing countries suffer from a lack of vitamin A; 1m die because they have weak immune systems and 500,000 go blind each year. Iron deficiency causes anaemia, which affects almost half of poor-country children and over 500m women, killing more than 60,000 of them each year in pregnancy. Iodine deficiency—easily cured by adding the stuff to salt—causes 18m babies each year to be born with mental impairments.

Malnutrition is associated with over a third of children’s deaths and is the single most important risk factor in many diseases (see chart). A third of all children in the world are underweight or stunted (too short for their age), the classic symptoms of malnourishment.

The damage malnutrition does in the first 1,000 days of life is also irreversible. According to research published in TheLancet, a medical journal, malnourished children are less likely (all things being equal) to go to school, less likely to stay there, and more likely to struggle academically. They earn less than their better-fed peers over their lifetimes, marry poorer spouses and die earlier.

Paradoxically, malnutrition can also cause obesity later in life. In the womb and during the first couple of years, the body adjusts to a poor diet by squirrelling away whatever it can as fat (an energy reserve). It never loses its acquired metabolism. This explains the astronomical obesity rates in countries that have switched from poor to middle-income status. In Mexico, for instance, obesity was almost unknown in 1980. Now 30% of Mexican adults are clinically obese and 70% are overweight.

These are among the highest rates in the world, almost as bad as in America. India has an obesity epidemic in cities, as people eat more processed food and adopt more sedentary lifestyles. And with obesity will come new diseases such as diabetes and heart disease—as if India did not have enough diseases to worry about.

Nutrition is also attracting attention because of some puzzling failures. In a few big countries, notably India and Egypt, malnutrition is much higher than either economic growth or improvements in farming would suggest it should be. India’s income per head grew more than fourfold between 1990 and 2010; yet the proportion of underweight children fell by only around a quarter. By contrast, Bangladesh is half as rich as India and its income per head rose only threefold during the same period; yet its share of underweight children dropped by a third and is now below India’s. Egypt’s agricultural value-added per person rose more than 20% in 1990-2007. Yet both malnutrition and obesity rose—an extremely unusual combination.

The good news is that better nutrition can be a stunningly good investment. Fixing micro-nutrient deficiencies is cheap. Vitamin supplements cost next to nothing and bring lifelong benefits. Every dollar spent promoting breastfeeding in hospitals yields returns of between $5-67. And every dollar spent giving pregnant women extra iron generates between $6-14. Nothing else in development policy has such high returns on investment.

If malnutrition does so much damage and the actions against it are cheap and effective, why is the affliction only now being taken seriously? Some countries have successfully tackled it. Brazil cut the number of underweight people by 0.7% a year between 1986 and 1996 and reduced stunting by 1.9% a year. Bangladesh reduced both rates by 2% a year in 1994-2005.

But in many countries the problem of “hidden hunger” is hidden from victims themselves, so there is no pressure for change. If everyone in a village is undernourished, poor nutrition becomes the norm and everyone accepts it. This may also explain the reluctance of poor, ill-fed people to spend extra money on food, preferring instead to buy such things as televisions or a fancy wedding. When asked about his spending choices, an ill-fed Moroccan farmer told Abhijit Banerjee and Esther Duflo of the Poverty Action Laboratory, a think-tank: “Oh, but television is more important than food.”

Education can help change attitudes by persuading people they would benefit from a better (if more expensive) diet. But people in rich countries consume vast quantities of junk food knowing full well that it is bad for them. It is unrealistic to expect consumers in poor countries to behave differently. Hence the idea of doing good by stealth.

HarvestPlus, a research group, breeds staple crops with extra nutrients and distributes the “bio-fortified” seeds. It released a vitamin A-rich cassava in Nigeria in 2011. This year it will bring vitamin A-rich maize (corn) to Zambia and iron-rich beans and pearl millet to Rwanda and India. Companies do something similar with processed foods: Kraft’s Biskuat biscuits (sold in Indonesia) have nine vitamins and six minerals added.

But education or fortified foods alone will not overcome the most intractable barrier to better nutrition, which is the sheer complexity of the task. Some problems of development are relatively straightforward. You can improve education by building schools and paying teachers. Nutrition is not like that.

A successful effort to improve nutrition has to push all the buttons at once. Brazil’s Fome Zero has 90 separate programmes run by 19 ministries. It embraces everything from a conditional cash-transfer scheme, called Bolsa Família, to irrigation projects and help for smallholders. Such an effort is hard to organise and cannot work unless politicians support it.

Hence the importance of Mr Graziano, the FAO’s new boss. Interest in improving nutrition is growing; so is alarm at the failures of fighting malnutrition so far. He will not find it easy to cajole more countries into a large, broad-based effort. Governments are reluctant to change and want clear evidence. And just as the damage from malnutrition builds up over a lifetime, so better nutrition reveals its benefits only over many years, as well-fed mothers pass on good health to well-fed children.

At a recent FAO conference someone was heard to remark that “at the moment nutritionists are in a position similar to environmentalists in the 1990s.” That is depressing, because it means progress will be slow; but it is encouraging, because progress will come eventually.”

My immediate reaction to this analysis  is ‘where’s the politics?’ – it seems to discuss only apolitical problems (ignorance, bad policies) and proffer technical solutions. Politics, power and inequality help explain those ’surprising’ failures in India and Egypt. But maybe poor nutrition really is at least partly soluble with technical fixes – iodine in salt, vitamin supplements etc. What do you think? Does helping the one billion people who are wrongly- (rather than under- or over-) nourished particularly lend itself to technical solutions?

Ending world hunger is possible – so why hasn’t it been done?

Time for something a bit less wonky than usual. Yesterday the Guardian asked me to bash out a quick response to the new Save the Children report on hunger (which got amazing coverage). It went up on their Comment is Free site, which always gets loads of comments. Often they are very nasty, but this time around, the conversation seems to be pretty polite. Here’s the piece:

Save the Children is to be applauded for reminding us all of one of the most extraordinary and humiliating aspects of living in the modern world: child hunger. Drawing a parallel with the fight to abolish slavery, the Ghanaian philosopher Kwame Anthony Appiah recently asked what future generations will condemn us for. One sure candidate is the needless human carnage wrought by hunger. Some 850 million people (one in eight of the world’s population) go to bed hungry every night. Many of them are children, for whom early hunger leaves a lifelong legacy of cognitive and physical impairment. The human and economic waste is horrifying.

Such hunger is not due to a shortage of food – globally there is enough to go round and if (a big if) we make the right decisions now, we can continue to feed the world despite population growth and climate change. By some estimates, stopping the waste of food after harvest due to poor storage or transport infrastructure, and then in our own kitchens, could free up half of all food grown. The number of overweight and obese people in the world, suffering their own health problems, including a sharp rise in heart disease and diabetes, is roughly equal to the number of hungry people. That highlights one of the underlying causes of hunger – extreme levels of inequality, both within and between countries.

Ending hunger is entirely feasible (indeed, once achieved, the only question will be why it took us so long). It requires action at several different levels. At a national level, progressive governments in Brazil and Ghana have shown how to cut hunger sharply, through cash transfers to poor people, raising the minimum wage and investing in smallholder farmers (especially women), who both produce food, and are some of the poorest and hungriest people in the Alice in Wonderland world of a brutally unfair farming system.

That focus on national decisions and national politics highlights how fast the world is changing. In many cases, aid is no longer the main story – countries like India, growing at 8% a year and with a mushrooming middle class, need to take responsibility for their hungry masses, introducing proper taxation and effective social services to end hunger and malnutrition. Oxfam is working with people’s organisations within the country to bring that about. Elsewhere, though, international food aid remains essential, but should be improved, for example by ending the waste and delay of transporting food thousands of miles from donor countries and giving cash instead.

Beyond supporting aid for food and agricultural investment, what else can we in the well-fed countries do? Start by putting our own house in order. The rich countries are part of both the solution and the problem. Europe and America’s push to reduce their dependence on imported oil and gas has led them to introduce targets and subsidies for biofuels, but these compete directly with food production, forcing up prices for poor people. Rich country greenhouse gas emissions are driving climate change at a pace that outstrips even the most pessimistic projections of the climate modellers, and there are few signs of governments agreeing (still less achieving) the kinds of reductions needed to avoid catastrophic temperature rises that will particularly harm tropical agriculture. We urgently need an international effort to find a way to feed the planet’s growing population without destroying its ecosystems, yet current investments are feeble.

Hunger is both a cause and a symptom of poverty. Damaged bodies and brains are a moral scandal and a tragic waste of economic potential. That hunger exists at all shows the urgency of redistributing income and assets to achieve a fairer world. Providing the additional calories needed by the 13% of the world’s population facing hunger would require just 1% of the current global food supply. That that redistribution has not already taken place is truly something to be ashamed of.

Any other views on the Save report?

Why seasonality is back and that’s a good thing

A Welsh friend of mine once came back home after a long stint in Nicaragua. A mate picked him up at the airport and on the long drive back to Cardiff, Alun turned to him and asked ’so, how’s the harvest been this year?’ His friend looked at him as if he’d gone mad. Which brings us seamlessly to this guest post on seasonality from John Magrath……

Seasonality describes the fact that rural livelihoods in developing countries undergo regular, predictable, and often massive, changes according to the pattern of the seasons. In particular, the annual rains bring about – or bring to a peak – all sorts of effects – most of them adverse if you are poor. These include starvation, energy depletion, increases in sickness, migration, shortage of money and going into debt.

It was a regular theme in development studies from the late 1970s – when it was pioneered by the great Robert Chambers at the UK’s Institute of Development Studies – to the 1990s. Then it rather fell from favour. Now a new book, Seasonality, Rural Livelihoods and Development, the result of a conference at IDS in 2009, aims to revive the topic.

I declare an interest, as the book opens with a scene setter of a chapter written by myself and Steve Jennings about the growing influence of climate change. It draws on Oxfam research to describe how farmers in many countries perceive that their seasons are changing, throwing up new challenges.

Advocates for taking seasonality more seriously argue that, by showing how “normal” seasonal vulnerabilities underpin tip-overs into crisis when the weather is particularly bad, seasonality can be a powerful argument for proper planning to even out seasonal variations and enable people to have “a-seasonal” livelihoods.  Furthermore, seasonality affects every aspect of people’s lives, and understanding the complex and ratcheted (to use Robert Chambers’  favourite word) interactions enables one to intervene holistically, rather than sectorally.

But seasonality has always been neglected by governments and by aid workers because they don’t tend to live in rural communities – especially not during the rains. There are urban,  “tarmac” and  dry season travel biases in their understanding.

Then on top of those, in the 1990s interest faded away, largely because of the precipitate decline in public investment in agriculture generally.  With that went the abolition of many of those counter-seasonal measures that actually were in place (though not always effective), like grain reserves.

Many things have changed since the 70s: the growth of towns, communications that reduce isolation, the spread of social protection systems such as India’s employment guarantee schemes.  But the seasons have not gone away. Stephen Devereux, Rachel Sabates-Wheeler, Richard Longhurst and the other authors argue that understanding and building seasonality into policies is still relevant – in fact maybe more relevant than ever as climate change bites. And that still isn’t happening; they say that disaggregated data on seasonal poverty is still hard to find, and one of their recommendations is that poverty statistics should reflect seasonal variation, instead of reporting a single poverty headcount for a given year.

They also make the point that seasonality isn’t, fundamentally, about “blaming the weather”; rather, the weather exposes fundamental inequalities in resource distribution – that is, social injustice. But maybe the fact that seasonality is triggered by weather has made campaigners for social justice wary of embracing the subject and contributes to its neglect.

As I say, I declare an interest because I think that seasonality is one of those things that is staring us in the face so closely that we don’t see it properly; we take it for granted as “just another thing poor people have to put up with” when it could illuminate our understanding, analysis and practice. But am I right? Or do people working in development say a) we recognise seasonality but actually, we don’t see it as particularly important compared to other influences on poor people’s lives, or other ways into helping them tackle their problems? Or b), we think it is important but we think that it is already incorporated sufficiently into planning for long-term development, humanitarian response and, in particular, social protection initiatives?

So how many of the world’s people are hungry? Dunno. Work in progress…….

Richard King, my highly numerate colleague, grapples with the confusion surrounding the FAO’s hunger numbers.

Global hunger numbers must be among the most widely quoted and over-interpreted of all the indicators at development wonks’ and campaigners’ disposal. ‘One billion people (one in seven of the world’s population) go to bed hungry’ is a compelling headline and is used variously to argue for more effective social protection mechanisms, increased investment in smallholder agriculture, and effective measures to curb food price volatility. All are urgent causes, and all are worthy of a punchy ‘killer fact’ or two.

In fact, so powerful is the draw of a current big-scary-number that until recently the World Bank’s website displayed a ticking ‘hunger clock’, which extrapolated the (then) latest hunger estimate from the UN’s Food and Agriculture Organization (FAO) and portrayed a situation getting graver by the second. In April the same clock was displayed several metres above the heads of Washington pedestrians in the lead-up to the Bank’s Spring Meetings. But for all the power of a big number, and all the urgency of the underlying situation, is this metric anything more than smoke and mirrors?

Over at Global Dashboard, David Steven has succinctly summarised what we don’t know about how many people are hungry. He notes that the FAO’s estimates for the number of undernourished people in 2009 and 2010 have been withdrawn and no figures for 2011 have been estimated. As David puts it:

“In the midst of the first ever global food crisis… the lights have been turned off. 837m people were probably hungry four to six years ago. Maybe. That might have gone up above a billion, or perhaps it didn’t. Hunger is either resurgent or it isn’t.”

Whilst it is frustrating as an advocate to have no current global data with which to bash people over the head, this isn’t all bad news.

First, the FAO should be applauded for revoking their problematic 2009 and 2010 estimates.

In probable response to political pressure for data relating to the food price crisis of the time, these guesstimates departed from the usual estimation method and leaned heavily on a USDA trade model that was based on expectation of global economic collapse in 2009. Largely as a result of this economic conjecture, the number of ‘hungry people’ topped one billion for the first time. As it transpired, the sky didn’t fall in, economic projections improved, and the 2010 hunger projections consequently returned below the billion mark to 925 million people. To leave this model-based yo-yoing in the historical record would be deeply misleading, and I am pleased to see these figures scrubbed out.

Second, with the lights currently out and FAO statisticians back at the drawing board, the rest of us should take the chance to pause and consider how we have been using the FAO’s Prevalence of Undernourishment (PoU) indicator (the proper term for the 1 billion number). In truth, this has never been suited to tracking hunger in anything like real-time, and has been routinely over-interpreted.

How is such a global figure arrived at? By asking people if they’re hungry? By sampling people’s nutritional intake? No. As the otherwise excellent technical background paper for the recent Committee on World Food Security round table on monitoring food security rather abstrusely notes,

“The calculation is an exercise in model-based statistical inference: A probability distribution model is assumed for the annual average dietary energy intake of a representative individual in the population and its parameters are estimated on the basis of the best available data. Required data include: (a) the total availability of food in the population, (b) the demographic structure of the population (by sex and age-classes), (c) information on the distribution of food access within the population, and (d) a normative level of minimum dietary energy requirements to set a lower bound of adequate nutrition. Once the probability distribution is characterized and the threshold is set, the proportion of the population that is likely suffering from chronic food deprivation, PoU, is estimated as the probability mass that falls below the threshold.”

Right. In other words, no hungry people were harmed (or even consulted) in the making of this number. The calculation relates not to any real person, household, or other group experiencing any actual hunger but instead to a ‘representative’ individual within a population. Equally, because the reference period is a year, the calculation is not equipped to capture the impacts of acute food shocks due to factors such as price volatility, or climatic events, or even due to regular, seasonal, waxing and waning of hunger.

And because the calculation is based on the food available to a whole population, rather than actual access to food, it doesn’t account for intra-household inequalities, or food wasted or spoilt in the home, or even food produced for subsistence consumption. The calculation is also very sensitive to errors in food balance sheets (used to calculate the total availability of food), which measure food consumption from a food supply perspective. There are several weaknesses of a food balance sheets approach, not least that if changes to food storage are not accurately captured (which is difficult to do) this throws off the rest of the calculation. This is why hunger estimates (until 2008) were averaged across three years, to try to minimise any distortions from year-to-year inaccuracies in storage data. Couple these limitations with the time taken to collect other food distribution parameters from nationally representative household surveys, and it’s soon apparent that this FAO measure is poorly suited to the timely tracking of current food insecurity.

So where next? Following the CFS Round Table, the Committee endorsed a proposal to create a richer suite of core food security indicators and strongly recommended that the FAO improves its current measure of undernourishment. According to the FAO’s State of Food Insecurity in the World 2011 report:

FAO will make several adjustments, including in the estimation of how changes in food access due to changes in income and food prices affect undernourishment. Work is also underway to improve the construction of food balance sheets. A large number of household expenditure surveys are being processed to provide improved estimates of the distribution of food consumption within a country. FAO’s measures of undernourishment will also be complemented with a number of other indicators intended to better capture the multifaceted nature of food insecurity.

But all this will take time to overhaul, and will likely still result in indicators that are more suited to measuring recent chronic food insecurity rather than current acute hunger. For that, we may have to turn to more subjective indicators, such as those in the Gallup World Poll surveys recently analysed by IFPRI, in which people were asked: “Have there been times in the past 12 months when you did not have enough money to buy the food that you or your family needed?” (yes or no). This is an imperfect alternative, not least because ‘food’ and ‘need’ are more abstract than counting calories and are likely to be interpreted differently depending on respondents’ location. And, because the question is asked of the household unit as a whole, this still fails to capture gender-based inequalities in food insecurity. If nothing else, let’s hope that the FAO review finally gives us an indicator that helps us to track this particularly crucial dimension of hunger…