In 2007 and 2008, the world witnessed a dramatic increase in food prices. High food prices caused civil unrest and exacerbated the humanitarian crisis of food insecurity and malnutrition. The global financial crisis that began in 2008 compounded the burden of high food prices, exacerbating the problems of hunger and malnutrition in developing countries. The tandem food price and economic crises struck amidst the massive, chronic problem of hunger and under-nutrition in developing countries. The nutritional consequences of the food price increases, compounded by the economic downturn, could be considerable in poor urban populations, rural areas that are net food purchasers, and in female-headed households. Malnutrition affects the survival, health, well-being, and developmental potential of vulnerable groups.
National governments and international actors have taken a variety of steps to mitigate the negative effects of increased food prices on particular groups. Emphasizing the importance of child and maternal health and nutrition to international development, the Millennium Development Goals (MDGs) represent a global commitment to poverty and hunger eradication.1 The recent abrupt increase in food prices, in tandem with the current global economic crisis, threatens progress made in these areas and could prove a serious barrier to achieving the MDGs.
The Institute of Medicine (IOM), with funding from the Bill & Melinda Gates Foundation and the PepsiCo Foundation, held a workshop titled Mitigating the Nutritional Impacts of the Global Food Price Crisis on July 14–16, 2009, in Washington, DC, at the Kaiser Family Foundation’s Barbara Jordan Conference Center. Presenters were chosen by a planning committee to describe the dynamic technological, agricultural, and economic issues contributing to the food price increases of 2007 and 2008 and their impacts on health and nutrition in resource-poor regions. The planning committee quickly realized that it was impossible to ignore the compounding effects of the current global economic downturn on nutrition. Subject matter experts were invited to the workshop and asked to discuss these tandem crises, their impacts on the nutritional status of vulnerable populations, and opportunities to mitigate their negative nutritional effects.
The planning committee’s role was limited to planning the workshop, and the workshop summary has been prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. The reader should be aware that the material presented here expresses the views and opinions of the individuals participating in the workshop and not the deliberations and conclusions of a formally constituted IOM consensus study committee. These proceedings summarize only what participants stated in the workshop and are not intended to be an exhaustive exploration of the subject matter and should not be perceived as a consensus of the participants, nor the views of the planning committee, the IOM, or its sponsors.
THE DUAL CRISES: TANDEM THREATS TO NUTRITION
A strong evidence base underpinning and motivating investment in nutrition of vulnerable populations has emerged over the past 5 years. Specifically, a Lancet series, published in January 2008, clearly showed that maternal and child undernutrition is the underlying cause of 3.5 million deaths, 35 percent of the disease burden in children younger than 5 years, and 11 percent of total global disability-adjusted life years (DALYs) (Black et al., 2008). With this foundation, it seemed that the will, the tools, and the technologies had all been mobilized, and real progress in nutrition could be made. Then the sudden increases in global food prices in 2007 and 2008, exacerbated by the current global economic downturn, began to threaten the hoped-for trajectory of progress. Between March 2007 and March 2008, price rises of 31 percent for corn, 74 percent for rice, 87 percent for soya, and 130 percent for wheat were documented (Hawtin, 2008).
Per Pinstrup-Andersen explained that price volatility and rapid food price fluctuations most significantly affect the global poor. While higher food prices are of course problematic, if they were consistent and predictable, food buyers could better cope. Dr. Pinstrup-Andersen forewarned that such price volatility is
predicted to increase in the future. The World Bank’s Hans Timmer forecasted that more than half of the global economic recovery from the current downturn will come from developing countries. In this sense, he argued, protecting and promoting the growth of developing countries’ economies serves the interests of rich and poor countries alike.
IMPACTS ON NUTRITION
The food price and economic crises will have both short-term and long-term impacts on the nutritional status of vulnerable populations. The global poor are usually the hardest hit by food price increases and economic strife. At the household level in developing countries, poor consumers spend 50 to 70 percent of their budget on food (von Braun et al., 2008), so their capacity to absorb rises in prices (or lowered incomes) is limited and often forces difficult household choices that adversely affect women and children in particular.
Ricardo Uauy noted that decreasing household income has a disproportionate effect on micronutrient intake and thus the quality of diets, rather than quantity; families forced to feed themselves with less purchasing power tend not to decrease the staples in their diets (rice or grain), but instead to eliminate the vegetables and animal products—which contain essential micronutrients. Dr. Uauy also predicted that economic growth will be restricted by the reduced productivity of children who are suffering the negative impacts of the global food crisis, which will have a long-term, transformational effect upon society’s development. Marie Ruel explained that poverty itself is a strong indicator of how people will be affected by soaring food prices. A large proportion of poor people—in both urban and rural areas—are “net buyers” of food and therefore need money to purchase food. Dr. Ruel further noted that female-headed households are the most vulnerable of all and may be forced to cope in ways that deinvest in children (e.g., taking children out of school) and have lifelong effects on those children’s development and future earning potential.
RESPONDING TO THE CRISES AT THE COUNTRY LEVEL
Between 2003 and 2008, the world prices of maize and wheat tripled and the price of rice quadrupled (von Braun, 2008). Individual countries dealt with these dramatic food price spikes in a range of ways. In evaluating how the food crisis affected food security and nutrition to varying degrees in different countries and regions, Hafez Ghanem of the Food and Agriculture Organization argued that the term crisis is a misnomer. The billion hungry people in the world signify a chronic, structural problem in the global food and agriculture system. According to Mr. Ghanem, because there has been no public outcry, the problem of chronic hunger receives no political attention. Ruth Oniang’o lamented that country governments reacted to the riots and demonstrations during the food price spikes in
order to protect themselves and maintain public safety, not to tackle the broader, systemic issues of poverty and malnutrition.
A ROLE FOR NUTRITION SURVEILLANCE IN ADDRESSING THE GLOBAL FOOD CRISIS
The food price and economic crises have highlighted the need for data collection in order to understand the effects of these phenomena on populations. There are a variety of tactical measures and approaches to nutrition surveillance at work in different countries and regions. A number of presenters spoke of the need to aggregate data, compile it quickly using new technologies, and deliver it to the food security and nutrition community for decision making at the program and policy level. Several workshop participants emphasized the need to develop in-country capacity (of governments and nongovernmental organizations) to conduct their own surveillance in order to ensure local acceptance and use of the data collected.
Nutrition surveillance mechanisms can play a role in predicting and preventing future crises, as well as documenting the impacts of crises to inform programs and policies that work to ameliorate the negative nutritional impacts of food crises. The effects of undernutrition are known, and the 2008 Lancet series describes effective strategies for mitigation (Bhutta et al., 2008). The hungry and malnourished deserve such evidence-based action to alleviate their circumstances.
THE GLOBAL RESPONSE TO THE CRISES
A broad group of people and organizations work in the nutrition landscape. These include multilateral UN agencies, bilateral government agencies, nongovernmental organizations, universities, research institutions, foundations, and the private sector. The people and organizations who work in the field of nutrition have varying roles, functions, and capacities to deal with the outcomes of the recent food price and current economic crises.
There are a number of new players in food security and nutrition who require leadership and coordinating mechanisms to function efficiently and without overlap. Ruth Levine recommended that a high-level mandate for institutional change should set the expectations for how institutions should allocate roles and work together. Dr. Levine also stated that additional resources for bolstering institutional capacity within the UN and other agencies would be needed to respond to such a mandate and that serious engagement of the private sector should be fostered. Dr. Levine and other speakers urged the spectrum of players in the nutrition landscape to heed the call for major structural changes on a sustainable, long-term basis, because short-term, emergency actions are not sufficient in dealing with the growing numbers of global hungry.
U.S. POLICY IN FOOD AND NUTRITION
The U.S. government can play an important role in the fight to end global hunger, and there is a renewed sense of political will to address these issues. U.S. Congressman James McGovern presented the Roadmap to End Global Hunger—a coalition of more than 30 nonprofit organizations—that calls for a comprehensive government-wide approach to alleviate global hunger and promote food and nutrition security (Roadmap to End Global Hunger, 2009). Rajiv Shah described how the U.S. Department of Agriculture is expanding its resources in technology development in promising areas like food biofortification, pest and disease resistant vegetable breeding, and livestock improvement, with hopes of extending these technologies to smallholder farmers in developing countries. Catherine Bertini and Dan Glickman presented the Chicago Council on Global Affairs’ report, Renewing American Leadership in the Fight Against Global Hunger and Poverty, which aims to put agricultural development back at the center of U.S. development policy.
THE WAY FORWARD—THEMES FROM THE WORKSHOP
The following themes emerged during the workshop through several speakers’ presentations and during discussion sessions with workshop participants. These themes are not intended to be and should not be perceived as a consensus of the participants, nor the views of the planning committee, the IOM, or its sponsors.
The current crisis presents an opportunity to motivate donors and engage affected country governments in efforts to address undernutrition, hunger, and food insecurity in vulnerable populations.
There is a window of opportunity with women and children where known nutritional interventions will be most effective and have a long-term payoff, as described in the 2008 Lancet series on maternal and child undernutrition.
There is a simultaneous call for better quality data to inform program design and effectiveness, but there is also a critical need to immediately move forward with proven programs and policies to mitigate hunger and undernutrition in vulnerable populations.
Short-term, emergency actions are not sufficient to remedy recurring food crises; instead, both short- and long-term investments in global food and agriculture systems are needed.
Mechanisms to help vulnerable populations cope with food price volatility and to prevent future shocks are required.
It is important to draw upon the expertise of governments, nongovernmental organizations (NGOs) and civil society, the private sector, foundations, and the broad spectrum of actors in the international nutrition and agriculture sectors.
The roles of the multiple UN agencies that work to promote the food and nutrition security of vulnerable populations need to be clarified.
Fostering engagement with the private sector may yield new expertise and resources.
A stronger voice from indigenous non-governmental organizations is needed. Such local non-governmental organizations could benefit from capacity-building efforts to encourage ownership and political involvement.
Bhutta, Z. A., T. Ahmed, R. E. Black, S. Cousens, K. Dewey, E. Giugliani, B. A. Haider, B. Kirkwood, S. S. Morris, H. Sachdev, and M. Shekar. 2008. What works? Interventions for maternal and child undernutrition and survival. Lancet 371(9610):417-440.
Black, R. E., L. H. Allen, Z. A. Bhutta, L. E. Caulfield, M. de Onis, M. Ezzati, C. Mathers, and J. Rivera. 2008. Maternal and child undernutrition: Global and regional exposures and health consequences. Lancet 371(9608):243-260.
Hawtin, G. 2008. CIAT’s Response to the World Food Situation. Cali, Columbia: CIAT.
Roadmap to End Global Hunger. 2009. Washington, DC.
von Braun, J. 2008. Food and Financial Crises: Implications for Agriculture and the Poor. Washington, DC: International Food Policy Research Institute.
von Braun, J., A. Ahmed, K. Asenso-Okyere, S. Fan, A. Gulati, J. Hoddinott, R. Pandya-Lorch, M. W. Rosegrant, M. Ruel, M. Torero, T. van Rheenen, and K. von Grebmer. 2008. High Food Prices: The What, Who, and How of Proposed Policy Actions. Washington, DC: International Food Policy Research Institute.